Tip:
Highlight text to annotate it
X
[ Mid-tempo music plays ]
FROLING: Welcome to this event, hosted by
the International Association of Assistance Dog Partners.
My name is Joan -- Joan Froling,
and I am one of the cofounders
and currently the chairperson of IAADP.
And today's workshop is titled
"Access to Hospitals & Other Health Care Facilities
for Disabled Persons with Service Animals."
Do hospitals and other medical providers
have a legal obligation in the United States
to accommodate disabled persons
with guide, hearing, and service dogs?
And if so, to what extent?
We are honored to have with us today
two very distinguished guest speakers
to educate us on this topic.
Sally Conway represents the U.S. Department of Justice,
and she is the Deputy Chief of the Disability Rights section.
Eileen Hanrahan is a senior official
at the U.S. Department of Health and Human Services,
and she is an attorney with their Office of Civil Rights.
Before I turn this over to our guest speakers,
I would like to talk for a bit about myself and IAADP
and our goals in having this workshop.
On this next slide, you will see a photo
of me and my mobility-assistance dog, Spirit.
He's a big white Samoyed,
which is a sled-dog breed with a very gentle temperament.
And it's thanks to the many tasks that Spirit can perform,
like his predecessors,
that I've learned that I can live on my own,
I can go many places
without having to drag a family member along with me,
and I've even been able to travel.
And I do recognize that some of the independence
that we have here in the United States
is due to our wonderful laws that give us access rights.
These are laws that permit disabled persons
to work outside the home with an assistance dog
in many places in the public and private sector.
Under the law, these dogs are regarded as medical equipment,
although we know they are so much more.
Unfortunately, although it sure has gotten a lot better
in the last 20 years,
there are a number of persons out there
who are unfamiliar with these laws,
and they may think we're trying to bring a pet
into their facility.
So we still have a lot of educational work to do,
and this workshop is part of that effort.
So, what is IAADP?
We're an independent, nonprofit cross-disability organization
run by disabled volunteers.
And IAADP represents and advocates for disabled persons
who work with guide, hearing, and service dogs.
We held our inaugural meeting in 1993
in conjunction with the conference
of Assistance Dogs International and, also, the Delta Society.
And our founders viewed IAADP as a self-help organization.
We wanted it to empower disabled people
with different kinds of assistance dogs
to work together on goals
to foster the assistance-dog movement.
And over the years, thousands have done so
through our education campaigns,
our advocacy work, and our peer support projects.
And as some of you know, IAADP promotes
high training and behavioral standards for assistance dogs
and the responsible use of access rights.
On this next slide, you'll see a photo
of our networking newsletter, Partners Forum.
We launched it in 1994 with the intention of fostering
a global information-sharing and advocacy network.
And it currently links together
over 350 assistance-dog training organizations
worldwide,
3,000 IAADP members with guide, hearing, and service dogs,
and others with a personal or professional interest
in the assistance-dog movement.
And the list next to the photo
just enumerates some of our activities over the years,
and I'll only touch on a few.
We have put on a number of conferences.
We've held workshops in different countries.
We have an educational website
that receives over 250,000 visitors every year,
and it facilitates our educational outreach
and our advocacy campaigns.
And the list also mentions CADO.
That is the acronym
for the Coalition of Assistance Dog Organizations.
IAADP was a founding member in 2001.
What CADO does is that it enables
the umbrella organizations
representing nonprofit training programs,
such as Assistance Dogs International
and the U.S. Council of Dog Guide Schools,
and organizations representing
disabled persons with guide, hearing, or service dogs
to work together whenever an issue comes up,
such as new legislation, proposed rulemaking,
or something else that could have a serious impact
on our community and it needs a response.
And we've learned that by speaking with one voice
and showing a united front on a number of issues,
it can be very advantageous to our advocacy goals.
Our next slide asks how this workshop can assist you.
This has been a very murky area of civil rights law.
It gets very little publicity, compared to fair-housing cases
and cases involving a denial of access --
disabled persons with service animals
that want to enter a restaurant, store, or in school districts
in the USA.
