Supported Decision Making | UC Davis MIND Institute

Toma de Decisiones con Apoyo (SDM in Spanish)

Quyền Tự Quyết định có Hỗ trợ (Vietnamese version)

When a young person with disabilities approaches the age of 18, families are often incorrectly told that they must seek conservatorship (guardianship) or they will no longer be able to obtain information or provide guidance and support in the areas of healthcare, education and other services. In fact there are a variety of tools commonly used that allow families to continue to provide support to their loved ones. While some people with disabilities may need assistance with understanding information and making decisions, conservatorship is the most restrictive option. Conservatorships are rarely altered or reversed, locking people into permanently having other people making binding decisions for them, often without their input. Families are often unaware of potential complications of conservatorship or the alternatives available to support their loved ones. The following materials present an overview of concerns about the current conservatorship process for people who can participate in the decision-making process:

• Beyond Guardianship: Toward Alternatives That Promote Greater Self-Determination (PDF)
  (2018 National Council on Disability report)
• Turning Rights Into Reality: How Guardianship and Alternatives Impact the Autonomy of People with Intellectual and Developmental Disabilities (PDF)
  (2019 National Council on Disability report)

Introduction to supported decision-making

Supported decision making (SDM) allows people to obtain guidance and support without relinquishing their legal right to make decisions about their lives. Using supported decision-making, a person with a disability chooses a person or a team of trusted people to help understand, make, and communicate their decisions. The person may rely heavily on their supporters when making decisions, but the decisions ultimately remain within their control. Supported decision-making is a very flexible process; as the person gains experience, the areas in which they seek support and the people who they choose to support them may change. The following materials provide an overview of the supported decision-making process:

• Supported Decision-Making / A companion booklet to the CEDD/ACLU video series (PDF)
• What is Supported Decision-Making and What Does a Supporter Do? (ACLU)
• Supported Decision-Making: Frequently Asked Questions (ACLU)

Getting started with supported decision-making

Supported decision-making is a simple process and is often informally practiced by families and our service system. Formalizing supported decision-making is a relatively new process. The following resources are helpful to help get started with exploring a formal supported decision-making process.

• Supported Decision-Making Teams: Setting the Wheels in Motion  (Suzanne Francisco and Jonathon Martinis)
• Brainstorming Guide: How Are We Already Using Supported Decision-Making? (ACLU)
• How to Make a Supported Decision-Making Agreement (ACLU)
• Implementing Supported Healthcare Decision-Making for Users of Augmentative and Alternative Communication in California (PDF)
• Steps in Supported Decision-Making (American Bar Association). This tool was written for attorneys but is a very practical guide for families and support teams.
• You Can Do It Without a Conservatorship! (ACLU)  Includes authorizations to share medical and educational records.
• Partners in Health: Implementing Supported Healthcare Decision-Making for Users of Augmentative and Alternative Communication in California

For more Information

• American Bar Association resolution Urging supported decision-making be identified and fully considered as a less restrictive alternative before guardianship is imposed. Sample arguments for brief opposing conservatorship in California.
• Supported health care decision-making for people with intellectual and cognitive disabilities (Clarissa Kripke, Department of Family and Community Medicine, University of California San Francisco) Using a Supported Decision Making lens in evaluating competence.
• Principles: Conservatorship of Persons with Disabilities (Disability Rights California)
• Limited Conservatorships and Alternatives

Supported decision-making resources for other states

Several states have supported decision-making legislation.  While legislation is not required to use supported decision-making where you live, it is helpful to be aware that the model has been legally recognized. 

• The National Resource Center for Supported Decision-Making is an excellent resource for current information about legislation throughout the US.
• California’s 2022 Assembly Bill 1663 (Legislative text)
• California’s 2022 Assembly Bill 1663 (Fact sheet)

Support for CEDD's Supported Decision Making Project, including development of this webpage,
was provided by the WITH Foundation.