MHF-F15-3741

Came to our ED after physical altercation with another resident at Prairie Care Residential, can not return there. History of multiple inpatient admissions and PHP. Grandma is guardian and pt is unable to return there due to another child living there that pt can’t be placed with. CMH worker has made multiple RTC referrals and patient has been denied by almost all. Currently looking into a RTC out of state in TN, however this provider does not have a contract so would be a long time before this placement was obtained. Also looking at shelter options.

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.

PH-F14-3695

Update 4/23/24: Patient discharged from inpatient on 4/23/24. Patient scheduled to begin PrairieCare PHP on 4/24/24 while continuing to pursue Group Home placement as recommended by the county.

Patient is a 14-year-old female presenting to inpatient on 03/19/2024 from the ED due to running away from shelter placement. Patient has a history of participating in PHP two times, DBT, ongoing outpatient mental health services, and being in shelter placement.

Discharge Plan:
RTC:
-North Homes (on the wait list)

CD-RTC: Referrals submitted/considered for the following facilities:
-Hazelden (Pt’s insurance not accepted in Minnesota)
-Rogers (Declined due to elopement risk)
-M Health Fairview (Declined due to elopement risk)
-Anthony Louis Center (referral sent 03/27/24)

Group Home Placement (as recommended by JST/county):
-Little Sands (Referral submitted by CM; declined d/t LON)
-Village Ranch (Referral submitted by CM; reviewing 4/10; pending additional review on 4/17)
-North Homes (Pt is on the waitlist for RTC; pt is not eligible for their group home due to age)

Existing Outpatient Providers:
CHMCH: Hennepin County
Psychiatry: Nystrom & Associates

PH-F16-3669

Update 4/29/24: Patient discharged from Inpatient on 04/19/24 to wraparound outpatient mental health services while continuing to pursue RTC options.

Patient admitted to PrairieCare Inpatient Hospital 3/19/24 from the ED following increased thoughts of suicide with a plan. Pt has had previous IP stays at PrairieCare, Mayo Clinic, Riverside and Prairie St. John’s. Pt had a previous residential stay at Gerard. RTC has been pursued and funding has been approved through Dakota County although currently pt has been declined by viable in-state options. Level 6/PRTF programming is also being explored.

Referral is currently pending at Bar None Haven. Referral also made to Acadia to explore out of state options. Referral will be made to Nexus East Bethel PRTF as CMHCM is willing to help pt switch to straight MA if Nexus is able to accept. Patient is medically ready for discharge and is pursuing an interim plan of dcing home with wrap around services while awaiting placement.

RTC (CASII LEVEL 5) (funding approved, in QI process):
-Acadia (referral sent to explore out of state options)
-Avanti (declined)
-PCR (declined)
-North Homes (declined)
-Gerard (declined)
-Northwoods (waitlist 2+ years, so not a viable option)
-Newport (Insurance not accepted, so not a viable option)
-Nexus Mille Lacs (only accepts biologically male patients, so not a viable option)

PRTF/CASII LEVEL 6
-Bar None Haven (referral pending)
-Nexus East Bethel (referral to be sent, CMHCM able to help switch to straight MA if accepted)
-Grafton (requires ID dx)
-Leo Hoffman (only accepts biologically male patients)
-Northwoods (2+ year WL)

MHF-M11-3615

Came to ED 4/5 after some property destruction at family home. Previously in FV’s PHP program. Mom refusing to pick up and refusing family first services in home. County now has temporary custody for out of home placement, has not been in out of home placement previously. Ongoing CPS worker assigned 4/18 and is starting placement search.

MHF-M13-3518

Presented from foster care home after making threats to shoot foster parents and himself. History of PTSD, RAD, IQ of 62. Ongoing aggressive behaviors and impulsivity in the home. Foster parents do not feel safe with patient returning home and is in need of new long term placement. CM has explored Dragonfly, Newport academy, RSI, Genesis, Meridian, Beacon, Twin Ports, Pine City crisis, Northstar community respite. CM/guardian allowed our team to make Nexus YCT referral so intake with them for placement coordination is 4/17.

CH-M8-3464

Update 4.18.24 – on wait list for Northwoods, admission wouldn’t be until summer. Looking for a foster family until residential.
update 4/15/24: The patient is medically stable and has been doing very well here on the unit. Has not shown aggression towards others. One minor episode of head banging when frustrated. Medications are providing therapeutic benefit.

