Transition to Success Map

A map to making dreams a reality.

With the protocols built into Transition to Success, individuals are able to define a path based on their needs, challenges and circumstances—ultimately moving them closer to making their dreams reality.


What TTS does for you


The first of its kind, TTS integrates standards of care, uniform protocols and analytics to treat the condition of poverty—a condition brought on by negative exposures to the social determinants of health.

Circumstances like poor-performing schools, low-paying jobs, food insecurity, and lack of access to healthcare, transportation, affordable, safe housing, and reliable, stable childcare are game changers in life. With the added exposures of racism, and social injustice and stigma, the impact of economic insecurity on health and well-being for individuals and the community are amplified.

Transition to Success responds to the condition of poverty by coordinating care across health care, human services, government, faith-based organizations and education. Using and maximizing existing funding streams, integrating uniform protocols and analytics, we can—and do—improve health and self-sufficiency.


How It Works

Shifting the paradigm

TTS is dedicated to transforming the nation’s understanding of poverty from a stigmatized and shameful character flaw, to a treatable, environmentally-based condition. Working to shift the social and cultural paradigm around poverty, TTS is framing the issue around how negative exposures and conditions in which people are born, live, learn, work, play, worship and age—the social determinants of health—lead to myriad issues and a diagnosis of poverty.

Maximizing resources

TTS responds to the condition of poverty asking a simple question: What is your dream? We then identify the areas of need to bring that dream to life. We then help coordinate care across existing, funded programs in health care, human services, government, faith-based and educational organizations—all resources already in place. By maximizing these existing funding streams and integrating uniform TTS protocols based upon best practices, we bridge the gap between hope and opportunity, improving the health and self-sufficiency of those struggling with poverty.

Measuring outcomes

TTS is a scalable, sustainable, multi-generational, measurable, generative business model. TTS curriculums define specific screening and treatment protocols, and our screening allows clients to self report on 18 life areas in an easy-to-understand, easy-to-score survey. With 18 specific areas of measurement that assess exposures, clients and practitioners can measure individual outcomes. Organizations can measure individual, program and multiple program outcomes.

Coordinating CARE

TTS trains staff working directly with clients, so together we identify, prioritize and ensure access to all available services across the community. For example, a client struggling with money management can be enrolled in free financial literacy courses at a local bank; a client who needs assistance with food is connected with local food banks, soup kitchens, government food-support programs, and/or a cooperative community garden. With TTS, each client’s CARE (Coordinating All Resources Effectively) Plan integrates opportunities for evidence-based practices of peer mentoring, financial literacy and volunteerism, all proven to improve health and economic self-sufficiency.

Training a community

TTS expands into local communities by working with a community-based lead agency or agencies that build the program from the ground up. Using a train-the-trainer model, TTS community champions integrate TTS training and best practices to CARE (Coordinating All Resources Effectively) team members. The train-the-trainer approach promotes community-led transformational change with consistency in practice and uniform analytics. This improves access to and accountability of all available programs.

Tracking success

TTS is based on a continuous quality improvement model with independent evaluation partners that employ social determinant and CMS-approved behavioral health and substance abuse screenings. This protocol creates an integrated, billable and clinically accurate screening process; as well as a care-management platform that identifies all resources, tracks referral completions and data across multiple providers.