CSAP's Southwest CAPT State Service Plan Information Form

(1) Your Name

(3) Think about the LOCAL-LEVEL T/TA needs in your state (e.g., the needs of local practitioners such as grantee and community coalition). Please indicate your LOCAL-LEVEL priority of receiving assistance in each area listed below and the timeframe in which you need such assistance. We have also left room for you to provide details on any need that you might have in a particular area, as well as the opportunity to identify any other local needs that you might have.

Level of Priority

Timeframe

Details

0 1 2 3 4 5 Not a Priority This Year Next 3 Months Next 6 Months Next 9 Months Next 12 Months (255 character limit)

Cultural Competence
(e.g., working with populations defined by such
characteristics as race/ethnicity, geographic
location, etc.; assessing and tailoring program
activities to cultural conditions; conducting
individual and agency self-assessments)

Sustainability and Resource
Development
(e.g., continuing collaboration, work, and/or
outcomes past award; identification and
accessing renewable financial support;
grant writing)

Model Programs and Strategies
(e.g., identifying; selecting appropriate;
implementing; making adaptations; obtaining
training; evaluating)

Advancing Innovative Programs
(e.g. support for innovative programs on
enhancing their program design, materials,
implementation, and evaluation; developing
curricula materials; understanding and
advancing through the NREP process and
review criteria)

survey software

	*Level of Priority*						*Timeframe*					*Details*
	0	1	2	3	4	5	Not a Priority This Year	Next 3 Months	Next 6 Months	Next 9 Months	Next 12 Months	(255 character limit)
Cultural Competence (e.g., working with populations defined by such characteristics as race/ethnicity, geographic location, etc.; assessing and tailoring program activities to cultural conditions; conducting individual and agency self-assessments)
Sustainability and Resource Development (e.g., continuing collaboration, work, and/or outcomes past award; identification and accessing renewable financial support; grant writing)
Model Programs and Strategies (e.g., identifying; selecting appropriate; implementing; making adaptations; obtaining training; evaluating)
Advancing Innovative Programs (e.g. support for innovative programs on enhancing their program design, materials, implementation, and evaluation; developing curricula materials; understanding and advancing through the NREP process and review criteria)