Service Animals: Access to Dental Facilities

A person walks into your dental office with a dog on a leash. The person appears to be totally normal, and the dog is not wearing any identification markings. The person walks to the front desk, signs in, and takes a seat in the reception room to await dental treatment. What would you do? How would you approach this person? What are you required to do legally?
The Americans with Disabilities Act (ADA) has a variety of important definitions and laws regarding what you may and may not do and say.1 Letís explore these terms and prepare to aid the disabled patient in a calm, caring, and legal manner.

Illustration by Cheryl Gloss

First, according to the ADA, a service animal is ìany guide dog, signal dog, or other animal individually trained to provide assistance to an individual with a disability. If they meet this definition, animals are considered service animals under the ADA regardless of whether they have been licensed or certified by a state or local government.î2 Types of service animals include dogs, miniature horses, and other animals, the most common being the service dog. The animals are trained for many different types of disabilities. Service dogs are used for some people who are blind, use wheelchairs (or need stability when walking), suffer from seizures, are deaf (or hard of hearing), or who have other disabilities as qualified by the Americans with Disabilities Act.2 All service animals, regardless of the type of service or ownerís age, have full access and privileges to enter any place a normal person would be permitted to enter. Businesses may not charge for the service animal or increase prices or fees due to the animalís presence.
According to federal law, service animals are not considered pets. They are not subject to any rule that normally applies to pets. Service animals are allowed to work without a leash (even where leash laws exist) if their service task requires that they are not leashed to complete that task. For example, opening a door for a person in a wheelchair is not usually possible with a leash on the animal.
Second, only certain people are protected by the ADA law and allowed to use service animals in public places. Only a person who is legally defined as disabled is allowed special access privileges under the ADA law. A disabled person is defined as follows: "with respect to an individual, a physical or mental impairment that substantially limits one or more of the major life activities of such individual; a record of such an impairment; or being regarded as having such an impairment. 'Major life activities' is normally defined as: functions such as caring for one's self, performing manual tasks, walking, seeing, hearing, speaking, breathing, learning, and working." This disability may or may not be visible to anyone. That is, the person may not look handicapped.
Therefore, for a person to be protected under the ADA, the person must be legally disabled, and the service animal must be specifically trained to aid that individual. To determine if the person and animal qualifies, you may ask only the following questions:

• Are you disabled?

• Is that a service animal?

You may not ask the nature of the disability, degree of disability, or ask for identification or certification of the person or service animal. You can refuse entry or ask the animal to be removed only for a limited number of reasons:

• The person says he or she is not disabled.

• The person says the animal is not a service animal.

• The animal shows aggression toward the owner or another human.

• The presence of the service animal will result in a fundamental alteration to the nature of the business.

Therapy animals are not legally defined by federal law, but some states have laws defining therapy animals. They provide people with contact to animals but are not limited to working with people who have disabilities. They are usually the personal pets of their handlers and work with their handlers to provide services to others. Federal laws have no provisions for people to be accompanied by therapy animals in places of public accommodation that have "no pets" policies. Therapy animals usually are not service animals.
Other important details regarding service animals:

• You are not required to provide special accommodations for the animal.

• The owner (or someone who the owner has made arrangements with) must ensure the animal urinates and defecates in the appropriate places, and any waste is disposed of in a proper manner.

• You must provide corridors, seating areas, doorways, and other public or patient access areas wide enough for a wheelchair to maneuver easily.

• There is appropriate etiquette regarding how to treat a person with a service animal. You and your staff should be familiar with these rules and encourage compliance with others in the area.
Service animal etiquette:

• Always speak to the person.

• Do not pet a service dog. The service dog/animal might be distracted from its work.

• Do not offer food or treats to a service dog.

• Do not harass or startle a service animal.

• Do not bark and/or whistle at the service dog.

• Do not ask questions about the personís disability. Some people may feel uncomfortable discussing their disability or their service animal.

• If you are afraid of dogs/ animals, then remove yourself and go to another area.

• Do not try to separate the handler from his or her service animal.

Note: Most states have additional regulations as well as penalties for noncompliance.

DENTAL OFFICES AS PUBLIC ACCOMMODATION

Although most dental offices are privately owned and operated, they are still required to comply with the ADA regulations and provide access to disabled people using service animals.
"The Americans with Disabilities Act defines a dental office as a public accommodation. Therefore, dental offices cannot discriminate against individuals with disabilities such as blindness or hearing loss who utilize the services of a dog or other trained service animal."3
"Hospitals, medical or dental offices, and other healthcare provider sites, as places of public accommodation, must permit the use of a service animal by an individual with a disability. Like other places of public accommodation, they may enforce "no pets" policies in certain areas (such as operating rooms) if they can show that permitting service animals in would result in a fundamental alteration or safety hazard to those areas. For example, if appropriate medical personnel can show that the presence or use of a service animal would pose a significant health risk in certain designated areas of a hospital, then service animals may legally be excluded in those areas (Americans with Disabilities Act Title III Technical Assistance Manual, 4.2300)."4


References

1. Americans with Disabilities Act: Part 36, Section 104, 302(c). Available at: http://www.usdoj.gov/crt/ada/reg3a.html#Anchor-36104. Accessed on July 11, 2006.

2. Americans with Disabilities Act: questions and answers. Question #2. Available at: http://www.usdoj.gov/crt/ada/qasrvc.htm. Accessed on July 11, 2006.

3. Americans with Disabilities Act: questions & answers. J Am Dent Assoc. 1992;123(suppl):1-12.

4. Delta Society. Access Denied ñ Now What? Available at: http://www.deltasociety.org/ServiceAccessDenied.htm. Accessed on June 8, 2006.


Ms. Henson is the president of Cornerstone Dental Academy, where she authored the curriculum and oversees the education of dental auxiliaries and continuing education of dental auxiliaries, hygienists, and dentists. She travels as a speaker and consultant and presents a variety of seminars and clinical programs. In 2005, Ms. Henson received the Woman of Distinction award from Success in the City for her passion, ethics, and commitment to dental education. Ms. Henson is a registered dental assistant, a 2006 member of The Speaking Consulting Network, a national, state, and local member of the American Dental Assistants Association, an approved provider for the AGD through the PACE program, certified in nitrous oxide monitoring, and a BLS CPR instructor. She can be reached at (281) 855-4370, This e-mail address is being protected from spambots. You need JavaScript enabled to view it , or by visiting cornerstoneden-talacademy.com.




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Wendy Hoechstetter, BS, EMT/P (ret.), CAPS (09.11.2013 (22:25:54))
Correction Yes No An excellent article, Ms. Henson!

I'd just like to offer two small corrections and additions. *Only* dogs and miniature horses are currently recognized as service animals. All others were excluded with the changes made to the ADA in 2010.

Other types of animals may still serve as emotional support animals, but they are expressly not covered by the ADA.

The handler may also be asked if it is a service animal *required* because of a disability, because the service must be related to the disability.

If there is any reasonable doubt about the response, they may then be asked what *tasks* the animal is trained to do to help mitigate the disability.

There must be specific task training, not just things dogs naturally do like cuddle or keep one company, and cannot include protection like guard dogs do. Responses are not required to disclose the nature of the disability, or great detail, only the general nature of tasks the animal performs.

HTH.


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