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
Patient was placed at Passageways shelter for 1 month. Near the end of that time, patient became upset that time was ending and would transition back to home. Is not recommended for IP MH care and needs a d/c plan from the ED. Several referrals to shelters have been made.
Pt came to ED after ongoing behavioral concerns at home with guardian/grandmother, physical and verbal aggression, and threats. Previously discharged from CADI GH for physical aggression, went to JDC for that but was released after a rule 20. Declined by North Homes, Northwoods, and CABHH. A CADI home in Duluth that may be an option.
Patient came to our ED after a physical altercation with another resident at Aspen House, is not able to return there. Has been to multiple shelters and RTCs in the past, success with some of these programs. County is looking at other shelters as well as waiting for a previous provider to send recommendation for PRTF. Has been denied by VOA Bar None- all programs, can’t return to Von Wald shelters, discharged previously from Prairie Care, and can’t return to Aspen. 3rd time in the ED in a month.
Update 4/25/25: Patient discharged from inpatient to Willow Trails Group Home on 4/25.
Update 4/24/24: Patient is medically ready for discharge from inpatient. Tentative admission to Willow Trails Group Home on 4/25.
Update 4/18/24: Patient is medically ready for discharge from inpatient. County is their guardian. County is working on finding foster care/group home placement. Patient has been denied at Village Ranch, is being reviewed at Port Place, Hunter’s Place, and Anoka County Juvenile Center.
Patient presented to the ED on 03/15/2024 after making suicidal statements while at school. Patient noted they have been being bullied, which contributed to the increased in suicidal ideation. Patient denied having a plan to complete suicide but was experiencing passive suicidal ideation and indicated that they would “probably do something with cutting.” The school contacted law enforcement and patient was transported to the ED for further mental health evaluation. Patient was unable to contrast for safety, resulting in them being transported via non-emergent transportation to PrairieCare for short-term stabilization.
Patient is under guardianship of Ottertail County at this time. Placement is being pursued by the county to either a Group Home or Foster Home.
Discharge Plan:
Continue care with existing outpatient providers:
-Individual therapy, PCP and Psychiatry at Behavioral Health in Badger, MN
Patient is medically ready for discharge and is awaiting placement in an appropriate group home/foster home, as identified by the county.
Update 4/23/24: Patient discharged from inpatient on 4/23/24. Patient scheduled to begin PrairieCare PHP on 4/24/24 while continuing to pursue Group Home placement as recommended by the county.
Patient is a 14-year-old female presenting to inpatient on 03/19/2024 from the ED due to running away from shelter placement. Patient has a history of participating in PHP two times, DBT, ongoing outpatient mental health services, and being in shelter placement.
Discharge Plan:
RTC:
-North Homes (on the wait list)
CD-RTC: Referrals submitted/considered for the following facilities:
-Hazelden (Pt’s insurance not accepted in Minnesota)
-Rogers (Declined due to elopement risk)
-M Health Fairview (Declined due to elopement risk)
-Anthony Louis Center (referral sent 03/27/24)
Group Home Placement (as recommended by JST/county):
-Little Sands (Referral submitted by CM; declined d/t LON)
-Village Ranch (Referral submitted by CM; reviewing 4/10; pending additional review on 4/17)
-North Homes (Pt is on the waitlist for RTC; pt is not eligible for their group home due to age)
Existing Outpatient Providers:
CHMCH: Hennepin County
Psychiatry: Nystrom & Associates
Update 4/29/24: Patient discharged from Inpatient on 04/19/24 to wraparound outpatient mental health services while continuing to pursue RTC options.
Patient admitted to PrairieCare Inpatient Hospital 3/19/24 from the ED following increased thoughts of suicide with a plan. Pt has had previous IP stays at PrairieCare, Mayo Clinic, Riverside and Prairie St. John’s. Pt had a previous residential stay at Gerard. RTC has been pursued and funding has been approved through Dakota County although currently pt has been declined by viable in-state options. Level 6/PRTF programming is also being explored.