Last year, as editor of Partners Forum,
I published a press release from the Office of Civil Rights
of the U.S. Department of Health and Human Services.
And we learned that a gentleman with a service dog
who he relied on for balance support
took his father to the hospital for treatment,
and the hospital refused him access with his service dog.
He subsequently filed a complaint
with the U.S. Department of Health and Human Services,
and the hospital settled out of court
as violating Section 504 of the Rehabilitation Act of 1973.
I had to ask myself, "Why Section 504
rather than the Americans with Disabilities Act?"
And it does bring up the question of,
which law should we cite
if we have an access problem in a healthcare facility?
So, I'm looking forward to learning a lot more
about this area of civil rights law,
and we also hope this workshop will educate employees
of hospitals and other healthcare settings
on their rights and responsibilities
when they encounter a disabled person
with an assistance dog in their facility.
And on the last slide, it says, if you have a question
about an access problem
or some other assistance-dog-related question
and the website information is insufficient,
you can contact our Information & Advocacy Center,
which, over the years, has responded
to thousands of inquiries from disabled persons and others
about access problems and other assistance-dog-related topics.
Our phone number is 1-888-54-IAADP,
or maybe to make it easier for some,
it is 1-888-544-2237.
Or you could e-mail us at PartnerSupport@iaadp.org.
Now I'm going to turn this workshop over
to our guest speakers
from the U.S. Department of Health and Human Services
and the U.S. Department of Justice.
And I would just like to take this opportunity
to thank them very much for working with IAADP
to bring us all a better understanding
of civil rights of disabled persons with assistance dogs
in regard to hospitals and healthcare settings.
CONWAY: Hello. And thank you for joining us.
This is the "Healthcare Access for Individuals
with Disabilities Who Use Service Animals."
Eileen Hanrahan, my colleague
at the Department of Health and Human Services,
and I are really thrilled to be here.
And we thank very much Joan for all her work
in getting this to actually air, which was not a simple task.
What we're going to do today is --
This will be pretty brief.
And we're going to talk about three federal laws
that provide protection for folks with disabilities,
and in this case, specifically folks with disabilities
who use service animals as it relates to healthcare providers.
I will talk for a little bit.
Eileen will talk later on,
and, then, we have received some really good questions
from Joan and from the folks at IAADP,
which we will answer sort of toward the end.
And we'll end with a couple of questions.
So, with all that, we're going to get moving.
And I'm going to talk a little bit about who is covered
and talk about some legal stuff,
but I promise, with the exception of one slide,
there will be very little legal language.
Okay, so, what are the laws
that we're going to be talking about here?
And we're going to talk about Section 504
of the Rehabilitation Act of 1973.
And this applies to anyone, any covered entity
that receives federal financial assistance.
And it doesn't matter who the organization
or company or business that receives the funding.
It could be for-profit, not-for-profit, big, small.
The key is that they have to have agreed
to accept federal funding,
and with that comes a responsibility
not to discriminate against people with disabilities.
And we'll also talk about the Americans with Disabilities Act.
And we're primarily going to talk about Title II.
And Title II applies to state and local governments,
and that's state, county, local, municipal --
all kinds of governments that aren't the federal government.
And Title III -- it applies to things
that we call public accommodations,
which are actually private entities.
They're private businesses, social-service agencies --
things that offer goods and services
to the general public, and that's key.
So, as you can see from this list,
when we asked, "What Health Care Providers Are Covered?"
really, it's anybody who is providing a healthcare service.
And in addition to this list,
I just wanted to be real clear that --
we had gotten a question -- that dental offices
are certainly offices of healthcare providers.
And that could be a general dentist.
It could be a specialist. It could be an oral surgeon.
But we just wanted to make very clear
that, yes, in fact, dental offices are covered.
And what kinds of healthcare activities are covered?
First of all, this list is not all-inclusive,
but these are representative examples.
Pretty much, what any healthcare provider offers to the public.
