MA
Massachusetts House Bill H261

Massachusetts 2025-2026 Regular Session

Massachusetts House Bill H261 Compare Versions

Only one version of the bill is available at this time.
OldNewDifferences
11 1 of 2
22 HOUSE DOCKET, NO. 3407 FILED ON: 1/17/2025
33 HOUSE . . . . . . . . . . . . . . . No. 261
44 The Commonwealth of Massachusetts
55 _________________
66 PRESENTED BY:
77 Jay D. Livingstone and Michael J. Finn
88 _________________
99 To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
1010 Court assembled:
1111 The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
1212 An Act relative to supported decision-making agreements for certain adults.
1313 _______________
1414 PETITION OF:
1515 NAME:DISTRICT/ADDRESS :DATE ADDED:Jay D. Livingstone8th Suffolk1/17/2025Michael J. Finn6th Hampden1/17/2025Sean Garballey23rd Middlesex2/4/2025Susannah M. Whipps2nd Franklin2/10/2025Natalie M. Higgins4th Worcester2/10/2025David Paul Linsky5th Middlesex2/25/2025Christopher Hendricks11th Bristol2/25/2025Colleen M. Garry36th Middlesex2/25/2025James K. Hawkins2nd Bristol2/25/2025John J. Marsi6th Worcester2/25/2025Daniel Cahill10th Essex2/25/2025Vanna Howard17th Middlesex2/25/2025Joanne M. ComerfordHampshire, Franklin and Worcester2/25/2025Erika Uyterhoeven27th Middlesex2/25/2025James Arciero2nd Middlesex2/25/2025William C. Galvin6th Norfolk2/26/2025Bruce E. TarrFirst Essex and Middlesex2/28/2025Manny Cruz7th Essex2/28/2025 2 of 2
1616 Thomas M. Stanley9th Middlesex3/6/2025Steven Ultrino33rd Middlesex3/6/2025 1 of 14
1717 HOUSE DOCKET, NO. 3407 FILED ON: 1/17/2025
1818 HOUSE . . . . . . . . . . . . . . . No. 261
1919 By Representatives Livingstone of Boston and Finn of West Springfield, a petition (accompanied
2020 by bill, House, No. 261) of Jay D. Livingstone, Michael J. Finn and others relative to supported
2121 decision-making agreements for certain adults with disabilities. Children, Families and Persons
2222 with Disabilities.
2323 The Commonwealth of Massachusetts
2424 _______________
2525 In the One Hundred and Ninety-Fourth General Court
2626 (2025-2026)
2727 _______________
2828 An Act relative to supported decision-making agreements for certain adults.
2929 Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
3030 of the same, as follows:
3131 1 SECTION 1. Chapter 6A of the General Laws is hereby amended by inserting after
3232 2section 16F the following section:-
3333 3 Section 16F½. The executive office of health and human services shall establish a
3434 4training program on supported decision-making. The training program shall include instruction
3535 5by state agencies including, but not limited to, the department of developmental services, the
3636 6department of mental health and the executive office of elder affairs. The training program shall
3737 7be provided to any supporter or decision-maker pursuant to section 5-601 of chapter 190B and
3838 8shall include instruction on the rights and obligations contained in section 5-602 of chapter 190B
3939 9and dispute resolution. The executive office of health and human services shall consult with the
4040 10executive office of elder affairs, the department of developmental services, the department of
4141 11mental health, the department of public health, the Disability Law Center, the Massachusetts
4242 12Health and Hospital Association, the Massachusetts Medical Society, the Massachusetts Bankers 2 of 14
4343 13Association and adults who receive supported decision-making assistance and supporters who
4444 14assist in decision-making pursuant to a supported-decision making agreement in the development
4545 15of the training. The training shall be in a format accessible to the individuals receiving the
4646 16training.
4747 17 SECTION 2. Section 2 of chapter 71B of the General Laws, as appearing in the 2022
4848 18Official Edition, is hereby amended by inserting, in line 86, after the words “et sec.” the
4949 19following paragraph:- The department of elementary and secondary education shall promulgate
5050 20regulations in consultation with the department of higher education requiring school districts, as
5151 21part of their transitional planning process for students with disabilities, to inform students and
5252 22their families of the availability of supported decision-making as an alternative to adult
5353 23guardianship and conservatorship for students with disabilities that are receiving services at age
5454 24sixteen. The department shall provide supported decision-making agreement training to schools
5555 25and post all training materials on the department’s website including a sample form for a
5656 26decision-maker to request the release of educational records.
