Guardianship Alternatives

Guardianship is a legal tool, which allows a person to make decisions for another person. It removes the civil rights and privileges of a person by assigning control of a person’s life to someone else. Although the state directs a court to “design a guardianship to encourage the development or maintenance of maximum self-reliance and independence of the incapacitated person,” it is not uncommon for courts to create full guardianships, which deprive persons with disabilities of the right to make fundamental decisions about their lives.

The vast majority of Texans with disabilities and the elderly can make sound decisions for themselves with appropriate supports. Guardianship removes the person’s personal and civil rights, including the right to say where you live, work, and what you do with your free time. Learn more about Some Alternatives to Guardianship.

Supported Decision-Making

Supported Decision-Making (SDM) is a new alternative in the Texas Estates Code that supports people to make their own decisions and stay in charge of their lives, while receiving any help they need to do so. In 2015, Texas became the first state to put supported decision-making in law.

Representative Payee

If you are a person with a disability or an older adult and you cannot manage your benefits, a representative payee may help ensure that your money is used correctly while still allowing you to make other important decisions about your life. Learn more about Representative Payee.

More Information

Texas Legislature Online Bill: SB 1881    

Table of Contents

Health and wellness play a crucial role in the lives of individuals with developmental disabilities (DD). However, accessing appropriate care that is tailored to their needs can be challenging. TCDD is dedicated to expanding health care access, mental health resources, and sexual health education for Texans with DD. Studies reveal that adults with disabilities experience mental distress almost five times more frequently than those without disabilities. Additionally, the National Intimate Partner and Sexual Violence Survey indicates that both women and men with disabilities are at a higher risk of experiencing sexual violence. The COVID-19 pandemic also impacted the lives, health, and mental health of Texans with DD in significant ways. TCDD works diligently to improve the understanding and availability of inclusive health care services for people with DD.

TCDD’s Contributions to Health and Wellness

Through grant opportunities, policy activities, and community engagement, TCDD expands opportunities for Texans with DD to engage in healthy behaviors and access DD-informed health care services and supports. During the COVID-19 pandemic, TCDD engaged in ongoing statewide surveys to better understand how the virus was affecting the lives and health of Texans with DD. We developed and collected resources to help navigate the pandemic from statewide shutdowns to the end of the public health emergency. Our activities also support building community provider networks, developing mental health training for providers who work with people with all types of disabilities, and educating people with DD about sexual health and healthy relationships.

The following TCDD-funded projects developed and tested programs related to health care access, mental health, and sexual assault response and prevention.

Health Care Access

Mental Health

Sexual Assault Response and Prevention

Public Policy

All people, regardless of their disability, age, or income level, should have access to affordable, comprehensive health care. The Council supports efforts and initiatives to increase the accessibility, affordability, and effectiveness of health care for everyone. TCDD Policy Analysts are experts on disability related issues and serve as resources for Texas legislators and their staff when considering disability-related issues. Health and Wellness is integrated into TCDD’s Public Policy Priorities, stated below.

Ensure Texans with disabilities have equal access to and are proactively included in using all community resources designed to maintain and improve individual and public health and safety, including during public health emergencies. Texans with disabilities deserve health care that is available, accessible, and affordable, as well as emergency planning that is responsive to their needs.

Policy Input From the 87th Texas Legislative Session:

Written Comments on HB 119 and HB 473, Regarding a Prohibition on Organ Donor Transplant Discrimination Against People with Disabilities

Informal Comment: Draft Rule 18R047 – New Rights of Persons Receiving Mental Health Services Rules and Draft Repeal of Existing Rules

Health and Wellness Stories

The following stories show the impact of TCDD-funded health and wellness projects on people, organizations, and communities:

Dental Health Improvement

One patient in the dental portion of the Advancing Behavioral Health Integration grant with Baylor College of Medicine has participated in the program for two years. Prior to this project, she had never gone to the dentist without some form of sedation. After receiving behavioral intervention through the project, the patient has been able to have her teeth brushed and flossed on a weekly schedule. This is an enormous improvement for her oral health.

Supporting Students with Dual Diagnoses

One special education teacher in Corpus Christi said Project TEDD has given her knowledge, skills, and materials to support her students with dual diagnoses as well as her colleagues who have students with dual diagnoses. This teacher found the training on distinguishing between mental health issues and mental illness to be very impactful in her teaching and found crisis intervention strategies helpful in her classroom. With her training and the materials and support from Project TEDD, this teacher is confident that she can continue sharing this information with colleagues to support students with DD and mental illness.


Extending Health Insurance After Age 26

What you need to know about the extension of health insurance coverage for adults with disabilities once they reach age 26. This resource is available in English (PDF, 64 KB, 1 page) and in Español – Extensión del seguro de salud (PDF, 69KB, 1 page).

Dual Diagnosis Resources from Project TEDD

Through their Project TEDD grant project, Texas Tech University has developed multiple resources related to mental health. These resources and links provide information specific to dual diagnosis and may be shared to promote awareness

Medicaid and IDD in Texas

This fact sheet (PDF, 338 KB, 1 page) provides information on how access to Medicaid services impacts people with DD in Texas. The fact sheet covers some of the Medicaid programs that help people with DD participate in community life, where Texas ranks compared to other states, and more.

Texas Partners for Inclusive Access

The Texas Partners for Inclusive Access website is a collaboration among Texans with disabilities, state leaders, and community organizations to ensure Texas communities meet the unique needs of individuals with disabilities and their families.

Whole Person Project Videos

The Arc of Texas has developed videos featuring people with disabilities. These interviews highlight mental health and community inclusion.


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