And it's surgery.
It's access to emergency-room care,
admission and discharge,
outpatient services --
if you have to go to P.T.
or occupational therapy or go in for other testing.
All of these things are covered.
The other thing that we want to make very clear
is that someone who is a companion
or a family member of a patient or another member of the public
that has a disability -- they're covered by this.
So it's not just limited to the individual
who is receiving that healthcare at that particular time.
And certainly, when we talk about access to facilities,
we're talking, in a hospital context,
access to everything that's in the hospital,
including, you know, the gift shop, the cafeteria,
lobbies, restrooms.
So, wherever people are allowed to go in a healthcare provider,
you should be able to go
as a person with a disability with a service animal.
Here's the legal stuff that I talked to you about.
And this is an actual definition of "service animal."
And it's really important that you understand this.
Right now, "Service animal means any dog
that is individually trained to do work or perform tasks
for the benefit of an individual with a disability,"
and that includes folks with,
"physical, sensory, psychiatric, intellectual,"
or other kinds of mental disabilities.
And, again, it's a dog.
And the last sentence is later on in the definition,
but whatever work or task that dog has been trained to perform
has got to be "directly related to the individual's disability."
And that's very important, as well.
So, what does all that legal language really mean?
It means that the species that qualify as service animals
under federal law here are -- it's limited to dogs.
One thing we do want to make very clear
is that there are other kinds of federal laws --
for example, HUD's Federal Fair Housing Act,
the Air Carrier Access Act --
that have a much more expansive definition, and they allow --
They provide access for folks
who may use emotional-support or comfort animals.
So, what we're --
Specifically today, we're talking about Section 504
and the Americans with Disabilities Act.
It doesn't have any impact on any other law,
other federal law, or state or local law
that provides more expansive definition.
And we also wanted to make very clear,
particularly that folks
with psychiatric or mental disabilities
can absolutely benefit from and use service animals.
Just because someone says --
or discloses that they have a psychiatric disability
doesn't automatically discount whatever that dog is
as just "being an emotional-support animal."
So we wanted to be very clear about that.
So, what do we mean when we talk
about this "do work or perform tasks"?
And that really is a term of art.
And that's good language for you to learn and to use.
And we just say that this dog has to be individually trained
to do something on behalf of the person with the disability.
And I want to just quickly talk about "individually trained."
That just means that that dog has been specifically trained
to do the work or perform tasks.
It doesn't mean that it has to be trained --
that animal has to be trained by any kind of an organization
that does, in fact, train service animals
for a variety of different things.
The ADA -- these laws do not require that.
But it does require that that dog
has actually individually been trained to do this work.
And, again, the work or task
have got to be directly related to the disability.
Now, we have given you here an absolutely non-exhaustive list
of examples of kinds of work and tasks
that service dogs are trained to do.
And it could be retrieving items -- we all know that --
like medicine or telephone.
Or for someone, perhaps like me, who has a mobility disability --
and I use a wheelchair --
it may be fetching something out of the refrigerator.
It may be doing those kinds of tasks -- fetching a straw.
And, again, the coverage of folks
with psychiatric or other mental kinds of disabilities
is really, really important.
And we give an example here that's fairly broad,
but let me give you one example.
And that is --
again, it's not particularly in the healthcare context,
but we see it a lot in education --
that kids with autism or who are somewhere on the autism spectrum
are benefiting just incredibly --
things we never thought about --
by using service animals.
And one good example of this
is if somebody with autism wants to elope, or bolting,
these animals are trained to recognize when that's happening,
and there's a very specific thing that they do
and that that kid can respond to.
And it prevents that elopement.
So, again, service animals are being trained
to do some remarkable work or tasks
for types of disabilities that we never, ever anticipated,
even just a few years ago.
Here, I just want to again state that emotional-support animals
are not covered in the definition of service animals
simply because they have not been individually trained
to perform a task or do work for someone with a disability.
