Just a few weeks ago we told you about the Arizona legislature’s bill to create a “supported decision making” law in our state. We told you then that there was no chance the bill would even get a committee hearing, much less become a law.
We were wrong. In a flurry of last-minute activity, the legislature cobbled together two different guardianship bills. With no committee review or general discussion, the legislature overwhelmingly adopted the hybrid measure. Without much fanfare, Governor Katie Hobbs signed the bill on June 20, and it will become effective in mid-November.
The new law will provide an alternative to guardianship in many cases. Or at least that’s the hope of its sponsors. But what does the phrase (and the law) mean in actual practice?
What is “supported decision making”?
The whole idea behind the new law is to permit adults with disabilities to seek assistance but not give up their own autonomy. Imagine a complicated medical decision facing an adult with a disability. Can they weigh the options and come to a responsible decision? Might the process lead to anxiety and confusion? Wouldn’t it be great to have someone — someone of their own choice — available to help work through the process, and eventually help the individual sign the consents and authorizations?
At least that’s the idea. Could our imaginary adult, despite their disability, agree in advance with a supporter that they will fill that role if and when the time comes? That’s exactly what the supported decision making law imagines — and encourages.
But isn’t that just a new name for a health care agent?
Not exactly. A health care power of attorney can give someone authority to make decisions for you. The supported decision making agreement imagines the other person making decisions with you.
Of course, a good health care agent will try to involve the principal in decision-making as much as possible. But there’s nothing in the health care power of attorney laws that compels them to seek that participation.
And, more critically, the supported decision making statute does not allow the “supporter” to sign the medical documents for the person with a disability. It does allow the supporter to help “in communicating the adult’s decisions to the appropriate person.” But the agreement terminates if the individual becomes incapacitated. That can happen if a guardian is appointed, for instance.
Which choice is better?
It’s a very good question, and hard to answer. We imagine that many individuals with a disability might consider signing both a health care power of attorney AND a substituted decision making agreement. That should help make clear that they want to give authority to their selected choice, but to also direct them to engage in discussions about health care issues.
If the signer’s condition deteriorates and they become incapacitated, the supported decision making agreement ends. But a health care power of attorney does not end. That suggests that the power of attorney is a better long-term solution, and better at avoiding the need for guardianship down the road.
One thing seems pretty clear, though. Either a health care power of attorney OR a supported decision making agreement is probably a better choice than a guardianship for a reasonably communicative person with a disability. Of course both the power of attorney and the supported decision making agreement are revocable — meaning that the signer can end the authority at any time. But our experience over the years is that doctors, hospitals and clinics are interested in helping, not obstructing. They just need some authority in order to engage family members or other supportive individuals.
Sounds great! Where do I sign up?
Not so fast! The new law won’t be effective until 90 days after the legislature adjourns. Adjournment is now predicted to be August 11. If the legislature actually adjourns that day, the supported decision making agreement would be an option on or after November 9, 2023.
Some time before that date we’ll be posting a cleaned-up version of the form (it’s right there in the law) for people who want to use it. But not yet. If you want to get a copy as soon as we’re ready, feel free to call or email us; we’ll add you to the circulation list.
Is that all?
Actually, no. We haven’t mentioned all the other changes in the same recently-signed law. We’re not excited about them, but they’ll be effective in mid-November, too. They should end up increasing the cost of guardianship and conservatorship proceedings, and make life more difficult for guardians and conservators (and their lawyers, who already have to grapple with a bunch of complicated notice requirements).
Was that the intent? No, probably not — the actual intent was to protect individuals who are (or might become) subject to guardianship or conservatorship proceedings. We are doubtful about most of the new provisions, though. We can set that discussion aside for another day, closer to the effective date of the new law.