Recommended Service: PRTF

PRTF facilities provide intensive psychiatric care in a residential setting for individuals, often children and adolescents, with severe mental health issues.

MHF-M14-5751

Youth came to our ED on 6/13 straight from a Missouri RTC that he was discharged from due to aggressive behavior. Came to us as there was no other place for him to go. Has CMH and they are reporting they are not seeking another placement at this time and recommend pt return to adoptive Mom, or we contact CPS. Mom also requested we contact CPS so she can get further assistance and potentially out of home placement. No waiver at this time.

MHF-F15-5707

Youth came to our ED on 5/24/25 after physical altercation at Red River Valley placement, and they refuse to let her return. Has history of physical aggression and a rule 20. Has boarded with us multiple times prior- 12/5/23-12/29/23, 2/13/25-2/27/25, and 3/6/25-3/12/25. Looking both in and out of state for placements that might take her.

AH-M15-5556

Impression of Crisis Behavior (precipitants): Patient presented to the ED due to agitation and SI. The identified precipitant for this crisis is a verbal and physical argument with his mother and her boyfriend at the home. Patient was released from the JDC to home on 4/5/25.
Vulnerabilities: adolescent, ASD, h/o trauma, recently released from JDC, parent-child conflict, inadequate outpatient supports
Behaviors / Symptoms to address in the ED: deferred
Methods to increase desirable behaviors in the ED: meet basic needs, set behavioral boundaries/limits,
Barriers to Discharge include: At this time, patient is NOT felt to meet criteria for inpatient hospitalization. There are no new acute safety needs that warrant admission. His mental health concerns are chronic and environmental.

Mom is refusing to take him home, JDC won’t take him back as there are no new charges and he has no place to go. CPS is investigating allegations of abuse by parents and child but are not seeking placement. Mom does not consent to use of a shelter or Nexus YCT.

MCR-M9-5609

He has been in foster care since he was removed from home in 10/2022 due to physical abuse. He was in foster care with a family and was relatively stable until the past few months, when the foster father died and since then there has been an increase in behaviors. He is unable to return to that foster home. He has very low cognitive functioning, reported to be around a 3 year old, and he was attending school only a few hours per day. He was on a lot of medications and psychiatry has optimized them during his time here.

HCMCH-F13-5634

13-year-old female with a history of autism spectrum disorder, oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD), major depressive disorder (MDD), and traumatic brain injury (TBI).

On 4/23/25 according to EMS, the patient had an argument with her mother around 5:00 PM today and subsequently left the home abruptly.
This is her second time boarding in APS; she was admitted two weeks ago and remained for two weeks while in-home services were being arranged. She was discharged but returned due to elopement and aggressive behavior toward her mother.

During her previous admission, she was referred to CABHH but placed on the waiting list. She has also been referred to Beacon for respite care and has been on the waiting list at Grafton for over a year.

MHF-F14-5621

Youth came into our ED on 5/6 from the Bridge for Youth shelter. Shelter refusing to take her back. She has boarded with us before for a short time last June. Currently has CADI and CMH, both through contracted agencies. Unable to access County screening team due to contracted CM, so MH GH and residential are not options currently. MCCP referral is in, also have referral to CABHHS and Grafton- awaiting approval from Arkansas Foundation and for acceptance at the program.

PH-F15-5562

Patient is a 15-year-old female, currently at PrairieCare Inpatient Hospital.
Recommendation is for level 6 PRTF.
Patient has had five previous inpatient hospitalizations through Abbott Northwestern and PrairieCare since April of 2022. Patient has had two admissions to PrairieCare partial hospitalization programming, and one admission to Anthony Louis Center RTC.

Establish PRTF:
-Nexus East Bethel (CMHCM sent referral, PC also sent a referral, declined for admission 04/16 due to believing PT needs a higher level of care- CABHH)
-Northwoods (Not a viable option due to insurance and 2 year waitlist)
-Grafton (Not a viable option due to patient not meeting admission criteria)
-Leo Hoffmann Center (Not a viable option due to patient not meeting admission criteria- only accept biological males)

PH-F12-5504

Patient is a 12-year-old female, currently at PrairieCare Inpatient Hospital.
Recommendation is for level 6 PRTF.
Patient would be able to discharge to a lower level of care while awaiting admission to a PRTF, although she does not have a current placement through the county.
Patient has had a previous inpatient hospitalizations, through UMMC for 38 days waiting for a placement through the county and
PrairieCare Inpatient Hospital 02/02/2025-03/17/2025. Patient was admitted to PrairieCare Residential 03/17/2025-03/20/2025 although was stepped back up to inpatient due to safety concerns.
She has a known history significant for MDD, GAD, and PTSD.

SEE UPDATES BELOW
Establish PRTF:
(eligibility form sent to AFMC on 3/26)
-Nexus East Bethel (referral sent & under review)
-Northwood (referral sent, pt’s mother revoked consent on 4/10 due to distance)
-Leo Hoffman (not viable option due to only male patients)
-Grafton (not viable option due to needing ASD, ID, or DD)

CH-F14-5404

Patient presents from group home. Patient is known to our ER and previously boarded 12/3/24-1/7/25. Patient presents after engaging in aggressive behavior that reportedly included verbal threats and chasing them with a shovel. She has had episodes of aggression with staff in the ER and has been targeting another patient that is boarding. The group home has provided a suspension of services and plans to submit a termination of services. County case worker has been making referrals and looking for crisis respite placement. She will likely need a home created for her.

MHF-F13-5407

Kiddo came to us on 3/17 from residing with aunt who adopted her, and aunt is refusing to let her return. She has previously been in PRTF and has a felony assault charge that she was deemed incompetent for via a rule 20. Due to that most placement options have declined her. She has a CMH CM and the County team is exploring getting MNchoices expedited to look at waiver placement options.