depression, dissociation, SIB, Ids as female. County is not involved. Health Partners is payor.
Recommended Service: PRTF
PRTF facilities provide intensive psychiatric care in a residential setting for individuals, often children and adolescents, with severe mental health issues.
RMC-F17-2074
History of suicide attempts and self-harm, verbal and physical agression, DD, FAS, ADHD, identifies as non-binary
MCR-F12-1396
Update on 8/17/23 – still waiting placement, relocated to peds area, not admitted, still an ED patient.
Patient is ward of state with guardianship by Otter Tail County. On a stay of commitment. Terrible trauma history and aggression – toward inanimate objects, but occ if staff gets close, she will be aggressive toward a person. Multiple hospitalizations/boarding situations, multiple (5-6) PRTF placements and failures, including an out of state facility that was suddenly shut down. Was in Rochester for hotel with respite, but they brought her in after less than a week due to behaviors. Struggles to regulate when frustrated.
MHF-F10-1695
UPDATE 9/14/23: Intake date at Gerard next week.
Patient is presenting to the ED for the following concerns: suicidal ideation, verbal agitation. Per Hennepin County workers, patient had been in inpatient at Prairie Care since June due to behaviors and suicidal ideation. Patient was abruptly discharged because she was not safe, and spending a lot of time in seclusion. Patient was to be transported to her grandmother’s home but ran away, and into traffic. Patient reports that she will kill herself and her grandmother if she is to live there. Patient would like to live with her mother, but is unable to due to a court order. Patient has a history of trauma, has witnessed parental domestic violence, and parental substance abuse.
Patient has a bed at Gerard for residential treatment, but not until 9/18.
MCR-M14-1389
UPDATE: 9/7/23 – discharged to AMAS Inc (CADI group home)
UPDATE: 8/31/23 – Care conf tomorrow. Accepted by Sunset House, having zoom meeting with patient today to get to know him better before transition- waiting on them to get licensing.
UPDATE: 8/17/23 – Still in ED. Not able to go to Mille Lacs due to non-participation. There is a CADI group home willing to take him, working on licensing.
UPDATE 7/27 – had a video interview with Nexus Mille Lacs on 7/26, awaiting updates.
Previously MCR 1086: Discharged 6/15/23 to VonWald, returned ED 6/30. 14 year old with significant trauma history, ward of Hennepin County, recent placement at his request with young adult brother that was disrupted due to conflict. Briefly placed at Von Wald shelter but repeatedly eloped in an effort to reunite with his brother, and was brought to the ED. Calm overall except when relocated to a unit that required observation while in the restroom, then repeatedly escalated with verbal threats, closing himself in the bathroom, and hitting the walls. Had an interview with Nexus Mille Lacs on 7/26/23. He is familiar with Nexus Gerard and would feel comfortable there.
PH-F16-1316
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.
CH-M8-1340
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.
MCR-F15-1269
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.
MCR-M10-1427
History of DMDD and ODD with worsening of extreme violent outbursts since March without known trigger or stressor. Kicked out of PHP due to aggression, sent to SERCC and brought here from SERCC after an aggressive event. Family concerned about home safety.
EH8D-M15-414
15 year old male with a history of ASD, ADHD, trauma, and multiple prior psychiatric hospitalizations and residential placements. He was admitted to the hospital after becoming aggressive and self-injurious while at crisis stabilization home. Patient has a history of making significant threats of violence and has been repeatedly sexually inappropriate. He was removed from his home after having molested a younger cousin. Patient will, at times, express remorse for his behaviors while at other times appearing grandiose and narcissistic, with violence perpetrated in response to narcissistic injury.