Patient with a past history of RAD, PTSD, ODD and questionable FASD that presented to the ER with foster parents of 4.5 months for concerns of aggression, suicidal ideation, and sexually inappropriate behaviors towards others and pets. He has been in several foster/kinship homes since age 5 with significant trauma prior to this including witnessing mom overdosing on several occasions, witnessing the overdose and death of housemate, sexual abuse by bio father, homelessness, sister attempting to suffocate and strangle him on multiple occasions, and physical abuse by caretakers. He was recently found on video touching the house dog sexually and physically inappropriate and has been threatening and pushing his foster mom. Foster providers are unable to accept him back in their home.

PH-M17-3527

Update 4/16/24: Patient discharged from inpatient on 4/16/24 to outpatient mental health services while awaiting admission to CD RTC.

4/3/24 Update: Waiting accepting CD RTC tx

Case Description: 17 y/o male w/ ASD, depression, polysubstance use, ADHD, presenting due to intrusive SI . Biologically, there is a genetic predisposition for depression, anxiety and substance abuse in the family. Patient recently underwent chemical dependency tx outpatient and was using concurrently.

Discharge Plan:
– Omegon Pathways (referral submitted)
– MHealth Fairview-MW (referral submitted; denied 3/27/24 due to ED/behavior concerns)
– Lakeside (referral submitted)
– CMHCM through Blue Earth

Current Providers:
– Individual Therapy ACFS (Adult, Child, & Family Services, LLC) – Mankato
– Depression and Teens Group (DAT) Weekly Group at ACFS (12 week program)
– Medication Management at Mankato Clinic
– Truancy Worker at Blue Earth County Community Corrections
– Primary Care at Mayo Clinic Health System – Eastridge

PH-M17-3533

4/10/24: Patient discharged from inpatient on 4/10/24 and admitted to Gerard RTC.

4/3/24 Update: Accepted at Gerard, parent and pt excited for Gerard RTC. However, pt’s parent not in agreement to VPA for the purpose of RTC funding, thus, missed admission. Parent working with county to make some edits on VPA and then pt will admit to Gerard RTC on 4/10/24.

Case Description: 17 y/o male w/ hx of MDD, GAD, ODD, PTSD, polysubstance abuse( in remission), multiple suicide attempts currently presenting due to SI w/ plan to hang self. Patient has been struggling w/ worsening symptoms of depression due to mothers upcoming death anniversary coming up.

Insurance is BCBS MN PMAP

Discharge Plan: RTC:
– Gerard (Referral submitted by IT, Tentative admit Weds 4/3 at 1300 pending county funding; 3.21.24 County funding approved but adoptive parent not in agreement to “sign custody to the county” for the purpose of RTC funding, thus, missed admission, next admission scheduled for 4/10/24)
– North Homes (Referral submitted by IT)
– Nexus Mille Lacs (Referral submitted)
– Village Ranch (Referral submitted)

Current Providers:
– Individual Therapy at Rooted Counseling in Moorhead
– Primary Care with Sanford Children’s Southwest Clinic
– Medication Management at Midwest Mental Health
– Group Home Case Management at Valley-Lake Boys Home
– Probation at Clay County
– Group Therapy through Valley-Lake Boys Home
– CMHCM at Clay County

PH-F12-3422

Update 4/15/24: Patient discharged from inpatient on 4/15/24 to home with outpatient services while awaiting level 6 RTC/PRTF placement.

Update 4/3/24: Bar None Haven (Referral submitted, Denied 3.22.24), Northwood Children’s (Referral submitted, On waitlist), Grafton (Referral submitted), Nexus East Bethel (Referral submitted). County also working on referral for MITH program (MN Intensive Therapeutic Homes). MN Choice Assessment done.

12-year-old female with DMDD and RAD presenting to PrairieCare Inpatient Hospital. Patient has had multiple psychiatric hospitalizations, 2 RTC placements and 2 JDC placements.

Discharge Plan:
Locked Level 6 RTC – Bar None Haven (Referral submitted)

Current Providers:
CMCHM at Beltrami County
Individual Therapy
Medication Management
Wavier Case Management Services through Beltrami County (In process)