Background
Supported decision making is an official legal arrangement. It allows individuals with disabilities who find it difficult to make decisions concerning themselves, but have the capacity to do so with the appropriate support, to choose one or more persons (hereinafter “decision making supporters”) who they trust to assist them in decision-making processes. The decision-making supporters assist with financial, personal or medical matters or in understanding information, and they can also support the decision makers in expressing their decisions and implementing them. The arrangement enables decision makers to conduct their lives as autonomously as possible, and according to their will. Guardianship, in comparison, expropriates a person’s right to make decisions about his or her life and to implement them.
Amendment 18 to the Legal Capacity and Guardianship Law, 5722-1962 was accepted in 2016 and recognizes for the first time “supported decision-making” as an alternative to guardianship in Israel. There are three types of decision-making supporters: relative supporters, professional (paid) supporters, and volunteer supporters. A supporter must operate in accordance with the court’s order of appointment, explain the relevant information to the decision maker in a way the decision maker can understand, and specify the relevant options.
As of 2020, JDC–Israel Unlimited in collaboration with the Department for Supervision of Guardians and Alternatives to Guardianship at the Administrator General in the Ministry of Justice, is operating a pilot program in which volunteers serve as decision-making supporters (hereinafter “the pilot program”). The pilot program’s purpose is to establish an optimal model for supported decision making by volunteer supporters. JDC–Israel Unlimited and the Administrator General commissioned an evaluation study of this program from the MJB Institute to support decision making about the continued operation and assimilation of the program as a service within the Administrative General.
Study Purpose
The study’s purpose is to evaluate the pilot program for supported decision making by volunteer supporters.
Methodology
Data collection was conducted using four research methods:
- Analysis of documents that were produced as part of the pilot program.
- Analysis of administrative data about the pilot program’s scope.
- 24 semi-structured in-depth interviews with decision makers, volunteer supporters, and with officials/professionals from the Ministry of Justice, from the non-profits operating the program and from JDC-Israel Unlimited.
- An online survey – sent to 54 volunteer supporters in the pilot program, past and present, who served as supporters for at least six months or more. Among them 28 answered the survey.
Main Findings and Conclusions
The study found that the pilot program has established a service which enables the target population to exercise its right for legal capacity and its autonomy, and to make decisions pertaining to its life. It also appears that the pilot program addresses the various professional needs of the team – the regional coordinators and the volunteer supporters – and that there is a professional address for various issues concerning the pilot program’s operation and the actual volunteer work. These are reflected in the volunteers’ high level of satisfaction.
The study also highlights several issues and problems which need to be addressed:
- Recruiting, sorting, and selecting program participants – study findings indicate that two aspects should be taken into account when considering decision makers’ suitability for program participation: (a) the scope of required or requested support (if the hourly scope is considerable, it is harder to find volunteers who can commit to the required hours); (b) interest in being assisted by a decision-making supporter and willingness to cooperate (the more the decision maker is interested in being assisted by and in cooperating with the volunteer supporter, the greater the chance of optimal support).
Many resources are invested in recruiting volunteers for supporter roles. The findings show that there is difficulty in recruiting volunteers in certain geographic areas, from certain groups of the population (such as the Arab society), and from among certain language speakers (such as Russian speakers).
- Supporter training takes place before support commencement as well as during. In the years that the program has been active, there was no uniform or organized outline for preliminary training, and about half of the supporters reported that they did not participate in such training. The supporters who had participated reported a high level of satisfaction and felt that they had obtained useful knowledge and tools. Moreover, supporters who had participated in preliminary training felt more prepared for the volunteer work than those who had not participated. It was also found that there is a high level of satisfaction among the supporters concerning the content and duration of the group training sessions provided during the volunteer work, but only part of the volunteers participate in these training sessions.
- Guidance to supporters – is provided by the regional coordinator in meetings held with and without the decision maker. Although guidance meetings of coordinators and supporters are usually not conducted periodically, the supporters feel that the coordinators are readily available and provide good support.
- Record keeping, follow-up, and reporting – recording the information is important and essential, yet the findings indicate that this aspect of the program needs to be improved: the follow-up tools are not accessible enough to the supporters and coordinators; there are no clear procedures or instructions about record keeping and the reporting that is required from the supporters; the supporters do not regularly report through the reporting system; the coordinators do not follow-up on the supporters’ reports, and do not enforce the instruction to report. The regional coordinators themselves only partially report and record their day-to-day work. Therefore, the national coordinator’s ability to oversee and supervise their work is limited, and it is difficult to establish operating procedures for the program and to optimize its operation in general and the coordinators’ work specifically.
Main Recommendations
- In preparation for the implementation of the program as an official service, it is suggested to complete the characterization of its target population and establish a work plan for expanding the cohort of volunteers, with an emphasis on providing service in various languages and among the Arab population.
- It is important to ensure that new volunteers complete the preliminary training, and that the efficacy of this training be evaluated. It is also recommended to integrate practical aspects in both stages of training, using peer learning and case studies.
- The program should develop a supporters guidance manual, and it should examine the need for periodic personal coordinator-supporter meetings as a standard component of volunteer work.
- We recommend maintaining methodical and structured record keeping, forming convenient and accessible tools for record keeping, and including instructions for record keeping and supervision in the coordinators’ and the supporters’ role definitions.
- Before expanding the program further, it is important to define and formulate all the work processes that have not yet been established, for example defining the national coordinator’s role, scope of responsibilities, and tasks.
Citing suggestion: Ayali, T., Koren, Y., & Rimon-Greenspan, H. (2024). Supported Decision Making – Evaluation Study for the ‘Volunteer Supporters’ Pilot Program. RR-983-24. Myers-JDC-Brookdale Institute. (Hebrew)