Recommendation is for QRTP or PRTF – either could potentially meet the needs of this patient and limited treatment centers available due to patient’s age. Patient is currently in psychiatric inpatient hospitalization.
Patient is an 8-year-old female. Patient presented to inpatient from the ED due to increase in unsafe and risk-taking behaviors. This is her fourth inpatient hospitalization; one in 2022 and three in 2024. Patient has attended day treatment twice and participated in outpatient psychotherapy and medication management.
Discharge Plan:
PRTF/QRTP: (county funding approved for QRTP)
– Grafton (declined due to not meeting criteria)
– Northwood (referrals submitted 9/9, on waitlist 9/23 – awaiting update on admission timelines)
– Gerard (unable to accept due to age)
– Avanti (unable to accept due to age)
– Bar None Haven (unable to accept due to age)
– North Homes (unable to accept due to age)
– Heartland Girls Ranch (unable to accept due to age
Continue with following outside providers:
– Therapy/Therapist: Solutions Behavioral Healthcare Professionals
– Primary Care Provider: Sanford Health
– Medication Management: Solutions Behavioral Healthcare Professionals
– Case Management: Solutions Behavioral Healthcare Professionals
– Occupational Therapy: Beyond Boundaries Therapy and Wellness
Patient presented to the ER following an intentional overdose to end her life and had just started PHP the week of admission. She had an additional overdose of the same medications in March 2023 and has had reported several other suicide attempts. Patient is on probation for assaulting her mother and has a history of running away, physical & verbal aggression, sexual misconduct (sending nude photos of herself to adult males for money), alcohol/chemical use, school difficulties, and parent/child conflict.
12 year old male with ADHD, unspecified mood disorder with recent suicide attempt, T1DM, hypothyroidism, asthma who is in the ED after intentionally setting fire and burning house down. Has an IEP for speech therapy.
Kiddo came into ED on 9/24 from school for aggressive behavior, was in foster care who is not willing to take pt back. Under custody of the County. Has history of both residential txt (Northwoods 2x) and juvenile detention centers, and has a rule 20. Referral has been made to Prairie Lakes, waiting for response.
Kiddo came to the ED 9/19 after aggression at his group home. Boarded at our hospital summer of 2023 for a few months. Team does not want him to return to his group home and is seeking crisis respite while they work on finding a new group home. Has DD waiver.
Came to our ED 9/22 from home due to aggressive threats. Previously was IP with our hospital 9/3-9/12. Mom does not feel she can take kiddo home at this time. Is in process of obtaining Childrens Mental Health CM and CADI waiver, but has neither as of now (did request these to be expedited.) Mom is also working on referrals to Residentials (has private insurance) but has not been placed on any lists yet.
Pt per chart presented 9/15/2024 d/t sent from JAF facility after agitation episode during which pt expressed self-harm ideation via electric outlets. Of note this is a behavior for which he has been sent to ED multiple times and regulates in ED and has been sent back. However, currently facility is not agreeing to take pt back and apparently for the past 5 days since last visit, there has been a plan to discharge pt if there was 1 more ED visit, which is current visit.
Recommendation for level 5 QRTP or level 6 PRTF. Patient is currently in psychiatric inpatient hospitalization.
Ten-year-old female patient with a history of in utero exposure and early childhood trauma and attachment concerns, with a historical diagnosis of FASD-Alcohol-Related Neurodevelopment Disorder (ARND). Patient presents with emotional dysregulation, violent threats and aggression, as well as passive suicidal ideation. Patient has been hospitalized multiple times and participated in several outpatient services.
Discharge Plan:
RTC (recommendation letter sent to CMHCM who is requesting county screening meeting)
-Nexus Gerard (referral sent, reviewing, will hear back week of 9/2)
-Northwood (referral submitted, next opening end of year, will review for acceptance at that time)
-North Homes (declined due not have staffing to meet needs related to aggression, SW requested reconsideration; declined 8/21)
PRTF (PRTF eligibility form sent to DHS 8/16)
-Nexus East Bethel (referral submitted w/PRTF eligibility approval 9/4)
-Grafton (referral submitted w/PRTF eligibility approval 9/4)
Bridging with Day tx
-Catholic Charities (referral pending although may not consider d/t RTC rec, IEP sent, 8 person WL)
Current Providers:
Med Management- Mayo Clinic
CM- Dakota County
CADI waiver- Dakota County contracted provider
CTSS
Pt came to our ED on 8/10 from Grandparents home who were providing foster care and there was an altercation. Grandparents are refusing to take pt back. Hennepin County CPS/ICWA have temp custody. Pt not appropriate for IP due to fecal incontinence and struggles with communication. County is looking for DD waiver CRS and doing a MNchoices assessment on 8/16.
Patient presented to the ER via law enforcement for homicidal ideation towards his foster family (maternal aunt) and biological brother and had threatened them with a knife. Was removed from his biological home in June due to neglect, abuse, domestic abuse, substance use in the home. Patient with dissociative episodes and resorting back to small child like behaviors.