Referral is currently pending at Bar None Haven. Referral also made to Acadia to explore out of state options. Referral will be made to Nexus East Bethel PRTF as CMHCM is willing to help pt switch to straight MA if Nexus is able to accept. Patient is medically ready for discharge and is pursuing an interim plan of dcing home with wrap around services while awaiting placement.
RTC (CASII LEVEL 5) (funding approved, in QI process):
-Acadia (referral sent to explore out of state options)
-Avanti (declined)
-PCR (declined)
-North Homes (declined)
-Gerard (declined)
-Northwoods (waitlist 2+ years, so not a viable option)
-Newport (Insurance not accepted, so not a viable option)
-Nexus Mille Lacs (only accepts biologically male patients, so not a viable option)
PRTF/CASII LEVEL 6
-Bar None Haven (referral pending)
-Nexus East Bethel (referral to be sent, CMHCM able to help switch to straight MA if accepted)
-Grafton (requires ID dx)
-Leo Hoffman (only accepts biologically male patients)
-Northwoods (2+ year WL)
Update 4/16/24: Patient discharged from inpatient on 4/16/24 to outpatient mental health services while awaiting admission to CD RTC.
4/3/24 Update: Waiting accepting CD RTC tx
Case Description: 17 y/o male w/ ASD, depression, polysubstance use, ADHD, presenting due to intrusive SI . Biologically, there is a genetic predisposition for depression, anxiety and substance abuse in the family. Patient recently underwent chemical dependency tx outpatient and was using concurrently.
Discharge Plan:
– Omegon Pathways (referral submitted)
– MHealth Fairview-MW (referral submitted; denied 3/27/24 due to ED/behavior concerns)
– Lakeside (referral submitted)
– CMHCM through Blue Earth
Current Providers:
– Individual Therapy ACFS (Adult, Child, & Family Services, LLC) – Mankato
– Depression and Teens Group (DAT) Weekly Group at ACFS (12 week program)
– Medication Management at Mankato Clinic
– Truancy Worker at Blue Earth County Community Corrections
– Primary Care at Mayo Clinic Health System – Eastridge
4/10/24: Patient discharged from inpatient on 4/10/24 and admitted to Gerard RTC.
4/3/24 Update: Accepted at Gerard, parent and pt excited for Gerard RTC. However, pt’s parent not in agreement to VPA for the purpose of RTC funding, thus, missed admission. Parent working with county to make some edits on VPA and then pt will admit to Gerard RTC on 4/10/24.
Case Description: 17 y/o male w/ hx of MDD, GAD, ODD, PTSD, polysubstance abuse( in remission), multiple suicide attempts currently presenting due to SI w/ plan to hang self. Patient has been struggling w/ worsening symptoms of depression due to mothers upcoming death anniversary coming up.
Insurance is BCBS MN PMAP
Discharge Plan: RTC:
– Gerard (Referral submitted by IT, Tentative admit Weds 4/3 at 1300 pending county funding; 3.21.24 County funding approved but adoptive parent not in agreement to “sign custody to the county” for the purpose of RTC funding, thus, missed admission, next admission scheduled for 4/10/24)
– North Homes (Referral submitted by IT)
– Nexus Mille Lacs (Referral submitted)
– Village Ranch (Referral submitted)
Current Providers:
– Individual Therapy at Rooted Counseling in Moorhead
– Primary Care with Sanford Children’s Southwest Clinic
– Medication Management at Midwest Mental Health
– Group Home Case Management at Valley-Lake Boys Home
– Probation at Clay County
– Group Therapy through Valley-Lake Boys Home
– CMHCM at Clay County
Update: Has been accepted at CABHH but discharge there has been delayed due to pts not discharging from their facility.
Pt was at North Homes, then was in Fairview’s inpatient unit for 35 days. Was going to return to North Homes from there, in transport there on 3/27 pt attempted to overdose on pills stating he didn’t want to go back to North Homes and was brought back to Fairview ED where he is currently boarding. Prior to being at North Homes he was at CABHH. County team have referred to Nexus Mille Lacs- long wait and Passageways. Hospital referred to Nexus YCT.
