Head Start Connects: Case Study Protocols OMB- and IRB-Approved (Feb. 4, 2020)
Instrument 4: Head Start
Family Support Staff Interview
This collection of information is voluntary and will be used to learn how Head Start programs coordinate family well-being support services. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB number for this information collection is 0970-0538 and the expiration date is 4/30/2021.
This protocol uses the term “site” because respondents may come from the grantee, delegate, center, and/or program levels; study staff will replace “site” with “grantee,” “delegate,” “center,” and/or “program” depending on what is appropriate for the respondent.
The questions with asterisks (*) are of lower priority and can be skipped if the interviewer is running short on time.
This protocol includes probes, which will be used if a respondent doesn’t understand the question or gives a brief answer. This protocol also includes sub-bullets, which are example questions that will be asked, time-permitting, if the respondent doesn’t touch on that topic in their first response. Interviewers may probe more deeply in response to an interviewee’s comment, in-line with the Head Start Connects research questions.
Thank you for meeting with me today! As you may recall from our phone call, I’m [NAME] and I work for [MDRC, MEF, OR NORC – SHORT DESCRIPTION]. I know we discussed Head Start Connects during our call, but to refresh your memory, I’ll give you a quick overview. Head Start Connects is a research study funded by the Administration for Children and Families and conducted by MDRC, MEF Associates, and NORC at the University of Chicago. The aim of the study is to build knowledge about how Head Start programs (Head Start or Early Head Start grantees, delegate agencies, and staff) across the country coordinate family support services for parents and the processes or practices used to ensure that service coordination is aligned with individual family needs and fosters family well-being. When I say, “family support services,” I mean services for parents and guardians such as education, employment services, financial capability services, housing and food assistance, emergency or crisis intervention services, substance abuse treatment, physical health services (such as tobacco cessation services, nutritional services, or other services to maintain and promote physical health and well-being), and mental health services. By tailoring services, I mean personalizing, matching, or fitting supports and services to meet parents’ needs. I understand that the service coordination processes may have changed as a result of COVID-19; while we are primarily looking to understand what service coordination was like prior to COVID-19, I will also ask you about how processes have been affected by COVID-19.
I would like to interview you today because your site is participating in Head Start Connects as a site for the case study on how Head Start programs coordinate family support services. We are conducting interviews with staff, parents, and community providers from the six programs participating in the case study. I emailed you an information sheet about the study for you to keep for your records – did you have a chance to read it? If not, please feel free to read the full form now and I’ll also now give you an overview. [IF DIDN’T RECEIVE INFORMATION SHEET VIA EMAIL, SHOW SHEET ON VIDEO CALL, SUMMARIZE, AND SEND EMAIL AFTER INTERVIEW.]
If you are OK with talking to me today, I will ask you some questions about how you work with families and other Head Start staff to coordinate family support services for parents. I am very interested in the details of this process, and how it may be different for different kinds of families you support. Your opinions and ideas will provide valuable information about how programs coordinate Head Start family support services, which will help us figure out how to improve the services offered to parents.1
This is not an audit. Our study staff will not view the actual case file or records of any families. We will not use your name or the name of your site or otherwise identify you when we report our findings. Your name or other identifying information will be protected and will not be shared outside the research team. During our interview we ask that you not provide specific names or other identifying information about particular families, as we want to maintain their privacy.
This interview will take about two hours, and your participation is voluntary. If you need to leave early or don’t want to answer certain questions, that’s fine – just let me know. Your name will be protected and will never be shared outside the research team. While we may use what you say during the interview in our reports, we won’t include your name or the name of your site. Though, there is always a small risk that people may be able to figure out the name of your site. This study has a Certificate of Confidentiality from the U.S. Department of Health and Human Services which says that we cannot be required to share any identifiable information, even under a court order or subpoena.
Finally, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB number for this information collection is 0970-0538 and the expiration date is 4/30/2021.
Do you agree to participate in this interview?
We are also asking to audio record the interview. The audio recording is to help our team keep track of what you said; the audio recording will never be shared beyond our research team, the recordings will be deleted after transcription, and your name will not be attached to the transcription. Do you give permission for me to audio record?
Do you have any questions before we start? So you know, whenever I reference “parents” in this interview I’m talking about parents and legal guardians.
