AH-F17-2107

SUD, running away from treatment. trauma. Discharging to VOA-CRTC, connection made thanks to this meeting!!!

MCR-M16-1842

Long history of impulsive behavior and emotional dysregulation in the context of in utero substance exposure, prematurity, and repeated disruption of parental caregiver relationships. The current history suggests that he functioned fairly well over the last couple of years with relatively low level mental health services – highly experienced foster parent, individual therapy every 1-2 weeks, and occasional pharmacology. However, he began using cannabis more regularly and was unable to stop use when limits were set, leading to disruption of his foster placement. He has had significant dysregulation in a shelter and then crisis center setting since losing his foster home placement, including threatening peers, brandishing makeshift weapons, destroying property, and then finally physically attacking a peer (we do not have information about what provoked this) leading to his being sent to the ED. He has been consistently calm and polite here, though withdrawn, without evidence of clear active mood, psychotic, or anxiety disorder that would indicate a need for psychiatric hospitalization.

MHF-M14-2026

Patient is presenting to the ED for the following concerns: verbal agitation, physical aggression, and significant behavioral change. Per patient’s mom, patient has been struggling for several years with anger and aggression, but this past month things have been escalating. Patient got upset at home, threw things, and punched his mom in the face. Patient’s mother called the police. Patient was in Riverside’s inpatient unit 3x in 2020. Patient was referred to PHP, and attended a 3-week PHP at Children’s Hospital. At the completion of the 3-week PHP, patient was recommended for additional treatment in a residential/inpatient setting. Patient has previous mental health diagnosis of PTSD, ADHD, DMDD, anxiety, and depression. Patient has a mental health CM and a psychiatrist.

MHF-M15-2014

Patient is presenting to the ED for the following concerns: physical aggression. Patient became escalated at home, following his PCA staff leaving for the night. Details on the escalation are unclear at this time. Patient is diagnosed with Autism with little to no verbalization. Patient has a case manager, PCA support for before and after school until 8 pm, and on weekends from 8 am – 8 pm. Patient has a history of biting himself, scratching himself, and aggressive behaviors towards others. Patient historically escalates before/after school, and after his PCA staff leave for the night. Patient has been to the ED 19 times in 2023, due to aggression/symptoms of ASD.

MHF-F11-1660

9/28: Youth still awaits placement to RTC.
9/19: Accepted to Nexus FACTS to assist with Placement Coordination.

9/14/23 UPDATE: Nexus YCT program looking into helping with this child.
Patient is presenting to the ED for the following concerns: verbal agitation, physical aggression, significant behavioral change, abuse or neglect, anxiety, worsening psychosocial stress, suicidal ideation, depression. Patient was staying at a crisis residence after discharging from the ED on 9/1/23. Police were called due to patient becoming aggressive/violent, dysregulated and exhibiting SI/HI plans and threats. Staff at the crisis residence do not feel safe keeping patient at the home due to her violent outbursts, and fear for other residents’ safety.
Patient is a Hennepin County state ward. She has an extensive history of childhood trauma, including neglect, physical abuse, and suspected sexual abuse. She was also prenatally exposed to cocaine. Patient’s grandmother adopted her, who fled with the patient to a different state. Her grandmother’s rights were terminated, and patient has been living in foster care with her aunt since the end of June 2023. Prior to that, patient was living in a group home for approx. six months in Duluth, after completing residential treatment at Northwoods. She arrived to the ED on 08/09/23 following an episode of significant behavioral dysregulation involving throwing furniture down the stairs. She was subsequently admitted to 7ITC and discharged on 08/28/23, returning to the ED on 8/28, and discharging to crisis residence on 9/1. Has a CPS worker, who is her guardian, but no other services/case managers.

CH-M18-1987

Patient presents with SI and HI and auditory hallucinations. Attempted to wrap blanket around his neck in the ER on 10/28/23 in an attempt to end his life. Hears voices telling him to hurt others. Intellectual disability (FSIQ 67)

PH-F15-1621

Updated 10/23/23: DC home to in home therapy through CIBS. Still no county funding for QRTP
Updated 10/19/23: Still no county funding for QRTP. Discharge home 10/23 or 10/24 with in home therapy through CIBS.
Update 10/12/23: Still no county funding. Likely moving forward with CIBS at Gerard, will likely discharge next week home.
Update 10/5/23: Gerard admission pending 10/11 now. County funding remains pending. Pt declined from CD RTC noting Mental Health long term RTC.
Update: 9/7/2/3 Gerard admission tentative 9/20, pending county funding.
Update: 8/31/23 Approved for Gerard admission week of 9/18, pending county funding. Also accepted at NorthHomes, 3-6 month waitlist.

SI since the 4th grade, history of trauma, living in cars/shelters, history of CD use.

Discharge Plan:
Primary DC recommendation is RTC*:
Gerard (accepted; pt is next on list for placement; openings week of September 18th)
North Homes (accepted; 3-6m waitlist)
CRTC (referral placed; admissions paused due to staffing)
Avanti (referral not placed; facility not accepting referrals)

*QRTP/RTC County Funding needed as pt has a UCARE PMAP Plan:
Dakota County CMHCM: Referral Placed
-Mother lives in Dakota County and father lives in Rice County (pt will reside with mother following hospitalization, mother provided consents)
-Le Suer County and Scott County CMHCM previously referred to: Cancelled Referral due to Family Moving

PH-F15-1865

**Update 10/18/23: Patient discharged home with outpatient supports, while awaiting Group Home placement**

Patient came to inpatient hospital from residential treatment, patient cannot return to RTC and is not being recommended to attend RTC at this time. Patient in need of group home placement. Adoptive parents are legal guardians and have verbalized that the patient cannot return to their home.

County currently pursuing:
-Group Home (CMHCM pursuing this)

Current/In Progress Wraparound services:
Continue CADI Waiver Services through Hennepin County
Continue Medication Management with Associated Clinic of Psychology
Continue PCP with Sara Brandt at Southdale Pediatrics
Continue with Jessica at Southdale Pediatrics
Continue CMHCM with Doug Inwards at Hennepin County (612-490-9342)
Continue BCBS Insurance Case Management with Allison (888-815-7461)

MCR-14-1888

a history of diagnoses of PTSD, reactive attachment disorder, Oppositional Defiant Disorder, ADHD and substance use disorder. Her social and developmental history is notable for significant early life trauma related to parental substance use, including at least one episode of Lily herself ingesting methamphetamine as an infant. She was removed from mother’s care at age 10 months and father’s care at age 5 years, and was adopted by maternal grandparents at age 7. She has had essentially lifelong difficulties with dysregulated behavior. She has been at Mayo Clinic since 9/6/2023 following an altercation at the home where she was staying. She was previously residing with a family friend, but is unable to return due to safety concerns by all adults involved, including Olmsted County who assessed this not to be a safe discharge location. Her legal decision maker is her maternal grandmother who has previously adopted her.