Risk Factor: Aggression (chronic/ongoing)

This term describes a pattern of repeated and persistent aggressive behaviors, such as chronic physical or verbal aggression.

MHF-M18-6827

Came into our ED on 5/14 from his CRS home, they issued a suspension and termination notice. He had 3:1 staffing at the home. Needing a home for him. Referrals have been made to MCCP and MSOCS, has DD waiver and Case Manager. Guardian is his father.

MHF-M15-6824

Youth came into our ED 5/8. Has been to our ED many times in the past, coming in almost weekly. Dad frequently brings him in as he feels overwhelmed by kiddos needs. Pt has behavioral concerns of elopement and some aggression. Has intellectual disability though it seems IQ testing has not been completed since he was 5, is mostly non-verbal. CPS is petitioning for custody. DD waiver is being opened, and crisis respite options are being explored. Reported that he is a “2 county kid” with both Ramsey and Hennepin involvement. Has a referral in for stabilization center however its unknown how long that list is or if he will be accepted.

MHF-M8-6816

Youth came into our ED on 5/5 after seriously injuring another child. Parents are refusing to allow him to return. He is being screened via JST today to determine if County approves RTC level of care. On wait list for crisis stabilization but unsure how long that is or if he will be accepted. MNchoices is taking place on Friday for waiver.

MHF-F17-6780

Youth came into our ED 5/5. This is her 3rd time boarding with us in 3 weeks. She discharged to Dignity House and Aspen House the last times and is needing placement again as she can’t return to either. (Eloped from Dignity and got into an altercation at Aspen. ) Looking for waiver or treatment placement, but has been denied from many options.

MHF-F11-6771

Youth came to our ED in a smaller town on 4/27/26. Was in a pre-adoptive home who is refusing to allow her to return, was at RTC prior to that. Struggling to identify placement options due to age, IQ, and history of behaviors. County is currently exploring all options for her- PRTF, QRTP, Group Homes, DD waiver placements- Crisis and CRS, shelters, and fosters.

MHF-F18-6762

Pt came to us 4/23. Was residing with adoptive parent who is refusing to let her return. Pt turned 18 days before coming to us and is currently her own guardian, hearing for guardianship 4/30, will be a professional guardian agency. Adoptive Mom got custody in July 2025, waited 8 months for the MNchoices, done in Feb, and has since been waiting over 2 months for SMRT in order to get waiver. DD Case Manager (non-waiver) was just assigned 2 weeks ago. We were able to expedite SMRT due to being in the hospital and she is now certified as of 4/30, so moving forward with waiver. Looking for waiver placement, immediate and long term for this individual, perhaps a transition age program. Pt is vulnerable so typically shelters would not be an option. Still in High School currently.

MHF-F16-6757

Youth came to our ED 4/24 from a foster home that is refusing to let her return. Reported she has recently boarded in multiple other hospitals. County is currently seeking group home placement, in both therapeutic group home settings and CRS and crisis respite settings via the waiver. The last DA done earlier this month has a recommendation for OP services which the team does not agree with so they are also seeking an assessment program to determine appropriate level of care, North Homes denied, waiting to hear on Gerards assessment program.

CH8SCH-M12-6473

Patient presented to the ER 1/21. Patient is familiar to us. Patient has a complex psychosocial history with prior CPS involvement and a chaotic home environment. Patient typically does well in the ER & hospital setting but struggles at home with severe aggression and behavioral dysregulation in relation to conflict with parents. Patient does not appear to comprehend the severity of his actions and feels like his actions are justified (which appears to be related to his level of functioning). Patient likely needs a crisis respite placement/group home placement, but his CADI waiver and insurance are on hold while transferring to Benton County.

Doing very well for the most part at CentraCare.

PH-M10-6705

Recommending PRTF/RTC
10-year-old male who presents to PrairieCare Inpatient Hospital after an episode of behavioral escalation at home.
This is his 2nd psychiatric inpatient hospitalization and had been engaging in outpatient therapy services.
Funding is in place for QRTP with Mower County

Discharge Plan as of 04/20/2026:
RTC/QRTP: (Funding approved 2/17)
– Gerard (Declined due to safety concerns, recommending Bar None Haven or PRTF level of care)
– PrairieCare Residential (Declined due to acuity)
– Northwoods (one year WL, not viable immediate option)
– Bar None Haven (Declined due to safety concerns)
– Nexus Mille Lacs (Declined due to safety concerns)
-Avanti (unable to refer d/t gender criteria)
-North Homes (unable to refer d/t age)
-Newport (unable to refer d/t insurance)

PRTF:
– Grafton (Declined due to request for further diagnostic clarity)
– Nexus East Bethel (reviewing)
-Leo Hoffman (unable to refer d/t age)
-Northwoods (one year WL, not viable immediate option)

Interim Plan:
Establish Psychological Testing
-Sagent Behavioral Health in Rochester
-Southern MN Psychological Services
Establish Occupational Therapy with School
Establish CTSS
-Fernbrook
-Independent Management Services
-Cedar House

Continue with following outpatient providers:
– Medication Management at Olmstead County Medical Center
– CMHCM with Mower County

MHF-F17-6700

Youth came to our ED on 4/9 after being on the run for 3 weeks. Has a long history of elopement and some aggression as well. Is open with CPS, ACT team, and DD waiver, and there is a VPA for placement currently. County team is looking at all placement options- all waiver options, RTC, out of state. Has been denied many places already primarily due to the elopement behaviors.