[SPEND UP TO 1 HOUR ON SECTIONS 2 – 6]
I’d like to start by learning a little about you – your background and your role.
Please tell me a little about your professional and educational background.
[PROBE: What were you doing before you came to this site?]
Do you speak any other languages that may help you work with different families?
Are you a former HS parent?
Please describe your role at this site. What is your formal title?
[PROBE: Do you work full- or part-time? How long have you been in this role? What is the scope of your position—what are you responsible for?]
How much time would you estimate that you spend providing family support services?
What is your current caseload?
How much time do you spend doing other activities around your center? For example, teaching, enrollment and recruitment, health services, transition services, subbing for sick staff or vacant positions, bus aiding, etc.?
I know the COVID-19 pandemic – that is, the illness caused by the coronavirus that has closed non-essential businesses in many areas – may have affected your work. Has COVID-19 affected…
Your role (that is, your responsibilities, daily tasks)? If so, how?
The size of your current caseload? If so, how?
How much time you spend doing other activities around your center? If so, in what ways?
I’d like to learn about how you work with others at your center or program to provide parents with family support services. Which staff are involved and in what ways?
[PROBE: In what ways do you work with Head Start teachers or other staff to discuss individual families – for example, do they provide input on the family plan, do you keep teachers and other staff informed? Do you have meetings to discuss individual families?]
What kind of information do you share – for example, known needs, available resources, referral suggestions, community services?
Do you share information about families informally? If so, how?
Next, I’d like to understand your overall process for supporting parents at your site. I understand that the COVID-19 pandemic may have affected how you do your work. First, though, let’s talk about what your process looked like prior to the pandemic. Afterwards, I’ll ask you how your process may have changed because of the pandemic.
First, please describe how you recruit and enroll the parents on your caseload.
[PROBE: How are parents assigned to you? For example, who sends you parents, when, and how? Do you ever get referrals from other staff members? What does recruitment involve? When does enrollment happen?]
Do you ever get assigned parents that had children in Early Head Start who have now transitioned to Head Start?
Once parents are enrolled and assigned to you, what is your next step – how do you start engaging parents?
[PROBE: In what ways do you reach out to parents so that you could begin working with them (phone, email, in-person)?]
In two parent families, do you often work with both parents or just one?
What do you do with parents during your first meeting with them?
How often do you meet with the parents on your caseload – both formally and informally – and how long do your meetings last, on average?
Do you usually meet or check-in in-person, over the phone, via email, or in another way? Remember, I’m asking about your process prior to the COVID-19 pandemic.
Where do you typically meet with or work with parents, and when? For example, in-person at your site, in-person at a different location, over the phone, via email?
Why do you meet with parents in one place over the other?
Outside of your meetings, what are some specific ways you communicate with parents – by phone, email, text, social media, another way?
Which mode is the most effective and under which circumstances or for what need?
Do you use different communications strategies, depending on the parent or family’s situation?
About how often do you communicate with the families you serve?
Do you have other opportunities to meet with parents outside of the times when you formally work with them – for example, at site events?
What strategies do you use to build and maintain relationships with parents?
[PROBE: For example, getting in touch with parents regularly, getting to know a little about the parents’ personal lives when you meet with them.]
Does this differ by parent – that is, do you use different strategies depending on the parent or family’s situation, if you are working with a mother vs. father?
If yes, how and why?
How would you describe your relationships with parents? For example, would you say that you’re more like a mentor, a counselor, a colleague, a coach, a support system?
I imagine you work with families that come from many different backgrounds, cultures, and languages – what are some specific ways you take that into consideration when you work with these families?
[PROBE: Do you adjust any part of your process supporting families to accommodate different backgrounds, culture, and/or language?]
To what extent do you work with fathers? What are some specific ways you take that into consideration in your work?
How long do you typically work with a parent?
Do you continue to stay in touch with parents after they leave your site or does your relationship end when they leave?
To what extent do you gather and track information on parents?
[PROBE: What kind of information do you gather/track?]
How do you use your program’s MIS to do this?
How do you like the database?
[PROBE: What works well? Is there anything you would change?]
