- What is the Surrogate Decision-Making Committee (SDMC) program?
- Who is eligible for the SDMC program?
- When is a person considered to be incapable?
- Who serves on SDMC panels?
- How can I become an SDMC panelist?
- What are my responsibilities as a panelist
- What determinations must the SDMC panels make?
- What medical decisions can be made by the SDMC program?
- What treatment is excluded by law from the SDMC program?
- Where can I obtain more information about the SDMC program?
The Surrogate Decision-Making Committee (SDMC) program is the only program of its kind in the nation. It is authorized to provide consent for non-emergency major medical treatment and end-of-life decisions on behalf of qualifying individuals. The SDMC panels are convened to provide a quicker, more easily accessible, cost-free and personalized decision on behalf of individuals with disabilities.
Eligible individuals are persons believed to be incapable of providing informed consent, who lack an individual authorized to act on their behalf and either:
· Currently reside or have formerly resided in a residential program operated, licensed, approved or funded by the Office for People With Developmental Disabilities (OPWDD), the Office of Mental Health (OMH), or the Office of Alcoholism and Substance Abuse Services (OASAS)
· Currently or previously receive(d) services under the federal Home and Community Based Waiver
· Currently or previously receive(d) individual support services or case management approved or funded by OPWDD
An individual is considered to be incapable when he or she is unable to assess the risks, benefits and alternatives to a proposed medical treatment, including the risks of non-treatment and cannot make an informed decision to consent or refuse such treatment.
A Surrogate Decision Making Committee (SDMC) relies on 12 volunteers appointed by the Justice Center. These volunteers serve on committees throughout New York State. When a panel is convened it must consist of at least 3, and no more than 4 members.
The committees and panels consist of one member from each of the following categories:
· NYS Licensed Health Care Professional (e.g., physician, nurse, clinical social worker)
· NYS Attorney
· Family Member or Former Client
· Advocate for Persons with Mental Disabilities (e.g., persons with recognized expertise or demonstrated interest in the care and treatment or individuals with behavioral health or developmental disabilities)
To date, the Justice Center has appointed and trained more than 1,600 volunteers who serve throughout New York State.
Prospective panel members, must submit an application to the Justice Center, complete a one-day training session and affirm an oath of office. Volunteers serve for two-year terms and may be reappointed for additional two-year terms.
Indemnification is provided by the State. All travel expenses for training and hearing participation are reimbursed.
Panelists review declarations regarding an individual's capacity and need for treatment. The decisions are made by the panels during a hearing where the panel takes testimony on each declaration.
The workload of a panelist is manageable because cases are reviewed by the panelists prior to the hearing and panel determinations are, in most cases, made on the day of the hearing. Panel members have the flexibility to select the amount of time and geographic areas where they are able to participate in hearings.
After carefully reviewing the submitted case filing forms, the SDMC panels will make as many as three decisions:
1. Determination of the individual’s ability to consent to or refuse the proposed major medical treatment decision.
2. Determination of whether there is an authorized surrogate who is willing and available to consent to or refuse the proposed major medical procedure on behalf of the individual.
3. Determination of whether the proposed major medical treatment decision is in the best interest of the patient.
The panel must make these decisions in this order to protect the individual’s rights. In all cases, the individual will be seen by the panel or one of its members, before a decision is made.
Medical, surgical, dental, or diagnostic interventions or procedures which involve:
· The use of a general anesthetic
· Any significant invasion of bodily integrity requiring an incision or producing substantial pain, discomfort, debilitation, or having a significant recovery period
· Significant risk (e.g., colonoscopies, endoscopies, MRIs, CT Scans with contrast)
· HIV testing
· Withdrawal or withholding of life sustaining treatment as provided in the Health Care Decisions Act for persons with an intellectual or developmental disability
· Any other treatment or procedure for which informed consent is required by law
· Routine diagnosis or treatment including the administration of routine medications
· Dental care performed under a local anesthetic
· Emergency medical treatment
· Electroconvulsive therapy (ECT)
· Withdrawal or discontinuation of life sustaining medical treatment except as provided in the Health Care Decisions Act for persons with an intellectual or developmental disability
· Termination of pregnancy
Please visit the Justice Center’s website at http://www.justicecenter.ny.gov/services-supports/sdmc[LD1] or contact SDMC staff directly at (518) 549-0328, or by fax at (518) 549-0460 or by email at SDMC@justicecenter.ny.gov