Despite the national proliferation of technical assistance as a driver for school reform and as a model for embedded and sustained professional development, very little is known about the organizational structures and processes needed to support technical assistance. The purpose of this paper is to describe a structured needs assessment process whereby three organizational supports were identified by technical assistance providers. The context for the provision of technical assistance was a state-wide multi-tiered system of support initiative that integrated Positive Behavioral Interventions and Supports and Response to Intervention. The results of this study are informed conceptually by the Instructional Hierarchy Model and the need to match organizational structures and processes to address the identified needs.