And the innate ability of that dog
simply to provide a sense of well-being
or emotional support or companionship
is terribly useful for that individual,
but it doesn't constitute work or tasks
for the purposes of the "service animal" definition.
Now, here's a really big deal.
And folks who use service animals
need to know what kinds of inquiries can be made
and what kinds really can't.
And the first thing is that --
And this is inquiries made by a covered entity --
that is, somebody that has obligations
not to discriminate under the ADA,
so it would be a healthcare provider
or a healthcare facility.
Generally speaking, if it's really apparent
that this individual has a disability
and is using a service animal --
the best example is someone with a vision disability.
I mean, since the '40s, people have understood
that folks who are maybe blind or have low vision
have been using guide dogs.
So, if it's pretty apparent,
a covered entity should not be asking any questions.
There are only two inquiries, and this is --
We are very, very clear on this --
that can be made by a covered entity.
And that can be, one, is that animal required
because of a disability?
And they may ask what work or task
that animal has been trained to perform.
They can't ask, "Would you demonstrate anything for me?"
So, those inquiries are very limited and very specific.
Now, the whole issue of exclusion of service animals
has always been a big deal.
And as you know, the general rule
is if you're a person with a disability,
covered entities have to permit you
to come in with your service animal.
But we have two very specific exceptions
where a service animal can be excluded.
And Eileen is going to talk about this
a little bit more later.
One is that the animal is out of control
and the handler doesn't take effective action to control it.
And this really means out of control.
And the other is if the animal is not housebroken.
And, again, Eileen is going to talk about this in more depth,
but these are not isolated instances.
So, those are the two times
when a service animal can be excluded.
And if you notice, we say "service animal,"
not the person.
If there's a legitimate reason
for exclusion of a service animal,
the handler or the individual with a disability
has to be given the opportunity to still come in
and participate in whatever the program is
or whatever goods and services without the animal.
The top says "Under Handler's Control,"
and this is also very important.
The service animal
has got to be on a harness, a leash, or some other tether.
And that's the general rule.
The other is that there may be times
when either the nature of the individual's disability
makes it impossible for him or her
to actually handle a leash or a harness
or if the use of that harness, leash, or tether
interferes with whatever the work or task is
that that animal has been trained to perform,
then that animal still has to be under that handler's control.
And that would be voice control, signals --
other effective means
that essentially would keep that animal
in the close proximity of the individual with the disability
like it would be were that animal
on one of the other kinds of devices.
So there are times when, perhaps,
the use of a tether is not possible,
but it doesn't lessen the requirement
that that individual has to keep that animal under its control.
There are other limits.
And, again, we're talking about policy modifications.
And covered entities aren't required to modify policies
where this modification
would fundamentally alter the nature of the program.
And they're also not required to permit an animal
if, number one, it runs counter
to legitimate safety requirements
that all covered entities will have,
or if it poses a direct threat
to the health and safety of others.
And the direct threat is a very specific provision.
It's not necessarily included
in the service-animal provisions,
but always it is a legal defense.
Now, there are some miscellaneous provisions,
and everything always comes under "Miscellaneous,"
doesn't it?
It's the things we didn't know where else they needed to go.
So, the first is covered entities are not ever --
or they're not responsible
for the care or supervision of a service animal.
And this means feeding, watering,
taking the animal out for restroom breaks,
exercise, grooming -- any of those things.
Those responsibilities always lie with the individual
with the disability, or the handler.
And the second, again,
is that service animals may accompany their handlers,
or people with disabilities,
to all areas of a public accommodation
or public entity --
remember, public entity is state, county, and
to which the handler can go.
Generally, if the general public can go,
you with a service animal should be able to go there, as well.
And you may not see this too much in the healthcare context,
but you may in halfway-house kinds of things
or sort of step-up, intermediate care.
If you have a service animal,
an entity cannot require you to pay a pet fee or a surcharge.
And the reason is, is that service animals are not pets.
So they can't have any surcharges
that they wouldn't apply
to folks who didn't come in with pets.