5757 27 SECTION 3. Section 3 of said chapter 71B of the General Laws, as so appearing, is
5858 28hereby amended by inserting, in line 301 after the word “program.” the following paragraph:- At
5959 29the first IEP meeting after a student has turned age sixteen or older, the IEP team shall inform the
6060 30student and their family or guardian, of the availability of supported decision-making agreements
6161 31as an alternative to guardianship and conservatorship. The IEP team shall assist the child and
6262 32their family or guardian in locating resources to assist in establishing a supported decision-
6363 33making plan if the child and their family or guardian are interested in supported decision-
6464 34making. 3 of 14
6565 35 SECTION 4. Section 5-303 of said chapter 190B, as appearing in the 2022 Official
6666 36Edition, is hereby amended by inserting, in line 50, after the word “guardianship”, the following
6767 37words:- or a supported decision-making agreement. 
6868 38 SECTION 5. Subsection (b) of section 5-303 of said chapter 190B, as so appearing, is
6969 39hereby amended, by inserting after paragraph (9) the following paragraph:-
7070 40 (9½) a copy of any supported decision-making agreement executed by the person alleged
7171 41to be incapacitated, if available:-
7272 42 SECTION 6. Subsection (c)(3) of section 5-404 of said chapter 190B, as so appearing, is
7373 43hereby amended, by inserting after the word “conservatorship” in the first instance, the following
7474 44words:- “or a supported decision-making agreement”.
7575 45 SECTION 7. Subsection (b) of section 5-404 of said chapter 190B, as so appearing, is
7676 46hereby amended, by inserting after paragraph (8) the following paragraph:-
7777 47 (8½) a copy of any supported decision-making agreement executed by the person alleged
7878 48to be incapacitated, if available:
7979 49 SECTION 8. Chapter 190B of the General Laws is hereby amended by inserting after
8080 50section 5-507 the following sections:-
8181 51 Section 5-601. Definitions:
8282 52 As used in this section, the following words shall have the following meaning unless the
8383 53context clearly requires otherwise:
8484 54 “Adult”, an individual 18 years of age or older. 4 of 14
8585 55 “Coercion”, the use of force or threats to persuade someone to do something.
8686 56 “Decision-maker”, an adult who seeks to execute, or has executed, a supported decision-
8787 57making agreement with 1 or more supporters under this chapter.
8888 58 “Executed”, a supported decision-making agreement that is signed by both the decision
8989 59maker and all supporters in accordance with requirements set forth in this chapter.
9090 60 “Supported decision-making”, the process of supporting and accommodating the
9191 61decision-maker, without impeding the self-determination of the decision-maker, in making life
9292 62decisions, including, but not limited to: (i) decisions related to where the decision-maker wants
9393 63to live; (ii) the services, supports, financial decisions and medical care the decision-maker wants
9494 64to receive; (iii) whom the decision-maker wants to live with; and (iv) where the decision-maker
9595 65wants to work.
9696 66 “Supported decision-making agreement”, a voluntary, written agreement, written in plain
9797 67language that is accessible and understood by the decision-maker and entered into by the
9898 68decision-maker with one or more supporters pursuant to section 5-602 used to support decision-
9999 69making.
100100 70 “Supporter”, an adult who meets the requirements of section 5-602 and has executed a
101101 71supported decision-making agreement with a decision-maker.
102102 72 Section 5-602.
103103 73 (1)(a) A decision-maker may voluntarily enter into a supported decision-making
104104 74agreement with 1 or more supporters. 5 of 14
105105 75 (b) The decision-maker may amend or terminate a supported decision-making agreement
106106 76at any time pursuant to section 5-602(3)(e).
107107 77 (2)(a) Any person, eighteen years of age or older, may be a supporter.
108108 78 (b) A person shall not serve as a supporter in a supported decision-making agreement
109109 79when:
110110 80 (1) The decision-maker previously made, or makes, an allegation of elder abuse against
111111 81the supporter.
112112 82 (2) The decision-maker has obtained or obtains a Protection from Abuse Order against
113113 83the supporter or a harassment prevention order against the supporter under chapter 258 of the
114114 84General Laws.
115115 85 (3) The supporter is the subject of a civil or criminal order prohibiting contact with the
116116 86decision-maker;
117117 87 (4) The supporter has been removed as the conservator of the decision-maker, based upon
118118 88a finding that they did not act in the conservatee’s best interest; or
119119 89 (5) The supporter is found criminally, civilly, or administratively liable for abuse,
120120 90neglect, mistreatment, coercion, or fraud.
