UPDATE: Pt discharged home with improvement of some symptoms and wraparound services. CABHH and PRTF referral stand.
16 yo adopted white gender fluid/nonbinary adolescent with Albinism of Otter Tail County. No hx of attachment concerns. Delay with speech. Some historical cognitive and attentional concerns. No substance use. Expressing SI, SIB urges and lability. Hospitalized twice in early 2023 until admission to PrairieCare RTC on 4/11/23, needing a higher level of care, admitting to Inpatient 4/18/23. Patient has severe lip biting when dysregulating causing multiple lip lacerations, requiring suturing.
DISCHARGE PLANNING EFFORTS:
Primary Recommendation is CABHH; Referral made, on waitlist.
Residential Treatment or PRTF consideration:
-Avanti; referral made, declined due to aggression and seclusion history
-Northwoods; referral made, on call back list, 9 month waitlist
-North Homes; referral made, accepted, waitlist out to mid-summer/fall 2023> still would need QRTP funding*
-Gerard; referral made, reviewing, declined due to staffing needs in educational settings
-CRTC; referral made, declined
-Heartland Girls Ranch, county SW to refer
-Village Ranch, county SW to refer
PRTF:
-Grafton, referral made, denied, can reach out in a couple months for re-review due to their staffing
-NorthWoods, waitlist 12 months
-Leo A Hoffman; referral not made, only accepting Male patients
Out-of-state RTC:
Guardian declines referrals for out-of-state placement at this time
*QRTP funding is not in place- Parent does not consent to Relative Search which Otter Tail County uses in the QRTP pre placement screening process.
UPDATE 8/31/23: Discharge to family with wraparound services planned for 8/31/23 at 1300 while waiting next Gerard admission (tentative late September) as QRTP pre placement screening has now approved.
UPDATE 8/24/23: Pt remains accepted to Gerard, next admission now late September. QRTP pre placement screening team approved 60 days RTC as of 8/24/23. We will discharge home with wraparound services while waiting RTC admission.
UPDATE 8/8/23: Pt is accepted to Gerard and can admit tentative 8/21- pending preplacement screening/QRTP approval from Hennepin County.
10- year-old female with a history of anxiety, depression, social difficulties, anger and trauma. Aggressive behaviors and increase in suicidal ideations. Has participated in PHP, individual therapy, and psychiatry. Insured by BCBS PMAP.
DISCHARGE PLANNING EFFORTS:
Primary Recommendation: Residential Treatment.
Patient recommended to return to home/community with wraparound services while waiting for Residential. Discharges have been attempted, patient threatened grandmother. (Patient cannot return to mother or to grandmothers- CPS involved)
Wraparound:
Establish CMHCM (Referral to be made internally from CPS case worker)
Establish CTSS (Referral completed to Summer Counseling, reviewing; Referral completed to MN CarePartner, on waitlist, 2-3 months)
Establish FT (Referral completed to Family Attachment Center and Empower)
Continue Individual Therapy with Rachel at ELEOS Psychology Center
Continue Psychiatry with Catherine McCormick-Deaton, DO at Allina Health-St. Paul
Continue PCP at Allina Health-Maple Grove
Residential, when available due to waitlists*:
Consider Nexus-Gerard RTC (Declined due to aggression, being re-reviewed currently)
Consider Northwood Children’s RTC (Referral sent, waitlist 6-9 months)
*Juvenile Treatment Screening with Hennepin County needed to request funding for QRTP/RTC level of care. CPS worker aware of request.
Estimated length of stay:
Patient is medically ready for discharge as of 6/30/23
UPDATE 8/24/23 – remains at Abbott Northwestern.
ASD, lower functioning, home bound schooling, aggression towards family and staff. On wait list for MCCP crisis bed, out of state referrals being looked at. As of 4/11/23, still waiting on placement. got the waiver for group home, but no providers available.
Patient has a history of ADHD, DMDD, and trauma. He presented to the emergency trauma center with foster provider following an anger outburst where he hit himself. Patient also made comments about killing himself and threatened to kill another child in the home. Patient is unable to return to foster home.
UPDATE: Mom wouldn’t sign ROI for CRTC to she still awaits placement.
Patient is a 15 year-old with a history of PTSD, MDD, and GAD. She has a history of five previous psychiatric hospitalizations and one premature discharge from residential treatment this past spring after restricting her food and water intake (start of present hospitalization). Nutritional intake has continued to decline to the point of needing tube feeds to meet daily nutritional requirements, with symptoms more closely resembling anorexia nervosa at this time.
Patient is already connected with medication management, county case management, CPS, and psychotherapy.
Patient is an 11-year-old male presenting to Children’s Emergency Department due to increasing behavioral escalations at home. Patient has a history of trauma. Patient has not had stable housing and has been in several different placements within this last year.
Patient does not meet inpatient mental health criteria due to no ongoing or current suicidal ideation, thoughts of self-harm, or thoughts to harm others and was recommended to discharge home to his foster home with his grandmother.
Pt is a 10 yo male presenting due to increased aggressive and impulsive behaviors at home. Pt was attempting to light fires in the home prompting mom to call EMS. Mom has other small children in the home and feels as though she is not equipped to care for him. Pt has trauma history and has had inpatient mental health stays in the past. County recently approved funding for PRTF. Looking for a shelter in the meantime. Has sexual concerns so that needs to be considered with shelter placement. Extensive sexual and physical abuse history. Mom unable to take him back at this time, other children in the home. Has not has any sexualized behaviors while at the hospital. Nexus Mille Lacs is able to take someone with potential sexualized behaviors – and is interested in this child. Connecting offline.
*UPDATE: Admission to Gerard 7/28/23- just pending county funding at this time, 2nd screening today, 7/20
16 YO Female in 10th grade. Two previous psychiatric hospitalizations (2/23/22-3/4/22 and 9/17/23-9/27/23) in addition to the current admission. Has attended Day treatment. No alcohol or Drug use. Increasing SI and history of self harm. Hx of sexual abuse at age 9.
DISCHARGE EFFORTS:
-RTC: Avanti Center for Girls (Referral sent, pt accepted, 6 month wait list)
-RTC: Gerard Academy (Referral sent, pt accepted, admission, 7/28/23, pending county funding)
-RTC: North Homes (Referral Sent, pt approved, opening estimated for August-September)
-RTC: Northwood Children’s Services (Referral Sent)
Interim Plan:
-Day Treatment: TSA (pt able to return if/when it is safe to DC)
-CMHCM: Janet, Isanti County
-DBT: (SW to provide resources upon DC for guardian to use after RTC)
Patient was receiving residential services through Aspen House and sent to the ED following an altercation with another resident. Aspen House would not take Pt back. County is guardian and Patient has spent time in and out of foster care settings.
