Dodecaphony: Enacting support brokerage in the twelve cash & counseling expansion states

Support brokers are entities that provide information and assistance to self-directed clients in Medicaid waiver programs. Although all Cash & Counseling programs have support brokerage, each state has a great deal of liberty in determining how those functions are carried out, who provides those activities, which functions are emphasized, and how responsibility for support broker tasks coordinates with other support activities. In this article, we map out the various ways in which states have operationalized the support brokerage concept. Differences in title, qualifications, training, hiring preferences, and caseload are described, and further directions for research are suggested.