2510.1 Individual and family support services include the ways a Health Home supports the consumers and their support teams (including families and authorized representatives) in meeting the range of psychosocial needs and accessing resources (e.g., medical transportation; language interpretation; appropriate literacy materials; and other benefits to which they may be eligible or need). The services provide for continuity in relationships between the consumers/families with their physicians and other health service providers and can include communicating on the consumers’ and families’ behalf.

2510.2 Individual and Family Support Services include:

1. (a) Activities that facilitate the continuity in relationships between consumer/family and physician and care manager;
2. (b) Advocacy on a consumers' behalf to identify and obtain needed resources such as medical transportation and other benefits for which they may be eligible;
3. (c) Consumer education on how to self-manage their chronic condition (s);
4. (d) Providing opportunities for the families to participate in consumers' assessment and care treatment plan developments;
5. (e) Efforts that ensure that Health Home services are delivered in a manner that is culturally and linguistically competent;
6. (f) Efforts that promote personal independence and empower the consumers to improve their own environment and health. This may include engagement with consumers' families in identifying solutions to improve consumers' health and environment and helping consumers and their families with consumer's authorizations to access the consumers' health record information or other clinical information;
7. (g) Language interpretation services;
8. (h) Housing assistance services;
9. (i) Providing consumers with access to their EHR or other clinical information, and providing access to their family members and authorized representatives if the beneficiary provides written

authorization to do so;

(j) Developing family support materials and services, including creating family support groups where appropriate;

(k) Include the consumer family in the quality improvement process including surveys to capture their experience with Health Home services; and

(l) Facilitate referrals to support services that are available in the individual's community and assist with the establishment of and connection to natural supports.

SOURCE: Final Rulemaking published at 63 DCR 849 (January 22, 2016); as amended by Final Rulemaking published at 66 DCR 5625 (May 3, 2019).