Supported Decision-Making

What is supported decision-making?

Everyone, regardless of their disability or what supports they need, has the right to make choices. Supported decision-making (SDM) empowers people with disabilities to pick people they trust, usually family and friends, to help them understand, communicate choices, and make informed decisions. SDM is an alternative to conservatorship allowing people with disabilities to retain choice and control over their lives and to live a life with support, and without the court.

Whether or not you have a disability, we all use supported decision-making in our lives every day. Counting on your spouse to help you with your computer, calling a friend who is a nurse to give you advice on a medical procedure, or seeking a second opinion on a financial decision are all examples of using SDM.

SDM is recognized in over 30 states. In California, SDM was codified into law in 2022 through the Conservatorship Reform and Supported Decision-Making Act, legitimizing the practice of SDM formally or informally, and providing a route out of conservatorship through the use of SDM.

​What does Supported Decision-Making look like?

SDM looks different for everyone. While one person might have one or two supporters, another may have a large team consisting of family, friends, and professional staff. Each supporter may take on a different role, and each person practicing SDM might need help with different types of decisions. Some examples of customized tools to help people communicate and understand choices include:

• Chosen, trained partners who listen and facilitate communication – using Alternative and Augmentative Communication (AAC) if needed.
• Plain language, visual or audio material
• Extra time to discuss choices
•  Lists of the pros and cons of choices
• Role-play activities to help the person understand
• Supporters attending appointments to take notes and help discuss options
• Consideration of a joint bank account and other ways to manage financial decisions together

What is a Supported Decision-Making Agreement?

SDM can be formalized in a Supported Decision-Making Agreement (SDMA) where the roles and responsibilities of supporters are outlined and certified by the person with a disability and their team, but often it is practiced informally. SDM is flexible and is designed to change as life changes, therefore SDMAs can be created, amended, and terminated instantly, with no involvement of the court. SDMAs are optional. Only when exiting a conservatorship is a SDMA required.

Getting Started with SDM

Step One:
Learn more about SDM

• View this Introductory SDM Fact Sheet for families
• Download DVU’s Handbook for Parents.
• Join our Mailing List for upcoming trainings

Step Two:
Identify supporters and create goals

• Think of trusted individuals whom you and/or your loved one want to help you make decisions.  Supporters can be family, friends, neighbors, and even staff
• Consider the types of decisions you want to make yourself versus those where you would like support
• Determine the tools needed to communicate and understand choices.
• Use this Exploring Decision-Making Supports tool by Nexus.

Step Three:
If needed, create an SDM Agreement

• Determine if you would like to practice SDM informally, or if you would prefer to formalize it with a written SDM Agreement.
• Download a Sample SDM Agreement.

Step Four:
Combine SDM with other tools and legal documents

• Other legally binding documents can be used to help recognize a self-advocate’s choice to use SDM at school, at the doctor’s office, and in the world.
• Here are forms in plain language that the American Civil Liberties Union (ACLU) and the Autistic Self Advocacy Network (ASAN) created:
  • Sample HIPAA Authorization for Disclosure of Health Information
  • Sample Authorization to Disclose Educational Information
  • Sample Durable Power of Attorney for Healthcare
  • Sample Durable Power of Attorney for Finances
  • All Sample Authorizations in One Document

Step Five:
Advocate for SDM in your/your loved one’s life

• Encourage the use of SDM in all aspects of the life of the individual with a disability.
• Share this SDM Primer for Professionals.
• Utilize this SUPPORT Medical Tip Sheet.
• Use the Know Your Rights Card when needed.
• Create a Healthcare Passport

Supported Decision-Making Training and Information Center

Resources and training on supported decision-making are brought to you by Disability Voices United’s SDM Training and Information Center (SDM-TIC). Through generous funding from the State Council for Developmental Disabilities Supported Decision-Making Technical Assistance Program (SCDD SDM-TAP), all materials and workshops are available to all self-advocates, parents, and professionals across California free of cost.