121121 91 (3)(a) Except as limited by a supported decision-making agreement, a supporter shall do
122122 92all the following:
123123 93 (1) Respect the values, beliefs, and preferences of the decision-maker.
124124 94 (2) Act honestly, diligently, and in good faith. 6 of 14
125125 95 (3) Act within the scope identified by the decision-maker.
126126 96 (4) Support and implement the direction, will, and preferences of the decision-maker.
127127 97 (5) Maintain confidentiality of any information obtained by a supporter, unless the
128128 98decision-maker specifically authorizes its disclosure.
129129 99 (6) Exercise only the authority granted to the supporter in the supported decision-making
130130 100agreement. 
131131 101 (b) Except as limited by a supported decision-making agreement, a supporter may, with
132132 102the consent of the decision-maker, provide to the decision-maker decision-making assistance
133133 103regarding the decision-maker’s affairs, including, but not limited to: (i) communicating decisions
134134 104and understanding information about, options for, the responsibilities of and the consequences of
135135 105decisions; (ii) accessing, obtaining and understanding information that is relevant to decisions,
136136 106necessary for the decision-maker to manage their affairs, including, but not limited to, medical
137137 107records, including protected health information under the Health Insurance Portability and
138138 108Accountability Act of 1996 (Pub. L. 104-191); psychological and financial records; educational
139139 109records under the Family Education Rights and Privacy Act of 1974 (20 U.S.C. s. 1232g), or
140140 110information protected by 42 U.S.C.A. s. 290dd-2, 4 C.F.R. Part 2; as well as other educational
141141 111records including Individualized Education Programs, transcripts, a transition plan, a student
142142 112summary of performance and any other materials as requested; (iii) ascertaining the wishes and
143143 113decisions of the decision-maker, assisting in communicating those wishes and decisions to other
144144 114persons and assisting to ensure the decision-maker’ wishes and decisions are implemented; and
145145 115(iv) accompanying the decision-maker and participating in discussions with other persons when 7 of 14
146146 116the decision-maker is making decisions or attempting to obtain information needed to make
147147 117decisions.
148148 118 (c) Unless the supporter has a valid legal authorization to do so and the action is within
149149 119the scope of their authority, a supporter shall not do either of the following: (i) make decisions
150150 120for, or on behalf of, the decision-maker, or (ii) sign documents on behalf of the decision-maker.
151151 121 (d) A supporter shall not participate in any life decision in which they have a conflict of
152152 122interest. This includes, but is not limited to, any decision in which the supporter, his or her
153153 123immediate family or partner, a business organization in which he or she is serving as officer,
154154 124director, trustee, partner or employee has a financial interest or other direct and substantial
155155 125interest in the outcome.
156156 126 (e) A supporter shall only be authorized to assist the decision-maker in accessing,
157157 127collecting or obtaining information that is relevant to a decision authorized under the supported
158158 128decision-making agreement and to which the decision-maker agrees that the supporter should
159159 129have access pursuant to a written authorization in accordance with the applicable federal or state
160160 130privacy laws. The decision-maker may withdraw the authorization at any time in whatever
161161 131manner is authorized by applicable state or federal law. A supporter shall keep confidential any
162162 132information obtained in the process of assisting the decision-maker.
163163 133 (f) A decision-maker may bring a civil action for damages and equitable relief, including
164164 134injunctive relief, resulting from a violation of this section or a regulation promulgated under this
165165 135section in any court of competent jurisdiction.
166166 136 (4) The existence of a supported decision-making agreement shall not preclude a
167167 137decision-maker from seeking personal information without the assistance of a supporter. 8 of 14
168168 138 (5) To be valid, a supported decision-making agreement shall be signed and dated by the
169169 139decision-maker and each applicable supporter in the presence of a notary public. The decision-
170170 140maker may use reasonable modifications, such as assistive technology or physical assistance, to
171171 141sign the agreement.
172172 142 (6) Evidence of undue influence or coercion in the creation or signing of a supported
173173 143decision-making agreement shall render the supported decision-making agreement invalid.
