The Brokerage Model

In 1982, the Community Living Society published “Choices. The Community Living Society. New Methods of Responding to the Individual with a Handicap”. The document explained the brokerage model, and how it represented a significant change to the way service was provided to people with disability. The following has been excerpted from this document:

“Attaching dollars to the individual and providing him or her access to a service brokerage is a marked departure from the traditional pattern, which has evolved in human service delivery. In most communities it can be observed that the supply system (residences, workshops, special classes) has come to function as the demand side of the equation. Funding arrangements often require that spaces in existing service “be filled.” The individual is not then the prime consideration in the placement. It is therefore common to find individuals, capable of living or working independently, “locked” into a specific service that does not foster greater independence. For similar reasons, individuals are often routinely referred and accepted into resources primarily because of space availability. The size of a waiting list becomes a measure of hope. Usually, a particular resource’s large waiting list is explained as evidence of need for expansion of that resource, while in fact it is indicative of nothing more than a limited range of other options available to the people on the list.

If the individual with a handicap is to gain access to and enjoy maximum opportunities from the resources available in the society, a crucial link must be established to liaise or broker, in the best interests of that individual, with those resources. If this vital link is to function it must on an ongoing basis:

  • Be able to assist the individual to assess and articulate his or her particular needs and service requirements to service providers;
  • Be knowledgeable about the full range of existing resource systems, and be able to accurately appraise what they can and cannot do to appropriately meet the needs of the individual;
  • Stimulate service providers to enhance their systems where gaps exist between needs (demands) and service (supply)
  • Help initiate effective service providing systems where existing systems cannot properly respond;
  • Suggest a comprehensive strategy according to which the individual can accommodate his or her needs, given available or potentially available resources;
  • Assist the individual to access those resources;
  • Assess the individual’s ongoing levels of well-being and growth, monitor the effectiveness of that needs-meeting strategy, of those services and of the resources providing services;
  • Act in the best interests of the individual in relation to service providers; and
  • Where breakdowns occur in the supply of appropriate services, suggest to the individual specific and more effective alternative strategies, services and service providers.

 By availing him or herself of this sort of brokerage model as an assisting tool, the individual should be able to secure the particular range of services he or she requires from within the community at any given time. When properly implemented the brokerage process can enable a normal “meshing” of the individual with the community, thereby neutralizing and resolving many of the unnecessary and unjust difficulties the individual and his or her family could otherwise have to face, often alone.

It is a crucial practical necessity that funds to purchase services in the community must be “attached” (allocated) to the individual with a handicap, so that he or she will have the economic power which gives the real option to choose from several brokering bodies the one which most effectively assists in meeting his or her particular needs. In this way, the individual will have the power to demand options to the extent that dollars are power.

The twin focus of the brokerage approach is, on one hand, to help the individual access service supply systems, and on the other, to challenge those systems to respond appropriately to the requirements of the individual consumer, and not only to its own (the system’s) maintenance needs. The critical balance between the individual and community programme concentrations of the brokerage approach is maintained by equalizing the consumer demands (as expressed through the individual’s service requirements) and the ability of the service supply network to respond to those demands. The appropriate way to equalize is to stimulate the supply network to accommodate demands, and not to restrict consumer demands. In other words, the balance between service supply and consumer demand must be resolved in favour of the individual.

The effectiveness of the brokerage process, once implemented, will depend largely upon the extent to which it can identify and respond to the needs of the individual with a handicap. In point of fact, this statement holds no less truth for any direct service provider. In this regard, listening and responding insightfully to the individual will be a foundation of the brokering body.”

The Woodlands Parents' Group knew that the success of the brokerage model would depend on the ongoing involvement of one or more advocates who could assist the person with disability, or speak on their behalf to make their wishes clear. Some of the broker’s functions overlapped the advocacy role, opening the door to potential conflicts of interest. The group argued that family members were ultimately the best choice as advocates.

“It is the purpose of the advocacy process to keep systems and individuals true to the highest standards of conduct with respect to the person with a handicap and his or her family members. Therefore, the advocacy process should adhere in an exemplary fashion to those beliefs and values concerning the individual which guide the brokering body.

In every step of the process of life, there must be someone available to enable a way of life best suited to the fulfillment of the individual’s freedom, happiness and health. In these regards, understanding another’s wishes and needs is critical.

It will often be the case that the individual’s family members most effectively and most consistently fulfill the functions of advocacy. Family members may request another individual or group of individuals to augment the family’s advocacy efforts, in which case such person should be available. Where family members are not able to fulfill these functions, an alternative or group of individuals must act in this capacity.” 

Initially, the Community Living Society was established to connect families to existing services through a brokerage agency funded by the Ministry for Human Resources. However, as it became clear that certain services were not available or accessible to some of the individuals moving out of Woodlands, the society itself began to provide some of the much-needed residential and daytime supports.

The families knew it was important to maintain separation between brokerage and service provision, and they were also committed to broadening the range of services available in the community. In 1988, they launched a pilot project with the Ministry of Social Services and Housing to test the concept of independent brokerage and individualized funding with a group of 50 individuals and their families. Brokerage was split off from the society and became an independent entity.

Sources:
Choices. The Community Living Society. New Methods of Responding to the Individual with a Handicap. M. Rioux and C. Crawford 1982.
Development of a Comprehensive Community-Based System of Service as an alternative to Woodlands. Woodlands Parents’ Group. February 1977.
Explorations. A Presentation by Family Link Society (formerly Woodlands Parent’s Group)
A Master Plan for Community Living. Brian McKenney and Leigh Koenisfest. December 1990.