News & Insights

Tips on Handling Kangaroos in the Medical Office

October 27, 2017

By Joe Tran, Attorney at Law


Tips on Handling Kangaroos in the Medical Office

Casually, a man and his baby kangaroo walk into your medical clinic. Your patient shows you his rash and asks to be treated. You are momentarily stunned: partly because the kangaroo is so well behaved and partly because you don’t know if laws regarding service animals apply to kangaroos. The man insists that you are required to let his baby kangaroo stay. What do you do?

Is a Kangaroo a Service Animal?

To determine if a kangaroo is a service animal, first look to federal and state laws. A service animal is defined under the Americans with Disability Act (ADA) as any dog trained to perform work or tasks for an individual with a disability. Places of public accommodation must provide reasonable accommodations to avoid discrimination against individuals with a disability.

Hospitals and medical practices must comply with the ADA because they are places of public accommodation. Under the ADA, a hospital or medical practice should not treat a patient differently because of the patient’s disability. Under federal and state law, a service animal team (the handler and animal) should have access to and treatment at any place of public accommodation in a manner equal to other members of the public. The reason for the rule: a patient with a disability cannot simply choose to forgo a disability aid like a service animal, just as they cannot forgo a hearing aid or crutches.

What Do Disability Laws Say About Kangaroos?

This table summarizes both the state and federal law:

Question

The Law1

What is a service animal?

A service animal is defined as any dog already trained to perform work or tasks (directly related to the disability) for the benefit of the individual with a disability. Surprisingly, miniature horses sometimes must be accommodated under the ADA.

In Louisiana, service dogs in training are also considered service animals.

Some other states do not define service animals as only dogs. So, kangaroos might qualify as service animals in certain other states.

Who does the law protect?

Individuals with a disability are protected under ADA.

In Louisiana, dog trainers of service dogs in training are also protected.

What is a disability?

Any physical or mental impairment that substantially limits one or more major life activities of the individual, having a record of such an impairment, or being regarded as having such an impairment.

What protection is provided?

The handler’s use of a service animal without discrimination in a place of public accommodation, public entity, and other public place.

Who must comply?

Places of public accommodation like hospitals and medical practices.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Common examples of service animals include guide dogs, hearing dogs, seizure response dogs, and sensory signal dogs like diabetic alert dogs, autism service dogs, psychiatric dogs (such as those providing assistance to person with traumatic brain injury or post-traumatic stress disorder).

Back to the Kangaroo: Frequently Asked Questions

So, if a baby kangaroo hops into your medical practice, what can you do? What must you do?

Q:    Can I ever prevent a service animal and the handler (the service animal team) from entering my office?

Generally, no. You may ask that the service animal—not the patient—be removed if (1) the animal is out of control and the handler does not take control; or (2) the animal is not housebroken. Excluding the animal is only appropriate if the patient with the disability can obtain care without the service animal on the premises. “Out of control”, however, does not mean removing the animal because of a few barks. Minor problems like barking are not sufficient to warrant removing the animal.

The animal does not need a collar or leash to be under adequate control by the handler, e.g., the handler may use voice control. Keep in mind that even if exclusion is warranted, the service animal team should be treated with respect and compassion.

Risk Management Tip: Talk to your patient. Work with the patient when possible, looking at the big picture. It might change your decision if the patient is emergent, in which case asking the animal to leave will delay treatment. Only the managing physician or the hospital senior management should make the serious decision to exclude a service animal. Remember, you must treat the patient without discrimination, even if the animal should be removed. Your reasoning for excluding an animal should be thoroughly documented in the patient’s record.

Q. Can I require documentation to prove they are service animals? Can I charge a fee?

No. No special gear, ID, paperwork, certification, or other proof are required. Staff can ask only the following two questions and only when it is not obvious what the animal was trained to do:
(1)    Is the dog a service animal required because of a disability?  
(2)    What work or task has the dog been trained to perform?

You cannot charge a patient with a disability service animal an additional fee for the animal. While it may at first seem fair to charge a fee for all patients with an animal, the fee is likely to have a more adverse effect on service animal teams. Unlike pets, service animals must be with the owner, and the service animal team would have no option to avoid a fee. In some cases, this disproportionate effect can be discriminatory.

