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.
Recommended Service: PRTF
PRTF facilities provide intensive psychiatric care in a residential setting for individuals, often children and adolescents, with severe mental health issues.
MFIUP-F13-5535
Pt presented to the FV Riverside ED on 3/17/25 from school for agitation and aggression in the context of being questioned by school security about misusing her medications (which was reported to school by her guardian). She has remained in the ED boarding awaiting placement at a residential facility as guardian/aunt has not felt safe to have her return home. In the ED, she has had multiple behavioral codes, has been aggressive to staff, and has self injured. Given her out of control behaviors and the ED’s inability to manage her, she was admitted to UMMC unit 7ITC on 4/11/25 as a boarder while she awaits placement. Significant symptoms on the initial presentation include irritability, aggression, out of control behaviors, impulsivity, and SIB. Was previously admitted to Nexus-East Bethel but assaulted staff so unable to return.
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.
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)
MHF-F13-5435
Youth came to our ED 3/24 after altercation at home with Mom. Mom is refusing to pick her up. Has briefly boarded with us twice in the recent past, discharged home both times with WARM and FRSS services. Has contracted CMH CM. Mom is wanting RTC or PRTF. Reportedly County is working on switching her to operated CM to potentially access the screening team and those services.
MCR-F8-5371
This 8 year old has been in two foster homes (skilled) that have been unable to keep her safe; no other foster homes available. Getting updated DA today. Has a YBH worker since 2022, in-home family therapy with family, in-home CTSS skills, individual therapy, medication management, partial hospitalization at PrairieCare Feb 2023 and March 2024, hospitalization Jan 2023; Level 3 at school.
Complex trauma (sex abuse, poor attachment, placement / moves); ongoing CPS case with pending charges. Parenting assessment indicates to cease parenting time
CH-M15-5352
Patient presented via law enforcement after jumping in front of a vehicle in an attempt to end his life with additional thoughts to jump off of the bridge he was standing on until law enforcement intervened. Patient reports a 3 year history of auditory hallucinations that tell him to harm himself or others which occurs when he is alone or stressed. (hallucinations appear consistent with audible thoughts). This is his 4th inpatient hospitalization for suicide attempts and he has had multiple ER visits. While here, he attempted to assault a younger peer and was assaulted by a different patient. He was placed in the BICU where he has attempted to “snap” his neck on multiple occasions, head bangs, ingested hygiene supplies x1, and tied towel around his neck x1. Suicidal thoughts are perseverative when they occur and can be difficult to redirect.
PH-F15-5177
Patient is currently inpatient and are unable to move further with discharge planning due to not having a County of Financial Responsibility. Stearns County and Wadena County have both been consulted and neither have accepted responsibility at this time.
Discharge Plan:
Establish PRTF; referral made to Nexus East Bethel, INTAKE SCHEDULED 3/3/25
Establish Level 6 Program; referral made to Bar None Haven
Establish County Support/Funding; assigned for CMHCM at VOA
Continue with established outpatient providers:
-PCP: Lakewood Health System
-MM: Lakewood Health System
-Therapy: Lakewood Health System
CH-F11-5026
Pt presented from home, adopted parents, for aggressive behaviors. Third ER visit this month, unable to take pt back home due to frequency and intensity of behaviors as well as 4 other children in the home. Pt initially recommended IP hospitalization, however unable to find placement due to acuity, no beds, or declined due to IQ (56) and inability to participate in programming. Medications adjusted in ER. No violence since medication increase. Family/CADI worker have been looking for more support for several years and pt seems to fall through the cracks due to IQ and aggression.
CH-F14-4594
Patient presented to the Emergency Trauma Center at St. Cloud Hosptial with aunt. Patient presented after being on run from NW Passages in Wisconsin. During times of elopement, patient is known to spend time at the home of a person known for drugs and trafficking. Patient has a county mental health case manager that is working to make referrals for appropriate levels of care. Patient has a history of aggression towards their aunt. Patient does not have any contact with biological father as he is incarcerated and limited contact with biological mother. Parental rights have not been terminated, but patient’s aunt has physical and legal custody. Patient is very vulnerable and has no insight into the unsafe nature of his behaviors.
MFIUP-M17-5076
Brought to ED for abnormal and erratic behaviors. Pt barricaded himself in his room with a knife and refused to come out. Previously diagnosed with acute psychosis who presents with aggression, psychosis, and mania under unclear context. His UDS on admission was negative this hospitalization. He was previously prescribed antipsychotic medications but not prescribed any medications on discharge from IMPH after his hospitalization in 08/2024 under similar circumstances. This is his third psychiatric hospitalization this year (PrairieCare, CABHH in Wilmar). Patient has not been going to school. Current civil commitment. Has not been fully complying with treatment.