Vital Sounds 2020, Quarter 3

Vital Sounds 2020, Quarter 3

Service & Emotional Support Animals in the Healthcare Setting

August 18, 2020


Service & Emotional Support Animals in the Healthcare Setting

August 18, 2020

Connie Christian, MBA, CPHRM
KAMMCO, Facility Risk Management and Patient Safety Advisor

Know Their Rights and Yours

Pets provide companionship and have a calming effect on people from the very young to the elderly. Occasionally, pet owners grow to depend on these animals to offer emotional support during stressful events such as illnesses, medical treatments, hospitalizations, moving into assisted living communities, or new housing arrangements. Unfortunately, bringing emotional support animals into some of these situations is simply not possible. Understanding the difference between an emotional support animal and a service/assistance animal is key to helping patients and residents determine when an animal can accompany them to a medical practice or facility. 

Public Accommodation
Under the federal Americans with Disabilities Act (ADA), the definition of public accommodations is quite broad. Title III of the ADA covers all “places of public accommodation.” This comprises all places open to the public where an individual obtains goods and services and includes, but is not limited to,  private doctors’ offices, hospitals and clinics, and nursing homes (irrespective of the receipt of federal funds). Also included are restaurants, hotels, recreational facilities, parks, zoos, educational institutions, social service centers, and any other place of public gathering.[1] 

Types of Service Animals
The ADA defines a service animal as any dog or miniature horse that has been trained to perform disability-related tasks for the benefit of a person with a disability. In addition to guide dogs and hearing assistance dogs, here are some examples of service animals under the ADA:

  • Psychiatric service animals: these help their handlers manage mental and emotional disabilities by, for example, interrupting self-harming behaviors, reminding handlers to take medication, checking spaces for intruders, or providing calming pressure during anxiety or panic attacks
  • Seizure alert animals: These let their handlers know of impending seizures and may also guard their handlers during seizure activity
  • Allergen alert animals: These let their handlers know of foods or other substances that could be dangerous (such as peanuts)  

Assistance Dogs
In Kansas, people with disabilities may bring their guide dogs, hearing assistance dogs, or service dogs on all common carriers and forms of public transportation, including buses, trains, boats, and cars; to all hotels, lodgings, restaurants and other places that sell food; to all places of public resort, amusement, or accommodation; and to all other places to which the public is invited. Kansas law applies to “assistance dogs,” which include:

  • Guide dogs: dogs that are specially selected, trained, and tested to guide those who are blind
  • Hearing assistance dogs: dogs that are specially selected, trained, and tested to alert or warn those who are hard of hearing to particular noises or sounds
  • Service dogs: dogs that are specially selected, trained and tested to perform tasks for those with other disabilities.

Emotional Support Animals
Neither the ADA nor Kansas’s public accommodations law includes what some people call “emotional support animals.” Emotional support animals provide a sense of safety, companionship and comfort to those with psychiatric or emotional conditions. Although these animals often have therapeutic benefits, they are not individually trained to perform specific tasks for their handlers. Owner/Operators of public accommodations are not required to allow emotional support animals or pets. Kansas law specifically states dogs who provide comfort, protection or personal defense (and are not trained to mitigate someone’s disability) do not qualify as assistance dogs.

What does the Law Say?
Under Kansas law, if a question arises regarding an animal’s status as an assistance animal, the animal’s owner may provide the public accommodation with a letter or identification card. The contents of the card depend on whether the owner trained the animal themselves or if it was trained by a school or professional trainer. The card must include a picture of the animal.

Under the ADA, however, a public accommodation may not ask questions about a person’s disability or demand to see certification, identification, or other proof of the animal’s training or status. If the function of a service animal is not apparent, an establishment may only ask the animal’s owner the following: 1) is the animal a service animal and 2) what tasks does the animal perform for the owner?

Public accommodations in Kansas must comply with both state and federal law.

Admission Fees
The ADA and Kansas law prohibits public accommodations from charging a special admission fee or requiring an owner/handler to pay an extra cost to have the service animal accompany them. However, the owner may be required to pay for any damage the service animal causes.

Excluding a Service Animal
The ADA and Kansas’s public accommodations laws allow a public accommodation to exclude a service animal if the animal poses a direct threat to health and safety. For example, if a service dog is aggressively barking and snapping at patrons or staff, a practice or facility can require the removal of the service dog from the property. A service animal may also be excluded if it is not housebroken or if it is out of control and its owner is unable or unwilling to control it effectively. The owner of the service animal is still entitled to enter a public accommodation even if their service animal is not allowed to accompany them.

Housing Laws
Kansas law and the federal Fair Housing Act prohibit discrimination in housing accommodations against those who use service or assistance animals. The owner of a service or assistance animal must be allowed full and equal access to all housing facilities, and they may not be charged an extra fee for possessing the animal. However, the owner may have to pay for damages caused by the animal.

If a facility policy, lease, or rental agreement includes a “no pets” provision, it does not apply to a service animal. Pursuant to the federal Fair Housing Act, housing facilities must allow service dogs and emotional support animals if these animals are necessary for a person with a disability to have an equal opportunity to use and enjoy the home. To fall under this provision, the animal’s owner must have a disability and must have a disability-related need for the animal. In other words, in order to qualify, the animal must work, perform tasks or services, or alleviate the emotional effects of the owner’s disability. Fortunately for many emotional support animals and their owners, in Kansas, there are over 300 “pet-friendly” assisted living communities and numerous “pet-friendly” housing providers. These may be an alternative for those who depend on their pet for emotional support and do not qualify under the service or assistance animal laws.

For More Information
See the Kansas Commission on Disability Concerns guidance on Service Dogs and the Department of Housing and Urban Development’s Guidance on Service Animals.

A special thank you to Gregory M. Meihn of Foley & Mansfield, Detroit, Michigan, for providing the information used in this article.

[1] ADA Title III Technical Assistance Manual Covering Public Accommodations and Commercial Facilities.