Academic journal article Care Management Journals

Dodecaphony: Enacting Support Brokerage in the 12 Cash & Counseling Expansion States

Academic journal article Care Management Journals

Dodecaphony: Enacting Support Brokerage in the 12 Cash & Counseling Expansion States

Article excerpt

The national Cash & Counseling Program is a Medicaid waiver program originally sponsored by the Robert Wood Johnson Foundation that allows recipients to manage a fl exible budget to purchase those goods and services so as to best meet their needs and increase access to personal care services. It was initially implemented in Arkansas, Florida, and New Jersey, and, in 2004, the program was expanded to include 12 additional states. In each state, there is a job title that performs support brokerage functions to assist consumers in learning how to direct their own care. The authors rightly argue that this is a diffi cult concept to defi ne. This article examines the implementation of the support broker concept-how this function is performed, what tasks are emphasized, who provides this assistance and how this function coordinates with other support activities.

When you grasp that dodecaphony, a somewhat obtuse convention, refers to 12 discordant voices, you begin to understand the focus of this article. The authors contend that this article will "map out the various ways in which [the 12 expansion] states have operationalized the support brokerage concept," and various they are. In fact, the overall fi ndings of this article indicate that the 12 expansion states have created 12 distinct programs, "each with it's own strengths and weaknesses, and each with it's own twist on the paradigm of consumer direction. …

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