Supported Decision-Making (SDM)

Supported Decision-Making (SDM) means people with disabilities get help to make their own decisions about their own lives. These choices could be about things like where to live, what to do during the day, how to spend money, or when to see a doctor. The SDM process understands that some people need extra support to make decisions, but that they don’t need a legal guardian or other limits that take away their civil rights. SDM looks different for different people. It means finding supports to help a person understand, make, and communicate their own choices. Some examples are of ways to support an individual through SDM are:

  • Finding materials written in a way a person can understand.
  • Finding materials in a different format.
  • Allowing extra time to talk and think about their choices.
  • Creating lists of the good and bad parts of the choices.
  • Bringing a supporter to appointments/meetings to help with taking notes, asking questions, understanding options, and encouraging self-determination.

SDM allows your adult child to direct the plan for their own life. It doesn’t require a contract, a court process, or a lawyer. An SDM agreement is based on the individual’s needs. It is a flexible option that can be handled by the person with a disability and their chosen family or friends. As of July 1, 2021, it is also supported in Virginia law as a result of the passage of HB 2230 which added § 37.2-314.3. to the Code of Virginia and changed several other code sections.

SDM means the person is still in charge of their own life. They: 

  • Choose – The person with the disability decides who will be involved in supporting them. The supporters must also agree to be involved.
  • Discuss – The person and the supporters talk about how the person will be supported. This can include finances, healthcare, education, employment, housing, etc.
  • Plan – The person and the supporters can create a document that outlines how the person will be supported. This is called a Supported Decision-Making Agreement. This agreement can be changed at any time. Everyone who signs the agreement gets a copy of it.

Some options for supported decision-making include natural supports (friends and families), and if the individual can provide informed consent, a power of attorney, an advanced medical directive, or a health care proxy (a person who makes health care decisions for the individual with a disability).

The Virginia Department of Behavioral Health and Developmental Services has developed a Supported Decision-Making Agreement (SDMA) template which individuals can use or adapt to meet their needs.  This template and a host of other resources to help individuals and supporters with the supported decision-making process can be found here: Supported Decision-Making & Supported Decision- Making Agreements – Virginia Department of Behavioral Health and Developmental Services. In addition, The disAbility Law Center of Virginia has some excellent resources on supported decision-making, including sample forms on these options.

It is important to be aware that many individuals, even those with the most significant disabilities, can make at least some decisions about their life if they have the appropriate supports.

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