Recommended Service: Group Home

Group Homes are residential facilities where individuals, often children or adults with special needs, live in a group setting with support and supervision provided by trained staff.

PH-F14-4234

6/4/24 admission note: Patient is a 14-year-old female admitted to PrairieCare for suicidal ideation and self-injurious behaviors. Patient was recently discharged from a 45-days residential program. 2 days post discharge patient began threatening to kill her mom and reported SI with plan to jump in front of a car. Pt has a history of recurrent major depression SI, and SIB.

Discharge Plan:
SMRT-Hennepin County (7/8)
PRTF/QRTP – Level 6:
-Grafton (declined due to current milieu at facility)
-Nexus East Bethel (unable to refer due to insurance)
-Leo A Hoffman (unable to refer due to males only)
-Bar None Haven (SW to send referral once consent obtained)
-Northwood (SW to send referral once consent obtained)
-The Youth Village in Tennessee (guardian pursuing)
-Acadia Healthcare (SW to send referral once consent obtained)

Current Providers-
Therapy- Paula Ocampo at Lake Country Associates
EMDR therapy-Tiffany Rundquist, Sanford Health Bemidji
Pediatric Neurology- Dr. Ilgarli, Essentia Health
Psychiatry- Daniel Janiczak, MD and Kayla Scheneit, MD- Sandford Bemidji
CMHCM- Erika Kjellberg, Hubbard County
CTSS- Megan Berg, Hubbard County
EMPATH at Bemidji Sanford 2 times/week

CH-F11-3461

Update 6/26/24: Patient doing well and has made improvement with emotional dysregulation. No longer recommending PRTF level of care. Interview with Divine House occurred last week.

Update-5/30/24- Patient has had severe decompensation in part due to child protection concerns along with prolonged hospitalization and has been in the BICU for aggression, self harm, and seeking/securing items to self harm with. It is now recommended that she be placed in a PRTF.

11 year old presented to the ER after discharging from residential for concerns of running away, recent sexual perpetration to 6 year old brother, and homicidal ideation towards current guardian. Active CPS investigation over the last 1.5 years and is unable to return to her mother’s care or a home with younger children. This patient struggles with low insight, poor boundaries, antagonizing behavior, and justifies her behaviors. We attempted to obtain psychological testing though patient was not cooperative and refused. Medications are stable. She continues to display oppositional behaviors at times.

MHF-F14-3744

Discharging today 6/20 to group home

Came to our ED solely due to not having another placement. Has boarded in our ED in the past. Was previously at Bar None Shelter plus where she assaulted others and was taken to JDC. Was in JDC for a week when a judge ordered her to be removed, so CPS brought her to the ED as they had no other place to go. CPS is searching for group home placement as that is what the County’s juvenile screening team deemed the appropriate level of care.

AH-F15-4120

Presented following disclosing suicidal ideation at school. Previous foster home is unwilling to take her back due to mental health needs. County/hospital is pursuing therapeutic foster care and group homes. She has previously been placed at JDC due to running away from home. She has not run away from previous placements

MHF-F12-4051

This pt arrived in Ridges ED on 5/31 after behaviors at her Grandma’s house. St Louis County has temporary guardianship. Grandma is refusing to let her return to her home. Made suicidal statements at home and was verbally escalated. County is exploring Heartland Girls Ranch and 35 day assessment programs. Referral is being completed to Nexus YCT.

EH8D-F15-4024

Pt is a 15 year old female with a history of unstable placements after having been removed from family care due to physical abuse. She has a history of irritability, impulsivity and mood instability which have led to outbursts, self-harm, aggression and property destruction. She was admitted to the hospital after being discharged from her residential treatment facility due to these behaviors. Patient is requesting medication management for the above listed symptoms while we work with her Hennepin County case manager on placement. She has not had any significant behavioral issues over the past 2 weeks while in the hospital.

