Clone of Minnesota Tribal Intergovernmental Reentry Workshop Registration Form

Choose Application Type*

AgencyTechnical Assistant Provider

Agency Name*

Agency's Leader*

First NameLast Name

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Contact Person Assigned to Lead Effort*

First NameLast Name

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Indicate why your agency is interested in implementing the Standards.*

Indicate when your agency did the following:*

	Year Implemented (enter N/A if not applicable)	Does your agency have a policy or procedures related to this area?
Implemented Risk-Need Assessment Tool (specify name of tool)
Incorporated the Use of Graduate Sanctions and/or Incentives
Trained Officers in Evidence-Based Supervision
Conducted a Recidivism Study

As part of this pilot, you will be asked to identify up to three standards that your agency plans to implement. The evaluation/implementation team will provide you with a baseline report which should help you select the standards that could address your performance metrics. You will then be asked to:

1. Select an implementation provider from a list of vendors provided by APPA.

2. Agree to have your staff engage in implementation of the standard.

3. Agree to have your staff complete a brief survey (approximately 20 minutes) twice in one year

4. Provide the evaluators with data on your system to include demographics of individual under supervision, progress on implementing said standards and compliance with supervision

The Standards focus on the following topic areas:*

	Do you specialize in this area? (yes/no)	Describe your implementation approach related to this in this area.
1. Goals of community supervision
2. Sentencing to probation or release on parole
3. Assessment
4. Transition to community/pre-release efforts
5. Supervision practices including collaboration with external agencies
6. Caseload size
7. Engagement and building relationships with partners (i.e. treatment providers, etc.)
8. Case management and planning
9. Effective interventions
10. Influencing behaviors
11. Performance measurement

Please provide references for the least three efforts to assist supervision organizations to implement improvements in their agency*

	Agency	Contact Person (Name/Email/Phone Number)	Services Provided	Duration of Service
1)
2)
3)

Under this agreement, you agree to:

1. Work with the assigned agency for a minimum of 12 months;

2. Provide status updates to the evaluators and APPA;

3. Work with the evaluators on measuring implementation; and

4. Provide structured feedback to the agency and APPA on the standards process.

Signature*

Please verify that you are human.*

Should you have specific questions, reach out to Faye Taxman.

Application to Participate in the APPA Standards Implementation Pilot

Agency Application

Technical Assistant Provider Application