Risk Management Tip: Review your service animal policy. Specifically note in the policy that no gear, ID, paperwork, certification, or other proof is required to qualify as a service animal. Instruct staff that only the two questions above may be asked of a patient with an animal. All interaction with the service animal team should be well documented in the patient’s record.

Q:     What is the difference between service, emotional and therapy animals? What if certain breeds are known to be vicious?

Service, emotional and therapy animals aren’t synonyms. Service animals perform tasks that the handler cannot because of his or her disability. In contrast, emotional support or therapy animals work to improve the health of the owner and are not protected by the discrimination law.  

Some dog breeds have a reputation as aggressive or vicious. Regardless, the law allows any dog breed to be a service animal.

Risk Management Tip: The disability laws are the floor– not the ceiling – of what a practice may choose to allow. Hospitals or medical practices may choose to allow animals that don’t meet the legal definitions of a service animal. Make exceptions on a case by case basis if necessary. Consider the animal’s size, whether it is housebroken, and whether it seems to provide the patient with comfort. Maybe you can make an exception for a baby kangaroo, but not a full-grown kangaroo. A flexible policy can highlight the compassionate care provided by your practice.

Q:     Can I exclude the service animal because the staff or another patient has an allergy?

The surprising answer is “No”. The disability laws are very specific regarding this common question. Even if you have patients who may be allergic to service animals, you must accommodate both equally.

Service animal teams should be allowed to remain together, except in very limited circumstances. The service animal can be separated from the handler only when the presence of the animal constitutes an undue burden, causes a fundamental alteration of services for all customers, or is a direct threat.

Risk Management Tip: Always ask yourself if the patient is being treated differently because of the presence of a service animal. Are other options available? Can you see the service animal team first and thus limit the time in the waiting room? Can the service animal team wait in a separate exam room? On the other hand, you likely would not be following the disability laws if you asked the service animal team to wait outside the building.

Q:     Who is responsible for the animals? What happens when the handler cannot control the animal?

Only the handler is responsible for the dog’s toileting, feeding, grooming, and veterinary care. The hospital or practice is not required to provide a “boarding room” to keep the animals when the patient cannot care for them.

Risk Management Tip: If the patient is unable to care for the animal, first ask if he or she wants to make arrangements to have someone else care for the animal. In the event arrangements cannot be made or the patient is unconscious, the hospital may identify a facility to board the animal until the patient is again able to care for the animal. If an animal becomes violent, a hospital may take precautions to neutralize the threat. Always document detailed accounts in the patient record, describing the time, place, location, and any measures taken regarding the treatment of the service animal.

Service Animal Best Practices

  • Let the animal do its job. Don’t talk to, pet, approach, or distract the animal. The animal may be conditioned to ignore distractions, but it is still possible to provoke the animal or prevent it from performing necessary work or tasks for the handler.
  • The service animal is not a pet. Don’t take photos of the animal without permission from the handler or ask the animal to do tricks.
  • Service animal teams are self-sufficient. Don’t be offended if the handler does not wish to chat or accept an offer to help. A handler may need to focus on controlling the animal or simply doesn’t have time to answer all questions. Ask questions respectfully, and let the handler determine if help is needed.
  • Respect the service animal team. Always talk to the handler first, not the service animal, and don’t assume anything. Sometimes an animal may wear a “head halter,” which can be mistaken as a muzzle. Don’t make disapproving faces because you assume an animal is dangerous.
  • Never feed a service animal. Don’t risk making the animal sick, thus preventing it from performing its job. When in doubt, treat the service animal like an inanimate aid such as a wheelchair. Don’t do anything to a service dog that you would not do to a patient’s wheelchair.

So, is a kangaroo a service animal? Plainly, a kangaroo is not a service animal under Louisiana and federal laws. But don’t be too quick to kick the baby kangaroo and his human companion out based only on the law. Talk with the patient first to see if a humane exception can be made.

Visit the ADA website at www.ada.gov for more information or call a LAMMICO Risk Manager at 504.841.5211 to discuss sample policies or other concerns.

1. The ADA is covered in 42 U.S.C. §12101 et seq. Further, the Department of Justice enacted regulations enforcing the ADA Titles II and III in 28 C.F.R. Parts 35 and 36, respectively. Louisiana laws relating to service dogs are found in Title 46, Chapter 23 of the Louisiana Revised statutes. See La. R.S. 46:1951 et seq.

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