Patient is under guardianship of Scott County; most recently residing at JAF who is not allowing her back. Foster family cannot take back.
Risk Factor: Aggression (chronic/ongoing)
This term describes a pattern of repeated and persistent aggressive behaviors, such as chronic physical or verbal aggression.
EH8D-F15-4024
Pt is a 15 year old female with a history of unstable placements after having been removed from family care due to physical abuse. She has a history of irritability, impulsivity and mood instability which have led to outbursts, self-harm, aggression and property destruction. She was admitted to the hospital after being discharged from her residential treatment facility due to these behaviors. Patient is requesting medication management for the above listed symptoms while we work with her Hennepin County case manager on placement. She has not had any significant behavioral issues over the past 2 weeks while in the hospital.
PH-F16-438
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.
HCMCH-F14-3794
Update 5/15: Referral madeEmbark (out of state PRTF) and other 2 PRTF out-of-state referrals, as well as Bar None Haven.
The patient is 14 y/o female with a PMH dx to include DMDD,, ADHD, PTSD, and FASD. The patient has presented to ED for SI, attempts elopement and aggression. The patient has significant hx of MH IP hospital admissions. She was recently d/c Dungarvan after 2.5 years.
Hx of sexual abuse and neglect. She ward of the state. Her extensive trauma history and attachment issues, which hinder her ability to form relationships.
MHF-M14-3589
Pt came to ED after ongoing behavioral concerns at home with guardian/grandmother, physical and verbal aggression, and threats. Previously discharged from CADI GH for physical aggression, went to JDC for that but was released after a rule 20. Declined by North Homes, Northwoods, and CABHH. A CADI home in Duluth that may be an option.
CH-F16-3722
Patient has a history of DMDD, PTSD, ADHD, intellectual disability with FSIQ of 50, TBI, as well as seizures and psychogenic non epileptiform seizures who presents from group home where she has been aggressive and threatening to staff and other house mates. She attacked another resident there. This resident is pursuing legal charges. The patient continues to describe intent to harm other residents and staff if she goes back there, as she wants a different group home. The group home has given letter of termination and suspension. Hennepin County is patient’s guardian. County is looking into previous respite home she was at as an option, as she did really well there prior to coming to this group home 1 month ago. This same situation occurred with the same group home last fall where they terminated her and brought her to the ER.
CH-M12-3595
This patient is a 12 Y year-old male with a self-reported history of depression, anxiety, and ADHD who presented to the ER on 4/8/24 by EMS from his residential facility for assessment of suicidal ideation. He was a direct admit to residential from JDC where he was placed due to allegations of sexual offenses towards his 8 year old step-sister. He reports he has harmed his step-sister on multiple occasions and has been in 3 different JDC’s including Red Wing over the last year and reports he didn’t know doing those things were wrong until now. He also reports a history of defending himself against bullies as well as head butting a female staff in the chin while in juvenile detention. He has had “13 or maybe less” attempts to harm himself or end his life and has been hospitalized psychiatrically x2. He reports he has attempted to wrap a scarf around his neck, tried drowning himself in the toilet while in a juvenile detention facility, and attempted to wrap the vacuum cord around his neck. More recently attempted to jump from a stair well, got out a window, and makes attempts to look for glass to harm himself. Residential is not willing to accept him back at this time.
CH-F16-3633
Patient presented to the ER with her mom for concerns of suicidal ideation though patient denies this. She has had several presentations to the ER due to aggressive behaviors and kicked out of group home for aggression towards peers and staff. She has been in and out of crisis centers and alternative housing verses being at home along with several inpatient hospitalizations.
**Full details of patient history is unknown to writer as I am not currently following her***
CH-F16-3629
Patient presented to the ER via law enforcement for aggressive behaviors at shelter care resulting in property destruction. Patient is not able to return to the shelter and does not have any safe disposition options.
CH-M13-3592
The patient is a 13 Y year-old male with a history of autism spectrum disorder, disruptive mood dysregulation disorder, ADHD, and depression who presented to the ER on 4/5/24 via EMS from his residential facility for assessment of aggression and suicidal ideation. He has a long history of aggressive behaviors that per chart review worsened around October, 2023 and he has not been able to be safely maintained in his home since that time. He has had several extended hospitalizations and since he was admitted to residential on 2/5 has had 41 incident reports related to attempts to harm himself and aggression when staff attempt to intervene. He has had increasing dysregulation resulting in an increase in restraints, length of time in restraints, and the amount of staff it requires to calm him resulting in the inability to return to residential. Home is not an option at this time.