COMMUNITY TRANSITION LIAISON PROGRAM

DO YOU NEED HELP RETURNING TO YOUR HOME OR COMMUNITY?

The Community Transition Liaison Program offers nursing home residents (age 22 or older) individualized assistance in overcoming barriers to being discharged and returning to the community. 

Trained Coastline CTLP staff are available in nursing home settings to meet with any resident who wishes to be discharged. They work one-on-one with residents or their family members to assist the resident in transitioning back to their home or community.

 

WHO IS ELIGIBLE FOR HELP?

The program is open to those who have been in a nursing home in any of the towns that Coastline serves whether their stay has been short- or long-term. 

Being discharged and returning home or to a new location can be a complex process with sometimes confusing barriers, such as the availability of housing, access to appropriate levels of care in a new environment, required documentation, and other factors.

 

HOW CAN CTLP STAFF HELP?

CTLP staff are available to guide the individual and family through this complicated process which is different for everyone. Everyone’s situation is unique and is approached by CTLP staff in individualized ways. 

They can: 

  • Assist with determining eligibility to supportive programs, services, or housing as needed.  
  • Assist with obtaining documentation for programs or services, including helping to complete applications and necessary paperwork.  
  • Assist with the communication flow between the nursing home resident and nursing facility staff throughout the discharge process. 
  • Help the nursing home resident and/or family members understand resources that may be available to them and assist them in accessing those resources.

 

HOW DO I GET HELP?

CTLP staff will be visible within local nursing homes with regular visits and can be approached within the nursing facility. They can also be reached by calling Coastline at 508-999-6400.