So, I mean, that's the key thing is --
if somebody says a surcharge or a pet fee, you just say,
"This isn't a pet. It's a service animal."
Now, I have to talk a little bit about miniature horses,
and I will talk a very little bit.
There are some folks in the country
who are very effectively using miniature horses.
And what I want to do is just give you a quick overview.
And I know that this may not be a topic
that you folks are dealing with,
but it is something that's out there.
So, miniature horses are not ponies.
They're not small horses.
They are really miniature horses.
And they typically range in weight from 70 to 100 pounds.
And they range in height from 24 to 34 inches,
right to the bottom of their mane.
So, as you can see, they're the size of a lot of dogs.
And while miniature horses are not considered service animals,
we do have specific requirements
that reasonable modifications have to be made
to permit someone who has a disability
to come in with a miniature horse.
And, again, if you look at that language,
it's going to look really, really familiar to you --
that it's been individually trained
to do work or perform tasks.
And we provide some assessment factors
to help covered entities figure out
whether they can allow miniature horses
as a reasonable modification of their policies.
And they are the type, size, and weight of the horse,
and can that animal be accommodated
within the features of that facility?
This is really a size issue.
The handler has sufficient control of the horse.
Sound familiar?
The horse must be housebroken,
and whether the horse's presence
in a specific facility undermines
or compromises legitimate safety requirements.
And I believe I'm going to turn this over to my friend Eileen,
who will talk to you about,
really, how does this apply in the healthcare context?
HANRAHAN: Hi, everyone.
And I just would like to echo the comments and appreciation
that Sally Conway, my colleague, expressed
for the opportunity to be here today.
Service animals are a very important compliance concern
for both of our agencies, so we are really glad
to have this opportunity to talk about them with you.
Now, Sally has given us a good walk-through
of the general standards that apply under the ADA,
as well as 504, for service animals generally
in the very wide diversity of context
that are covered by the Americans with Disabilities Act.
And now I'd like to talk with you a little bit more
about how those standards are applied
in the healthcare context.
As many of you, I'm sure, are familiar with,
just based on your own experience and almost intuition,
some of the issues and challenges
that service animals raise in healthcare
are very unique and challenging,
in large part because of the concern
about the risk of transmission of disease or infection
to people that may be in the environment.
And clearly, we're looking at people
who are not necessarily your typical population.
We're looking at people
that have already compromised health,
and some of whom may have very significant health concerns.
So the concern that the medical community has
about the risk of transmission of infection
is a very legitimate one.
So, we'll talk about how those standards apply.
Because this is a healthcare issue,
we would like to be able to look to some of the medical science
and the background information in the healthcare environment
that there is on the risk of transmission of infection
from service animals.
So we are very lucky to have guidelines that we can turn to,
"we" being lawyers.
The Centers for Disease Control and Prevention
and the Department of Health and Human Services, where I work,
actually issued guidelines back in 2003.
These guidelines are still current.
We continue to look to them today.
They're still good science and good medicine.
We're going to walk through a little bit
about those guidelines right now.
Okay, let me just mention --
As you can see, these guidelines were issued in 2003.
They are still current, and we will be talking
about these standards as they apply today.
So, in the CDC guidelines, they make a point
that there is no evidence that animals pose
a more significant health risk to people than do other people.
And if you think about your own experience,
this seems common sense --
that you're more likely to catch a cold or a flu or some virus
from some person in your workplace or in your family
than you are from your service animal
or from some companion animal.
In light of this, the principle in the CDC guidelines
is that a service animal should not be excluded
from an area in a healthcare facility
unless the patient's situation or a particular service animal
raises some greater risk than would be posed by an animal
that cannot be accommodated through reasonable measures.
And we'll talk about what those are.
You remember that Sally said that we're talking
about dogs now when we talk about service animals.
We used to be talking about other animals,
where the risk of transmission was higher.
So, primates, for example, or birds
really do pose a greater risk than the evidence is for dogs,
and this is an important fact to keep in mind.
