Housing Referral & Discharge Housing Support

Purpose

Lighthouse Behavioral Health Center at 1723 Gwynns Falls Parkway (Gwynns Falls Wellness) recognizes that stable housing is a critical component of long-term recovery for individuals receiving treatment for substance use disorders. Individuals who complete residential treatment without stable housing may face increased risk of relapse, homelessness, hospitalization, or involvement with the criminal justice system.

The purpose of this policy is to establish procedures for identifying housing needs and facilitating referrals to appropriate housing resources during treatment and as part of the discharge planning process. This policy supports our commitment to helping residents transition from residential treatment to stable living environments that promote continued recovery and community reintegration.

Homelessness and Recovery

We recognize that housing instability is a critical barrier to health and recovery. Research shows that stable housing improves mental health outcomes, increases treatment adherence, and reduces hospitalizations.

"Without stable housing, people with mental illness or substance use disorders often cycle through hospitals, jails, and emergency rooms."

"Permanent supportive housing is associated with reductions in psychiatric symptoms and improved treatment adherence."

"Housing is a form of healthcare."

Scope

This policy applies to all residential treatment services at our Baltimore program, including services operating at ASAM Levels of Care 3.1, 3.3, and 3.5.

The policy applies to all clinical staff, program coordinators, counselors, case managers, discharge planners, and administrative staff responsible for coordinating services and supporting residents transitioning from residential care.

Policy Statement

Gwynns Falls Wellness provides residential treatment services but does not directly provide permanent housing. We recognize that housing stability is a key factor in maintaining recovery following residential treatment.

When a resident expresses a need for housing or when staff determine that housing instability may place the resident at risk after discharge, we will make reasonable efforts to assist the resident in identifying and accessing appropriate housing resources.

Housing referrals may include affiliated and non-affiliated housing providers, recovery housing programs, transitional housing, supportive housing, affordable housing programs, and emergency shelter resources.

Housing referrals are intended to promote continuity of care and support the resident's transition into stable living conditions that support long-term recovery.

Recovery Stability and Relapse Prevention

We recognize that housing instability is a significant risk factor for relapse among individuals recovering from substance use disorders. Individuals who leave residential treatment without stable housing may face increased exposure to environments that trigger substance use or interfere with recovery progress.

As part of relapse prevention and recovery planning, the program incorporates housing stability into treatment planning and discharge planning when appropriate. Staff will work with residents to identify living environments that support sobriety, safety, and continued engagement in recovery-oriented services.

This may include referrals to recovery housing environments, sober living residences, supportive housing programs, or other housing arrangements that promote stability and reduce the risk of relapse following treatment.

Identification of Housing Needs

Housing needs may be identified during several phases of the treatment process, including:

• admission assessments
• clinical evaluations and treatment planning
• case management sessions
• recovery planning discussions
• discharge planning meetings

During these interactions, staff will assess whether the resident has a safe and stable living environment available following discharge from residential treatment.

If housing instability is identified, staff shall document the housing need in the resident's treatment record and initiate the housing referral process described in this policy.

Housing Referral Process

When housing needs are identified, the Program Coordinator, Case Manager, or other designated clinical staff member will work collaboratively with the resident to identify appropriate housing resources.

The referral process may include:

• identifying housing programs appropriate for the resident's needs
• assisting residents in contacting housing providers
• assisting with completion of referral applications or required documentation
• coordinating intake appointments with housing providers
• providing information about housing eligibility requirements
• communicating with housing providers when authorized by the resident

The goal of the referral process is to assist residents in identifying housing environments that support recovery and stability following residential treatment.

Integration with Discharge Planning

Housing needs shall be addressed during discharge planning when stable housing is necessary to support the resident's recovery following completion of residential treatment.

During discharge planning, the Program Coordinator and the resident will review housing needs and identify potential housing resources.

When housing referrals are made, the discharge plan may include:

• recommended housing providers or programs
• contact information for housing resources
• referrals to transitional or supportive housing programs
• information regarding recovery housing or sober living options
• instructions for accessing emergency housing services if needed

Residents will receive housing referral information prior to discharge when housing needs have been identified.

How to Access Housing Referral Support

Residents participating in residential treatment at Gwynns Falls Wellness may request housing referral assistance through their assigned Program Coordinator, Counselor, Case Manager, or other designated clinical staff member.

Referring professionals, family members, or authorized representatives may also contact the program's administrative office to request assistance with housing referrals or community resource coordination.

Ask your counselor or case manager anytime you have questions about housing referral support—we are here to help you plan for a safe transition.

Documentation

All housing referrals and housing-related discharge planning activities shall be documented in the resident's clinical record.

Documentation may include:

• identification of housing needs
• housing options discussed with the resident
• referrals made to housing providers
• assistance provided in completing housing applications
• housing information included in the discharge plan

Documentation ensures continuity of care and demonstrates the program's efforts to assist residents in securing stable housing.

Limitations of Housing Referrals

We do not operate standalone housing programs and cannot guarantee placement in any housing program or facility.

Housing providers maintain independent eligibility requirements, admission criteria, and capacity limitations that determine whether an individual may receive housing services.

Referrals are intended to assist residents in accessing available community resources but do not guarantee housing placement.

Commitment to Recovery and Stability

Gwynns Falls Wellness is committed to assisting residents in identifying housing options that promote stability, safety, and long-term recovery. By integrating housing referrals into treatment planning and discharge planning, we seek to reduce relapse risk and support successful reintegration into the community following residential treatment.

Type of Housing

Our residential substance use disorder treatment programs include temporary residential housing provided to individuals during the course of treatment at ASAM Levels of Care 3.1, 3.3, and 3.5. The housing is integrated with the clinical services delivered by the program and provides a structured, supervised, and recovery-oriented living environment for residents while they are actively participating in residential treatment services.

The housing provided by the program is not intended to function as permanent housing and is available only for individuals who are admitted to and actively participating in the residential treatment program.

As part of treatment planning and discharge planning, we evaluate whether residents have a safe and stable community residence to which they can return following discharge. When a resident does not have an appropriate residence available or when housing instability is identified as a potential risk to recovery, the program may assist the resident by providing referrals to recovery housing, supportive housing, transitional housing, or other community-based housing resources.

Housing referrals are made only when an identified need exists and when the resident is not returning to their own stable community residence following discharge. Residents are not required to accept any particular housing referral and may choose housing options independently.

Residential properties associated with the program maintain applicable local housing approvals, such as rental housing licenses or other applicable housing certifications where required.