Hospital Discharge Follow up
Visits
Up to three In-Home visits by a Masters
Level Clinician to review established
hospital dc plan, determine improve
compliance with treatment follow up.
Identification of barriers to the client
remaining in the community.
Family support and intervention to follow
the dc plan.
Assessment of psychosocial needs and
referrals.
Visits occur over a one month period
of time.
Duration of visits 30-60 minutes.
Letters sent to clients difficult
to track (i.e. homeless clients)