[INTERVIEWER: TAILOR BASED ON SITE’S CURRENT WORK STATUS – OPEN OR WORKING REMOTELY – AND TO GET AT PERIODS WHEN COVID-19 WAS MOST EXTREME – E.G., CENTER COMPLETELY CLOSED AND ALL SERVICES REMOTE – AND MORE OF A HYBRID – E.G., CENTER PARTIALLY RE-OPENED, SOME SERVICES IN-PERSON AND SOME REMOTE]: What are some specific ways the COVID-19 pandemic may have affected your process for working with parents?
[PROBE: Processes for recruiting/enrolling parents, engaging with parents, frequency of meetings with parents, how you meet with parents, how you communicate with parents]
In what ways has the pandemic affected your process for building and maintaining relationships with families, now that you can't see them in-person?
What has made working with families easier or harder?
Next, I’d like to learn about your process for understanding parents’ needs and strengths, and then setting goals with them. Let’s first talk about what the process looked like prior to the COVID-19 pandemic, and at the end I’ll ask about how it may have changed in response to the pandemic.
What are some specific ways you determine parents’ needs and strengths?
What tools and supports do you use with parents to understand and keep track of their strengths and needs?
[PROBE: For example, do you use any templates, assessments, or other materials (like paper forms)? Are these forms in your MIS?]
Do you ever bring in other staff to work with you to assess parents’ needs and strengths (for example, a specialist, an interpreter)?
When do you determine parents’ needs and strengths – what is your timeline?
What might make you determine one family’s needs and strengths right away and another family’s needs and strengths at a later date?
What kinds of services and supports to parents typically say they need – for example, education, economic assistance, asset development, housing and food assistance, physical health (such as tobacco cessation, nutrition, or other services to maintain and promote physical health and well-being), or mental health?
What services and supports do you often observe they need?
What are some specific ways you set goals with parents?
What tools and supports do you use to specify and keep track of parents’ goals?
[PROBE: For example, did you use any templates or other materials (for example, paper forms) in this process? Are these forms in your MIS?]
When do you begin the goal-setting process with parents – what’s your timeline?
What might make you determine one parent’s goals right away and another parent’s goals at a later date?
Please give me some examples of goals parents set with you.
[PROBE: Are these short- or long-term goals, or both? Did the parent set goals for their children versus goals for the parent?]
Who generally takes the lead in determining and setting goals – you or the parent?
Do you offer suggestions or “nudge” parents to consider different or additional goals?
What are some specific strategies and action steps you develop with parents to help them achieve their goals?
Do you ever break any of these goals into smaller steps?
How did you develop these steps?
I’d like to learn how this process is going, generally. What are some specific things that have made it hard for you to go through this process – to determine parents’ needs and strengths and set goals with them?
[PROBE: What has been challenging about going through this process?]
Are there any situations when some parents may require more prompting and follow-up to go through this process than other parents?
What are some specific things that have made it easier for you to go through this process – to determine parents’ needs and strengths and set goals with them?
[PROBE: What has gone well for you as you have gone through this process?]
What are some specific ways the COVID-19 pandemic may have affected your process for determining parents’ needs and strengths, and setting goals?
[PROBE: Processes for determining parents’ needs and strengths, determining families’ well-being needs and interests, setting goals with parents, the goals parents set, helping parents achieve their goals, things that make this process harder and easier]
Next, let’s talk about the family support services parents receive. Again, let’s first talk about what these services looked like prior to the COVID-19 pandemic; afterwards, I’ll ask about how the pandemic may have affected this process.
Do you generally refer parents to receive services provided by your Head Start program, by your parent agency (that is, the delegate, grantee, or another part of your organization), or services provided by external community providers (that is, other organizations, agencies, or people in your community that provide services to help families), or a combination?
Which types of services are provided by which provider (your Head Start program, your parent agency, community providers)?
Where are these services provided – at your site, at the provider’s location?
What steps do you take to refer a parent to receive services?
[PROBE: What did that referral look like (for example, was it done via a database, a phone call, an email, signing the parent up for an orientation)?]
How does this differ depending on whether you are referring them to services provided by your parent agency or a community provider?
When you are referring a parent, what do you do to hand the parent off to the provider?
[PROBE: What, if anything, do you discuss with the provider about parents? Do you call providers and introduce them to parents? Do you provide transportation to providers?]
Do you accompany parents to facilitate the introduction?
Are there any situations where one family may require more help on your part with this referral and hand-off than another family?
*What kind of information do you share with parents about providers outside your site?
What are your observations about how parents use these types of resources?
