PH-F17-3791

5/20/24: Patient discharged from inpatient and admitted to PCR.

5/8 update: Patient scheduled for admission to PrairieCare Residential on 5/20/24 at 10:00am.
5/6 update: Patient is currently awaiting an RTC bed through PrairieCare Residential in Maple Grove. Patient has been approved for 3rd pathway funding through Hennepin County. Due to patient behaviors seeming to increase, other options are being explored for aftercare as denials are a possibility. Parents do not feel safe with the patient coming home.

Discharge Plan:
Residential Treatment:
-PrairieCare Residential; intake 5/20/24 at 1000

Other RTC Referrals:
-Nexus Gerard; referral made
-North Homes; referral made, declined due to FAS and IQ
-Avanti Center for Girls; referral made, declined due to aggression and peer conflict

Outpatient Providers:
Establish CMHCM; opened with Soreya Jama through Hennepin County, 3rd pathway funding approved

Establish/Continue CTSS with Samira through Nexus FACTS
Continue Therapy with Mary Midler at Great Lakes Neurobehavioral Center in Edina (weekly)
Continue PCP with Dr. Megan Reilly at Partners in Pediatrics in Plymouth
Continue Psychiatry with Gerard Balan at Plymouth Psych Group
Continue IEP Case Management with Yvette Zeese at Wayzata High School
Continue Neurological Services with Dr. Catalfamo at Noral Neurological Clinic in Bloomington

ADMISSION NOTE: Patient was admitted due to acute safety concern and was unable to contract for safety at home. Pt was in PHP in the past and family was monitoring her 24/7 at home as instructed. Pt became irritated that she is constantly being watched and ended up having altercation with her mother because she was instructed by her mother to change outside of her bedroom because the mother was unable to see her. Pt ended up leaving and went to her grandmother’s house which is next door while mom followed her, pt went straight to the kitchen grabbed a knife and start threatening to stab herself. Mother was able to wrestle the knife out of her hands and called EMS. Pt has a history of depression, anxiety, epilepsy, and fetal alcohol syndrome.

PH-F12-3368

Update 5/17/24: Patient discharged home to guardian with PHP in place. Still pursuing PRTF/level 6 RTC.

Update 5/15/24: PRTF funding approved. Patient accepted to Nexus East Bethel PRTF, tentative opening August-September. Referral sent to Bar None Haven level 6 RTC, referral is under review. Scheduled discharge home to PHP interim on 5/17
Update 5/9/254: PRTF funding approved. Patient accepted to Nexus East Bethel PRTF, tentative opening August-September. Referral sent to Bar None Haven level 6 RTC, referral is under review. Tentative discharge home to PHP interim on 5/15
Update 4/24/24: Patient has been accepted to Nexus East Bethel PRTF. Estimated availability for opening is August-September.
Update 4/4/24: Updated inpatient clinical has been sent to Nexus East Bethel PRTF for review. Nexus East Bethel PRTF did not get to pt’s review on 3/26/24 and is requesting inpatient psychiatrist and PRTF psychiatrist consult directly.
Update 3/21/24 Nexus East Bethel PRTF reviewing for acceptance on 3/26/24.

12-year-old female presenting to inpatient from the ED. This is her second psychiatric inpatient hospitalization.
Recommendation is PRTF. Patient has been approved for funding through MN AFMC PRTF team.
Referral has been sent to Nexus East Bethel PRTF and is under review.

PH-F14-3891

Update 5/23/24: Patient accepted to Heartland Girls Ranch with scheduled admission Wednesday 5/29 – county funding was approved.

Patient presents to inpatient from the ED due to an increase in SI. This is her third psychiatric inpatient hospitalization. She has done PHP twice and engaged in outpatient mental health services.

