PH-F16-4123

Recommendation is for level 6 RTC/PRTF – patient is currently inpatient.
16-year-old Female from RTC level 5. Patient admitted to inpatient after struggling with self-regulation shortly after arriving to RTC. Patient has had several other inpatient hospitalizations and has admitted to RTC twice, discharging both times to inpatient. In alignment with CMHCM, seeking RTC level of care. At this time pt is under temporary guardianship of the county. Referrals have been sent to Nexus East Bethel, Bar None Haven, and PrairieCare.
Patient insured by Medicaid.
Pt has the following outpatient supports:
County guardian/CPS worker
CMHCM
Guardian ad Litem

CH-M10-4290

Patient presented via law enforcement to the St. Cloud ETC after eloping from mother’s home and found wandering on Highway 10. Initially aggressive/combative with law enforcement. Patient was cleared for discharge but refused to go with mom, because combative and required PRN to calm down. Was kept overnight. Patient’s mom refused to pick patient up once cleared for discharge due to his ongoing aggressive behaviors. CPS is involved and a new report was filed.

Police hold initiated 7/9/24 and CHIPs petition is being pursued. County CPS worker is seeking foster care placement.

Update (7/18)- Court hearing for CHIPs petition. County CPS case worker is continuing to look for foster care placement. Patient will have twice weekly phone calls with his mother.

MHF-F13-4407

Patient came to ED on 7/19 from Nexus East Bethel PRTF after swallowing a foreign object. Was in our inpatient unit from 7/15-7/19 and discharged for only hours before returning. Reports that repeat behavior was pt seeking to be removed from program. Nexus PRTF is not accepting pt back at this time and Mom is unable to have pt return home. Sending referral to Nexus YCT to assist with placement.

MHF-F12-4412

Patient came to our ED on 7/22 after an altercation with mother and mother is refusing to pick pt up. Was previously in ED on 7/12 for same reason. Was reportedly discharged from Nexus East Bethel 7/12. Has been denied by Northwoods, Gerard. Was somewhat successful in the past with day treatment, CM is exploring day treatment options.

CH-M16-4217

Brought to ER after assaultive behavior towards group home staff. Since being in the ER, patient has denied SI/HI and been behaviorally regulated with the exception of one incident after being here for 6 days, and was asked to go to his room to avoid potential problems with other patient’s in the ER and he was upset and got restrained. He’s been up for discharge back to his group home since the day he presented to the ER. The county worker has been main contact with group home and are trying to problem solve ways to support patient at the group home. Ombudsmen involved.

Update 7/10 – patient remains boarded, now on EmPATH unit (observation unit/extension of ER) without aggression or behaviors. County guardian making referrals for placement options including respite, crisis, group home, shelter

RMC-M15-4330

On 7/8/24, patient was told he would be spending time with his mother, to which patient had a negative response, causing patient to assault his father and run away. Police located patient at a local middle school just before patient ran across a highway and had to be sedated by EMS due to safety concerns.

Pt has dx that include: reactive attachment d.o., disruptive mood dysregulation disorder, PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections), ADHD, ODD, OCD, pervasive social communication d.o., with low non-verbal skills, high verbal skills, low memory skills, and average IQ.

CH-M11-4380

Patient endorses homicidal ideation towards his sibling. Increasing behaviors at home. PHP (Clara’s House) attempted and will be discharged with recommendation of high level of care (residential). Patient has significant trauma after extensive physical abuse from biological mother and likely operates at a much younger age. Patient was removed from his mother’s custody by Ramsey County CPS in May 2024. Aunt is foster care provider.

MHF-F17-4377

Pt came to our ED via ambulance after running away from Avanti, because they planned to discharge her home to family where she did not want to go. Avanti will not take her back. She has been cooperative and has not had any behavioral incidents in the ED. She is at her baseline, which includes non-suicidal self injurious behavior. Has history of therapy, psych, PHP, IPMH, foster care. Going to a different family member for kinship placement is currently being discussed though pt is not agreeable at this time.

AH-M15-4368

Under Hennepin County custody. Came to the hospital after assaulting a peer and staff at crisis respite. Has been in multiple placements (residential, group homes, foster care and shelters) and has been terminated from them due to aggression. There were concerns for psychosis prior to admission but symptoms have stabilized with medication.

MHF-M15-4172

Pt came to ED from North Homes, after increase in physical/verbal aggression and 30 day notice was given and lapsed without another placement found. Was boarding in our ED in Nov 2023 prior to admit to North Homes. Planning to connect with parent/County about re-involving Nexus YCT. Some sexual inappropriate behavior making him difficult to place.