So, the CDC states that, if healthcare staff or visitors
or patients are able to go into a care area
without taking additional precautions
to prevent transmission of infection,
then a clean, healthy, and well-behaved service animal
should be allowed access, as well.
So, I want to focus on additional precautions
and the clean, healthy, and well-behaved service animal
as we go forward.
Now, let me just mention the CDC guidelines
were developed in consultation
with the Justice Department's Civil Rights Division,
with some of our colleagues back then.
And consequently, they were developed
consistent with standards that apply
under the ADA and Section 504.
Of course, those standards have been updated to some extent
in the 2010 ADA regulations.
For example, the CDC guidelines talk about animals generally,
and now we're talking about dogs.
But in the important respects,
the standards are still consistent,
and they're still current.
And these concepts will be familiar to you
from what Sally talked about previously.
The service animal should be permitted access
with the person with the disability,
unless the animal's presence or behavior
creates either a fundamental alternation
in the service or the program
or a direct threat to other persons.
So, here's sort of the bottom line here,
the punch line, the gold standard.
Excluding a service animal from a particular area is appropriate
if the area has restricted access.
So, by "restricted access," we mean the area
is maybe one that is subject to certain environmental standards.
They may use certain filters to keep the air clean.
There may be particular attention
to hand washing in the environment,
or that there are barrier-protective measures
required of staff or visitors,
such as gowns or masks or gloves.
And the reason why it would be permissible
to exclude a service animal from an area such as this --
and this, again, seems pretty reasonable --
is that the service animal, unlike the person,
cannot really make use of these protective measures,
such as masks, gowns, and gloves.
So you can't minimize the risk from an animal
in the way that you would be able to from a person.
Let me just add a couple of additional principles
from the CDC guideline, which will come up a little bit later
when we talk about some of the cases that we get.
A service animal can't be excluded
simply because the healthcare staff feel that they are able
to perform the functions of the service animal
or because they don't see the need for the service animal.
And typically, you may see staff saying
that they either can push the wheelchair around
and take the person to the locations that they need to go
or they can retrieve any of the items
that the service animal may be able to do.
Again, irrespective of what that function is,
that is not a sufficient basis
for ever excluding a service animal from an area.
And, again, care for a service animal --
This is in the ADA. Sally talked about it earlier.
It's in the CDC guidelines, as well.
The care for the service animal
and the control of the service animal
is the responsibility of the patient throughout the stay,
although the patient can turn to family and friends
to help meet that responsibility.
So, now we actually want to spend some time
talking about the issues and the cases that we have seen
in our past few years in enforcement in our agencies.
Let us start out by saying that we actually do see
a fair amount of cases involving service animals in HHS.
I did look through maybe 35 or 40 of them
as we were working to develop our presentation.
I didn't actually see any
involving animals other than dogs, surprisingly,
but I know this does come up often
for the Justice Department.
But I do want to add, in nearly all of these cases,
we did identify compliance concerns,
either with how a particular person was treated
or with the service-animal policy
that an entity had in place.
So it's important to understand what your rights are
because there will frequently be circumstances
where you may be facing a policy or certain actions
that may not always be consistent with the law.
Great. And now we're going to take some time
to talk about how the medical standards
and the legal standards intersect.
And we'll do that by talking about some of the issues
that we have seen in our cases and, sometimes --
I know that DOJ has a very active hotline
that gets a lot of service-animal questions.
CONWAY: And do not adjust your set. You do see two people.
HANRAHAN: Oh, thank you.
[ Both laugh ]
Yeah, so, one issue that, of course, is important
is, who has a right to a service animal?
As Sally mentioned, any person with a disability
who has a legitimate need to be in the facility,
including patients, companions of patients,
as well as visitors and members of the public.
And I wanted to mention one case
where we had a facility that excluded a person
because the person, on previous visits,
had never used a service animal,
and now they were using a service animal.
So, I think there was some suspicion
that the animal was a pet.
But as we know, individuals' needs
can change from time to time, as well as a person's interest
in using different types of assistance.
