When it comes to animals working in a healthcare setting, the terms used to describe such animals and the services they provide are often considered interchangeable. However, there are significant differences in the role each animal may play. An emotional support animal serves a different purpose than a service animal and pet therapy offer a different level of support.
While each animal assists their owners in some way, there are certain criteria that will differentiate one from another.
The categories reviewed here include personal pets, pet therapy/therapy animal, emotional support animal, working dog, and service animals.
A personal pet is just that, an animal that is part of the family and one that offers companionship. An organization may elect to not allow a personal pet to have access into the organization except in unique exceptions, such as end of life. Even so, the animal must be healthy, have limited exposure to other patients, be in good behavior and under the control of a handler or family member.
A therapy animal such as a canine are trained and certified to visit and provide comfort to people who may benefit, such as those patients in hospital settings. Pet therapy is considered complementary to the care being provided in a healthcare setting.
These animals are only allowed access to public places when they are working to improve patient outcomes. “Therapy animals are typically registered with or certified by an animal-assisted intervention organization after successful training, and proper behavioral and physical evaluation by a veterinarian.” The therapy animal is not recognized by federal law in the same way as a service animal (see below).
Emotional support animals (ESA) are pets and not in the same league as trained service animals. The ESA does not receive training or is licensing required. The animals provide aid to those experiencing mental health or emotional disorders. For example, a person with anxiety may find that when they are in close contact with the animal, they feel comforted and calmed. However, it is important to note that the emotional support animal is not considered a service animal based on federal law. Airlines are no longer required to accommodate emotional support animals. There is also variability in state laws. When assessing a patient’s eligibility for an ESA, one must be aware of evolving state legislation.
A working dog is purpose-trained and utilized for such activities as detection, herding, and search and rescue. You may have seen such animals at work following natural disasters searching for injured and deceased. Law enforcement may utilize the working dog to detect explosives or illegal drug detection.
By law, under the Americans with Disabilities Act (ADA), “A service animal means any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability.”
A service animal are individually trained to perform work or services to a person with a disability. An example would be a guide dog assisting a person with visual limitations. Hearing or signal dogs alert deaf people to sounds.
Service animals are allowed in public settings where other animals are not. The American Disability Act mandates that service animals have full public access which means the animal is allowed to go in places where other animals are forbidden.
Types of animals:
In addition to the provisions about service dogs, the Department’s ADA regulations have a separate provision about miniature horses that have been individually trained to do work or perform tasks for people with disabilities.
What questions can a staff member asked a patient?
Staff may only ask, by law the following questions:
Allergies and fear of dogs are not valid reasons for denying access or refusing service. The organization will need to create a workflow to accommodate the needs of the patient and the staff member. However, a disruptive service animal may be removed from the premises.
Animal handler’s responsibilities
Per the ADA, the service animal’s handler:
| Term | Species | Who is helped? | Training required? | Performs specific task? | Mitigates an individual's disability? | Regulations |
|---|---|---|---|---|---|---|
| Service animal | Dogs or miniature horses only | Individual owner with the disability | Individually trained to assist one person | Yes - related to the owner's disability | Yes - any disability under the ADA | ADA |
| Psychiatric service animal | Dogs or miniature horses only | Individual owner with the psychiatric disability | Individually trained to assist one person | Yes - related to the owner's psychiatric disability | Yes - disability from psychiatric illness | ADA |
| Emotional support animal | Any | Individual owner with the psychiatric disability | No | No - provides emotional comfort, well-being, support or companionship | Yes - disability from psychiatric illness | FHA, ACAA, state and local laws |
| Therapy animal | Any | Various (can be used in large group settings or individual psychotherapy) | Animal and handler trained in obedience and socialization | No - provides emotional comfort, well-being, support or companionship | No - used to mitigate suffering/illness, but not legal disability | State and local laws |
| Pet | Any | Owner | No | No - provides comfort and companionship to owner | No | None |
Dog bites can turn nasty, may be difficult to heal and damage may be permanent. Although not as common in the trained service dog, bites do happen with and without human provocation.
A common question then arises as to who is liable for any injuries sustained by an animal who harms employees or other patients in a healthcare setting.
Each state has statutes on dog bites and those laws cover service dogs as well. However, the law is not always clear. The answer may first rest with the type of animal that is involved in the incident, the state where the event occurred and the nature of the altercation.
Most laws indicate that the animal must be under reasonable control of the owner or their delegate. The owner, their delegate or the animal handler will need to monitor the animal while at the facility. If the injury happened when the dog was outside of the control of the handler due to neglect, liability may rest with the owner.
In a demand or notice of lawsuit, multiple defendants will likely be named, starting with the owner of the animal. Each of those named will need to defend their position. Working with your insurance carrier and broker is best practice as they will be able to evaluate the incident, determine if there is insurance coverage for the event, and assist in resolving the claim.
A business who refuses to allow a service dog entry may be risking a lawsuit unless there is a clear threat of harm from the animal.
In closing, best practices for the organization to consider include:
Additional information may be found at the ADA’s website.
Willis Towers Watson hopes you found the general information provided in this publication informative and helpful. The information contained herein is not intended to constitute legal or other professional advice and should not be relied upon in lieu of consultation with your own legal advisors. In the event you would like more information regarding your insurance coverage, please do not hesitate to reach out to us. In North America, Willis Towers Watson offers insurance products through licensed entities, including Willis Towers Watson Northeast, Inc. (in the United States) and Willis Canada Inc. (in Canada).
