| Massachusetts Councils on Aging

Name

First

Last

Email

Phone

COA

Job Title

If you are not a COA director, does your director fully support involvement in the UMass FIRST Initiative and understand the details of the commitment, which includes leading two 16-session program cycles with a co-CST facilitator between the completion of CST training in early 2026 and May 1, 2027?

Yes
No
I am a COA director

Do you have experience working with people living with dementia?

Yes
No

Do you have experience leading small group discussions or trainings?

Yes
No

Please describe your experience leading small groups. If you have experience following and applying an intervention protocol or practice guidelines (i.e., prewritten instructions on how to conduct a procedure) please include that.

Have you collaborated with other COAs, municipal departments, or community partners on past programs or projects?

Yes
No

Please describe a collaborative project with another COA, municipal department, or community partner that you have been involved in.

Describe your strategy for recruiting, with the help of a partnering COA, up to eight people per cycle with mild or moderate dementia to participate in your sessions. Please include in your response how you will recruit at least one person per cycle who lives alone and has mild or moderate dementia.

Trained facilitators are required to offer two CST program cycles between May 2026 and May 2027. Please provide an estimated timeline for when you envision offering two program cycles to your community in partnership with a CST facilitator from another COA.

experience CST or

Please note if you have the capability to offer the CST program in-person, virtually, or both. CST session cycles can be held either in-person or virtually, but cannot be delivered via a hybrid model.