Recommendation is now for level 6 PRTF. Patient is currently in psychiatric inpatient hospitalization.
Patient is a 16-year-old who identifies as non-binary using they/them. They presented to inpatient from ED due to increased SI. This is patient’s 14th psychiatric inpatient hospitalization. They have participated in outpatient services and PHP historically.
Patient was initially recommended for level 5 QRTP by inpatient providers although Dakota County recommended level 6 PRTF.
Discharge Plans:
PRTF (county determination/recommendation – DHS approved)
-Nexus East Bethel (referral submitted & under review)
-Grafton (not an option as they do not meet admission criteria)
-Northwood (referral submitted; two year waitlist)
RTC: (county declined funding for level 5 QRTP, recommended Level 6)
-Avanti (declined)
-Gerard (referral sent, unable to move forward due to lack of funding)
-North Homes (referral sent, unable to move forward due to lack of funding)
Established outpatient providers:
Individual Therapist: Your Vision
Psychiatrist: Associated Clinic of Psychology
PCP: Allina Healthcare
CMHCM: Dakota County
PO: Dakota County
17 y/o male with MDD with psychotic features, neurodevelopmental disorder, intellectual disability. He recently discharged from CABHS. Waiting for MSCOCS placement hopefully will be admitted on 10/2. There concern of excessive irritability, agitation, disorganized thoughts, delusions, history of auditory or visual hallucinations, history of self injury and impulsive behaviors leaving to being in dangerous situations.
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 9/6 following a verbal altercation with foster parent. Foster parent is refusing to let kiddo return. County has custody, limited parental involvement. Was supposed to begin Fairview’s PHP program 9/10 however is unable to being in the ED, should be able to begin that program once placement is found. County is currently searching for shelter/other foster care options and screening for MH group home placements.
Came to ED after altercation with mother. Ongoing family conflict between Mother and Daughter. CPS has just began getting involved on case. Currently mother is telling our team we must admit to IP and has not been willing to sign any ROIs to proceed with anything as of yet. Unable to proceed with any placements, waiting for further direction from CPS.
A 16-year-old female presented to the ED after being away from her group home placement for about 2 weeks. She is a ward of the state and is currently boarding in the ED due to her complex social and mental health history, increased risk of elopement, and the care team’s challenges in developing a safe discharge plan. Referrals are pending.
Pt came to our ED on 8/9 from parents home after an altercation. Parents are refusing to pick pt up. They report pt is involved in some gang activity and verbal and physical aggression toward them at home. Has been to 3 residential programs, and multiple placements Northwoods, Gerard and Bar None. He continues to exhibit behaviors in all settings. County does not feel another residential would be beneficial as the last 3 haven’t improved behaviors. Therapist is currently working on IQ testing but unsure if that can be completed in the hospital. Team is looking at starting MNchoices process to get waiver options.
Recommendation is for level 5 RTC – patient is currently inpatient.
14-year-old Male from ED. Patient got in a fight with their father and ran away from home. Patient has had several other inpatient hospitalizations and has completed a partial hospitalization program with PrairieCare. In alignment with CMHCM, seeking RTC level of care. At this time parents do not feel they can have the child return home. Referrals have been sent to Gerard Academy and Nexus Mille Lacs.
Patient insured by UCARE MA PMAP.
Pt has the following outpatient supports:
Individual Therapy
Psychiatry
PCP
CMHCM
Kiddo came to GICH ED on 7/31 from Little Sand GH after an altercation there. Pt had verbally and physically aggressed toward peer and staff, and had self harm/head banging. According to the team this was her first incident of physical aggression, she has not been violent in the past. Does have history of self harm and verbal aggression. Little Sand is recommending a higher level of care. Team would like PRTF placement and have made referral to Nexus East Bethel. Exploring VOA Bar None for interim plan, has not been accepted anywhere yet.
