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Integrated Care Collective
Cultivating Dignity, Independence & Belonging for Every Arizonan We Serve
⚕ Support Staff Application
Begin Your Career With
Integrated Care Collective
"Cultivating Dignity, Independence & Belonging for Every Arizonan We Serve"
We support Arizonans with developmental disabilities and complex medical needs. We are seeking individuals whose character, compassion, and commitment distinguish them — prior healthcare experience is not required.
We welcome applicants from these backgrounds — officially select yours inside the form:
🛒 Retail & Customer Service
🎓 Educators & Coaches
🎖 Military Veterans
👨👩👧 Family Caregivers
⛪ Faith & Community Volunteers
🍽 Hospitality Professionals
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Personal Information
Contact details, position preferences, and professional background
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Important — Read Before Completing This Page
Every field must contain a response. If a question does not apply, enter N/A or 0 — blank fields will prevent you from moving forward.
✏️ Not Applicable → N/A🔢 No Number → 0
Fields marked * are mandatory per AHCCCS provider participation requirements.
Position(s) of Interest — select all that apply
Professional Background — select all that apply
This helps our hiring team understand your transferable strengths.
Schedule Availability
Days available:
Shift preferences:
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Education & Professional Training
No advanced degree required — all learning is valued
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N/A or 0 Required in All Fields
Every field must have a response. Enter N/A if a question does not apply. Blank fields will block your progress.
A Note on QualificationsA high school diploma or GED is the standard requirement. Comprehensive paid training is provided to all new team members before their first client assignment.
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Employment History
Most recent four positions — all industries welcome
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N/A Required for All Opened Fields
Complete every visible field. Enter N/A if it does not apply. Collapsed blocks may be left closed. Employment Gap field must be completed.
All Professional Experience Is RelevantInclude any sector — retail, hospitality, military, education, construction, self-employment. Account for any gaps of 30+ days at the bottom.
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Candidate Profile
Values, temperament, and professional philosophy
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Every Question Requires a Written Response
Write N/A and briefly explain if a question truly does not apply to your experience.
Authenticity Over PerfectionThese questions illuminate your values and judgment. Draw from any life experience. Respond in your own voice.
Motivation & Purpose
1
What compels you to pursue a career supporting individuals with disabilities or medically complex needs?
Articulate the specific values or experiences that orient you toward this work.
2
Describe a meaningful experience in which you provided support, comfort, or advocacy to someone navigating significant challenges.
Family member, neighbor, student, peer, or community member — formal employment not required.
3
In your estimation, what constitutes the most indispensable quality in an effective support professional, and why?
Communication & Interpersonal Competency
4
Recount an instance in which exercising sustained patience was essential to a successful outcome. What approach did you employ?
5
Describe your experience communicating with individuals whose verbal expression was significantly limited or absent. What strategies did you employ?
6
Describe a situation in which you were the subject of another person's frustration or hostility. How did you navigate the interaction?
7
Individuals receiving support services retain the legal and ethical right to direct their own lives — including decisions with which their support staff may disagree. How do you approach that tension?
Professional Accountability & Reliability
8
Characterize your professional record with respect to attendance and punctuality. Describe a context in which your consistent presence was essential to others.
In direct support work, absences can directly compromise a client's safety and wellbeing.
9
Describe your experience adhering to detailed procedural protocols — even when you perceived them as unnecessarily rigid. How did you reconcile personal judgment with institutional expectation?
10
In the event of an unexpected client health or safety incident during your shift, walk through your decision-making process — including who you would contact and in what sequence.
Emotional Intelligence & Professional Boundaries
11
Identify the professional circumstances you find most emotionally taxing. Describe the specific strategies you employ to sustain your wellbeing and prevent compassion fatigue.
12
Describe how you would cultivate a warm, trusting professional relationship with a client while simultaneously maintaining appropriate boundaries.
13
Describe a context in which you were entrusted with sensitive or confidential information. Why is strict confidentiality particularly essential in healthcare and human services settings?
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Situational Judgment Assessment
Applied ethical and practical reasoning — no clinical terminology required
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All Six Scenarios Must Be Answered — N/A Is Not Acceptable Here
These are hypothetical — describe how you would respond. If unsure of formal procedure, describe how you would seek guidance.
