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CCBHC-E National Training and Technical Assistance Center

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Evidence-Based Practice Implementation Science Pilot
- Implementation Science Pilot Background

Receive assistance from our team of experts!

The CCBHC-E National Training and Technical Assistance Center provides free consultation and technical assistance on CCBHC implementation to expansion grantees. Fill out this form to request assistance today.

CCBHC-E NTTAC Request Form

Name(Required)

First Last

Title

Organization/Company(Required)

City

State(Required)

Email(Required)

Phone(Required)

Referral Source(Required)

Are you a National Council Member?(Required)

Yes

No

CCBHC Status(Required)

Medicaid Demonstration Site

SAMHSA CCBHC Grantee

Independent State Certified CCBHC

Prospective CCBHC/Interested in Adopting Model

Current CCBHC Partner

State Government Official or Policymaker

Other

If you are a SAMHSA grantee, what year(s) were you awarded your grant?

Please indicate which topics you’re looking for support on:(Required)

CCBHC Criteria and Core Services

Practice Transformation and Organizational Change Management

Data Management and Data-driven Decision-making

Workforce and Staffing

Financing and Sustainability

Other

Describe your specific TA request and the topics you are interested in learning more about.(Required)

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