Instructions for CBI Notification of Completion and Class Roster

I.	Notification of Completion
Agency/Program Providing CBI – Enter the name of the agency providing CBI training.

Program Type – Select the type of program from the dropdown list: Probation, ATI, Reentry Task Force, 200% of Poverty, Other

Name of CBI Provided – Select the CBI program being administered: Thinking for a Change, Interactive Journaling, NCTI, MRT, or Other. NOTE: This form is not to be used for OWDS – Ready, Set, Work! A different form is available for that purpose.

Total Program Hours: Enter the total number of hours that training was provided by an instructor.

County CBI provided: Enter the county in which CBI training was provided. Name/s of Facilitators: Enter names of all facilitators assisting with this session. Session Start Date: Enter the first session of the CBI training provided.

II.	Class Roster – Please complete the Class Roster tab in the spreadsheet. NYSID – NYSID must be nine characters long, including eight numbers and one letter at the end.  If NYSIDs are shorter than nine characters, pad the left side of the number with zeroes to make the length nine characters. For example, the NYSID 123456H should be entered as 00123456H.  If the combination of numbers and letter are not valid, you will get an error message.  Please double-check the NYSID to ensure it is valid.

First Name – Enter the participant’s first name. Last Name – Enter the participant’s last name.
Date of Birth – Enter the participant’s date of birth.

Sex – Select the participant’s sex from the drop-down list.

Participant Status – Select the participant’s status from the dropdown list.  Status includes: Probation, ATI, Reentry, and Other.
Arrest Date – Enter the arrest date for the criminal case associated with program participation. CBI Discharge Date – Please enter the date the client was no longer receiving CBI services from
the program.

Program Outcome – Select the appropriate program outcome from the drop down list:
Successful
Unsuccessful (incl. non-attendance, non-compliance, and dropout) Administrative Discharge (incl. Deceased, Transferred, or Moved)
Other (incl. case closure not listed)

Unsuccessful Discharge Reason – If the participant’s Program Outcome was Unsuccessful, select the most appropriate reason for the program failure (Note: this field should only be completed if the participant’s Program Outcome was Unsuccessful).  Discharge Reasons include:
New Arrest Violation
Non-Compliance (incl. non-attendance, lack of engagement, and dropout) Other

III.	Certification
The Group Facilitator and Program/Probation Director should both sign and date the form,
certifying that the participants, where indicated, successfully completed the CBI course, and that the curriculum was not altered, in either content or duration, from that which was provided by OPCA.

IV.	Submitting Forms
We expect that agencies will soon be able to upload the CBI Rosters through the IJ Portal.  DCJS
will advise programs when the secure upload functionality becomes available.  In the interim, agencies should submit the reports via email to dcjscbidata@dcjs.ny.gov.  Reports should be submitted within 30 days of program completion. NOTE: until a secure upload is available through the IJ Portal, agencies must password protect the monthly reports, and the password should be sent in a separate email.  To password protect the file, click on the Office button in the upper left-hand corner.  Click on ‘Prepare’ and then ‘Encrypt Document’.  Enter the password (Excel will ask you to re-enter the password) and save the Excel file.  Files should be named as: CBI_month and year_ program title (ex: “ATI _ Jan14_Albany Probation.xlsx”). Given the amount and variety of files we receive, it is important that all programs follow the same naming convention.