Supported Decision Making New York (SDMNY)

What SDMNY Is

SDMNY — Supported Decision-Making New York — is the initiative that brought supported decision-making from a pilot concept to a legally enforceable framework across the state. The movement culminated in Mental Hygiene Law Article 82, signed into law on July 26, 2022, which made New York one of the first states to give supported decision-making agreements (SDMAs) full statutory force.

The implementing regulations, 14 NYCRR Part 634, were finalized by OPWDD on July 30, 2025, published in the State Register on August 20, 2025, and became fully effective on November 18, 2025. Those regulations are what give SDMAs teeth: banks, hospitals, landlords, and government agencies must honor a formal SDMA, and they receive statutory immunity when they do.

The core idea is simple. Instead of transferring authority away from a person with an intellectual or developmental disability (which is what guardianship does), supported decision-making keeps the person in charge of their own life while formalizing the support network around them. The person — called the "decision-maker" — chooses trusted individuals (the "supporters") to help them gather information, weigh options, and communicate their choices.

A supporter cannot sign contracts, consent to medical treatment, or make financial decisions on the decision-maker's behalf. The decision-maker retains all of their legal rights.

Who Can Use It

Any adult in New York with an intellectual or developmental disability who can express preferences — through speech, sign language, augmentative communication devices, or behavioral cues that a trained facilitator can interpret — may enter into a supported decision-making agreement. There is no minimum IQ score, no diagnostic exclusion, and no judicial proceeding required.

The capacity threshold is the existing statutory presumption: all adults are presumed competent unless a court rules otherwise. If your adult child can indicate who they want to help them and in what areas of life, they likely qualify.

SDMAs are not appropriate when a person truly cannot express any preferences even with skilled facilitation, or when their safety requires someone else to make binding decisions on their behalf. In those situations, guardianship or a combination of a health care proxy and power of attorney may be necessary.

The Three-Phase Facilitation Process

To create a formal SDMA that carries the statutory protections of Article 82, families work with an authorized facilitator. AIM Services, Inc. holds the statewide OPWDD contract for Supported Decision-Making Facilitation.

Phase 1: Decision-Maker Discovery. The facilitator meets with the decision-maker (your adult child) to understand how they communicate, what areas of life they want support in, and what decisions they already make independently. This phase maps their existing strengths — many young adults already make daily choices about food, clothing, social activities, and routines that families take for granted.

Phase 2: Supporter Education. The facilitator works with the chosen supporters (typically parents and close family members) to shift from a decision-making-for model to a decision-supporting model. This is often the hardest phase for families. Parents who have spent 18 years making choices on their child's behalf must learn to present options, explain consequences in accessible terms, and then respect the decision — even when they disagree with it.

Phase 3: Agreement Negotiation. All parties draft and sign the SDMA with the facilitator's guidance. The agreement specifies which life domains (medical, financial, housing, employment, education) are covered, who serves as a supporter in each domain, and how the decision-maker communicates their choices. The completed SDMA is then legally validated under Article 82.

What Third Parties Must Do

Under MHL § 82.11, any third party who receives a formal SDMA must honor the decision-maker's choices made with support. A bank cannot refuse to process a transaction because the decision-maker had a supporter present during the discussion. A hospital cannot override the decision-maker's stated treatment preference because a family member helped them understand the options.

Third parties who comply in good faith receive statutory immunity — they cannot be sued for following a decision made through the SDMA process. This protection was one of the central demands of the disability rights community during the legislative process, because without it, institutions had every incentive to demand guardianship paperwork instead.

SDMA vs. Guardianship

The two exist on opposite ends of the legal authority spectrum:

A guardianship (whether Article 17-A or Article 81) transfers decision-making power from the person to the guardian. It requires a court proceeding, costs thousands of dollars, and restricts the person's civil rights to varying degrees.

An SDMA keeps all decision-making power with the person. It requires no court involvement, no attorneys, no fees, and no loss of rights. It can be revoked at any time by the decision-maker.

New York's legal landscape increasingly treats supported decision-making as the first option that must be exhausted before a court will grant guardianship. Article 81 petitions now require the petitioner to explain which alternatives — including SDMAs — were considered and why they were insufficient.

Getting Started

Contact AIM Services through their website or by calling their facilitation hotline to begin the intake process. There is no cost to the family for the facilitation — it is funded through OPWDD. Waitlist times vary by region, so starting early (ideally eight months before the 18th birthday) gives your family the best chance of having a completed SDMA in place by the time legal adulthood arrives.

The New York Guardianship & Alternatives Guide walks through the full spectrum of decision-making options side by side — from SDMAs through health care proxies, powers of attorney, representative payee designation, and both guardianship tracks — with a capacity self-assessment worksheet that helps families determine which path fits their child's specific abilities.

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