Transitions to Community Living

Transitions to Community Living (TCL) gives eligible adults living with serious mental illness or severe and persistent mental illness the opportunity to choose where they live and work.

The initiative connects people to wraparound mental health care and other services and supports that help them maintain a home in their own name, instead of living in a facility. Participants develop person-centered plans and are linked to mental and physical healthcare providers in the community to support whole-person care. TCL also helps individuals identify their interests and refers them to supported employment services. 

In North Carolina, Vaya Health manages the TCL program through its Care Management Department. Anyone, including providers, may refer an individual to the program.

Meet Sheron, Jonathan and Ronald by reading their stories. 

Individuals must meet all of the following criteria to be eligible for TCL. Participants must be: 

  • Diagnosed with a serious and persistent mental illness (SPMI) or a serious mental illness (SMI)
  • Being considered for admission to an adult care home (ACH) or family care home (FCH) OR being discharged from a state psychiatric facility into homelessness or unstable housing
  • An NC Medicaid beneficiary, eligible for Medicaid OR earning a monthly income of $2,000 or less
  • At least age 18 AND willing to accept a minimum of one tenancy support service per month

A new process is in place for referring individuals to TCL: the Referral Screening Verification Process, also known as RSVP. Referrals can be made three ways:

  1. Start the Referral Screening Verification Process (RSVP) online.
  2. Call Vaya’s Member & Recipient Services Line at 1-800-962-9003 to make an RSVP referral.
  3. Request a paper referral form by calling our Member & Recipient Services Line at 1-800-962-9003.

Learn more about TCL in our region by calling 1-800-962-8003 or sending an email to