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National Resource Center for Supported Decision Making
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Maryland

Maryland

Overview

In 2022, Maryland passed a bill legally recognizing and authorizing the use of supported decision-making as an alternative to guardianship for adults with disabilities. Maryland also has a statute recognizing supported decision-making as an auxiliary aid and service for transplant patients with disabilities. Maryland has pending legislation securing supported decision-making for individuals in establishing a self-directed mental health services pilot. We are not aware of any case law applying that statute, nor are we aware of any other case law denying petitions for guardianship in favor of supported decision-making.

Guardianship Laws

Adult Guardianship Statute: Md. Code. Ann. Est. & Trusts 13-101 to -222; 13-704 to -908; 13.5-101 to -504; Md. Code. Ann. Family Law 14-401 to -404

Supported Decision-Making

Supported Decision-Making Statute

  • Anti-Discrimination in Organ Transplants (includes SDM)
    • Statute Md. Code Ann., Health § 20-1601–1606, Insurance § 27-915 (2015)
    • Description: These sections prohibit discrimination on the basis of disability in organ donation and identify SDM as an auxiliary aid and service for transplant patients with disabilities.

State Legislation

  • S.B. 559, Gen. Assem., Reg. Sess. (Md. 2022):
    • Status: Enacted, Effective 10/1/2022
    • Description: This bill amends Maryland’s Estates and Trusts code by authorizing the use of supported decision making as an alternative to the use of guardians and other substitute decision-makers for adults with disabilities.
  • S. 792, 435th Gen. Assem., Reg. Sess. (Md. 2015):
    • Description: This bill prohibited discrimination on the basis of disability in organ transplants by, among other things, recognizing SDM as an Status: Enacted 5/12/15
  • S.B. 988, 2024 Leg., Reg. Sess. (Md. 2024)
    • Description: Identifies support decision-making as an available method of decision-making for individuals in establishing a Self-Directed Mental Health Services Pilot Program under the Maryland Department of Health.
    • Status: Died in committee on February 2, 2024; hearing on March 8, 2024.
  • H.B. 529, Gen. Assem., Reg. Sess. (Md. 2022)
    • Status: Failed (Adjourned, Executive deadline past)
    • Description: This bill aimed to amend Maryland Estates and Trusts code by authorizing the use of supported decision making as an alternative to guardianship for adults with disabilities.

    Case Law & Court Orders

    • In the Matter of Pughsley 265 Md.App. 706 (2025)
      • Description: William Pughsley (WP) had been denied the right to vote with the assistance of supported decision-making. His parents are his guardians and the Circuit Court for Prince George’s County refused on April 1, 2025 to modify the guardianship agreement to allow his parents to assist him in voting and refused to appoint his parents, an aunt, and a family friend as “Supported Decision-Makers under an SDMA. The Appellate Court of Maryland found on June 2, 2025 that the circuit court did err in disqualifying WP from voting and in refusing his parents to act as supporters for that reason. The case is remanded to address the issues of voting rights and supported decision-making.
    • In re. Bradshaw, No. 427, 2024 WL 910657 (Md. App. Ct. 2024)
      • Description: Johns Hopkins petitioned for a patient with “moderate cognitive dysfunction” to be appointed a guardian and the defense lawyer argued that the disabled woman did not require guardianship because there were less-restrictive alternatives like support decision-making available and identified family members willing to serve in this capacity. Johns Hopkins contended that the individual could not “make responsible decisions with the appropriate support.” Id. at *10. The Court did not consider supported decision-making in its analysis and upheld the circuit court’s appointment of guardianship.

    State Grant Programs

    State Grantee: Disability Rights Maryland
    Summary: Disability Rights Maryland used an initial grant grant from Developmental Disabilities Council to establish Maryland’s Cross-Disability SDM Coalition that unites state partners, advocacy agencies, and self-advocates to promote recognition of SDMAs.
    Contact: Megan Rusciano

    Other Resources

    Information Last Updated: January 24, 2025

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