Frequently Asked Questions About Supported Decision Making

Q: Am I already using Supported Decision Making (SDM)?

A: Maybe.  SDM is a process where people receive help in understanding, making, and communicating their own decisions.

Q: What is Supported Decision Making (SDM)?
A: Supports are ways to help a person with a disability understand, make, and communicate their own choices.  A person with a disability can execute a supported decision-making agreement which explains their method of making decisions.
Q: How is Supported Decision Making different from a Durable Power of Attorney?
A: A Supported Decision-Making Agreement identifies the people and tools that will support the person in making his or her own decisions.  It goes into effect as soon as it is signed.  A Durable Power of Attorney identifies the person who is to be a “substitute” decision-maker.  The Durable Power of Attorney for Healthcare becomes effective upon the incapacity or inability of the person to communicate his or her wishes.  A supporter can help a person with a disability in considering and obtaining a power of attorney.
Q: I discuss some of the things I am concerned about with my family already. Is that like Supported Decision Making?
A: Many persons with a disability are already having conversations and using supported Decision Making in their everyday life.  A person can learn decision-making skills by making their own choices with the help and guidance of other people.  This is Supported Decision Making.
Q: What are some examples of tools used in Supported Decision Making?
A: Here are some tools used in SDM:

  • Using plain language
  • Giving information by visual or hearing methods
  • Providing extra time to discuss choices
  • Creating a list of the pros and cons of a decision.
  • Use “role-playing” activities to assist the person in understanding choices.

·  Bringing a supporter to important meetings to take notes to help the person remember and discuss options.

Q: If I have a Supported Decision- Making Agreement that starts when I sign it, what if I get sick or injured later and cannot communicate my decisions. How can I have someone act for me?
A: A person with a disability can create a “Springing” Durable Power of Attorney. A Springing Durable Power of Attorney only starts working if you can no longer communicate your own wishes.   A person selected by you to make choices for you is called an agent.  An agent is required by law to follow your known wishes and to act in your best interests.
Q: Nevada has a new Supported Decision Making law. How can this law help persons with a disability in making decisions?
A: Self-Advocacy is a goal of Nevada’s law.  The supporter cannot be a substitute decision-maker.

The law states that it is to provide person centered assistance to a person with a disability.

 The law states that persons with a disability should be able to live in a manner in which he or she wishes and is capable of making such decisions.

 The law states that an adult should be informed and allowed to participate in the management of his or her affairs to the best of said adult’s ability.

 The law prohibits a supporter from:

  • Using undue influence upon the principal
  • Obtaining, without the consent of the principal, any information not needed to help the principal make a decision.
  • Improperly using the information of the principal.

 A valid Supported Decision-Making Agreement must be in writing and signed by the principal and all named supporters before two adult witnesses.

Q: How is Supported Decision Making different from guardianship?

A: Supported Decision making is the least restrictive decision-making method for the person with a disability because the person makes his or her own choices with the help of a supporter. In a guardianship the guardian makes decisions.

Supported Decision Making is the legally preferred decision-making process.  Guardianship should only be used if necessary.

Q: Who makes decisions while using Supported Decision Making versus Guardianship?

A: In Supported Decision Making, decisions are made by the adult.  Generally, in a guardianship, the guardian makes all decisions and does not need to ask the adult.

 A guardianship is ordered by a court and the court decides what choices the person with a disability can make.  A Nevada guardianship should only be considered if there is no alternate less restrictive arrangement.

Q: Who decides what the person with a disability needs?
A: In Supported Decision Making, the adult person with a disability, with the help of supporters, determines her/his own needs.

In a guardianship, the guardian makes all decisions.

A guardianship can result in the loss of legal rights such as voting, marriage, decision making, agreement making.