EH8D-F10-3962

Pt has been living in the Residential Services-Jewel Group home for over a year. They gave a 60 day termination of service due to their inability to manage her escalating behaviors (last day of services 6/25/24). They have 2:1 staffing for her. These behaviors include harm to self, or others, striking out, choking herself, throwing things and threatening to kill herself and others. She had been attending TSA day treatment until March after an altercation with a peer. She is currently at a 4th grade level and has an IEP. She was brought to the Welia Mora ED on 5/9 and 5/10 as well as Children’s ED on 5/14 looking for “other placement” and was discharged due to not meeting criteria for inpatient hospitalization.

PH-F16-438

Patient admitted directly to CRTC on 6/8/23 directly from PrairieCare Inpatient.

Patient had been hospitalized in the Inpatient setting numerous times, she was at PrairieCare Residential 12/19/22-2/22/23 and stepped up to Inpatient for stabilization. PrairieCare Residential is unable to have her return due to their staffing and current milieu. Please note aggressive behaviors have significantly decreased and have not been present in the past month. UPDATE: Accepted to CRTC, waitlist 5-7 weeks- any available bridging shelters/group homes?

Discharge Plan:
Referred to-
RTC:
-PrairieCare Residential (Re-admission declined on 4/11 due to milieu/staffing concerns)
-Grafton (Not currently accepting patients over age 14)
-Northwest Passage (Does not accept MN MA; Referral declined due to IQ)
-Avanti (Declined due to aggression 12/22; SW to re-refer)
-Gerard (Referral submitted 4/26)
-North Homes (Declined from RTC 11/22 due to IQ)
-CRTC (Referral submitted on 4/14; additional clinical sent 4/25, accepted for admission 5/9; estimated waitlist 5-7 weeks)
-Bar None, Shelter Plus Program (Preliminary Hub referral made, awaiting return message; SW to re-refer for interim placement while awaiting admission to CRTC)
-Refer to Treatment Placement Specialist at Acadia Healthcare for consideration of out-of-state RTC’s
-Consider referral to CIBS program at Avanti (Anoka County unable to fund – no contract)
-Consider referral to CIBS program at Nexus-FACTS (Anoka County unable to fund – no contract)

Group Home:
-PrairieLakes Haven House Group Home (waitlist 2 months)
-Port Group Home (waitlist 2 months)

Therapeutic/Corporate Foster Care:
-Solutions Behavioral Healthcare (Awaiting return call)

Estimated length of stay:
To be determined pending formulation & confirmation of alternative discharge plan

Was initially accepted by CRTC but couldn’t take due to her Casii level of 5.

CH-F16-3194

Update 5/16/24: Still on Empath. Cancelled follow up visit/pursuit of ChildServe due to county not being able to provide out of state funding. Starting over with contacting facilities in MN. Enriched living extensive waitlist, Beacon sent referral for long term crisis placement, Dragon fly still reviewing, JD homes reviewing, REM reviewing.
Update 5/9/24: Still on Empath unit. Being reviewed by ChildServe for potential placement out of state. County also pursuing waiver for adult group home.
Update 4/15/24: Still on the Empath unit and continues to do well. MN Choice Assessment completed last week. Referral made to ChildServe in Iowa.
Update 3/21/24: Still on Empath unit, doing well. Stearns county has guardianship, still working on CADI waiver. Referral made to Dragonfly.
Update:3/7/24: On Empath unit, used for assessments and stabilization. 48 hour stay. Doesn’t need hospital. Needs to be assigned a social worker. On a chips hold. Going to need a CADI waiver.
Patient is diagnosed with Soto’s syndrome and is non-verbal with significant developmental delay and suspected cognitive functioning of a toddler. Dad dropped her off at the ER with reports that he is not willing to bring her back home as he and mom are aging and are unable to manage her any longer as they have other disabled children in the home and mom has health issues. Patient has a chronic history of slapping herself, biting herself and others, and pulling hair. Patient is incontinent of bowel and bladder and requires significant assistance with ADL’s including toileting, bathing, dressing, and eating. Family currently has no supportive services in place with the exception of psychiatry. CPS report was filed with court scheduled Monday morning. Not aggressive or violent since in ER. Compliant. 1:1 since she’s on an adult unit.