Pt is adopted, Pts parents signed a voluntary out of home agreement with Rice County, Pt has not been home in approximately 3yrs. Numerous failed placements due to aggression. There has been zero movement in regard to placement options. Patient is very aggressive and has been so on the psychiatric unit. Pt presents with all the symptoms of RAD
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-F16-4834
Kiddo came to us on 11/7 from East Bethel PRTF. East Bethel has discharged reporting they are unable to meet his needs based on his ongoing SI and behaviors. They are completing a referral to CABHH. Has a long history of SI. There is currently no County involvement. Aunt is working on setting up CMH services, but County has reported they don’t have any placement options. Our team will be requesting County look at approval for out of state options once they are open due to limited options in MN for this level of care.
EHS-F16-4792
Patient is a 16-year-old girl with history of mental illness who was brought to the emergency department from port group home where she has been residing for about 5 days. Patient states that she was in juvenile detention immediately prior to going to the group home. Patient has been prescribed psychotropic medicines in the past, but is not currently using any medications. Recommendation from probation officer and county social worker is juvenile detention center or psychiatric inpatient hospitalization pending long term psych placement. However, LE states they can’t bring her to JDC as she has no charges that would make that appropriate at this time without order from probation. Pt has been aggressive, verbally and physically while in the ED. She has eloped on multiple occasions and has attempted to harm herself.
PH-F8-4701
Recommendation is for QRTP or PRTF – either could potentially meet the needs of this patient and limited treatment centers available due to patient’s age. Patient is currently in psychiatric inpatient hospitalization.
Patient is an 8-year-old female. Patient presented to inpatient from the ED due to increase in unsafe and risk-taking behaviors. This is her fourth inpatient hospitalization; one in 2022 and three in 2024. Patient has attended day treatment twice and participated in outpatient psychotherapy and medication management.
Discharge Plan:
PRTF/QRTP: (county funding approved for QRTP)
– Grafton (declined due to not meeting criteria)
– Northwood (referrals submitted 9/9, on waitlist 9/23 – awaiting update on admission timelines)
– Gerard (unable to accept due to age)
– Avanti (unable to accept due to age)
– Bar None Haven (unable to accept due to age)
– North Homes (unable to accept due to age)
– Heartland Girls Ranch (unable to accept due to age
Continue with following outside providers:
– Therapy/Therapist: Solutions Behavioral Healthcare Professionals
– Primary Care Provider: Sanford Health
– Medication Management: Solutions Behavioral Healthcare Professionals
– Case Management: Solutions Behavioral Healthcare Professionals
– Occupational Therapy: Beyond Boundaries Therapy and Wellness
EH8D-M14-4364
This patient was brought to the hospital by police for aggression and dysregulation exhibited at the group home. He was charged with 5th degree assault after injuring staff members at his group home. His behavior has persisted despite medication adjustments and behavioral plans. He struggles in settings where there is too much sensory input and lack of structure. He has been destroying property and presenting with escalating aggressive, dangerous behaviors, homicidal threats and sexualized behaviors. Despite his impulsive behaviors and subsequent harm to staff members, he displays no remorse, though some question of whether he is able to adequately engage in reality testing possibly related to intellectual disability.
He is a ward of the state. He was placed in foster care at age 6 after suffering from neglect by his biological family. Their rights have been terminated.
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-F16-4545
Recommendation is now for level 6 PRTF. Patient is currently in psychiatric inpatient hospitalization.
Patient is a 16-year-old who identifies as non-binary using they/them. They presented to inpatient from ED due to increased SI. This is patient’s 14th psychiatric inpatient hospitalization. They have participated in outpatient services and PHP historically.
Patient was initially recommended for level 5 QRTP by inpatient providers although Dakota County recommended level 6 PRTF.
Discharge Plans:
PRTF (county determination/recommendation – DHS approved)
-Nexus East Bethel (referral submitted & under review)
-Grafton (not an option as they do not meet admission criteria)
-Northwood (referral submitted; two year waitlist)
RTC: (county declined funding for level 5 QRTP, recommended Level 6)
-Avanti (declined)
-Gerard (referral sent, unable to move forward due to lack of funding)
-North Homes (referral sent, unable to move forward due to lack of funding)
Established outpatient providers:
Individual Therapist: Your Vision
Psychiatrist: Associated Clinic of Psychology
PCP: Allina Healthcare
CMHCM: Dakota County
PO: Dakota County
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
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.
CH-M11-4450
Patient presented to the ER via law enforcement for homicidal ideation towards his foster family (maternal aunt) and biological brother and had threatened them with a knife. Was removed from his biological home in June due to neglect, abuse, domestic abuse, substance use in the home. Patient with dissociative episodes and resorting back to small child like behaviors.