Residential Services

TLS provides specialized and restorative services in 24/7 supervised community residences in Clayton, Gouverneur, and Watertown. All residences are co-ed and open to individuals with a serious and persistent mental illness, for ages 18 and over. TLS also serves 33 adults in multiple apartment locations throughout Watertown with intermittent supervision based on individual needs and a 24 hour on-call service. All of these programs are certified by New York State Office of Mental Health (NYS OMH).

TLS assists residents to coordinate and access needed services within the community, such as behavioral health and medical services, substance abuse services, employment and day programming. Specialized services are provided by Qualified Mental Health Staff & Professionals, including completing assessments, person-centered strength-based creation of individualized action plans to meet residents’ needs and goals. Staff work together with residents and community providers to ensure continuity of care. These TLS staff also provide targeted one-on-one rehabilitation services to increase independent living skills to assist in the transition to independent community living. These services, known as Restorative services, include but are not limited to: Assertiveness & Self-Advocacy Training, Community Integration & Resource Development, Daily Living Skills Training, Parenting Training, Rehabilitation Counseling, Skill Development, Socialization, Substance Abuse Services, Symptom Management, Health Services, and Medication Management Training. Community residents participate in monthly resident meetings and activities. Residents are requested to complete annual satisfaction surveys.

Apartment Program

TLS serves 33 adults in multiple apartment locations in Watertown. The Apartment Program serves both men and women, though apartments are not co-ed. Similar to the more intensive residential program, TLS’ Apartment Program assists residents in acquiring Rehabilitative skills, including Medication Management, Socialization, and Daily Living Skills. This program provides a higher degree of independence to its residents than those enrolled in the community residences, placing more daily responsibility on those residents while providing a safety-net Managers and 24/7 on-call staff support. Residents in this program create with staff person-centered, strength-based individualized action plans in order to address their program goals. When available, residents participate in monthly activities, apartment program meetings, and are requested to complete satisfaction surveys annually.

Supportive Housing

These services are available to residents of Jefferson and Lewis Counties with a psychiatric illness. The services are grant funded by the New York State Office of Mental Health. TLS provides rental assistance and case management services to support successful living and housing stability.
Our Supportive Housing features the highest level of independent living, as clients live in their own home. Supportive Housing allows clients to participate in housing search, focusing on affordability and staying within Fair Market Rent. Case management will be strength based, focusing on housing stability and increasing skills to live successfully in the community.

Referrals for Supportive Housing are submitted to the county SPOE committee for review and assigned to TLS.

Non Medicaid Case Management

Non Medicaid Case Management provides similar services as the Adult Health Home Care Management program mentioned above. The eligibility requirements differ in that a person must have a Serious Mental Illness (SMI) and a risk factor which can be addressed with case management. Additionally, the individual will not meet the insurance eligibility requirements for the Health Home program. This program assists with continuity of care, maximizing a person’s independent functioning in the community and provides case-specific advocacy.

These services are offered in Jefferson and Lewis counties. In order to be referred to this program, a SPOA application must be completed and sent to the respective county’s SPOA Coordinator.

If you have questions, please reach out to our Intake Coordinator, Robin Deierlein, at 315-782-1777.

Adult Health Home Care Management

Health Home Care Management is a person centered program designed to assist eligible individuals with care and services they need to keep themselves healthy. Once an individual is determined to be eligible for Health Home Services, they will be assigned a Care Manager. The Care Manager will meet with the member to determine their needs and what is important to them. Together, the care manager and member will develop a care plan which will address any barriers in achieving goals. This process is driven by the individual, not the Care Manager.

Some examples of what a Care Manager may assist with include:

  • Connecting to health care providers;
  • Connecting to mental health and substance abuse providers;
  • Connecting to needed medications;
  • Social services (such as food, benefits, and transportation);
  • Other community programs that can support and assist you;
  • Working with your family and doctors to pay special attention to your unique health care needs;
  • Coordinating information among your providers so that a doctor doesn’t order a test for you that another doctor gave you just last week;
  • Helping you access specialty care you may require;
  • Helping you understand and keep track of medical information that can be overwhelming at times, and
  • Assisting you with other services you may need, such as housing, food, utilities, transportation, managing your benefits, etc.

Eligibility requirements for the Health Home Program are:

  • Must be enrolled in Medicaid or Managed Care and have:
    • Two or more chronic conditions (e.g. diabetes, obesity, asthma, substance use disorder) or
    • HIV/AIDS or
    • Serious Mental Illness (SMI) (Adults) and
  • Have a risk factor (e.g., homelessness, recent release from incarceration, recent release from hospitalization).


If you are interested in learning more about Transitional Living Services Adult Health Home Program, please feel free to contact us.

Jefferson County: Dana Van Hoesen 315-755-6526
Lewis County: Shari Abare 315-377-6015
St. Lawrence County: Nicole Rood 315-713-9296

Homeless Housing/Rental Assistance Programs

These services are available to residents of Jefferson, Lewis, and St. Lawrence Counties that are homeless. The services are grant funded by HUD through the Points North Housing Continuum of Care. These programs secure housing with the focus on permanent housing in the area they want to live in. TLS provides medium to long term rental assistance and case management services to all persons enrolled. While enrolled, identified needs are worked on with the goal of transitioning to self-sustainability.

Lewis County

Transitional Housing is provided in Lewis County for residents that are homeless. These services are intended to stabilize the homeless individual/family with intensive case management by focusing on services and supports to graduate to permanent housing.
Eligibility is determined after a Points North Coordinated Entry Homeless Assessment is completed. Please check out https://northcountryhomeless.org/ for more information on the Points North Housing Coalition.

If you are interested in learning more about these services, please contact Mark Waterhouse, Operations Manager at 315-755-6536.

St. Lawrence County

If you are interested in learning more about these services, please contact Brenda Moulton at 315-393-4610.

CHAAP

TLS Community Housing and Assistance Program (CHAAP)
Provide temporary and transitional housing assistance for homeless families and single men and women over the age of 18, and operate 4 low income housing properties serving the homeless and general population of St Lawrence County.

Gaslight Village

Our single family duplex style homes consist of two, three and four bedroom units, including several handicapped accessible units. These units are available for homeless families with a child/children under the age of 18 that meet the eligibility requirements. These homes are considered permanent housing with required case management services.
Located in a quiet section of Ogdensburg, these 16 duplexes are the first step in sheltering families whom find themselves without a home of their own. While the causes of homelessness are varied and complex, these homes are the best first step in changing a family’s direction towards a better future.

SRO (Single Resident Occupancy) Program For Homeless Men and Women

The SRO Program has three facilities that are designed not only to shelter homeless single men and women over the age of 18 that meet eligibility requirements, but also to provide assistance and access to many of the services available in St Lawrence County. The program is community style living, where each resident is provided with their own room and share common living, kitchen and bath areas.
The SRO Program offers supportive and temporary or “transitional” accommodations with a staff of experienced Resident Advocates whom work to reverse the causes of homelessness and move individuals along to permanent residences.

Low Income Housing

Features four properties available as low income rentals predominantly utilized as a stepping stone for the SRO Program residents that meet eligibility requirements. There are three separate 1-4 bedroom apartment units and one duplex property. The apartments are located in Ogdensburg, Waddington, and Heuvelton.

The typical causes of homelessness are addiction, unemployment, joblessness, mental health issues, health issues, domestic violence and family crisis. The immediate goal of the program is to provide shelter and then to follow up by identifying the cause of the homelessness and provide the family or individual with the necessary assistance and tools to reverse their circumstances to a better future.