174174 144 (7) A supported decision-making agreement shall be personalized by the decision-maker
175175 145to reflect the decision-maker’s personal circumstances. A supported decision-making agreement
176176 146shall:
177177 147 (a) be in writing in plain language that is accessible and understood by the decision-
178178 148maker;
179179 149 (b) identify the decision-maker and all supporters;
180180 150 (c) describe the types of decisions with which each supporter shall assist the decision-
181181 151maker. If the decision-maker wants assistance to access their medical records, the agreement
182182 152must specifically reference that the supporter shall have access to protected health information
183183 153under the Health Insurance Portability and Accountability Act of 1996 (Pub. L. 104-191). If the
184184 154decision-maker wants assistance to access their education records, the agreement must
185185 155specifically reference that the supporter shall have access to protected education records under
186186 156the Family Education Rights and Privacy Act of 1974 (20 U.S.C. s. 1232g) or information
187187 157protected by 42 U.S.C. a. s. 290dd-2, 4 C.F.R. Part2; as well as other education records including
188188 158Individualized Education Programs, transcripts, a transition plan, a student summary of
189189 159performance and any other materials. 9 of 14
190190 160 (d) indicate that all supporters agree to assist the decision-maker in making such
191191 161decisions, to respect the decision maker's decisions and to assist the decision-maker in
192192 162communicating such decisions;
193193 163 (e) state that supporters shall not make decisions for the decision-maker;
194194 164 (f) indicate that the decision-maker may amend or terminate the supported decision-
195195 165making agreement at any time and for any reason subject to the requirements of section 5-
196196 166602(3)(e);
197197 167 (g) list contact information for the disabled persons protection commission, the elder
198198 168abuse hotline and all programs providing services to the decision-maker; and
199199 169 (h) include a statement from each supporter that they understand and accept their roles,
200200 170responsibilities and limitations as outlined in section 5-602(3)(a).
201201 171 (8) A person who receives the original or a copy of a supported decision-making
202202 172agreement shall rely on the agreement and recognize a decision, request or communication made
203203 173with the decision-making assistance of a supporter as the decision, request or communication of
204204 174the decision-maker. A written confirmation from the decision-maker may be required affirming
205205 175that the supported decision-making agreement presented is current.
206206 176 (9) A person or entity that, in good faith, acts in reliance on a decision made pursuant to a
207207 177supported decision-making agreement shall not be subject to civil or criminal liability or to
208208 178professional discipline.
209209 179 (10)(a) The supported decision-making agreement shall remain in effect until it is
210210 180terminated or expires. 10 of 14
211211 181 (b) A supportive decision-making agreement shall be terminated as follows:
212212 182 (1) On any termination date set forth in the agreement but no more than a term of three
213213 183years, unless extended by agreement, in writing, of the decision-maker and supporters, pursuant
214214 184to section 5-602 with terms of execution.
215215 185 (2) A supporter may terminate participation in a supported decision-making agreement at
216216 186any time, by written notice to the decision-maker and any other supporters to the agreement;
217217 187provided, however, that if the agreement has more than 1 supporter, the agreement shall remain
218218 188valid as to all other supporters.
219219 189 (3) A decision-maker may terminate a supported decision-making agreement at any time
220220 190by written notice to all supporters to the agreement.
221221 191 (4) Notice of the suspension of a supporter pursuant to section 5-602 shall be given in
222222 192writing and delivered in hand to said person or his or her attorney, or sent by registered mail to
223223 193said person at his or her residence or his place of business. Such notice so given, delivered or
224224 194sent shall automatically suspend the authority of such person to perform the duties of his or her
225225 195office or employment until he or she is notified in like manner that his or her suspension is
226226 196removed.
227227 197 (5) The death or incapacitation of the decision-maker.
228228 198 (6) In the event that the decision-maker becomes subject to a guardianship and
229229 199conservatorship order, the scope of the supported decision-making agreement may be limited in
230230 200whole or in part by the probate and family court to those decisions reserved for the decision-
231231 201maker after the issuance of the guardianship or conservatorship order. 11 of 14
232232 202 (11)(a) The disabled persons protection commission, an elder protective services agency,
233233 203the department of developmental services, the department of mental health or any person
234234 204interested in the decision-maker's welfare may petition the probate and family court to revoke or
235235 205suspend the role of the supporter within one or more supported decision-making agreements on
236236 206the grounds of abuse, neglect, exploitation or failure of the supporter to follow their roles and
237237 207responsibilities resulting in serious physical, emotional, or financial harm to the decision-maker,
238238 208or on the grounds that the supporter is not qualified pursuant to section 5-602(2)(b). The court
239239 209shall provide notice to the decision-maker and supporter and provide an opportunity for the
240240 210decision-maker and supporter to be heard. The court shall revoke or suspend the role of the
241241 211supporter within the supported decision-making agreement, in whole or in part, if the court
242242 212makes a finding under any grounds set forth in this paragraph. The court shall not order a
243243 213supported decision-making agreement to remain in effect over the objection of the decision-
244244 214maker. If the decision-maker is indigent, the court shall appoint counsel for the decision-maker
245245 215upon the filing of any petition under this paragraph.
