Archives: Cases

Post Type Description

MHF-M10-3883

Update 5/23/24: Needs psycho-sexual eval, but there is no place to send him to have it done as it can’t be done in the hospital.
Pt was brought into ED on 5/11 by mother due to allegations of abuse. Mother resides in DV shelter and shelter is not allowing pt to return there due to pt behaviors (bangs his head, kicks walls, makes threats, aggression toward mother.) Mother is trying to find new housing so that pt can return to her. County referrals made to Northwoods, North Homes, Village Ranch and Mille Lacs Academy- programs thus far are months out. Barrier to many programs is pt age. County JST is meeting today at 10:30am to discuss further options. Planning to refer for Nexus YCT once discussed with all team members and ROI is received.

HCMCH-M16-3905

Update: O5/16, Central Pre-Admission denied the patient’s placement in CABHH, appealing this decision. Comprehensive Home Care (Respite Provider) accepted him moving date TBD.
Update: 5/15 referred to CABHH he previously denied on 3/29 along with residential and respite placement.
16 y/o M with hx of intellectual disability, poor distress tolerance, and maladaptive patterns to get needs met. Presents with chronic behavioral pattern of acting out to get needs met. Pervasive behavioral patterns in the community result in unsafe behaviors, high utilization of ERS, loss of placements, and exacerbating attachment struggles. He was d/c from respite placement through Twin Cities Home Care on 5/14 due to aggression and impulsive behaviors.

EH8D-F10-3962

Pt has been living in the Residential Services-Jewel Group home for over a year. They gave a 60 day termination of service due to their inability to manage her escalating behaviors (last day of services 6/25/24). They have 2:1 staffing for her. These behaviors include harm to self, or others, striking out, choking herself, throwing things and threatening to kill herself and others. She had been attending TSA day treatment until March after an altercation with a peer. She is currently at a 4th grade level and has an IEP. She was brought to the Welia Mora ED on 5/9 and 5/10 as well as Children’s ED on 5/14 looking for “other placement” and was discharged due to not meeting criteria for inpatient hospitalization.

PH-F17-3791

5/20/24: Patient discharged from inpatient and admitted to PCR.

5/8 update: Patient scheduled for admission to PrairieCare Residential on 5/20/24 at 10:00am.
5/6 update: Patient is currently awaiting an RTC bed through PrairieCare Residential in Maple Grove. Patient has been approved for 3rd pathway funding through Hennepin County. Due to patient behaviors seeming to increase, other options are being explored for aftercare as denials are a possibility. Parents do not feel safe with the patient coming home.

Discharge Plan:
Residential Treatment:
-PrairieCare Residential; intake 5/20/24 at 1000

Other RTC Referrals:
-Nexus Gerard; referral made
-North Homes; referral made, declined due to FAS and IQ
-Avanti Center for Girls; referral made, declined due to aggression and peer conflict

Outpatient Providers:
Establish CMHCM; opened with Soreya Jama through Hennepin County, 3rd pathway funding approved

Establish/Continue CTSS with Samira through Nexus FACTS
Continue Therapy with Mary Midler at Great Lakes Neurobehavioral Center in Edina (weekly)
Continue PCP with Dr. Megan Reilly at Partners in Pediatrics in Plymouth
Continue Psychiatry with Gerard Balan at Plymouth Psych Group
Continue IEP Case Management with Yvette Zeese at Wayzata High School
Continue Neurological Services with Dr. Catalfamo at Noral Neurological Clinic in Bloomington

ADMISSION NOTE: Patient was admitted due to acute safety concern and was unable to contract for safety at home. Pt was in PHP in the past and family was monitoring her 24/7 at home as instructed. Pt became irritated that she is constantly being watched and ended up having altercation with her mother because she was instructed by her mother to change outside of her bedroom because the mother was unable to see her. Pt ended up leaving and went to her grandmother’s house which is next door while mom followed her, pt went straight to the kitchen grabbed a knife and start threatening to stab herself. Mother was able to wrestle the knife out of her hands and called EMS. Pt has a history of depression, anxiety, epilepsy, and fetal alcohol syndrome.

PH-F14-3891

Update 5/23/24: Patient accepted to Heartland Girls Ranch with scheduled admission Wednesday 5/29 – county funding was approved.

Patient presents to inpatient from the ED due to an increase in SI. This is her third psychiatric inpatient hospitalization. She has done PHP twice and engaged in outpatient mental health services.

Discharge Plans –
RTC: (JST funding meeting on 5/17)
-Avanti Center for Girls (referral under review)
-Nexus Gerard (referral under secondary review)
-North Homes (pt is on waitlist – 4-6 weeks out)
-Village Ranch- Annandale (pt is on waitlist – end of June)
-Heartland Girls Ranch (referral under review)

Continue with established outpatient providers:
– Therapist: Mayo Clinic Health Systems Austin
– Family Therapist: Albert Lea
– Medication Management: Mayo Clinic Austin
– Case Management: Freeborn County
– Occupational Therapist: Mayo Clinic Rochester

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.

CH-F16-3194

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.

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-F14-3886

Came to ED on 5/09/24 via police after increase in suicidal ideation. Pt reports being bullied at her group home, was at Divine. Divine is not allowing pt to return. No physical aggression, continues to have suicidal ideation without attempts. County is working on Group Home placements- wait listed at North Crow, has explored shelters, foster cares- denied by those. Referral was made for MCCP crisis bed and working on hotel crisis respite referrals, as well as CRS homes.

MHF-F11-3813

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.