So, just because they didn't need
or didn't want to use a service animal before
doesn't mean that it is that way today.
So we did find that the exclusion wasn't permissible.
CONWAY: And I'll just add one very quick thing.
We're really focusing on this a lot
because it just historically has been,
if you're not the patient, you don't have any other rights.
So it's really important
that if you're a companion or a visitor --
you're there to drive somebody home
after an outpatient surgery --
as long as you're a person with a disability, you have rights.
HANRAHAN: Here is a big question.
As we know, only dogs are service animals,
and we've talked about that.
The animal must have been trained.
We do see cases involving this issue,
and there is a presumption that a person needs to have
some evidence of training by an organization or society,
as Sally has made clear.
Animals can be individually trained
by either the person with the disability
or spouse or partner of some other individual.
Service animals now perform
a wide range of functions and tasks.
Surprisingly, we still continue to see cases
where security staff are blocking individuals' entrance
to healthcare facilities, particularly, hospitals,
where they're asking, "Is this a guide dog?
Is this a Seeing Eye dog?
And our policy only permits guide dogs for the blind."
And clearly, this is a much more traditional and an older view
of the function of a service animal,
and it's significantly more expanded than that.
So, that's important to keep in mind.
And another issue that we also see quite often --
healthcare providers may not require certification
or documentation or tags or jackets.
No documentation or certification of any sort
can be required.
We've had one facility that required someone
to have a certificate that there was a medical need
for the service animal,
which is inappropriate for a host of reasons,
but in any event, we just want to be clear
that certification can never be required.
And, Sally, would you like to add anything?
CONWAY: No, and I think this also goes
that there are only very clearly defined limited questions
that are permitted.
So, again, if you go back to what we talked about earlier,
it's, "Are you a person with a disability
that uses this animal as a service animal?"
And they may ask, "What work or task
has the animal been trained to perform?"
But they cannot ask to demonstrate.
HANRAHAN: Here is another very big issue that we see
in most service-animal policies, probably,
but the principle is -- and we've taken the position that --
healthcare providers may not require
a veterinarian's certificate of health
or any other health records.
And let me just give you some examples
of types of requirements that we've seen.
We had one covered entity
require that the certificate be maintained on file
in the hospital for the year.
We had another that required
an annual physical exam from somebody.
We had another entity
that wanted to refuse an animal for health reasons,
not based necessarily on the animal's condition
today, the day of the visit,
but because that, previously, they had excluded the animal
for reasons of health or apparent uncleanness.
So, we want to be clear that that is inappropriate.
What the entity really should be doing
is making a present-day judgment
about whether the current status of the animal...
poses significant risk
to the health or safety of other persons
that cannot be either eliminated or modified or mitigated
through modifications of policies or practices.
Another issue that we also see
are requirements of vaccinations for different kinds of diseases.
We had -- One hospital required vaccinations for distemper,
for parvovirus, and for rabies.
We actually did a fair amount of research on this
and could find almost no evidence of transmission
of parvovirus or distemper from dogs to people,
and although, as we know, rabies is a transmissible condition,
which is why most localities require vaccinations for rabies,
looking in the particular jurisdiction
where this was located,
we actually found about two or three instances
of transmission of rabies -- and this was a large city --
in about the past 10 years.
So, we really even found the transmission of rabies
in this circumstance was quite negligible.
But the entity did agree
to drop the requirement for the vaccinations,
as well as its health certificate.
CONWAY: And if I could sort of tack on at the end here,
again, it has to be for a legitimate reason.
It can't just be --
Like Eileen was talking about in the point above,
it can't just be, "Well, I heard,"
or, "I read on the Internet,"
or, "experienced from 10 years ago."
It has to be current, objective evidence
that is the basis for making a decision
to exclude someone with a disability.
And, remember, you're not just excluding the animal.
You're excluding that individual with a disability.
So, great care has to be taken
when these kinds of decisions get made.
