Patients with disabilities frequently rely on service animals. The Americans with Disabilities Act (ADA) compels almost all healthcare providers to accommodate patients with disabilities, including allowing some types of animals in the treatment room. So, what else should healthcare providers know? Confusion about the different animal-related terms is common.
1. What kinds of support animals are there?
“Assistance animals” is an umbrella term for two common categories: service and emotional support animals. Therapy animals make up a third common category.
• Service animals are animals that help a patient with a mental or physical disability by working, providing assistance, or performing tasks for the benefit of the individual patient. Common examples are guide (seeing eye) dogs, hearing dogs and psychiatric service dogs (PTSD or anxiety dogs).
• Emotional support animals are animals that help reduce either a patient’s identified emotional symptoms or some effect of a patient’s disability by providing companionship. See question 3 below for further definition.
• Therapy animals (sometimes called facility animals) are animals that provide therapeutic contact to one or more patients. These animals are typically trained to work with groups of people and be tolerant of various environments. They are used clinically, such as in hospital recovery settings or post-traumatic event counseling. Generally, assistance animals are owned by the person using the animals, while therapy animals can be owned by others, e.g., the trainer or counselor of the hospital or medical practice.
2. Why is there still confusion around service animals if the ADA’s stance is clear?
The culture of using animals for assistance, support, and therapy is rapidly evolving. The public misconception of these animals and the multiple laws at play all contribute to patients’ and providers’ confusion. Importantly, the ADA only protects the use of service animals by those with disabilities. It does not protect the use of emotional support animals, therapy animals, or pets. However, other laws sometimes do protect emotional support animals when used by individuals for air travel or on rental properties.
While the ADA provides strict rules protecting only service animals, hospitals and medical practices should determine if the ADA’s restrictive definitions should be a hard and fast rule. Consider whether additional policies about when and how to allow other categories of animals is appropriate.
3. What’s the difference between a psychiatric service animal (ADA-protected) and an emotional support animal (not ADA-protected) if both are used to alleviate anxiety or another mental disability?
These two kinds of support animals are perhaps the most difficult to differentiate. The classification of these animals depends on what each animal was trained to do. A dog that is trained to merely be present and provide comfort through companionship for an individual who suffers from anxiety attacks is likely an emotional support dog. In contrast, a dog trained to sense an anxiety attack and take some specific action to help avoid the attack or lessen the impact would likely qualify as an ADA-protected psychiatric service animal. Because of the narrow distinction, a provider in this case may choose to accept both kinds of animals in order to avoid making a detrimental determination.
It can be challenging for healthcare providers to determine how to handle patients’ support animals when the situation presents itself, but our team of Risk Managers can help. For more information, please contact the LAMMICO Risk Management and Patient Safety Department at 504.841.5211.