Thank you for your interest in the Dementia Caregiver Support Specialist recruitment with Dane County.

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CARLOS PABELLON Interim Director of Administration December 11, 2015 COUNTY OF DANE DEPARTMENT OF ADMINISTRATION EMPLOYEE RELATIONS DIVISION Room 418, 210 Martin Luther King, Jr. Boulevard, Madison, Wisconsin 53703 Phone: 608/266-4125 Fax: 608/266-4409 Dear Dementia Caregiver Support Specialist Applicant: Web Page: http://www.countyofdane.com AMY UTZIG Human Resources Director Thank you for your interest in the Dementia Caregiver Support Specialist recruitment with Dane County. The enclosed achievement history questionnaire is intended to give you the opportunity to describe your specific education, training and experience that would be relevant to this position. The examination procedures will be as follows: 1) All competitors will be required to respond to the questions and upload the file to your candidate profile under the additional documents section. Please be specific and factual in the information you provide. Limited to one page per question. 2) An impartial review panel who know the requirements of this position will be convened to evaluate and grade all responses to the questions. The panel will not have access to your application, resume, or any other materials you provide. Be sure to include all relevant information (education, training, experience, etc.) in each response as graders will grade each response question individually and will not refer to information which may have been provided in a different response. If you do not provide this necessary information, it may impact your final score. 3) Those applicants receiving the highest exam scores will be invited to participate further in the process. It is our belief that by providing competitors with written guidelines for describing their training and experience related to the demands of this position, we can obtain a better assessment of each applicant s relevant qualifications. If you wish us to consider your application further, your answers to this document must be uploaded no later than the closing date of the posting. Sorry, late application materials will not be accepted. JEAN FILLNER HUMAN RESOURCES ANALYST

DANE COUNTY DEPARTMENT OF HUMAN SERVICES DEMENTIA CAREGIVER SUPPORT SPECIALIST ACHIEVEMENT HISTORY QUESTIONNAIRE Print or Type Your Name: Candidate Profile Number: (found in your Candidate Profile on the Personal Information page under candidate details) Instructions: Please insert your name above and sign the certificate provided below for your answers to be considered. Answer the following questions in a concise and well organized manner, attaching your responses to these pages. Limit your responses to one page per question. Please provide your candidate profile number in the upper-right-hand corner of each page of your responses to the questions. Do NOT include your name anywhere on the sheets containing your responses. In your answers, provide only specific relevant responses, including any information that may duplicate what you provided with your application for this position. It is important that each of your responses provides applicable or pertinent identifying information, such as job titles, employer names, time periods, etc. Since being able to communicate effectively in writing is an important element of this position, your writing ability will also be evaluated. PLEASE NOTE: Graders will not have access to your resume or any other application materials. CERTIFICATE By checking here, I certify that I prepared my responses without assistance. (If you are successful in reaching the employment selection interview stage, you will be asked background questions regarding one or more of your responses to this examination.) I further certify that to the best of my knowledge, the experience and/or training I specified in my attached responses are true and correct, and can be independently verified. I understand that any falsification of this certificate can be grounds for removal from the eligibles list or discharge from County Service.

DANE COUNTY DEPARTMENT OF HUMAN SERVICES DEMENTIA CAREGIVER SUPPORT SPECIALIST ACHIEVEMENT HISTORY QUESTIONNAIRE 1. Describe your experience working with the African American population who have dementia, their families and caregivers. 2. Describe your experience developing collaborative relationships with community organizations. 3. Describe your experience with program development and implementation, and monitoring program progress. 4. Describe your experience doing outreach? Include experience in public speaking, developing presentations, and working with outside organizations to present information to a variety of audiences (professional groups, church groups, civic organizations, etc.).

Additional Required Documents DEMENTIA CARE SPECIALIST AHQ Start Application Recruitment Begins: 12/11/2015 12:00:00 AM CST Recruitment Ends: 12/29/2015 11:59:59 PM CST Description The Dane County Human Services Department in Madison, Wisconsin has a grant funded position from the Office of Resource Center Development. This position will work t create a more dementia capable ADRC and dementia friendly community. This position also provides dementia-specific consultation and technical assistance related to cognitive screening, individual and family caregiver issues, the adult protective services agency (APS), county/tribal aging offices and ADRC staff members. Purpose Works directly with African American families to provide support to spousal and family caregivers of people with Alzheimer s disease and other dementias. Function Provides outreach to African American community organizations, health care professionals and organizations, and other community partners; conduct cognitive screening to identify people with possible dementia and make referrals for physician evaluation and interventions; follow-up with affected individuals and their caregivers after diagnosis; provide caregiver education, support and referral to dementia programs and services; provide Memory Care Connections and other caregiver support interventions; work with the ADSSP grant project team to examine the marketing strategies used with Memory Care Connections to determine how to address the obstacles raised by family caregivers in choosing not to enroll in the program; provide cultural sensitivity training for ADRC staff, focusing on work with African Americans with dementia and their families; provide consultation and technical assistance to adult protective services and mobile crisis team workers on an as needed basis; attend all project related trainings and well as attend the Dementia Care Specialist conference calls, trainings and other meetings; document demographic characteristics of the people served and the types and amounts of services provided for program reporting and evaluation purposes. Knowledge, Skills and Abilities: Expertise and knowledge regarding older adults, dementia, dementia care and support, family and informal caregiver needs, and challenging behaviors; skills and experience in facilitating small group learning and discussion programs; experience with family caregivers of people with dementia and family dynamics; experience in

developing collaborative relationships, preferably with community organizations and health care professionals; competence in public speaking and engaging community members and professionals in discussions about dementia and community resources; experience in program development and implementation; the ability to provide culturally competent services and supports, function independently and be resourceful in the roles undertaken; the ability to adjust work hours to meet with program participants and to provide community and employer outreach and educational programs; and basic computer skills, including ability to record and report program data and information. Special Requirements: Valid Wisconsin driver s license (or eligibility for), access to personal transportation. Lifting 20 pounds maximum with frequent lifting and/or carrying of objects weighing up to 10 pounds. Maintain driver s license, access to reliable personal transportation. Prerequisites Education and Experience: A Bachelor s Degree, Master s preferred, from an accredited college or university. Must have a minimum of one year of paid experience working directly with the African American population with dementia and family/informal caregivers, such as providing direct care, caregiver support, support group facilitation, residential care management, or home care. Compensation $21.24 Per hour with further increases to $27.59, plus excellent benefits including fully paid health and dental insurance for full time employees, along with contributions towards retirement, and short/long term disability. Additional benefits available include long term care, vision coverage, flex spending account and deferred compensation programs paid in full by the employee. Dane County is an Affirmative Action Employer operating under a Civil Service Merit System. If you are a person with a disability and need an accommodation at any time during the recruitment or employment process, please contact Dane County Employee Relations. All persons are responsible for informing Dane County of their needs. 2015 - Dane County