Does your practice’s policy on service and emotional support animals meet these requirements?

There is typically confusion in eyecare practices when a patient brings in an unusual animal (e.g., a parrot) and indicates it’s a service animal. Now staff are also hearing the term emotional support animal. Given those scenarios, let’s review relevant guidance for medical practices.

Service animals

According to the U.S. Department of Justice, “beginning on March 15, 2011, only dogs are recognized as service animals under titles II and III of the Americans with Disabilities Act (ADA). … Generally, title II and title III entities must permit service animals to accompany people with disabilities in all areas where members of the public are allowed to go.”¹

The ADA defines a service animal as “… limited to a dog that is individually trained to do work or perform tasks for an individual with a disability. The task(s) performed by the dog must be directly related to the person’s disability.”² When it’s “not apparent that the dog is a service animal,” practice staff can only ask the patient two questions:

1. Is the animal required because of a disability?
2. What work or task has the animal been trained to perform?

Additional questions are not allowed, and the practice can’t require documentation for service animal entry. “Businesses may exclude service animals only if:

1. The dog is out of control and the handler cannot or does not regain control; or
2. The dog is not housebroken.

If a service animal is excluded, the individual must be allowed to enter the business without the service animal.”²

Under the ADA, a service dog must be trained to be taken into public places. “However, some state or local laws cover animals that are still in training.”³

Emotional support animals

Conversely, emotional support animals offer comfort to patients who suffer from anxiety and are prescribed by licensed medical providers. “Under the ADA, ‘comfort,’ ‘therapy,’ or ‘emotional support animals’ do not meet the definition of a service animal.”²

As for admission into public places, “some state or local governments have laws that allow people to take emotional support animals into public places,” according to the U.S. Department of Justice.³ “You may check with your state and local government agencies to find out about these laws.”

How to set your policy

Section 1557 of the Affordable Care Act (ACA) prohibits discrimination based on several factors, including disability, in covered health programs or activities. In July 2016, the U.S. Department of Health & Human Services, Office of Civil Rights issued a training for those in health care on Section 1557, and offered this guidance on disability: “Under Section 1557, covered entities must take the following steps, unless they would result in an undue financial burden or would fundamentally alter the program: Make reasonable changes to policies, procedures, and practices where necessary to provide equal access for individuals with disabilities. For example, a clinic must modify its ‘no pets’ policy to permit an individual with a disability to be accompanied by a service animal.”⁴

In addition to these federal laws, review state and local laws to ensure your policy is compliant. Your state medical society will likely have some helpful guidance. OP

REFERENCES:

1. ADA Requirements: Service Animals. U.S. Department of Justice. https://bit.ly/3gWhGO8 . Accessed Nov. 3, 2022.
2. ADA Update: A Primer for Small Business. U.S. Department of Justice. https://bit.ly/3sShaDs . Accessed Nov. 3, 2022.
3. Frequently Asked Questions about Service Animals and the ADA. U.S. Department of Justice. https://bit.ly/3sTcH3w . Accessed Nov. 3, 2022.
4. Section 1557 of the Affordable Care Act: A Civil Rights Training for Health Providers and Employees of Health Programs and Health Insurance Issuers. Department of Health & Human Services, Office of Civil Rights. https://bit.ly/3FQrW4O . Accessed Nov. 3, 2022.

Ms. Brown is a senior consultant with BSM Consulting in Tucson, AZ. She has experience in the ophthalmic industry holding managerial, clinical, and surgical roles for more than 30 years.