Patient presented via law enforcement to the St. Cloud ETC after eloping from mother’s home and found wandering on Highway 10. Initially aggressive/combative with law enforcement. Patient was cleared for discharge but refused to go with mom, because combative and required PRN to calm down. Was kept overnight. Patient’s mom refused to pick patient up once cleared for discharge due to his ongoing aggressive behaviors. CPS is involved and a new report was filed.
Police hold initiated 7/9/24 and CHIPs petition is being pursued. County CPS worker is seeking foster care placement.
Update (7/18)- Court hearing for CHIPs petition. County CPS case worker is continuing to look for foster care placement. Patient will have twice weekly phone calls with his mother.
Pt came to our ED via ambulance after running away from Avanti, because they planned to discharge her home to family where she did not want to go. Avanti will not take her back. She has been cooperative and has not had any behavioral incidents in the ED. She is at her baseline, which includes non-suicidal self injurious behavior. Has history of therapy, psych, PHP, IPMH, foster care. Going to a different family member for kinship placement is currently being discussed though pt is not agreeable at this time.
Came to Grand Itasca ED 7/8 after altercation at home where he damaged his room. Has also made threats to family members and gotten in altercations with siblings. Was also in ED 7/5 and 7/3 for altercations taking place at home/in the community. Has history of being abused. Just had a CMH CM assigned a few weeks ago. Hospital has made referral for MNchoices. CMH is looking at placements, options are limited due to age.
Adopted at birth with in utero meth exposure. Several inpatient, residential and outpatient avenues explored both instate and out of state. Patient is declined or asked to leave to due aggression to peers. Juvenile system has discharged back to mental health. Engages in self harm, significant aggression, stealing and fraud, fire setting, etc.
Update 6/26/24: Patient doing well and has made improvement with emotional dysregulation. No longer recommending PRTF level of care. Interview with Divine House occurred last week.
Update-5/30/24- Patient has had severe decompensation in part due to child protection concerns along with prolonged hospitalization and has been in the BICU for aggression, self harm, and seeking/securing items to self harm with. It is now recommended that she be placed in a PRTF.
11 year old presented to the ER after discharging from residential for concerns of running away, recent sexual perpetration to 6 year old brother, and homicidal ideation towards current guardian. Active CPS investigation over the last 1.5 years and is unable to return to her mother’s care or a home with younger children. This patient struggles with low insight, poor boundaries, antagonizing behavior, and justifies her behaviors. We attempted to obtain psychological testing though patient was not cooperative and refused. Medications are stable. She continues to display oppositional behaviors at times.
Patient is under guardianship of Scott County; most recently residing at JAF who is not allowing her back. Foster family cannot take back.
Update: Discharged to Aspen House but was having suicidal ideation so returned to ED 5/25. County working with Prairie Care Residential for potential placement.
Pt came to ED on 5/10 via foster care parent due to suicidal ideation. Foster parent refusing to take back due to these behaviors. Was previously in North Homes residential and was in inpatient with us from 2/5-2/13. County reports they are exploring residential and PRTF, waiting for DA to come back with recommendation. Completing referral for Nexus YCT. Pt’s mental health is being negatively impacted by boarding, she has been continuously sobbing in our ED about being here.
Patient admitted directly to CRTC on 6/8/23 directly from PrairieCare Inpatient.
Patient had been hospitalized in the Inpatient setting numerous times, she was at PrairieCare Residential 12/19/22-2/22/23 and stepped up to Inpatient for stabilization. PrairieCare Residential is unable to have her return due to their staffing and current milieu. Please note aggressive behaviors have significantly decreased and have not been present in the past month. UPDATE: Accepted to CRTC, waitlist 5-7 weeks- any available bridging shelters/group homes?
Discharge Plan:
Referred to-
RTC:
-PrairieCare Residential (Re-admission declined on 4/11 due to milieu/staffing concerns)
-Grafton (Not currently accepting patients over age 14)
-Northwest Passage (Does not accept MN MA; Referral declined due to IQ)
-Avanti (Declined due to aggression 12/22; SW to re-refer)
-Gerard (Referral submitted 4/26)
-North Homes (Declined from RTC 11/22 due to IQ)
-CRTC (Referral submitted on 4/14; additional clinical sent 4/25, accepted for admission 5/9; estimated waitlist 5-7 weeks)
-Bar None, Shelter Plus Program (Preliminary Hub referral made, awaiting return message; SW to re-refer for interim placement while awaiting admission to CRTC)
-Refer to Treatment Placement Specialist at Acadia Healthcare for consideration of out-of-state RTC’s
-Consider referral to CIBS program at Avanti (Anoka County unable to fund – no contract)
-Consider referral to CIBS program at Nexus-FACTS (Anoka County unable to fund – no contract)
Group Home:
-PrairieLakes Haven House Group Home (waitlist 2 months)
-Port Group Home (waitlist 2 months)
Therapeutic/Corporate Foster Care:
-Solutions Behavioral Healthcare (Awaiting return call)
Estimated length of stay:
To be determined pending formulation & confirmation of alternative discharge plan
Was initially accepted by CRTC but couldn’t take due to her Casii level of 5.
Update 5/16/24: Still on Empath. Cancelled follow up visit/pursuit of ChildServe due to county not being able to provide out of state funding. Starting over with contacting facilities in MN. Enriched living extensive waitlist, Beacon sent referral for long term crisis placement, Dragon fly still reviewing, JD homes reviewing, REM reviewing.
Update 5/9/24: Still on Empath unit. Being reviewed by ChildServe for potential placement out of state. County also pursuing waiver for adult group home.
Update 4/15/24: Still on the Empath unit and continues to do well. MN Choice Assessment completed last week. Referral made to ChildServe in Iowa.
Update 3/21/24: Still on Empath unit, doing well. Stearns county has guardianship, still working on CADI waiver. Referral made to Dragonfly.
Update:3/7/24: On Empath unit, used for assessments and stabilization. 48 hour stay. Doesn’t need hospital. Needs to be assigned a social worker. On a chips hold. Going to need a CADI waiver.
Patient is diagnosed with Soto’s syndrome and is non-verbal with significant developmental delay and suspected cognitive functioning of a toddler. Dad dropped her off at the ER with reports that he is not willing to bring her back home as he and mom are aging and are unable to manage her any longer as they have other disabled children in the home and mom has health issues. Patient has a chronic history of slapping herself, biting herself and others, and pulling hair. Patient is incontinent of bowel and bladder and requires significant assistance with ADL’s including toileting, bathing, dressing, and eating. Family currently has no supportive services in place with the exception of psychiatry. CPS report was filed with court scheduled Monday morning. Not aggressive or violent since in ER. Compliant. 1:1 since she’s on an adult unit.
Patient came to the ED on 5/4 after running away from her foster care. Patient reports she does not want to return to that foster care. County is guardian and CPS/ICWA worker is exploring shelters, denied from Dignity House and Passageways, still waiting to hear from Brittney’s Place. Elopement is main behavioral concern currently, pt did not like the foster care she was in. Not suicidal or violent according to foster parent.
