Service Animals in Health Care Settings. What is Disability Rights NC? Common Types of Assistance 4/25/2016

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1 Service Animals in Health Care Settings presented by Holly Stiles Lead Attorney, Community Access Team What is Disability Rights NC? Protection and Advocacy (P&A) system for people with disabilities in NC. We: Investigate complaints of serious abuse or neglect Advocate for legal rights Tell people with disabilities about their rights and support selfadvocacy All of our services are FREE for people with disabilities! Common Types of Assistance Guide: navigational assistance Hearing: alerts to phone ringing, knock on door, traffic, smoke alarm, etc. Medical alert: detect and alert to drops in blood sugar, impending seizure, etc. Autism, sensory issues: tethering, deep pressure therapy, behavior disruption Psychiatric: behavior disruption, grounding, scouting 1

2 Woof to Wash: dog operated washing machine FAQs Does a service animal have to wear a vest or have an ID? No. They can wear a vest, harness, or have an ID tag, but it s not required. Does a service animal have to trained by a professional dog trainer? No. Someone with a disability can train his/her own service dog to perform tasks that assist with his/her disability. 2

3 FAQs How can I tell if a dog/miniature horse is a service animal? If it s not obvious, there are 2 questions you are permitted to ask: 1) Is this a service animal required for a disability? 2) What task or work has the dog been trained to perform? Service Animal Etiquette Ignore the service animal! Do not pet, touch, or distract it. Service animals are working animals. Distractions prevent the animal from doing its job, or reinforces undesirable behavior (such as paying attention to you instead of their handler). FAQs Where am I required to allow service animals to go within my facility? Anywhere you would permit human companions unless the service animal would present an actual, objective, articulable significant risk to health and safety. Fear of aggression or unpredictable behavior without individualized basis for this concern is discriminatory Recognized exceptions: operating rooms, coronary care units, hemodialysis units, intensive care units, and areas designated as infectious care or isolation areas. 3

4 Infection Control The CDC does not recommend additional infection control measures beyond standard cleaning procedures. Existing disinfectants in use should be equally effective against zoonotic agents as it is against human ones. (Consult your disinfectant manufacturer.) Branson v. West The Plaintiff was a doctor who worked at a Veteran s Administration (VA) hospital in Illinois. The doctor wanted to use her service animal at work to pull her wheelchair and do other tasks for her. The court found that the VA hospital had to allow the doctor to use her service animal at work. The only places that the service animal was not allowed to go were operating rooms, coronary care units, hemodialysis units, intensive care units, and areas designated as infectious care or isolation areas. Day v. Sumner Regional Health Systems, Inc. The Plaintiff was a patient who wanted to bring her service animal with her into the emergency room treatment area. The Tennessee hospital said that no animals, including service animals, were allowed past the waiting room area. The court ruled that hospitals and healthcare providers can only keep a service animal out of the treatment area when they can prove that a particular patient s service animal poses a risk that cannot be eliminated. 4

5 Roe v. Providence Health Systems An Oregon hospital patient had a service animal present in hospital room. (History of more than 100 hospitalizations.) The hospital asked her to remove the dog because of its overwhelming smell. The dog also growled and snapped at hospital staff. Before asking that the dog leave, the hospital tried to accommodate the dog by putting an air filter in the room, by shutting the door to the room, by assigning staff allergic to the dog to other areas of the hospital, etc. Nothing worked. Although the dog was truly a service animal, the hospital was allowed to have the dog removed. Pool v. Riverside Health Servs., Inc. Pre dates the CDC Guidance (2003), the current Title III regulations promulgated by the Department of Justice, and Supreme Court decisions about the standard for establishing direct threat. Plaintiff was a visitor to a hospital emergency room. The hospital had a general prohibition on permitting service animals into the emergency department. The court did not apply a direct threat analysis may have led to a different outcome. Rose v. Springfield Greene Cty. Health Dep't Plaintiff sought access with monkey. Court determined that she did not have a disability, and that her monkey was not a service animal. Most importantly, Court found that the defendant health department had engaged in an individualized assessment of the risk posed by the monkey before denying access. That assessment included consulting the CDC Guidance, which recommends against allowing monkeys in hospitals because of the infection and behaviors risks associated with monkeys. This harmonizes with DOJ regulations adopted in 2010 that specifically considered and excluded monkeys as legally protected service animals. 5

6 Capell v. NC Div. of Voc. Rehab Access was sought for two sugar gliders (marsupials) during in patient stay Access was permissibly denied because the ADA limits service animals to dogs and miniature horses Johnson v. Gambrinus Co. A beer brewery in Texas offered tours to the public. A man wanted to take his service animal on the tour. The brewery said no because they would get in trouble with the Food and Drug Administration if an animal got that close to their beer brewing process. The court found that humans and animals were equally likely to get their hair in the beer. The court even hinted that service animals might be less likely to get hair in the beer because of their regular grooming. Disability rights preempted FDA general regulations. Questions? Disability Rights North Carolina 3724 National Drive Suite 100 Raleigh, NC TTY 6