Alternatives to Guardianship: Supported Decision Making Agreements (SDM)

Family members and other caregivers may seek a guardian for someone with disabilities. However, guardianship has many downsides.

• Once a guardianship is in place, it is hard to remove.
• Guardianship can have negative consequences for people with disabilities and their families and caregivers.
• Guardianships often wrongly assume people with disabilities cannot make decisions for themselves. 

Before asking for guardianship, you should look into the alternatives. You should try to use an alternative to guardianship if you can.

A Supported Decision Making (SDM) Agreement is one such alternative. It helps people with disabilities without limiting their rights.

You will lean what SDM is, how it works, what is good and bad about SDM, and how to create, change, or end an SDM agreement

It lets people with disabilities choose supports to make decisions and exercise their legal rights.  With an SDM agreement, the person chooses a trusted friend, relative and/or other to help them understand and make decisions, and to communicate decisions to, for example, doctors and the bank. 

Some examples of supports you can choose include extra time to discuss choices, role playing with alternative outcomes, use of assistive technology, and having a support person to take notes and help the person discuss their options.

They only need to understand what the agreement covers. 

It must be in writing and list:

• areas in which the person wants support with decision-making
• names of supporters and their relationship to the person
• how the supporter will support the person in their decision-making

No. The person with the disability decides everything.

Here are some examples.

• Understanding how the person makes decisions - for example, allow extra time for a person's response.
• Understanding how the person wants to get information to help support them in decision-making.
• Helping to figure out what the person wants, not what the supporter believes is best.
• Making the decision-making process accessible to the person with the disability based on their wants and needs. This can include, for example, engaging in demonstration, role-playing, and/or one-on-one conversation.
• Respecting the person's values, preferences, and decisions.

Yes.  You can read the state law at RCW 11.130.700 through RCW 11.130.755.

• It promotes independence for people with disabilities. 
• It respects the wishes of the person with a disability.
• It does not take rights away from the person with a disability.
• Creating, executing, and changing a SDM agreement is easier and faster than getting or changing a guardianship. You do not need to use the court system.
• It does not cost anything. You do not need a lawyer.
• It is a formal document. Professionals, providers, and others are much more likely to cooperate with you if you use an SDM.

A person with disabilities should choose a trusted friend, relative and/or another person to provide SDM.

These people cannot be supporters:

• Paid employees of the person with a disability. There is an exception to this for immediate family members.
• Immediate family members or other persons against whom the person with a disability has gotten a court order of protection.
• Anyone subject to a civil or criminal no contact order keeping them from contacting the adult with a disability.

Yes. SDM is a flexible, less restrictive alternative to guardianship for someone with a disability who is turning 18.  Read Your Child with Disabilities is Turning 18 to learn more.

As the young person ages, their needs change. You can easily change the SDM agreement to keep up. It does not cost anything.

For students under age 22 and eligible for special education, you can combine an SDM Agreement with an agreement between student and parent to share education decision-making. You can read the state rule about this at WAC 392-172A-05135.

You can often combine SDM with other guardianship alternatives.

This is a good idea. Combining an SDM agreement with these other alternatives will give the person with a disability support and more self-determination:

• Durable power of attorney - read Durable Power of Attorney Documents to learn more
• Health care directives (or living will) - read Health Care Directive (or Living Will) to learn more
• Representative payee agreements, for people who get Social Security or SSI benefits - read ssa.gov/payee to learn more

The person who creates an SDM agreement must understand what they are doing. The person and their supporters must discuss the agreement's terms. They must make sure it is clear and understood.

Someone who often changes their mind about what support they want, how they want it and from whom, may not benefit from an SDM agreement. There may be ways to change the SDM agreement to anticipate such situations.

People with limited capacity to make decisions, or who need help to make decisions, can be abused and exploited. An abuser or exploitative person might take advantage of an SDM agreement. Use caution when the person selects supporters for an SDM.

• A person with a disability must decide if they should have elective surgery. The supporter takes the time to explain the surgery carefully to the person. Then they understand it well enough to give informed consent.
• Someone is having a hard time deciding if they should begin an intimate or sexual relationship, and with whom. The supporter explains the consequences of a sexual relationship. This should include the risks, benefits, and options.
• Someone is deciding if they should move out of a nursing facility to the community. The supporter helps the person understand their options. They also advocate for the person's choice.

This is not a complete list. You can visit bit.ly/40hPmZk and browse videos about other folks' stories to hear how SDM helped their situation.

It must say all these things:

• The person with a disability is making the agreement of their own free will.
• The name, address, phone number and email address of each supporter chosen by the person with the disability.
• What the supporters may do to help with everyday life decisions such as getting food, clothing & shelter, getting medical care, managing financial affairs, and other decisions.
• The supporter may not make decisions for the person with the disability.
• How the supporter can help the person with a disability make their decisions.
• The start and end date of the SMD agreement.
• The person with the disability can end the agreement at any time before the ending date.

The person with the disability and each supporter must sign the SDM agreement. You can then either have a notary public witness and sign it or have 2 witnesses who have no interest in the agreement witness its signing.

If you choose to sign the agreement in front of 2 witnesses, make sure that neither witness is a supporter of the person with the disability, an employee of a supporter, or paid to provide services to the person with disability. Also, if the person with a disability normally requires an interpreter to be present to be able to communicate with others, the interpreter must be there when everyone signs the agreement.

Yes. They must sign releases of information for each supporter so they can communicate with, for example, the person's doctor. This will let the supporter receive confidential information to better help support the person.

They can change or end any part of your SDM agreement any time and any way they want. It is not the decision of the supporters or anyone else. 

They can make changes on your current agreement and have each of their supporters sign it.  Or they can write up a new SDM agreement that says all earlier agreements are canceled (are revoked) and the new agreement is the only agreement.  The person with a disability and their supporters should sign the new agreement.

Where can I learn more?

• National Resource Center for Supported Decision-Making: supporteddecisionmaking.org  
• Center for Public Representation: supporteddecisions.org
• "Supported Decision-Making: Frequently Asked Questions," ACLU: bit.ly/3SAud7v