Please check the box next to the following questions if the answer is 'yes'.
Please enter the applicable Event Date if there is an Event associated with this TTA.
When entering an Event Date, the Time is also required.
If the TTA is targeted to a particular audience or location, please complete the questions below.
Milestones are an element, activity, work product, or key task associated with completing the TTA (e.g. kick-off meeting, collect data from stake holders, deliver initial data analysis).
Please complete the fields below, if applicable, to create a milestone for this TTA.
1. 8/4: Call with IMPACTS Project Coordinator (OHA), IMPACTS Analyst (CJC), IMPACTS Analyst (CJC), and Grant Coordinator (CJC) to discuss grantee contracts and technical assistance next steps (Organizations – 2: Participants – 4).
2. 8/11: Call with IMPACTS Project Coordinator (OHA), IMPACTS Analyst (CJC), IMPACTS Analyst (CJC), and Grant Coordinator (CJC) to discuss target population data collection next steps (Organizations – 2: Participants – 4).
3. 8/11: Call with IMPACTS Analyst (CJC) to discuss grantee technical assistance and data collection (Organizations – 1: Participants – 1).
4. 8/11: Call with IMPACTS Program Analyst (CJC), IMPACTS Program Coordinator (OHA), and IMPACTS Analyst (CJC), Programs Director (CJC), and Behavioral Health Director (OHA) to discuss contracting process and technical assistance planning (Organizations – 2, Participants – 5).
5. 8/18: Call with IMPACTS Project Coordinator (OHA), IMPACTS Analyst (CJC), IMPACTS Analyst (CJC), and Grant Coordinator (CJC) to discuss technical assistance surveys (Organizations – 2: Participants – 4).
6. 8/18: Call with IMPACTS Analyst (CJC) to discuss QI Subcommittee next steps (Organizations – 1: Participants – 1).
7. 8/26: Call with Call with IMPACTS Project Coordinator (OHA), IMPACTS Analyst (CJC), IMPACTS Analyst (CJC), and Grant Coordinator (CJC) to discuss IMPACTS grantee technical assistance and GRC work plan (Organizations – 2: Participants – 4).
8. 8/27: Call with IMPACTS Analyst (CJC) and Behavioral Health Manager (Klamath Tribal Health and Family) to discuss grantee target population data (Organizations – 2: Participants – 2).
9. 8/27: Call with IMPACTS Analyst (CJC) to discuss QI Subcommittee next steps (Organizations – 1: Participants – 1).
Please respond to the Performance Metrics below. The Performance Metrics questions are based on the TTA Type indicated in the General Information section of the TTA.
Please submit a signed letter of support from your agency’s executive or other senior staff member. The letter can be emailed to or uploaded with this request. The letter should be submitted on official letterhead and include the following information:
- General information regarding the request for TTA services, i.e., the who, what, where, when, and why.
- The organizational and/or community needs specific to the request for TTA services.
- The benefits or anticipated outcomes from the receipt of TTA services.
By submitting this application to BJA NTTAC, I understand that upon approval of this application for TTA, the requestor agrees to keep BJA NTTAC informed of any circumstances that may impact the delivery of the TTA, including changes in the date of the event, event cancellation, or difficulties communicating with the assigned TTA provider.
Please call [site:phone] if you need further assistance completing this application.