A critical analysis of the broker and strengths models of case management: identifying a potential framework for community case managers.

In Canada, case management has been applied to a variety of health care settings including the community care system, where case managers have become an integral component in the delivery of government-funded, in-home services. Specifically in Ontario, home care is accessed through 43 Community Care Access Centres (CCACs), and the model currently driving case management practices most closely resembles the Broker model. Not only does this create moral distress among the case managers, but it also hinders their ability to meet the health care needs of the community as current cost containment strategies can lead to suffering and emotional distress for a significant portion of the people who are cut from care. This article will identify a potential framework for case managers in CCACs. The Strengths model offers a framework that is consistent with the goals of Ontario case managers and is committed to client autonomy, empowerment, and client-driven care. Given the multitude of health care challenges facing CCAC case managers today, the Strengths model of practice has the potential to contain and maintain costs without compromising the psychological wellbeing and health care needs of the community.