Training program (new Section 16F½, Chapter 6A)
- The Executive Office of Health and Human Services (EOHHS) must establish a state-sponsored training program on supported decision-making.
- Training to be provided to supporters and decision-makers under 190B Chapter 5-601 et seq.
- Curriculum to cover rights and obligations in 190B sections 5-602, and dispute resolution.
- Requires broad consultation with state agencies, advocacy groups, professional associations, and adults who use supports.
- Training must be accessible to individuals receiving it.
Educational records access (Chapter 71B amendments)
- Adds a mandate for the Department of Elementary and Secondary Education to post a sample form for decision-makers to request the release of educational records by decision-makers’ supporters or others.
Adult education/guardianship information (Chapter 71B amendments)
- At the first IEP meeting after age 16, teams must inform students and families about the Office of Adult Guardianship and Conservatorship Oversight.
Recognition of supported decision-making in guardianship framework (Chapter 190B amendments)
- Section 5-303: Include “supported decision-making agreement” as a consideration alongside limited guardianship when discussing decision-making arrangements.
- Subsection (b)(9½) requires a copy of any supported decision-making agreement (SDMA) executed by the person alleged to be incapacitated, if available.
- Sections 5-404(C)(3) and 5-404(B)(8½): Allow SDMAs to be considered in court-based oversight and guardianship processes.
Definitions and framework for SDMAs (New Chapter 190B, Section 5-601 et seq.)
- Clears definitions for terms: adult, coercion, decision-maker, executed, supported decision-making, supporter.
- Decision-maker: an adult who signs an SDMA with one or more supporters.
- Supported decision-making: voluntary, written, plain-language agreement that supports decision-making without impeding self-determination.
- Supports: can include information access, decision assistance, and communication support, within the scope defined by the agreement.
- Supporters: adults who assist and sign the SDMA; must meet eligibility criteria and may be disqualified for prior abuse, exploitation, or other disqualifying conditions.
Roles and duties of supporters (Section 5-602)
- A supporter must respect the decision-maker’s values and preferences, act in good faith, maintain confidentiality, and operate within the scope of the agreement.
- Supporters may assist with decision-relevant information access, understanding options, and communicating wishes, but cannot unilaterally make decisions unless authorized by the agreement and applicable law.
- Certain records access (financial, medical, educational) is permitted with appropriate authorization; limited power of attorney may be used for financial records, with accompanying rights to participate in discussions.
- Supports must avoid conflicts of interest and must refrain from acting beyond the authority granted in the SDMA.
- SDMA participants may bring civil action for damages if rights are violated.
Validity, execution, and safeguarding (Section 5-602)
- An SDMA must be signed and dated by the decision-maker and all supporters in the presence of a notary; reasonable accommodations allowed (assistive tech, etc.).
- Undue influence or coercion renders the SDMA invalid.
- An SDMA is personalized, plainly written, identifies all parties, and details decision areas and access.
- Third parties are protected when acting in reliance on an SDMA, provided they act in good faith.
- SDMAs remain in effect until terminated or expired; termination rules specify timelines and methods for communication among involved parties.
- Termination can occur by date, by mutual agreement, or unilateral termination by the decision-maker (with notice to supporters).
- Suspension or guardianship scenarios can limit the SDMA scope; death or incapacity triggers termination or scope adjustment.
Oversight, protection, and reporting (Section 5-601, 5-507)
- Disabled Persons Protection Commission, elder protection services, and related agencies may petition probate and family court to revoke or suspend a supporter’s role for abuse, neglect, exploitation, or failure to comply with duties.
- Court processes include notice and an opportunity to be heard; indigent decision-makers may be appointed counsel.
- Annual reporting of court findings on SDMA issues to relevant legislative committees.
Safeguards for abuse reporting and rights preservation
- Individuals may report alleged abuse or exploitation to protection agencies or elder hotlines.
- Mandated reporters must report suspected abuse or exploitation.
- Execution of SDMAs is not a prerequisite for participation in services or activities.
- SDMAs do not limit or replace existing rights to health care proxies or powers of attorney.
Legislative and regulatory oversight
- A Special Legislative Commission (Authorization Documents Commission) is created to study and make recommendations on:
- Expanding health care authorization registries to include SDMAs and other authorizations.
- Creating online registries for authorizations (educational, financial, etc.) to verify current status of SDMAs.
- Commission composition includes legislative leaders, health and service secretaries, agency commissioners, and representatives from professional and advocacy organizations.
- Commission must report by June 1, 2027.
Effective dates and transition
- Existing SDMAs executed before July 31, 2026 remain valid until July 31, 2027; after that, SDMAs must conform to the new statutory requirements.
- Section 6 (related to effective date) takes effect July 31, 2026.
- Training program implementation required within six months of passage.
- Regulations for relevant agencies promulgated within six months for EOHHS, DESE (regarding 71B), and DHHS.