*What kinds of materials and resources do you share with parents?
[PROBE: For what purpose?]
In what languages?
What is your observation of how parents use the resources you give them?
*Do you ever connect parents to formal or informal social supports or cultural resources?
I’d like to learn how this process is going, generally. What are some specific things that have made it hard for you to connect parents to appropriate services?
[PROBE: What has been challenging about this process?]
Are there any situations when a family may have required more prompting and follow-up to use these services than another family?
Have you come across parents with needs or requests that could not be met because services were not available? (Either because the service was not offered at all, or there was a waiting list.)
What are some specific things that have made it easier for you to connect parents to appropriate services?
[PROBE: What has gone well with this process?]
What are some specific ways the COVID-19 pandemic has affected your process for referring parents to services?
[PROBE: Changes made to the services provided by Head Start center, agency, or external provider; steps for referring a parent to services; information shared with parents and with outside provider, when referred to outside provider; what has made the process harder and easier]
We’ve talked about parents who are receiving services. I’m also interested in learning about parents who either aren’t receiving services or who don’t seem to get a lot out of these services.
Are there any parents who do not seem to get a lot out of these services?
What are some specific reasons they don’t benefit from these services?
Do you have any examples of parents you tried to work with but were not successful?
What are some specific reasons parents declined services?
[PROBE: For example, they believe they don’t need help, they don’t feel a match with the particular family support worker, they don’t have enough time, they don’t have transportation, there are limited local resources, there aren’t enough culturally or linguistically appropriate resources, they perceive negative consequences for accessing safety-net programs]
Are there certain services that tend to be declined? If so, which services, and why do you think they aren’t used?
Next, let’s talk about how you monitor, track, and follow-up with parents. Again, let’s first talk about your process prior to the COVID-19 pandemic; afterwards, I’ll ask about how the pandemic may have affected this process.
What are some specific ways you monitor, track, and follow-up with parents on their progress towards meeting their goals?
[PROBE: In what specific ways do you follow-up with parents and how often?]
What specific tools and supports do you use to track parents’ progress?
How do you track parents’ uptake of services – how do you learn about the services parents are receiving (or did not receive)?
[PROBE: For example, from providers, from the parent, from others? How often do you follow up with the service provider to track family progress?]
Are there any situations when a parent might require more prompting and follow-up than another parent?
*In what specific ways do you work with community service providers to reassess needs or adjust the service plan for parents?
[PROBE: What are some specific things that involved?]
I’d like to learn how this process is going, generally. What are some specific things that have made it hard for you to track parents’ process and follow up with them?
[PROBE: What has been challenging about the tracking and follow-up process?]
What types of things have made it easier for you to track parents’ process and follow up with them?
[PROBE: What has gone well with the tracking and follow-up process?]
What are some specific ways the COVID-19 pandemic may have affected your process for monitoring, tracking, and following-up with parents?
[PROBE: Changes made to tools used to monitor, track, and follow-up; changes in terms of what has made the process harder and easier]
Thank you for describing the details of how you coordinate family support services for families at your site. Now, I’d like you to take a step back. In our pre-visit call, I mentioned that I would like to hear about how you went through/are going through this process with one specific family – the family with [COMMON SERVICE NEEDS OR EXCEPTIONAL SERVICE NEEDS]. Please tell me the story of your work with this family. I’m interested in understanding the arc of your work with this family, and their experiences with family support services in particular. Please walk me through how you started working with them, their needs and goals, your interactions with them, and their experiences in the program and with family support services, up to where things are now. Any details, examples, and stories you have to share about your work with this family and their experiences accessing family support services would be very helpful. FAs a reminder, please do not share their names so we can keep their identity private.
[STATE IF NEEDED – IF RESPONDENT IS HESITANT TO SHARE: I know that some of these topics are sensitive and may be difficult to share. Even if you’re able to share in a general way, it would be very helpful. We’re here on behalf of the Office of Head Start, but so you know, we have a Certificate of Confidentiality from the federal government, which says that we do not have to share any of this information, even under a court order or subpoena.]
