Magellan Health Services, Inc. 2 . Offer in-depth review of the 5 criteria of discharge planning .. Sample Discharge Plans .. Mental / Behavioral Health. 20 e. Review process. 21 f. Discharge planning. 22. 5. Summary. 24. Appendices. Appendix 1. Sample Individual Care Plan Template. 25. (For use at hospital). The discharge planning process begins at the time the child/adolescent is admitted to Laurel Heights. At admission or shortly thereafter, we establish a . In addition, the state's Baker Act also has the following discharge planning . be seen in local community mental health for med management? .. For example,. psychiatric disorders leave hospital they receive adequate treatment and care in the .. Discharge planning must incorporate mental health services that are currently safe for all ... Two examples of checklists are attached as Appendix 3. Past Psychiatric History (Mental Health and Chemical Dependency): . SAMPLE TREATMENT PLAN TEMPLATE. Patient's name: . Date of Discharge: .