Behavioral Health Bridge Housing (BHBH) Program Referral Form

Please note that intakes are reviewed during business hours Monday through Friday from 9-5pm. The BHBH team will respond to each referral within 1-3 business days.

The BHBH program provides funding to address the immediate and sustainable housing needs of people who are or will be imminently experiencing homelessness who have behavioral health conditions, including a mental illness and/or substance use disorder (SUD), that are causing impairment.

Please use this secure, HIPAA compliant form to refer an individual to the Behavioral Health Bridge Housing (BHBH) Program to obtain one or more of the following services. Questions? Email HHS.BHBH@marincounty.gov

440 Arrowood Transitional Housing Program (up to 12 months) in Santa Rosa, CA
- As of 3/24/2026 Arrowood is at full capacity and has a waitlist. If you are interested in Arrowood, please note that you will be notified of your placement on the waitlist.
Participant Assistance Funds are funds available to defray costs, address barriers and facilitate housing for BHBH participants.
These costs may include:

Identification & other vital documents (CDL, requesting birth certificate)
Housing application and holding fees
Credit reports
Up to one month of back rent if facing imminent eviction
Court or filing fees to apply to expunge criminal records that prevent housing or employment access when other resources are not available
Transportation, food, hygiene, and cleaning supplies if no other resources are available
Storage unit for up to 90 days if need for storage is a significant barrier to accessing housing
Pet support, if meeting pet needs is required for accessing housing
Move-In supports & moderate furnishings

Landlord Incentive Funds are housing-related expenses for a BHBH participant such as housing applications, security and pet deposits, and holding fees.
Landlord Loss Mitigation Funds are used for to defray damage to leased units outside normal wear and tear, vacancy payments and eviction prevention costs for BHBH participants placed in housing through the BHBH program.
Motel Funds are funds for brief motel stays intended to provide safe shelter for BHBH participants transitioning out of homelessness and into more stable housing opportunities, or prevent homelessness for BHBH participants at imminent risk of losing their housing
Sober Living Environment (SLE)/Recovery House Funds are funds available for BHBH participants who will be referred to a Sober Living Environment (SLE)/Recovery House stay to support the participant's recovery from alcohol/substance use.

Referral/Case Manager Information

Name of referring agency (program if BHRS client)*

Name of referring staff*

Email of referring staff*

example@example.com

Phone Number of referring staff*

Please enter a valid 10 digit phone number.Format: (000) 000-0000.

YesNo

Name of Case Manager

Email of Case Manager

example@example.com

Phone Number of Case Manager

Please enter a valid 10 digit phone number.Format: (000) 000-0000.

Eligibility for BHBH Program

An individual or family that lacks adequate nighttime residenceAn individual or family with a primary residence that is a public or private place not designed for or ordinarily used for habitationAn individual or family living in a shelterAn individual exiting an institution (including incarceration) into homelessnessAn individual or family who will imminently lose housing in next 30 daysUnaccompanied youth and homeless families and children and youth defined as homeless under other federal statutesIndividuals fleeing intimate partner violenceClient is not homelessUnknown

A client must be experiencing homelessness to qualify for the BHBH program. Please contact the BHBH Program for more information.

Mental Illness and/or Substance Use Disorder (SUD) with impairment

To be eligible for a BHBH Program-funded project, an individual must meet one of the following criteria:

The individual has one or more of the following:
1. Significant impairment, where “impairment” is defined as distress, disability, or dysfunction in social, occupational, or other important activities, including education and family relationships
2. A reasonable probability of significant deterioration in an important area of life functioning
3. A need for Specialty Mental Health Services, regardless of presence of impairment (for individuals under age 21)

AND

The individual’s condition, as defined in a, b, and/or c, is due to either of the following:
1. A diagnosed mental and/or substance-related or addictive disorder, according to the criteria of the current editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Statistical Classification of Diseases and Related Health Problems (ICD)
2. A suspected mental and/or substance-related or addictive disorder that has not yet been diagnosed

OR

The individual has at least one of the following:
1. At least one diagnosis from the current edition of the DSM for Substance-Related and Addictive Disorders, with the exception of Tobacco-Related Disorders and Non-Substance-Related Disorders
2. At least one suspected diagnosis from the current edition of the DSM for Substance-Related and Addictive Disorders, with the exception of Tobacco-Related Disorders and Non-Substance-Related Disorders

OR

The individual is a CARE Program participant, regardless of whether or not they meet the mental health or substance use criteria above

YesNoUnconfirmed diagnosis (Please contact BHRS Access Team 1-888-818-1115)Unknown (please contact HHS.BHBH@marincounty.gov for consultation)

YesNoUnconfirmed diagnosisUnknown

YesNoUnconfirmed diagnosis (Please contact BHRS Access Team 1-888-818-1115)Unknown

YesNoUnknown

Unconfirmed diagnosis (Please contact BHRS Access Team 1-888-818-1115)Unknown

440 Arrowood Transitional Housing Program (up to 12 months) in Santa Rosa, CAIndividual Transitional / Permanent Housing search and placement in Marin CountyParticipant Assistance FundsLandlord Incentive FundsLandlord Mitigation FundsMotel FundSober Living Environment (SLE)/Recovery House FundsRental Assistance, Housing Based Case Management

440 Arrowood Transitional Housing Program (up to 12 months) in Santa Rosa, CAParticipant Assistance FundsLandlord Incentive FundsLandlord Mitigation FundsMotel FundSober Living Environment (SLE)/Recovery House FundsRental AssistanceHousing Based Case Management

440 Arrowood Referral Documents

Please DOWNLOAD and complete these additional 440 Arrowood referral documents and upload the completed documents below.

File Upload

Client Name, Identifiers and Contact Information

Client Name*

First NameLast Name

Client Phone Number (if known)

Please enter a valid 10 digit phone number.Format: (000) 000-0000.

Client Email Address (if known)

example@example.com

YesNo

Date of Birth*

MonthDayYear

Birthdate not available.

Demographics (required for anonymous State reporting purposes only)

Race/Ethnicity*

Gender*

Sexual Orientation*

YesNoUnknown

Yes ( please visit https://www.marinbhrs.org/CARE for more information on how to connect to CARE.)NoUnknown

For potential CARE Court Clients, please visit: https://www.MarinBHRS.org/CARE

Additional Comments. Please use this space to indicate urgency of the referral, special circumstances, etc.