Twin brother adopted from Ecuador at age 11. DD, operate at about 5-6 year old. No MA or waiver due to parent income. County case manager referred to MSOCS and CSS. Mom working with Kennedy Krieger. Barriers: no MA, waiver or declined due to DD or aggression. DC from Chileda due to behaviors.
Patient has had several disrupted placements over the past year including shelters and foster homes. Patient has extensive trauma history and was most recently at a shelter where they engaged in self harm by cutting and expressed passive SI. Patient was sent to the ED and was not allowed back to the shelter.
UPDATE: 9/7/23 – discharged to AMAS Inc (CADI group home)
UPDATE: 8/31/23 – Care conf tomorrow. Accepted by Sunset House, having zoom meeting with patient today to get to know him better before transition- waiting on them to get licensing.
UPDATE: 8/17/23 – Still in ED. Not able to go to Mille Lacs due to non-participation. There is a CADI group home willing to take him, working on licensing.
UPDATE 7/27 – had a video interview with Nexus Mille Lacs on 7/26, awaiting updates.
Previously MCR 1086: Discharged 6/15/23 to VonWald, returned ED 6/30. 14 year old with significant trauma history, ward of Hennepin County, recent placement at his request with young adult brother that was disrupted due to conflict. Briefly placed at Von Wald shelter but repeatedly eloped in an effort to reunite with his brother, and was brought to the ED. Calm overall except when relocated to a unit that required observation while in the restroom, then repeatedly escalated with verbal threats, closing himself in the bathroom, and hitting the walls. Had an interview with Nexus Mille Lacs on 7/26/23. He is familiar with Nexus Gerard and would feel comfortable there.
Update 7/27 Genesis Group Homes is pursuing an intake to potentially utilize crisis services.
16 year old adopted from Ecuador at age 8 (with twin brother with similar difficulties, as well as 2 other siblings without similar struggles), with ASD and intellectual disability, associated with a microduplication at chromosome 8p23.1, likely in-utero substance exposure, as well as early life neglect (living in an orphanage for much of his young life). Significant aggression difficulties that are becoming more unmanageable by family as he grows larger; unsuccessfully discharged from Chileda in November 2022. Family have financial resources and have purchased a second home for the boys and hired private caregivers in the evenings, but their income limits eligibility for MA and state-funded services. New behavior analyst started working with the family in March. May be on the MSOCS wait list. Currently on the wait list for inpatient care at Kennedy Krieger near Baltimore (brother previously had a good experience there).
These notes are from when this child was at RMC – was admitted there 4/7/2022:
ASD, DD, physical and verbal aggression, agitation, trauma, IQ 51, intermittently toilet trained, was in foster care – didn’t work d/t violent behavior. Has a Waiver. Attending PT/OT/SLP while in ED. Tried a respite stay but came back – difficulty with another child there. Under Sibley County now. Grandmother legal custodian – appropriate and involved. He had a low IQ but hasn’t ever attended school regularly. Has done well at Ridgeview. ST/OT/PT. Language improving. Was behaviorally frequently incontinent, better now. Not as into his technology. Continuing to refer to multiple facilities- all say no for multiple reasons. Case manager looking for foster home. He eats well, limited sugar. Much less violence now since April, but it’s the reason why he’s been declined. He needs someone to take a chance – he’s doing well at Ridgeview. Once he gets established, he will most likely do well. Does not need 1:1 attn. Turns 11 in Feb. He’s 1:2 or 1:4. he is on his own 75% of day. He showers, gets dressed, uses toilet, cleans himself up if he has an accident. Takes meds well. Documentation from hospitals is problematic as they mostly document the problems or issues and not the strengths or improvements. CPS has closed the chip case on him. Gramma is now the custodian.
Update: He is completely stable w/ meds. He’s completely continent now. Participating w/ ST, PT, OT. Language skills have grown tremendously. Looking into foster care, w/ just him or 1 other child. Turns 11 in Feb.
Referrals in all over the country. Grafton reached out 11/17. 10 page list, both sides, of rejections. He is a big kid, and when he becomes aggressive – security comes – 98% of the time he can be redirected. In April – there was some violence toward staff, not now. Sibley county is looking for a congregate setting, more staff instead of family. Has Disability services been involved? yes. Multiple care conferences. Grafton originally declined because the behavior score was too high. Should Grafton receive new updates to reconsider? turns 11 in Feb.
Was sent to Juvenile Detention on 1/28/23. Then (date unknown) to home in custody of grandmother. Now at FV Masonic since 2/2023