Maryland Supported Decision Making Agreement

Maryland formalized supported decision-making agreements in 2022 under Title 18 of the Estates and Trusts Article (§§ 18-101 to 18-109). Since then, SDMAs have gone from a theoretical alternative to guardianship to a legally recognized tool that documents how supporters assist adults with hospitals, banks, schools, and other providers.

But the statute has specific requirements, and an agreement that doesn't meet them has no legal standing. Here's what actually goes into a valid Maryland SDMA.

Required Elements

Every Maryland SDMA must include:

• Written, dated document. Oral agreements don't qualify.
• Named supporter(s). At least one person designated to assist with decision-making. A supporter cannot be a minor, someone with an active protective order from the adult, or someone convicted of financial exploitation.
• Scope of assistance. The agreement must describe exactly what kind of help the supporter provides — gathering information, explaining options, helping communicate decisions.
• Multi-supporter coordination. If you name more than one supporter, the document must explain how they work together.
• Conflict of interest provisions. The agreement must describe how actual or perceived conflicts will be handled.
• Supporter selection rationale. Documentation of how the adult selected each supporter.
• Mandatory warning statements. The agreement must explicitly state that the supporter cannot make decisions for the adult, cannot execute transactions on their behalf, and that the SDMA does not replace a Power of Attorney or Advance Directive.

Witness Requirements

Signatures need witnesses — and the rules here are strict:

• Both the adult and each supporter must sign the agreement.
• Two adult witnesses must subscribe (sign and attest to) all signatures.
• Neither witness can be a named supporter.
• Neither witness can be an employee or agent of any named supporter.

No notarization is required. The witness requirement alone establishes validity.

What the Supporter Can and Cannot Do

This is where families most often misunderstand SDMAs. A supporter can:

• Help the adult research and gather information relevant to a decision
• Explain options in accessible language
• Help the adult communicate their preferences to third parties
• Accompany the adult to meetings, appointments, or transactions

A supporter cannot:

• Make decisions on the adult's behalf
• Sign documents or execute transactions for the adult
• Override the adult's expressed preference
• Act independently without the adult's direction

If you need someone who can actually make decisions or sign documents when the adult can't, you need a Power of Attorney (financial) or Advance Health Care Directive (medical) — not an SDMA.

Finding a Template

Maryland doesn't mandate a single official form. The most widely used model was developed by the Cross-Disability Supported Decision-Making Coalition and is distributed through Disability Rights Maryland. It follows the statutory structure and includes the required warning language.

The template is a starting point. Families should customize the scope of assistance to match their specific situation — a broadly drafted SDMA that says "help with everything" is less useful than one that identifies specific domains (medical appointments, financial decisions, employment choices) and the type of support needed in each.

What if a School Refuses to Recognize an SDMA?

Under Maryland law (Health-General § 5-601 and Health-General § 20-1601), supported decision-making is recognized as a valid reasonable accommodation and auxiliary aid. A hospital, bank, or other entity cannot refuse to let a supporter accompany the adult when the supporter acts within the agreement's documented scope.

If a school district refuses to honor an SDMA, families should put the refusal in writing and reference the statutory recognition provisions. Disability Rights Maryland can provide advocacy support for systemic refusals.

That said, for IEP-related decisions specifically, parents already retain educational decision-making authority in Maryland until the student exits the school system, unless a documented transfer condition applies (Education Article § 8-412.1). An SDMA doesn't change the IEP dynamic — it's more relevant for healthcare providers, banks, and adult service agencies.

The Pughsley Precedent

The 2025 Appellate Court ruling in In the Matter of Pughsley confirmed that SDMAs are valid even within existing guardianship arrangements. The court ruled that individuals under guardianship retain the right to vote unless there's clear and convincing evidence they cannot, even with supported decision-making and reasonable accommodations, communicate a desire to participate in the voting process — and that supported decision-making must be considered in all capacity evaluations.

This case strengthened the position of SDMAs across Maryland's legal system. It means that even families currently operating under a guardianship order can petition to incorporate supported decision-making into the arrangement, potentially narrowing the guardian's authority over time.

The Maryland Adult Guardianship & Alternatives Guide includes an SDMA preparation checklist and walks through the statutory requirements step by step, so you can draft a complete agreement without hiring an attorney for what is, by design, a private contractual arrangement.

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