Supported Decision-Making

CPR considers the right to exercise choice to be perhaps the most fundamental right people have as human beings.  CPR has long worked to promote guardianship reform and, since 2014, have primarily focused its efforts on promoting access to meaningful alternatives, including Supported Decision-Making (SDM). Under the SDM model, people turn to a network of supporters – family members, friends, colleagues, and others they trust – to help them make their own decisions regarding health care, finances, jobs, and other personal matters.  Based on what CPR has learned from its work in Massachusetts and nationally, too many people are unnecessarily placed under restrictive guardianships, even when they would be able to make their own decisions with individualized assistance from people they trust.  Widespread recognition of their rights to use SDM as an alternative would allow them to retain their legal rights and dignity. 

CPR has been a leader in promoting SDM in Massachusetts, across the country, and internationally with its ground-breaking pilot projects, training, technical assistance, and resource development.  Highlights of CPR’s SDM work include:

  • In 2014, CPR and Nonotuck Resource Associates launched the nation’s first externally evaluated SDM pilot.  As part of that pilot, CPR represented the first Massachusetts resident to have his guardianship terminated in favor of SDM.  Since then, CPR partnered on five additional SDM demonstration projects in Massachusetts and one in Georgia.  
  • CPR is a key partner of the Center on Youth Voice, Youth Choice (CYVYC), a national research, training, and resource center that promotes the use of alternatives to guardianship for youth with intellectual or developmental disabilities.  CPR spearheads CYVYC’s Community of Practice, providing technical assistance to teams in eleven States across the country. CYVYC is currently funded under a five-year grant (2020-2025) from the U.S. Administration for Community Living. 
  • CPR co-chairs the Rights Task Force of the Consortium for Constituents with Disabilities (CCD), which is the largest coalition of national organizations working together to advocate for federal public policy that ensures the self-determination, independence, empowerment, integration, and inclusion of people with disabilities in all aspects of society.  CPR also chairs a CCD Rights Task Force working group that focuses on developing and implementing a federal strategy to advance SDM and reform guardianship.  
  • CPR is a state-wide back-up center for legal services programs funded by the Massachusetts Legal Assistance Corporation and, in that capacity, consults with Massachusetts programs on SDM and other alternatives to guardianship.  CPR also provides technical assistance on these issues across the country through its work with the national Protection and Advocacy Systems (P&A) network.
  • CPR developed an on-line SDM library, with key resources for people with disabilities, family members, lawyers and other professionals, and policymakers. For example, CPR published a report on its project to advance alternatives to guardianship, including SDM, for youth through an innovative decision-making workshop, which was piloted as part of Medford Public Schools’ transition program in Massachusetts.
  • CPR authored two law review articles on Supported Decision-Making that informed the deliberations of the Fourth National Guardianship Summit.
  • CPR contributes to national press coverage of issues involving guardianship and alternatives, including Supported Decision-Making.
  • CPR contributed to international learning exchanges on ways to advance SDM.  This has included presenting on and discussing SDM at International Initiatives for Mental Health Leadership and Disability Leadership (IIMHL/IIDL) conferences and virtual meetings with representatives from Australia, England, Canada, New Zealand, Ireland, Scotland, Sweden, and the United States.  CPR also participated in a “Right to Decide” dialogue meetings that include representatives from the United States, Columbia, Czech Republic, Hong Kong, China, South Africa, Ireland, Romania, the United Kingdom, Canada, Bulgaria, Chile, Israel, Peru, and Australia.  In addition, CPR consulted with participants in a New Zealand project led by the Royal Commission of Inquiry into Abuse in Care.

To learn more about CPR’s initiatives in advancing SDM, please visit its SDM website.