Race/Ethnicity: American Indian or Alaska Native

PH-F12-3422

Update 4/15/24: Patient discharged from inpatient on 4/15/24 to home with outpatient services while awaiting level 6 RTC/PRTF placement.

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)

C8SM8M-M11-3149

Patient presented to hospital from group home with escalated bx, unable to return. County retains guardianship.

PH-F13-2494

Primary Recommendation – RTC
-Nexus Gerard, accepted, admission 2/9 at 1000

Other RTC referrals:
-Avanti, declined
-North Homes, declined
-PrairieCare Residential, declined due to aggression
-Northwoods, referral made, declined for RTC

Out-of-State:
-Northwest Passages (Prairieview), county made referral, waitlist 2-4 months
-Lad Lake in Wisconsin, county made referral
-Youth Villages in Memphis; county made referral, reviewing
-Lava Heights in Utah; county made referral
-Falcon Ridge in Utah; county made referral
-Newport News in Virginia; county made referral
-Summit Oaks in South Dakota, county made referral, declined
-Provo Canyon in Utah; county made referral, declined
-Rogers, Hennepin County does not contract/won’t provide funding

Due to declines from QRTP, exploring PRTF options:
-Nexus East Bethel; referral made, not covered by insurance, potential to switch insurance, reviewing
-Northwoods; referral made, waitlist 2+ years

Bridge to RTC/PRTF; if warranted:
Establish CMHCM (Assigned to Kimberly Trembley through Hennepin County, 612-743-1549, waiting for QI approval for funding)
Establish PHP (SW to reschedule if/when appropriate)

Other Referrals Made:
Acadia Treatment Placement Specialists; referral made

Outpatient Recommendations:
Establish Individual Therapy
Establish Family Therapy
Continue PCP at Indian Health Board in Minneapolis

INSURED BY PRIME WEST MA

Presenting Problems: Experiencing school stressors, family dynamic changes, depression, mood lability, SI via ingestion.

HCMCH-F14-2910

Presented after a sexual assault. She has a known history of depression and PTSD, polysubstance use and prior sexual assaults, trafficking and pelvic inflammatory disease.

HCMCH-F14-2906

Presented after a sexual assault. She has a known history of depression and PTSD, polysubstance use and prior sexual assaults trafficking, and pelvic inflammatory disease.
Leech Lake Band of Ojibwe Tribal Court Order 1/23/23 – Leech Lake Child Welfare Department has legal and physical custody of patient with right of placement, out of home placement.
Patient was last in school in 6th grade.

CH-F13-2724

Update 1/15/24- potential admission to Ain Duh Yung Center today.

Patient presented via EMS after running away from emergency foster placement. Foster home is not willing to take her back. The patient is polite and calm though guarded and provides minimal information. She was seen by psych on arrival to the ER with recommendations to return to foster placement. She was removed from her biological parent’s home at age 3 and has been in foster home placements since. We have received minimal information about her history from legal guardian though previous foster provider noted that she was found with cigarettes, pipe, and a needle in her possession recently.

EHSM8S-F10-2635

12.21.23 This week the case worker came and discharged the child. Created safely plan, and child went home with gramma.

12/13/2023-History of Present Illness: This is a 10-year-old female patient was assessed by the crisis team crisis team recommended the patient go to a higher level care. Patient brought to ED for placement. The patient currently lives with grandmother but is Custody Of Indian child welfare. The patient has a history of PTSD, ADHD, anxiety, The patient has been hospitalized previously at primary care in Brooklyn Center Minnesota for 9 days, on October 23, 2023. The patient has a history of a mental health team including a home counselor at school counselor and outpatient services. Patient was transported here by law enforcement services. On examination the patient denies any pain Or complaints. There are 2 workers from Indian child welfare present with the patient here.Patient evidence of UTI Macrobid 100 mg orally was given Patient will need prescription Patient is transferred or discharge. 
Impression: #1 Behavioral issue #2 UTI

Writer met with pt, sleeping and did not wake, and pt’s social worker Vanessa 218-850-9918 to discuss prior services. Pt has several services in place to assist with managing her behaviors. She has a therapist she sees regularly, medication management, is on an IEP, is able to take breaks at school, has in home services, engages in skills work, and does family therapy. Pt is in foster care with her grandma and has been since a young age. Pt does see her mom and gets violent with the siblings. Pt is violent both at school and will destroy property. Pt has aggression towards grandmother and will hit her, law enforcement has been called, however, grandmother does not file charges. Pt was in Prairie Care in October for roughly 9 days with no issues. At this time ICW social worker and grandmother feel inpatient treatment is the next option. Residential treatment was discussed briefly, however, without any legal charges or any recommendations, as well as pt’s young age as a barrier, residential placement is not an option at this time.
 
Staff will continue to look for inpatient treatment at this time.

HCMCH-F16-2410

Brought to the emergency department by police due to concerns for sexual exploitation. She was admitted with opioid withdrawal and need for safe discharge plan. In need of substance use treatment and mental health. Has history of running. not aggressive. Very collaborative and asking for treatment. Substance use tied to sexual exploitation. Wonderful partnership with HCMC CPS. Will be placed at Provo Canon in Springville UT tomorrow. Had to go way up the chain to get approval for out of state. Very high-risk youth. Still very collaborative and wanting treatment. Mom and dad have come to see her and brought things to take with her.

HCMCH-F13-2406

History of trauma, sexual exploitation, concurring with MH and substance use. Co-managed by psychology and addiction medicine in the hospital. Community PCP has been established who can also monitor suboxone. Patient in need of short-term placement. Has been referred to Heartland Girl’s Ranch.

HCMCH-M17-2398

First episode psychosis. Admission to HCMC 12/26/22. Exception made to accept a minor patient to HCMC Adult Psych Unit 1/6/23 – 1/16/23 in effort to get patient out of restraints, medication regimen and agreement to return to Peds Unit. Returned to Peds Unit 1/16/23 and remains here. Efforts to transfer to Adolesent Acute Pysch unsuccessful due to no capacity and/or patient declined. Update: 1/24/23. Continues to be medically cleared, awaiting placement. Awaiting Hennepin County MH Casemanager to be assigned. Consider referral to PRTS, concern for long waitlists. Concern if we continue to board patient on Peds Floor where he is not getting the mental health care he needs, he is at risk for decompensation. Patient has a Continuance Agreement through District Court Probate/Mental Health Division for six months from 1/17/23. grandmother is open to having him return home with a structured program during the day.