Altercation at CD treatment program, patient brought THC vape into the facility. He shared his vape a few days ago, and someone snitched on him. Pt reports he “blacked out” and doesn’t remember what happened next. He does know he threw a cup of cold tea at staff and then threw a rag and a reusable water bottle. Staff called 911. Pt denies making any suicidal statements. Pt reports he is on probation for assault and has been to juvenile detention twice. He reports he has assaulted a former foster parent and several facility staff. Pt reports he has been admitted several times and was at Gerard residential when he was eight. Pt reports he was last admitted July 2023. He was in juvie in Crookston and said he was suicidal, so he could get out of juvie.


11 year old presented to the ER for concerns of running away, recent sexual perpetration to 6 year old brother, and homicidal ideation towards current guardian who was released from residential treatment in the last 2 weeks after a 5 month admission. Active CPS investigation over the last 1.5 years and is unable to return to her mother’s care and was staying with her grandmother who she is threatening to stab to death if she returns. We are awaiting CPS recommendations.


Patient presented to the ED on 03/15/2024 after making suicidal statements while at school. Patient noted they have been being bullied, which contributed to the increased in suicidal ideation. Patient denied having a plan to complete suicide but was experiencing passive suicidal ideation and indicated that they would “probably do something with cutting.” The school contacted law enforcement and patient was transported to the ED for further mental health evaluation. Patient was unable to contrast for safety, resulting in them being transported via non-emergent transportation to PrairieCare for short-term stabilization.

Patient is under guardianship of Ottertail County at this time. Placement is being pursued by the county to either a Group Home or Foster Home.

Discharge Plan:
Continue care with existing outpatient providers:
-Individual therapy, PCP and Psychiatry at Behavioral Health in Badger, MN

Patient is medically ready for discharge and is awaiting placement in an appropriate group home/foster home, as identified by the county.


Under the guardianship tribal agency “prairie island indian community”; unsafe conditions at aunts house and aunt cannot continue kinship care; seeking alternative family placement; CPS from Hennepin county involved with concerns at aunts house


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.


2/29/24: Still inpatient. Children’s Mental Health Case Mgr assigned this week.
Update 2/8/24: Still in inpatient. Denied from Northwoods, Gerard, PrairieCare due to aggression and age. Denied from group homes as well. Exploring 2 family member possibilities. Trying to get a Case manager assigned. Anoka non secure 45-day assessment program could include a psycho-sexual assessment (? age requirements?).

Patient presented to the ED by mother’s boyfriend due to concerns of sexual abuse. History of physical and sexual abuse and recently has been perpetrating on his younger siblings and having increased behavioral concerns and aggression. Placed on a welfare hold for placement, court ordered to out of home placement. Has been denied by 7 foster homes, no shelters accepting patients his age. CPS currently has custody.


This patient presented to Ridgeview Medical Center via P.D. after running from his home. He was found in the woods nearby his home with a knife (patient has an ankle monitoring device). Patient reportedly desires out-of-home placement and verbalized plans to use the knife to harm kids who bully him at school. Patient has a significant history of running away from home with more than 30 reported incidents. Patient maintains a desire not to return home at this time. Carver Co. holds temporary decision making authority over patient, by court order.


Pt presents with behavioral escalations from out of home placement. Pt currently in hospital with no d/c plan at this time coordinated by county. Pt has a history of trauma and sexualized behaviors.


Update 2/22/224- Admission to Grafton tentatively scheduled 2/28/24, can discharge interim pending availability.
Update 2/15/24- waiting admission to Grafton end of Feb- date pending- can discharge home interim, pending availability.
Pt is medically cleared for discharge- parents informed county they need to pursue crisis respite for patient.

Discharge Plan:
Residential treatment referrals-
Grafton PRTF (Accepted, next opening tentative end of February)
Northwood Children’s (Referral not sent d/t insurance)
Nexus-East Bethel (Denied d/t not in 6th grade)
Nexus-Gerard (Denied d/t functioning for programming)
Avanti Center (Referral not sent d/t patient’s age)
VOA-Bar None (Referral not sent d/t patient’s age)
Heartland Girls’ Ranch (Referral not sent d/t patient’s age)
Nexus-Mille Lacs (Referral not sent d/t male only programming)
North Homes (Referral not sent d/t patient’s age)
Newport Academy (Referral not sent d/t patient’s age and insurance)
PrairieCare Residential (Referral not sent d/t insurance)
Village Ranch (Referral not sent d/t patient’s age)
Northwest Passage (Referral not sent d/t patient’s age)
Dakota Boys & Girls Ranch (Referral not sent d/t not ND resident)
Rogers Behavioral Health (Referral not sent d/t insurance)

Plan to bridge until residential availability:
Cradle of Love (Accepted, pending county funding)
Northwood Children’s Shelter (CM placing referral)
Kindred Care (CM placing referral)
MCCP Crisis Respite (CADI CM placing referral)
Trauma focused/attachment therapy (Referrals to be placed by CM)

Continue with established outpatient providers:
Ramsey County CADI- (Shakir Consulting Services)
Ramsey County CMHCM- B
PCP- (Entira Vadnais Heights)
OT- Fairview
CTSS- (Nystrom & Associates)
PCA/companion care 3x/week


**For follow up please contact Stacy Stickney-Ferguson, HCMC pediatric social worker at 612-873-2259 or email stacy.stickneyferguson@hcmed.org

Brought in my EMS after being kicked out of the Bridge for Youth shelter- tripped over 4-foot fence and broke right ankle while eloping. Has been staying with friends. Grandmother is guardian and lives in North Carolina. Returned to MN in Foster Care in December of 2023. Has a case manager through Brown County, Denise Kamm (507-276-3411). Denise reports patient has run away from multiple group homes, foster homes, and shelters. Denise the CM saying she has exhausted resources, places, and shelters for this patient. Denise says trying to find a shelter but likely not going to be able.

Currently in the HCMC Emergency Department but is pending admission up to our pediatric floor for boarding until placement can be determined. Please see above contact information for follow up. Has a broken ankle that is splinted and in a stirrup brace, she will have crutches on discharge. No pertinent medical history noted. High elopement risk.