InstructionsWe are assessing your reasoning process, ethical instincts, and professional judgment — not clinical knowledge.
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Situation A
Upon arriving for your shift, the client — a 35-year-old man who uses a wheelchair — exhibits markedly altered cognition relative to his baseline. He is unresponsive to eye contact and his communication has changed substantially. His family is not on the premises.
Articulate your response in sequential order. Identify who you would contact and when.
B
Situation B
During morning personal care, a client expresses strong objection to the clothing her family laid out. She is agitated and insists on choosing her own attire — in direct contradiction to the family's written instructions.
How do you navigate the competing interests? Identify the values informing your decision.
C
Situation C
You witness a colleague addressing a client in a demeaning manner — using language like "stop being difficult" and visibly expressing exasperation. No supervisory personnel are present.
Describe your response. Would it differ if this colleague were a personal friend?
D
Situation D
A family member calls your personal phone requesting a detailed account of the client's recent behavioral patterns and health status. They assert their familial relationship gives them an unconditional right to this information.
Clarify what, if anything, you would disclose and the rationale underlying your decision.
E
Situation E
Your vehicle breaks down 15 minutes from your worksite at 6:45am. Your shift starts at 7:00am and the client is currently unaccompanied in the residence.
Identify your immediate priorities and the sequence of contacts you would initiate.
F
Situation F
A client hands you a fifty-dollar bill and says you are the most meaningful source of support they have ever had.
Describe your response and articulate the professional rationale behind it.
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Professional Development & References
Growth orientation and professional endorsements
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All Questions and All Reference Fields Must Be Completed
Every question and reference field must have a response. Enter N/A if a field does not apply. Do not leave any field blank.
14
Identify the most substantive professional skill you have acquired on the job — one entirely absent from your repertoire when you were hired. Describe the developmental process.
15
Are there aspects of direct support work — medical complexity, behavioral challenges, or interpersonal dynamics — that generate apprehension or uncertainty for you? What would facilitate your readiness?
Candor reflects professional self-awareness — among the most valued competencies at Integrated Care Collective.
16
Describe how you characteristically respond when a supervisor identifies a deficiency or error in your professional conduct. Provide a concrete example if available.
Professional References — three required, non-family
Reference GuidanceReferences need not come from healthcare. Former supervisors, educators, coaches, clergy, or community leaders all qualify — anyone who can credibly testify to your reliability, character, and engagement with others.
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Background & Legal Disclosures
Mandatory per Arizona state law and AHCCCS provider standards
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All Five Questions Require Yes or No — Explanation Field Must Also Be Completed
Select Yes or No for each. The explanation box must be filled — enter N/A if your answer is No.
Required Disclosure NoticeICC is an AHCCCS-contracted provider. All applicants undergo comprehensive background screening. An affirmative response does not constitute automatic disqualification. Deliberate omission or misrepresentation is grounds for immediate disqualification or termination.
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Applicant Certification & Signature
Legal attestation of application accuracy and completeness
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Final Step — All Three Signature Fields Are Mandatory
Your printed name, signature date, and electronic signature are all required. Please read the certification statement carefully before signing.
⚠️ All three signature components are mandatory
Certification StatementBy signing, you attest that all information is truthful, complete, and accurate. Any misrepresentation is grounds for disqualification or immediate termination. You authorize ICC to verify all information submitted, including contacting former employers and references. Employment is contingent upon: (1) satisfactory criminal background screening; (2) a valid Arizona Fingerprint Clearance Card; (3) non-inclusion on state and federal exclusion registries; and (4) successful completion of mandatory AHCCCS and DDD onboarding training.
Electronic Signature *
Sign here using your mouse or finger
Draw your signature above using mouse, stylus, or touchscreen
Your typed name constitutes a legally binding electronic signature
Electronic Signature Disclosure: Your signature is legally binding pursuant to the Electronic Signatures in Global and National Commerce Act (15 U.S.C. §7001) and Arizona Revised Statutes §44-7007.
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Application Successfully Submitted!
"Cultivating Dignity, Independence & Belonging for Every Arizonan We Serve"
Thank you for your interest in joining the Integrated Care Collective team. Your application has been received and will be reviewed by our hiring professionals. Expect to hear from us within three to five business days.
ICC-AZ-000000
Retain this reference number for your records.
Professional Background(s) on File