Q: How are changes made?
A: A Supported Decision- Making Agreement can be changed by the principal and the supporter(s) in new writing witnessed by two adult witnesses. A guardianship can be changed only by the court.
Q: What if the person with a disability already is in a guardianship?
A: A guardianship can be terminated or modified.  The person with a disability and/or the guardian can ask the court to provide for Supported Decision making and terminate the guardianship or ask the court to modify the guardianship for a period of time so SDM can be tried on a temporary basis.
Q: What is a limited guardianship?
A: A limited guardianship is ordered by a court if a person needs a decision-maker for a specific area of life.
Q: I have a Health Care Power of Attorney for a Person with an Intellectual/Developmental Disability. Should I have a Supported Decision-Making Agreement?
 A: The Nevada Health Care Power of Attorney (HCPOA) for a Person with an Intellectual/Developmental Disability is set forth in NRS 162A.865.  This Health Care Power of Attorney law was established prior to the Supported Decision Making law.  A good part of the HCPOA is that there is a provision in it that allows for a decision-maker, called an agent, to make health care choices for the person with a disability if that person can no longer communicate his/her choices.  The agent is to make decisions based upon the person’s known wishes and/or best interests.  This is a type of substituted decision making.

Other portions of this law are similar to a Supported Decision-Making Agreement, but different wording is used to identify the person that is to help provide support and is known as an agent.  In an SDM agreement, the helping person is known as a supporter. 

If a person with a disability has or wants to utilize the form set forth in the Health Care Power of Attorney law (NRS162A.865) consideration should be given to naming the supporter in the Supported Decision-Making Agreement as the agent in the Health Care Power of Attorney.

Q: What does the Nevada Supported Decision Making Law say about the relationship between the person with a disability and a service provider?
A: NRS 162C.320 Acceptance and reliance upon supported decision-making agreement.  Any person who is not a party to a supported decision-making agreement, including, without limitation, a provider of health care or provider of financial services, that in good faith, as defined in NRS 162A.060, accepts a supported decision-making agreement:

1.  Without actual knowledge that any of the signatures thereon is not genuine may rely upon the presumption that such a signature is genuine.

2.  Without actual knowledge that the supported decision-making agreement or the purported supporter’s authority is void, invalid or terminated may rely upon the supported decision-making agreement as if the agreement and supporter’s authority are genuine, valid and still in effect.

3.  Is not subject to civil or criminal liability or discipline for unprofessional conduct for giving effect to a declaration contained within the supported decision-making agreement or for following the direction of a supporter named in the supported decision-making agreement.

(Added to NRS by 2019, 463)


Getting Started with Supported Decision Making

About the Self-Determination Law Project Community Legal Educators

Community Legal Educators Hank Cavallera and Emily Hancock are Nevada attorneys with a long history of serving Nevada’s seniors and people with disabilities.  Hank started Nevada’s first elder law practice in 1981, focusing on health care benefits, estate planning, and Medicaid spousal support.  The practice also did special needs trust, disability planning and guardianships. Hank is a graduate of the University of Nevada Reno and the University of Colorado Law School.  Emily served as the supervising attorney for the Senior Law Project in Washoe County and joined Hank in the private practice of law in 2013.   Emily is a graduate of the University of Colorado and the Seattle University School of Law.  After Hank’s retirement, the two attorneys decided to stay involved in the community and started the Self Determination Law  Project, a Nevada Non Profit Corporation, to focus on providing community based education to Nevadans about the emerging concept of Supported Decision Making.

This material is presented for educational purposes only. You are strongly encouraged to seek the advice of an attorney in any legal matter. The information contained herein does not take the place of legal advice nor is it offered as such by the Self Determination Law Project or the Nevada Governor’s Council on Developmental Disabilities. The information contained herein is based on the law at the time this website was produced. If you have questions about your legal rights, please consult an attorney.

Nevada Governor's Council on Developmental Disabilities

This website is supported by the Nevada Governor’s Council on Developmental Disabilities through grant funds from the Federal Department of Health & Human Services; Administration on Community Living grant #1901NVSCDD-01 and 25% matching funds appropriated by the Nevada State Legislature under NRS 232.320, administered through the State of Nevada Department of Health and Human Services. The contents are solely the responsibility of the authors & do not necessarily represent the official views of the NGCDD or any other associated or supporting agency.