Department of Budget and Management

**Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.**

Do you possess a Bachelor's degree in Nursing, Social Work, Psychology, Education, Counseling or a related field?

If you responded YES to the above question, what field is your Bachelor's degree in?

Describe your professional experience in health services.  Health services is defined as experience in areas other than Mental Health, Developmental Disabilities or Addictions.

Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application.  If you do not possess experience in this area, put N/A in the box below. 

Describe your knowledge of and/or experience with Medicaid.

This experience must also be included on your application (please include name of employer, job title, dates of employment and hours worked per week). If you do not possess this type of experience, please indicate N/A.

Describe your experience monitoring quality assurance.

Please include name of employer, job title, dates of employment, and hours worked per week, this information must also be reflected in your application. If you do not possess experience in this area, put N/A in the box below.

Describe your supervisory experience.  Please describe in detail your experience, including the name of your employers, dates of employment and hours worked per week in the box below. If you do not have this type of experience, please write N/A.

Please describe in 2-3 paragraphs your grant writing experience. Include in your response years of experience, employer name(s), and dates of employment. Please be very thorough. If you do not possess this experience, indicate N/A.

Describe your experience working with a diverse population.

This experience must also be included on your application. Please include name of employer, job title, dates of employment and hours worked per week. If you do not possess this type of experience, please indicate N/A.