title: Supporting people with disabilities in managing individual budgets: the role of support brokers.
abstract: OBJECTIVE
  Nationwide people with disabilities are self-directing their long-term care supports through individual budgets. Because these individuals may rely on a "support broker" to assist them in making and executing decisions regarding their budgets, the interactions between the participant and the support broker can influence participant autonomy.
  
  
  METHODS
  Massachusetts piloted a program for 14 participants to receive individual budgets for home and community-based services. Central to this pilot were the participant-designated support brokers, including home care case managers and peer advocates.
  
  
  CONCLUSIONS
  Analysis of data on participants and support brokers indicated that the support brokers struggled with when, how, and how much to assist participants to self-direct.
  
  
  CONCLUSIONS
  Case managers or other providers assuming the support broker's role will need proper training if they are to respond skillfully to challenging situations self-direction may bring.
authors.affiliation: University of Massachusetts Medical School, Shrewsbury, USA. emma.quach@umassmed.edu
authors.forename: Emma D
authors.initials: ED
authors.lastname: Quach
authors.forename: Darlene Dee
authors.initials: DD
authors.lastname: O'Connor
authors.forename: Erin
authors.initials: E
authors.lastname: McGaffigan
mesh_terms: D000203:Activities of Daily Living; D002017:Budgets; D019090:Case Management / Q000191:economics*; D003657:Decision Making; D006233:Persons with Disabilities; D005376:Financial Management / Q000379:methods; D017144:Focus Groups; D006801:Humans; D008404:Massachusetts; D008484:Medicaid; D017146:Models, Organizational; D026684:Personal Autonomy; D010865:Pilot Projects; D012944:Social Support; D014481:United States