Patient presented to the ER via law enforcement for aggressive behaviors at shelter care resulting in property destruction. Patient is not able to return to the shelter and does not have any safe disposition options.


Update 4/10/25: declined at Leo Hoffman, East Bethel, Bar None Haven, does not meet criteria for Grafton, Northwood wait list 2 years. Discharged from Mille Lacs RTC.
Update 4/3/24- declined Leo Hoffman, East Bethel, Waiting to hear back from Grafton, Bar None Haven. Discharged from Mille Lacs. Northwood waitlist 2 years.
Update 4/1/24: Nexus East Bethel PRTF declined pt due to not having a male unit at this time.

15-year-old female identifying patient with a history of depression, anxiety, RAD, PTSD, ADHD, and ODD. Patient has been in and out of treatment settings for 3+ years and has not been at home since. Patient was at an unknown treatment facility and was discharged due to its closing, Northwood Children’s Services PRTF (discharged due to not needing level 6 care) and most recently has been at Nexus Mille Lacs RTC since October 2022. Patient has a history of four inpatient hospitalizations. Patient has been discharged from Nexus Mille Lacs RTC as of 3/20/24 due to them recommending a higher level of care.

Current provider:
CMHCM: Kanabec County

PRTF: (MN DHS eligibility submitted by county and approved)
-Leo Hoffman (declined due to pt acuity)
-Northwood (added to wait list, about 2 years)
-Grafton (pt does not meet acceptance criteria)
-Nexus East Bethel (declined due to not having a male unit)

-Nexus Mille Lacs (pt discharged from program as of 3/20 due to lack of engagement)
-Bar None Haven (declined due to aggression and behaviors)

MN DHS Complex Transitions Team (in process of scheduling care conference)


Patient presented from North Homes due to suicidal ideation and aggressive behaviors. Patient was initially recommended for IPMH however stabilized in ED and no longer required admission. Patient has been discharged from North Homes and is in need of long-term placement as she cannot return to guardian’s home. Case manager will be working on referrals for RTC and out of home placements.


Presented from foster care home after making threats to shoot foster parents and himself. History of PTSD, RAD, IQ of 62. Ongoing aggressive behaviors and impulsivity in the home. Foster parents do not feel safe with patient returning home and is in need of new long term placement.


Update 4/3/24: Parent still not willing/able to take pt home. County involved. DC rec is PHP, openings available at PC PHP when parent is able.

Patient was admitted from Essentia Health in Duluth after attempting to run away from home. Pt has conflict w/ dad & has made HI statements toward him (burning him, switching meds out so he will OD). Pt also has a Hx of inappropriate sexual behavior with older men & on the internet.

Historically, patient lived with extended relatives for the first 11 years of her life due to mitigating circumstances that did not allow biological parents to meet her needs. Patient then went to live with her biological mom and was then sent to live with her dad, as mom was unable to meet patient needs. Patient has been with dad for about 1 month now, and he has indicated that he cannot meet her needs either, and declines for the patient to return home.


Update 4/3/24: Bar None Haven (Referral submitted, Denied 3.22.24), Northwood Children’s (Referral submitted, On waitlist), Grafton (Referral submitted), Nexus East Bethel (Referral submitted). County also working on referral for MITH program (MN Intensive Therapeutic Homes). MN Choice Assessment done.

12-year-old female with DMDD and RAD presenting to PrairieCare Inpatient Hospital. Patient has had multiple psychiatric hospitalizations, 2 RTC placements and 2 JDC placements.

Discharge Plan:
Locked Level 6 RTC – Bar None Haven (Referral submitted)

Current Providers:
CMCHM at Beltrami County
Individual Therapy
Medication Management
Wavier Case Management Services through Beltrami County (In process)


Patient with a past history of RAD, PTSD, ODD and questionable FASD that presented to the ER with foster parents of 4.5 months for concerns of aggression, suicidal ideation, and sexually inappropriate behaviors towards others and pets. He has been in several foster/kinship homes since age 5 with significant trauma prior to this including witnessing mom overdosing on several occasions, witnessing the overdose and death of housemate, sexual abuse by bio father, homelessness, sister attempting to suffocate and strangle him on multiple occasions, and physical abuse by caretakers. He was recently found on video touching the house dog sexually and physically inappropriate and has been threatening and pushing his foster mom. 3 recent episodes of aggression. Foster providers are unable to accept him back in their home.


Under the guardianship tribal agency “prairie island indian community”; unsafe conditions at aunts house and aunt cannot continue kinship care; seeking alternative family placement; CPS from Hennepin county involved with concerns at aunts house


Patient presented to the ED following an altercation with a housemate the same day Luke was informed he was no longer going to attend school in person per the school. He appeared easily agitated per the group staff and he called 911 himself. There was no physical violence reported. Andover House refused to take him back and served immediate suspension and termination of services. Parent declined to appeal. Active CPS involvement as well as GAL.

Michelle reports they are applying for a moratorium to create a group home for him; have two potential PRTFs considering. Northwoods did accept him 2 weeks ago but did not have a current DA (new one sent) and do not have an opening until May/June.
Leo Hoffman and several others have declined. Several others across all 50 states have been referred to and many have declined (list sent to Social work). Currently seeking either Level 5 psychiatric placement, Level 6 placement or a group home. Could consider a foster home but there is no current safe option. Willmar declined due to his staffing needs.


Patient presented from Prairie Care PHP due to aggression and dysregulated behaviors. PHP unwilling to accept patient back, mother unwilling to take home at this time and cites need for RTC. No RTC referrals made currently. Patient needs support in short term placement while outpatient team supports long term plan and placement. Has been in the ED 4 other times. Back and forth from ED to home. No letter of rec. for residential at the moment. Working on it. There is a case mgr, working on a care conference currently.