A report from the UCLA Center for Health Policy Research indicates that a California law intended to enhance decision-making autonomy for individuals with disabilities may not be achieving its full potential due to inadequate online resources. The law, known as supported decision-making (SDM), took effect on January 1, 2023, offering an alternative to conservatorship by allowing individuals with disabilities to choose trusted supporters to help them make decisions about health care and finances.
Kristen Choi, associate professor at the UCLA School of Nursing and UCLA Fielding School of Public Health, noted that “supported decision-making empowers individuals with disabilities to make — with the help of trusted supporters — these types of decisions.” However, she pointed out significant gaps in available resources after reviewing various online tools.
The study found that while 85% of SDM resources were aimed at caregivers and people with disabilities, only a small percentage catered to professionals working in sectors like health care or employment. Additionally, there was a lack of tailored resources for older adults, youth transitioning into adulthood with disabilities, and those with dementia or serious mental illness.
Language accessibility also proved inadequate; despite 44.1% of California households speaking languages other than English at home, only 21.4% of SDM resources were offered in multiple languages. Choi emphasized the need for linguistic accessibility reflecting California’s diverse population.
Another issue identified was non-compliance with ADA standards on many webpages meant for individuals with vision impairment. The report also criticized complex language unsuitable for those with cognitive impairments and a lack of cultural relevance in SDM templates.
Choi’s policy brief is part of her work funded by the California State Council on Developmental Disabilities aimed at developing a digital resource library for SDM. She highlighted recommendations such as creating targeted resources for high-risk populations and improving linguistic accessibility across different formats.
“To help ensure that supported decision-making genuinely improves the lives of Californians with disabilities,” Choi stated, “we need accessible, high-quality resources.”