[SPEND ABOUT 20 MINUTES ON THE CASE NARRATIVE. USE PROBES BELOW AS APPROPRIATE TO ELICIT DETAILS ABOUT WORKING WITH THE FAMILY, BUT TO EXTENT POSSIBLE, LET FSW GUIDE HOW THEY TALK ABOUT THE PROCESS. THE GOAL IS TO GET THE FSW TO GIVE A NARRATIVE OF WORKING WITH THE FAMILY AND THE FAMILY’S EXPERIENCES WITH FAMILY SUPPORT SERVICES, FROM THE BEGINNING OF THEIR WORK TOGETHER TO THE PRESENT DAY.]
Think back to when you met this family for the first time. How did this family come to be on your caseload?
Describe your first interaction with this family.
[PROBE: Where and when did this interaction take place? How long did it last? What did you discuss?]
Now, describe your first formal meeting with the parent(s) from this family.
[PROBE: Where and when did this meeting take place? How long did it last? What did you discuss?]
What did you do next with the parent from this family?
Why?
What are this family’s needs and strengths?
Tell me about how you learned about this family’s needs and strengths. When did you receive this information?
What are this parent’s goals?
Tell me about how you determined this parent’s goals.
What types of services did this parent need?
What role did you play in connecting this parent to the services they needed?
Tell me about any referrals you made for this parent.
To whom did you refer this parent (someone within your Head Start program, someone at your parent agency, and/or a community provider)? What steps did you take to make this referral?
[PROBE FOR THE FULL STORY, FOR DETAILS ON HOW THE FSW WORKED WITH THE PARENT AND THEIR PROCESS IN THE PAST UNTIL YOU GET TO THE PRESENT – WHERE THEY ARE WITH THIS PARENT]
Now, let’s think about where this family is now. Tell me about their current situation.
What services is this parent receiving currently?
Have this family’s circumstances have changed since you started working with them? If so, what are some specific ways their circumstances have changed?
[PROBE: How have the family’s needs or goals changed? How have their services changed?]
[IF CHANGES MENTIONED]: What are some specific things that led to these changes with this family?
[PROBE: Why do you think these changes happened? What was your role in bringing about these changes? What was the role of other staff, organizations, or outside factors in bringing about these changes?]
Have this family’s circumstances been affected by the COVID-19 pandemic? If so, in what ways?
Are you still working with this family? If so, in what ways, if at all, has the COVID-19 pandemic changed how you work with this family?
[PROBE: In terms of your process for working with this family, such as how you communicate with them, how often you communicate with them, services you refer them to, their uptake of services, how you track and monitor their service uptake]
What was/is challenging about coordinating family support services for this family?
[PROBE: What are some things that made it hard for you to coordinate services for this family?]
[INTERVIEWER: CLARIFY IF CHALLENGES DESCRIBED ARE DUE TO COVID-19 OR SEPARATE]
Were the needed services available and accessible to the family?
Did/do you receive enough support from your site to support this family?
Did/do you have the time you need to work with this family?
If you could go back in time, what are some specific things you would do differently with this parent?
Why?
What has gone well with coordinating family support services for this parent?
[PROBE: What are this parent’s accomplishments? What are you the most proud of having done with/for this family?]
What are some specific things that have made it easier for you to coordinate services for this family?
Now let’s talk about how you may work with other agencies and external community providers. Let’s first talk about how you work with external providers prior to COVID-19, and then I’ll ask specifically about how the pandemic has changed this process.
Do you ever coordinate with case managers from other agencies and programs? For example, public assistance (from the Temporary Assistance for Needy Families program [TANF]); food stamps or an EBT card (from the Supplemental Nutrition Assistance Program [SNAP]); a program that provides training and supports to learn a skill for a job (workforce development program); child support; services and supports from an agency to make sure that children are safe and that families have supports needed to care for them successfully (child welfare); health programs or Medicaid?
If so, which agencies do you coordinate with the most? Why?
What are some specific ways you coordinate with these other case managers?
Do you have regular meetings where you review all cases you have in common? Or do you meet/communicate as needed, ad hoc?
What are some specific ways you share information or coordinate services or plans?
What agencies or community services do you refer parents to most often?
*What are some specific ways you find out information about the different agencies or community services available and how they may change over time?
[PROBE: What sources of information about local or community resources do you have? Who are they – for example, managers, supervisors? Does your area use 211 to identify local services or another type of comprehensive health and human service referral and information service?]
Do you maintain a directory or handbook of community resources?
Do you give parents a copy?
