There are many alternatives, depending on why people think guardianship may be desirable in the first instance. For example, if the issue is financial, there are alternatives including representative payeeships for SSI payments, authorized representation for Medicaid benefits, joint or limited bank accounts, credit or bank cards with predetermined limits, and powers of attorney. For healthcare, the persons with I/DD may execute a healthcare proxy. Also, New York’s Family Healthcare Decisions Act permits involved family members to make decisions on behalf of persons with I/DD without guardianship.

Supported decision-making is also an alternative to guardianship. Supported decision‐making allows persons with I/DD to choose trusted others, often family members, to support them in making their own decisions. Supports may include gathering information, helping persons with I/DD evaluate the information and understand the consequences of a decision, communicating decisions to third parties and supporting persons with I/DD in taking responsibility for their decisions.

Often the arrangement will be reduced to writing in a contract called a “supported decision‐making agreement.” Some institutions, like schools, may agree to accept such agreements instead of guardianship as, for example, is the case in Washington, DC. Some states, like Texas and Delaware, now have laws requiring private third parties (like doctors, financial institutions, or landlords) to accept supported decision‐making agreements. While New York does not yet have such a law, SDMNY hopes to develop evidence that will support legislation, regulations, and policies that will make supported decision-making a more readily available alternative to guardianship in the future.

Guardianship & Alternatives FAQs