MaiHeaven

Hospital discharge → supported housing: the referral workflow

A step-by-step way to refer a patient who is clinically ready but has nowhere safe to go. Mai Heaven is a supported-housing resource, not an emergency service.

For an immediate need, call or text 988 for a mental-health crisis, 911 for a medical emergency, or see the numbers for your state. This workflow is for referring someone into supported housing, not for tonight.

The workflow

  1. Confirm the fit
    Adults who need daily support but not 24-hour nursing; behaviorally stable; a history of refusals is welcome, not disqualifying.
  2. Gather what you have
    Face sheet, level-of-care determination, medication list, behavior support plan, guardianship, funding source. An incomplete referral is still a referral.
  3. Send the referral
    De-identified, no login, about a minute. Do not send clinical detail by email; we collect specifics through a secure channel.
  4. Get an answer in one business day
    Yes, no, or exactly what else we need — and the system escalates internally when that is missed.
  5. When a home opens, we coordinate
    A referral joins the waiting list today. When a home opens near you we coordinate admission, transport, and onboarding with you.

Tools

Send a referral (no login) · The packet for this role · Placement criteria · text this link: maiheaven.com/go/referral

Send a referral

One business day to an answer. It joins the waiting list and we follow up securely.

Refer someone

Other workflows: Shelter step-down → supported housing: the referral workflow · Probation & re-entry → supported housing: the referral workflow · Community & nonprofit workers → supported housing: the referral workflow

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