RD95 - Annual Report on Supported Decision-Making Agreements – January 14, 2025


Executive Summary:

§ 37.2-314.3 of the Code of Virginia directs the Department of Behavioral Health and Developmental Services (DBHDS) to create a Supported Decision-Making Agreement (SDMA) template for individuals with intellectual and developmental disabilities to use, develop, and provide education regarding the development and use of SDMAs, develop information and protocols related to preventing, identifying, and addressing abuse and exploitation of individuals using SDMAs, and to collect data regarding the use of SDMAs in Virginia.

Virginia has studied supported decision-making in 2014, 2019, and, again, in 2020. In 2022 DBHDS created a workgroup to help with the development of the SDMA template and protocol to address abuse and exploitation of individuals using SDMAs. Since then, DBHDS has focused on increasing the public’s awareness of supported decision-making and SDMAs throughout Virginia by conducting trainings and building partnerships with stakeholders who interact with individuals with intellectual and developmental disabilities (DD). From July 2023 through June 2024 (fiscal year 2024) 36 training sessions were conducted, reaching over 1,250 individuals with DD, parents/caregivers/ family members of individuals with DD, practitioners, educators, waiver providers, those in the medical field, and more.

Training sessions covered the following topics:

• Overview of Supported Decision-Making and Supported Decision-Making Agreements
• Overview of Decision-making options in Virginia
• Decision-making for Children ages 0-8 years old
• Decision-making through the lifespan
• Risk and Supported Decision-Making

The following represents some of the organizations that collaborated with DBHDS to host training sessions, reviewed information and documentation, and increased awareness about the use of SDMAs for individuals with DD this year:

• The Arc of Virginia
• The Disability Law Center of Virginia (dLCV)
• The DBHDS Office of Human Rights
• The Department of Medical Assistance Services (DMAS)
• The Harrisonburg-Rockingham Community Services Board
• The Parent Educational Advocacy Training Center (PEATC)
• Virginia Commonwealth University’s Partnership for People with Disabilities

Additionally, the following recommendations remain from the 2022 Supported Decision-Making Workgroup and feedback from constituents and stakeholders over the past fiscal year:

1. Explore other sources for data collection.

2. Make recommendations for updating the state Administrative Code to reflect more person-centered wording and clarify roles and responsibilities.

3. Make recommendations for codifying SDMAs beyond the DBHDS administrative code to formally recognize SDMAs as an alternative to legal guardianships and/or conservatorships, and expand the use of SDMAs to other disability populations.

4. Ensure written information and forms are available in other languages and in alternate formats to increase accessibility and utilization.

5. Investigate the implementation of a uniform tool for capacity evaluations.

6. Explore the implementation of a volunteer Supporter program.

Supported decision-making and SDMAs are an integral piece to increasing autonomy and self-determination for individuals with disabilities. Continuing to provide education and training and removing barriers to the use of supported decision-making and SDMAs as opposed to more restrictive alternatives, will play an important part in increasing utilization. Additionally, continued outreach and training targeted to those who interact or support individuals with disabilities, will help more individuals to live independent, person-centered lives.