Respecting Choice – Informed Decision-Making & Dignity of Risk in HCBS Settings
Throughout our previous trainings, we have explored member rights, the HCBS Final Settings Rule, and the role of service planning. These trainings have highlighted a shift in thinking: from institutional protectionism to self-determination. Now, we will take that discussion even further by exploring two key principles—informed decision-making and dignity of risk—which are central to true autonomy and empowerment in HCBS settings.
As professionals, we are often trained to protect and prevent harm. But now, we must also recognize that every person has the right to make their own choices, even when those choices involve risk. Learning through experience—both successes and failures—is an essential part of personal growth and empowerment.
When discussing this topic, it’s natural for us as professionals to feel some discomfort—this is a shift in thinking. We are inherently driven to help, and that remains at the core of our role. However, it’s also important to recognize that in rare cases, rights modifications may still be necessary to prevent serious harm. While our priority is always to support autonomy, professional intervention should be a last resort, used sparingly and transparently, always with the individual’s rights and dignity at the forefront.
Learning Objectives: By the end of this training, you will understand:
- The concepts of informed decision-making and dignity of risk.
- How these principles align with HCBS regulations and person-centered planning.
- The role of providers, case managers, and caregivers in balancing autonomy and safety.
How to support individuals in making informed choices while managing reasonable risks.