The patient is a 13 year-old female with a history of ADHD, inattentive type, anxiety, depression, sexual abuse, suicidal ideation, and self-injurious behaviors that presented to the ER following an intentional overdose in an attempt to end her life. She has had 2 previous inpatient hospitalizations. Patient has a complicated home life with several CPS reports and basically does the caretaking for her younger siblings. Patient has several tattoos given to her by her mother and sister and mother is unwell as well and frequently struggles with suicide attempts and self-harm. Sounds like a significant sexual abuse history within the entire family that may still be occurring. The patient is at risk for sexual exploitation given increased sexuality.
Recommended Service: Mental Health Residential Treatment
Mental Health Residential Treatment offers specialized care for individuals with severe mental health issues in a residential setting, focusing on mental health treatment and support.
HCMCH-M12-4692
12 year old male with ADHD, unspecified mood disorder with recent suicide attempt, T1DM, hypothyroidism, asthma who is in the ED after intentionally setting fire and burning house down. Has an IEP for speech therapy.
PH-M15-4658
Pursuing QRTP – patient is currently in psychiatric inpatient hospitalization.
Patient is a 15-year-old male. He presented to inpatient via ED due to increased SI and SIB. He has three historical inpatient hospitalizations, has done DBT and outpatient psychotherapy services, and most recently was at Newport RTC – although was discharged early due to aggression and property destruction.
From an acute psychiatric standpoint, youth is safe to discharge form inpatient care and receive services in the community prior to admission to QRTP. He has made significant progress on treatment goals during hospitalization.
Discharge Plan:
Referrals sent to the following residentials:
– Omegon Ascend (Reviewing, no current waitlist)
– Nexus Gerard (Reviewing, waitlist about a week)
– Nexus Mille Lacs (Reviewing, Current waitlist 2 months)
– North Homes (Declined d/t hx of aggression towards others)
– Northwood (Received, 6-9 month waitlist)
– PrairieCare Residential (Reviewing, 2-3 week waitlist)
Alternative Placement through Wright County:
-Wright County unable to identify alternative placement as of 9/24/24
Plan to bridge until residential:
PrairieCare PHP at MOB (unable to pursue establishing care at this time due to pt continuing to be hospitalized)
Continue with established outpatient providers:
Individual Therapist- Bridging Hope Buffalo
Medication Management- LifeSpan Mental Health Monticello
PCP- HealthPartners Elk River
CMHCM- Wright County
Neuropsych Testing- Clary Clinic St. Cloud
MHF-F12-4640
Came to our ED 9/22 from home due to aggressive threats. Previously was IP with our hospital 9/3-9/12. Mom does not feel she can take kiddo home at this time. Is in process of obtaining Childrens Mental Health CM and CADI waiver, but has neither as of now (did request these to be expedited.) Mom is also working on referrals to Residentials (has private insurance) but has not been placed on any lists yet.
PH-F10-4549
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
HCMCH-F16-4505
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.
MHF-M12-4485
Pt came to our ED on 8/10 from Grandparents home who were providing foster care and there was an altercation. Grandparents are refusing to take pt back. Hennepin County CPS/ICWA have temp custody. Pt not appropriate for IP due to fecal incontinence and struggles with communication. County is looking for DD waiver CRS and doing a MNchoices assessment on 8/16.
PH-M14-4088
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
MHF-M14-4476
Pt came to our ED via EMT on 8/5/24 after an altercation at home. He has a history of multiple inpatient stays, done PHP and day treatment, been to Gerard, Newport, and JDC. There have been 2 rule 20 evals that have deemed him incompetent, one just finalized on 8/7. Dad currently has custody and is refusing to pick up, reporting that he wants more help. Pt has history of abuse from both parents. CPS is petitioning for temp custody and placement is at a stand still while we wait for that to go through.
MHF-F16-4455
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.