Discharge Plans –
RTC: (JST funding meeting on 5/17)
-Avanti Center for Girls (referral under review)
-Nexus Gerard (referral under secondary review)
-North Homes (pt is on waitlist – 4-6 weeks out)
-Village Ranch- Annandale (pt is on waitlist – end of June)
-Heartland Girls Ranch (referral under review)

Continue with established outpatient providers:
– Therapist: Mayo Clinic Health Systems Austin
– Family Therapist: Albert Lea
– Medication Management: Mayo Clinic Austin
– Case Management: Freeborn County
– Occupational Therapist: Mayo Clinic Rochester

PH-F17-3785

Update 5/23/24: Patient has been accepted to Avanti RTC with a scheduled admission for Tuesday 6/4.

Update 5/15/24: Patient was accepted to North Homes RTC, guardian declined. Patient accepted to Avanti RTC with tentative opening 6/10.

Patient is a 17-year-old individual who identifies as non-binary and uses they/them pronouns. They admitted to PrairieCare Inpatient Hosptial via ED due to an increase in suicidal ideation. This is their 3rd psychiatric inpatient hospitalization, they have done PHP, and engaged in outpatient mental health therapy and psychiatry. County funding has been approved for RTC on 4/25/24.

Discharge Plan:
RTC: (county funding approved on 4/25)
-Avanti (ACCEPTED, tentative opening 6/10)
-Gerard (Referral sent & received, awaiting secondary review)
-North Homes (accepted with immediate opening – county and guardian declined placement)

Continue with established outpatient providers:
-Individual therapy: South Central Human Relations-Owatonna
-CMHCM: MN Prairie County Alliance

PH-F15-3876

Update 5/23/24: Patient has been assigned a CMHCM through Sherburne County, waiting to have JST scheduled for funding approval. Referred to PrairieCare Residential and pt was accepted – county unable to support funding as insurance is OON. Referrals sent to Avanti, Gerard, North Homes, and Grafton – all under review and waiting to hear about acceptance decisions.

Patient presented to inpatient from the ED due to an increase in SI and risky behaviors. Patient has had two previous psychiatric inpatient hospitalization, has attempted PHP, and engaged in outpatient mental health services. CMHCM has been referred to through the county, will need to obtain funding for RTC.

Discharge Plans –
RTC:
Avanti (referral sent & received – under review)
Gerard (referral sent & received – under review, tentative openings August)
North Homes (referral resent & received – reviewed, virtual meeting with pt being scheduled)

PRTF:
Grafton (referral sent)
DHS PRTF eligibility (approved 5/13)

CMHCM: Sherburne County (Referral sent) (need to obtain county funding for RTC)

Interim to bridge RTC if/when pt stabilizes:
PHP: PrairieCare – MOB (Intake canceled due to delay in dc)

Continue with established outpatient providers:
-Individual Therapy: Nystrom & Associates
-Family Therapy: Nystrom & Associates
-Medication Management: Allina Health Clinic Cambridge

AH-F13-3930

She has been in foster care placement for the past 3 years. She has four other siblings whom are also in the foster care system. mother’s rights are in the process of being terminated. She ran away from foster home and was staying with a friend. Friend’s mother called police for fear of being in trouble housing a runaway. She refuses to go back to foster provider and foster provider cannot keep patient safe from running. CPS guardian and seeking shelter placement

PH-F16-3212

Update 5/16/24: No new information from 5/8 update. Accepted at Bar None Haven, county funding approved. QI completed with recommendation for secure residential setting that is able to accommodate both chemical dependency and mental health treatment. County is inquiring to see if this can be accommodated at Bar None Haven or if they have to look into additional placement options. Medical recommendation is locked mental health RTC. Comprehensive assessment (rule 25) recommends Mental Health Residential. Accepted at Nexus East Bethel PRTF- opening midsummer.

Update 5/8/24: Accepted at Bar None Haven, county funding approved. QI completed with recommendation for secure residential setting that is able to accommodate both chemical dependency and mental health treatment. County is inquiring to see if this can be accommodated at Bar None Haven or if they have to look into additional placement options.
 
Update 5/01/24: Accepted at Bar None Haven, county funding approved. Missed admissions on 3/20 and 4/30 due to county wanting to complete QI process and having VPA signed in front of a judge before approving placement.