Do you have a role in initiating or maintaining partnerships with service providers? If so, can you describe your role – how do you initiate or maintain a partnership with a service provider?
Have you developed new partnerships in the past year to address family needs? If so, with what service providers?
Which organizations or services do you wish you had more access to in your community? For instance, think about which services you may not have in your community as well as services that are in your community but there are not enough to meet the need.
Do you feel as though you have enough services or organizations that match families’ backgrounds or that can provide services in a culturally sensitive way?
Are there any services that are available but aren’t widely used by your parents? If so, why do you think that might be?
What are some specific ways the COVID-19 pandemic may have affected your process for working with other agencies and external community providers?
[PROBE: How you find out about services, the types of services you seek out, how you communicate with external providers]
Next, I have a few questions about how you are supervised and supported, and about any professional development you might receive.
Please describe your formal supervision and support. Who do you report to?
When you meet ,do you discuss topics related to service coordination? If so, tell me about what you discuss related to service coordination.
*To what extent does your supervisor provide the support and guidance needed for you to generate answers to your own questions?
Does anyone else work with you to improve practice around service coordination on an ongoing basis like a mentor or coach? What do you discuss?
Please describe how you were trained for your position.
Do you engage in reflective practice?
[PROBE: That is, do you intentionally self-reflect about your work, thinking about your past practices in order to gather information on how to adjust your practices in the future?]
If so, please describe what that looks like.
How does your supervisor support you in engaging in reflective practice?
Are there any areas where you would benefit from additional training, professional development, or technical assistance (TA) to coordinate family support services at your site?
In what ways, if at all, has the COVID-19 pandemic affected the training, professional develop, and or technical assistance needs you might have?
Next, I have a few questions about staff wellness and morale at work.
Thinking overall about your workplace, how would you generally describe current staff morale?
[PROBE: That is, are staff generally happy and satisfied at work?]
Does this differ by the staff position? For instance, would you say there is more positive morale among administrators than there is among teachers?
What is morale like with the staff who provide family support services, specifically?
In what ways, if at all, has the COVID-19 pandemic affected staff morale?
Do you ever feel stressed, emotionally drained, or burned-out at work?
Is your caseload manageable?
What do you think causes these feelings? Are there specific aspects of your job or tasks that cause more stress than others?
Is there anything your site offers to staff who feel stressed, drained, or burned-out at work? For instance, does your site provide any mental health resources for staff?
What other specific things do you wish your site would provide for staff to help with staff wellness?
We’re almost finished – I have just a few more questions about how everything is going for you, overall.
What are some specific things that have been challenging about providing parents with support services?
Why do you think this is the case?
How have you addressed these challenges?
What are some things that have been challenging about providing parents with support services specifically because of the COVID-19 pandemic?
To what extent has remote service delivery been challenging?
[PROBE: For example, internet access issues]
What are some specific things you would do to improve on your site’s provision of family support services?
What do you wish you could do differently?
To what extent do you need additional support to improve family support services?
*Thinking about your overall role providing parents with support services, what are some specific things that have been going well?
Do parents seem to benefit from the services your Head Start site provides to them?
How so – do you have an example?
*Finally, what is the thing you’re most proud of doing this year, in terms of providing family support services?
Those are the last of my questions. Before we end, I wanted to ask you – is there anything I missed about how you provide and coordinate family support services? Anything more you want to add in or any questions I should have asked?
Thank you so much for your time! Our next steps are to complete this site visit, interviewing staff, parents, and community providers, and then to visit additional case study sites.
1 Family support services include: Help or assistance with obtaining a high school diploma, a training certificate or a degree; or English language classes (Education); Help or assistance with finding a job (Employment); Help or assistance in managing money and making financial decisions (Financial capability services); Help or assistance with finding an affordable house or apartment to live in (Housing); Help or assistance with finding food pantries or food banks in your community (Food assistance); Immediate help and support when you have an emergency or crisis with your family or living situation (Emergency or crisis intervention services); Help or assistance with getting substance abuse treatment (Substance abuse treatment); Help or assistance with accessing medical and dental services, such as tobacco cessation services, nutritional services, or other services to maintain and promote physical health and well-being (Physical health services); and Help or assistance for depression or anxiety (Mental health services).
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Michelle Maier |
| File Modified | 0000-00-00 |
| File Created | 2022-09-12 |