Supported Decision-Making in West Virginia

What Supported Decision-Making Is

Supported decision-making is a framework where a person with a disability works with trusted supporters — parents, siblings, friends, service providers — to understand information, weigh choices, and communicate decisions. The person keeps all of their legal rights. The supporters help with the decision-making process but do not make decisions for them.

For families of young adults with intellectual or developmental disabilities approaching 18, SDM can serve as a less restrictive alternative to guardianship. Instead of asking a court to transfer decision-making authority away from your child, you build a support network around them.

West Virginia's Legal Status

West Virginia does not have a comprehensive supported decision-making statute. In January 2024, House Bill 5136 — the Supported Decision-Making Act — was introduced in the state legislature. It would have established standardized agreement forms, witness requirements, and legal protections for third parties who relied on SDM agreements. HB 5136 died in the House Judiciary Committee on March 30, 2024.

What West Virginia does have is narrow statutory recognition. Under W. Va. Code § 16-65-2, the state's organ transplantation non-discrimination law, "provision of supported decision-making services" is defined as an "auxiliary aid and service." This means individuals with disabilities can use supporters to help them understand and communicate transplant-related decisions. That statute does not extend to general SDM agreements.

Why Informal SDM Still Works

The absence of a statute does not mean SDM is illegal or impractical in West Virginia. It means there is no standardized form and no statutory requirement that third parties accept an SDM agreement on its own.

In practice, families address this by pairing an SDM agreement with documents that do carry statutory force:

• HIPAA Patient Authorization — allows healthcare providers to share medical records and discuss treatment with the supporter
• FERPA Educational Release — authorizes schools to share IEP records and educational information with the supporter
• Medical Power of Attorney — provides legal authority if the young adult needs someone to make a binding healthcare decision during incapacity
• Durable Financial Power of Attorney — gives the supporter legal authority for financial transactions

The SDM agreement itself documents the relationship and the scope of support. The supporting documents give third parties — hospitals, schools, banks — the legal basis they need to cooperate.

The WV Developmental Disabilities Council and Disability Rights of West Virginia both actively promote this approach. The WV Center for Excellence in Disabilities at West Virginia University also provides training and resources for families setting up SDM arrangements.

Who SDM Works For

SDM works best for individuals who can express basic preferences and understand advice, even if they need significant support to process complex information. This includes many young adults with:

• Mild to moderate intellectual disabilities
• Autism spectrum disorder with functional communication
• Learning disabilities that affect executive function
• Mental health conditions that are managed but affect complex decision-making

SDM is typically not sufficient for individuals who cannot communicate preferences or cannot understand the concept of receiving advice — those situations generally require some form of guardianship.

SDM vs. Guardianship: The Key Differences

Getting Started

To set up an SDM arrangement in West Virginia:

1. Identify the decision-making areas where your child needs support — medical, financial, educational, daily living
2. Choose supporters for each area — family members, trusted professionals, mentors
3. Draft a written SDM agreement that describes each supporter's role and the areas they assist with
4. Execute the supporting legal documents — HIPAA authorization, FERPA release, powers of attorney as applicable
5. Distribute copies of all documents to healthcare providers, the school, financial institutions, and any other parties that need to recognize the arrangement

The West Virginia Adult Guardianship & Alternatives Guide includes a template SDM agreement, the supporting release forms, and a step-by-step walkthrough for presenting the package to third parties who may not be familiar with the concept.

See more West Virginia guides →