Update 4/25/24: Accepted at Bar None Haven, second opening is now 4/30 and county approved for placement, they are not approving transition on 4/30 wanting a judge to sign the VPA in court and wait the QI process.
Accepted to Nexus East Bethel PRTF, estimated wait list out until August-September.

Update 4/17/24: County funding approved, awaiting open placement at Bar None Haven, previously missed admission due to no funding. Pending acceptance decision at Nexus East Bethel PRTF.

Update 4/3/24: Pt has MA now. CMHCM in process of being assigned and requesting preplacement screening for funding. Denied from Grafton. On waitlist at Bar None Haven, missed admission due to no funding. Pending East Bethel.

Discharge Plan:
Level 6 RTC/PRTF-
Grafton (Referral submitted; Not in network with Prime west, can contract with MA MCO’s and obtain SCA, Denied 2.8.24, re-reviewed, denied)
Nexus East Bethel (Referral submitted; pt will need straight MA; several month waitlist, now has MA so re-reviewing, accepted, admission waitlist til mid-summer)
Bar None Haven (Referral submitted, Tentative admit 3/20-3/21, dependent on county funding, county declining JST screening, requested again, approved)
CMHCM at Beltrami County (Guardian currently in communication with the county, case manager was not being assigned until pt has CD treatment, requested reconsideration)

Notably, Previous services/interventions attempted: Dual Diagnosis IOP, Outpatient therapy, outpatient psychiatry, PCP, CMHCM, CTSS, CD RTCs, Inpatient x3, JDC, previous foster placements.

CMHCM at Beltrami County (Referral completed, services in intake)
INSURANCE- NOW Straight MN MA (was a PRIME WEST MA)
Description: Patient is a 16-year-old Native American female who has a history of depression, anxiety, ADHD, nicotine use disorder, cannabis use disorder, and unspecified trauma. Patient experiences significant impairment(s) in the area(s) of social, emotional, and academical. Patient identifies current supports as her father, sisters, and grandmother. Patient has a history of inpatient psychiatric hospitalization through PrairieCare and Prairie St. Johns.

MHF-F14-3886

Came to ED on 5/09/24 via police after increase in suicidal ideation. Pt reports being bullied at her group home, was at Divine. Divine is not allowing pt to return. No physical aggression, continues to have suicidal ideation without attempts. County is working on Group Home placements- wait listed at North Crow, has explored shelters, foster cares- denied by those. Referral was made for MCCP crisis bed and working on hotel crisis respite referrals, as well as CRS homes.

PH-F16-3692

Update 5/09/24: Patient discharged from inpatient to home with outpatient supports in place while awaiting admission to RTC. Admission to Avanti RTC tentative 6/4/24

Update 5/08/24: Patient is accepted to Avanti Center for Girls RTC. Tentative admission date is 6/04/24.
Update 5/01/24: Patient is accepted to Avanti Center for Girls RTC. Estimated opening early-mid May. County funding approved for placement.
Update 4/24/24: Patient is accepted to Avanti Center for Girls RTC. Estimated opening early-mid May.

Patient is a 16-year-old female who presented to inpatient from ED due to increase in SI and suicide attempt. She has had 6+ psychiatric inpatient hospitalizations. She has had two residential 35/45-day evaluations as well as a history of participating in outpatient mental health services.

Discharge Plans:
RTC:
-Gerard (Referral sent & received, wait list out until September or later)
-North Homes (declined due to previous programming experience)
-Avanti Center for Girls (Accepted, opening early-mid May)

CMHCM: Carlton County

MHF-F16-3864

Pt came to ED on 5/10 via foster care parent due to suicidal ideation. Foster parent refusing to take back due to these behaviors. Was previously in North Homes residential and was in inpatient with us from 2/5-2/13. County reports they are exploring residential and PRTF, waiting for DA to come back with recommendation. Completing referral for Nexus YCT. Pt’s mental health is being negatively impacted by boarding, she has been continuously sobbing in our ED about being here.