246246 216 The court shall tally the number of individuals who appear before the court on supported
247247 217decision-making agreement issues. A report of the court’s findings shall be submitted annually,
248248 218as of June 30, to the clerks of the senate and house of representatives, the joint committee on
249249 219committee on children, families and persons with disabilities and the senate house committees on
250250 220ways and means.
251251 221 (b)(1) If a person who receives a copy of a supported decision-making agreement or is
252252 222aware of the existence of a supported decision-making agreement has cause to believe that the
253253 223decision maker is being abused, neglected or exploited by a supporter, the person may report the 12 of 14
254254 224alleged abuse, neglect or exploitation to the disabled persons protection commission pursuant to
255255 225chapter 19C or the elder abuse prevention hotline pursuant to chapter 19A.
256256 226 (2) If a mandated reporter pursuant to subsection (a) of section 15 of said chapter 19A or
257257 227said chapter 19C has reasonable cause to believe that the decision-maker has been abused,
258258 228neglected or exploited by a supporter, the mandated reporter shall make a report to the disabled
259259 229persons protection commission or an elder protective services agency, as applicable.
260260 230 (c) Execution of a supported decision-making agreement shall not be a condition of
261261 231participation in any activity, service or program.
262262 232 (d) Nothing in this section shall be interpreted to limit or restrict the right of an individual
263263 233to execute a health care proxy pursuant to chapter 201D or a power of attorney pursuant to this
264264 234chapter.
265265 235 SECTION 8. There shall be established pursuant to section 2A of chapter 4 of the
266266 236General Laws a special legislative commission, known as the Supported Decision-Making
267267 237Commission, to study, examine and make recommendations regarding: (i) the expansion of the
268268 238authorized state registry for health care authorizations to tally the number of individuals with a
269269 239supported decision-making agreement and that enables providers to verify that the supported
270270 240decision-making agreement presented by a decision-maker or a supporter is current; or (2) the
271271 241creation of one or more new online registries for authorizations for educational, financial, and
272272 242other information, including supported decision-making agreements, and that enables providers
273273 243to verify that the authorization, including supported decision making agreements, presented is
274274 244current. 13 of 14
275275 245 (a) The commission shall consist of: the chairs of the joint committee on children,
276276 246families and persons with disabilities, who shall serve as co-chairs; 1 member to be appointed by
277277 247the senate president; 1 member to be appointed by the speaker of the house of representatives; 1
278278 248member to be appointed by the minority leader of the senate; 1 member to be appointed by the
279279 249minority leader of the house of representatives; the secretary of health and human services or a
280280 250designee; the secretary of the executive office of technology services and security or a designee;
281281 251the commissioner of public health or a designee; the commissioner of the division of insurance
282282 252or designee; the commissioner of the division of banks or designee; the chief justice of the trial
283283 253court or a designee; the chief justice of probate and family court or a designee; 1 member
284284 254representing the Massachusetts Health and Hospital Association; 1 member representing the
285285 255Massachusetts Bankers Association; 1 member representing The Arc of Massachusetts; and 1
286286 256member representing the Disability Law Center.
287287 257 (b) State agencies shall make available to the commission any documents, data or
288288 258materials in a timely manner when reasonably requested by the commission.
289289 259 (c) The commission shall submit a report of its findings and recommendations to the
290290 260clerks of the senate and house of representatives, the joint committee on committee on children,
291291 261families and persons with disabilities and the senate house committees on ways and means not
292292 262later than June 1, 2027.
293293 263 SECTION 9. A supported decision-making agreement executed before July 31, 2026,
294294 264shall be valid until July 31, 2027. Thereafter, only supported decision-making agreements that
295295 265conform to the requirements of section 5-602 of chapter 190B of the General Laws shall be
296296 266valid. 14 of 14
297297 267 SECTION 10. Section 6 shall take effect on July 31, 2026.
298298 268 SECTION 11. The training program required by section 16F½ of chapter 6A of the
299299 269General Laws shall be implemented by the department of health and human services no later
300300 270than 6 months after the passage of this act.
301301 271 SECTION 12. The department of elementary and secondary education shall promulgate
302302 272regulations pursuant to section 2 of chapter 71B of the General Laws no later than 6 months after
303303 273passage of this act.
304304 274 SECTION 13. The executive office of health and human services shall promulgate
305305 275regulations no later than 6 months after the passage of this act.