This is a single-arm pilot study to test the feasibility of homelessness prevention and substance use interventions to be delivered to at-risk patients in the Bellevue Hospital emergency department (ED). ED patients (n=40) found eligible for the study will complete a baseline assessment and receive referrals to appropriate services, with a final six-month follow-up assessment.

ED patients found eligible for the study will complete a baseline survey and receive one-time, in person services at the time of the baseline/enrollment ED visit including referrals to homelessness prevention and substance use services, with a final six-month follow-up survey. Interim contacts at 7-10 days, 3 months, and 5 months will be used to assure intervention components were received and to confirm participant contact information.

Inclusion Criteria:

• Be a patient in the Bellevue Hospital Center ED.
• Be ≥18 years old.
• Screen positive for homelessness risk using a homelessness risk screening tool (HRST).
• Screen positive for unhealthy alcohol or drug use.
• Able to provide consent.

Exclusion Criteria:

• Medically (e.g., critically ill) or psychiatrically unstable.
• Unable to provide informed consent for other reason (e.g., cognitive deficit, profound intoxication).
• Incarcerated or in police custody.
• Unable to understand and speak English.
• Lives outside NYC and/or cannot give a NYC ZIP code.
• Already homeless (residing in a shelter or on the streets).
• Does not have a telephone where can be reached for follow-up.
• Has already received specialized peer navigator/addiction social worker services during current ED visit.
• Has already participated in the study.

6 months