HANRAHAN: And I just wanted to add one point,
because I know, for many people, it seems logical --
it seems reasonable that a hospital or a doctor's office
should require a certificate of health
for an animal coming in a place.
The reason why we don't find that it's reasonable
is because, as with people, animal's health conditions
can change very much from day to day.
Just because an animal
had a health certificate six months ago
doesn't mean that the animal is healthy today.
And because they may not have been healthy six months ago,
it doesn't mean that they're not healthy today.
So, for one reason, we find
that it really is not as much value --
it doesn't demonstrate the animal's health
as it might appear to be at first glance,
and, second, because it's viewed as an unwarranted burden
on the person with the disability.
It means that they have to go to the vet, to take the time,
to spend the money to do that,
and, then, basically carry around these pieces of paper
with them all the time, even on the possibility
that they may have an unanticipated visit
to an emergency room.
So, I think in light of the lack of evidentiary value
of the piece of paper to the animal's condition
and whether it does actually pose
a risk to health or safety of others,
it's just not viewed as something
that's appropriate to require.
Control and behavior are also big issues.
And these are general standards that Sally talked about before
that apply just as much in the healthcare context
in another.
I just wanted to talk
about two kind of interesting cases that we had,
although one seems perhaps the no-brainer.
A person who used a wheelchair
came into the hospital waiting room
and had three small service animals with her.
They were dogs.
One was in her lap, and the other two were running around,
barking and kind of skidding here and there.
So we did say that she needed -- if they were service animals --
to either get the animals under control,
or that the hospital was in a permissible position
to actually remove the animals from the location.
Another case presented a little bit of a different issue.
It was a doctor's office.
They had a single treatment/examination room.
And the doctor was concerned
that, if the patient, who was a person
with a disability with a service animal,
brought her dog in,
given the physical examination that would take place,
the physical touching of the patient, of the handler,
as well as potentially any expressions of discomfort
by the handler --
The doctor was concerned that the animal would perceive this
as an aggression towards the handler
and might become aggressive toward the doctor.
It seems like, "Okay, that, you know, could happen."
But, again, we really want to look at,
what is the evidence in the given case
and not just sort of unfounded assumptions
about what might happen?
And in that case, we actually did not find any evidence
of aggression by the animal,
so we did find that the exclusion was inappropriate.
CONWAY: And the whole issue of control and behavior
to the occasional nature of something --
If a dog yips, it doesn't automatically mean,
"Oh, that dog's out of control, and now we can make them leave."
That would be problematic if a covered entity did that.
I mean, this really is --
First of all, the individual has to be given the chance --
If, let's say, that it is more barking, you still --
you have to be given the chance to correct that behavior.
So...
Or, you know, if you're in an environment
where you have a bunch of little kids
and they're pulling the tail of the dog,
that dog is going to yip.
And so, again, you have to look
at what does, you know, "out of control" really mean?
HANRAHAN: And the person, as we talked about earlier,
also has the right to turn to family members or companions
to take control of the animal and maintain that
while the person may be otherwise
not able to do it personally.
Isolation and separation -- another important issue.
As a general rule, the person with the disability
should not be separated from their service animal,
and the person with the disability
and their service animal should not be separated
from other individuals receiving comparable services
in comparable circumstances.
We did have a case involving
what was essentially a business meeting
between the person with the disability
and their service animal,
and the person who was on the staff was afraid of dogs
and so wanted the animal omitted completely
from the meeting area.
The person with the disability appropriately said no.
And as a compromise, they agreed to meet in a very large room
with the individual and her service animal at one end
and the staff person at the other end.
And we did also find concerns about that.
There are alternatives.
They could have had a different staff person
meet with the individual.
They could have ensured
that the animal was sufficiently under control
to assuage any concerns that the staff person may have had.
But fear of animals is generally
not going to be a permissible reason
to treat the person with a disability differently.
Also wanted to mention another case --
and this was interesting -- involving a dialysis center.
A person with a disability
came to the dialysis center with her service animal,
and they said that, unless she had documentation
demonstrating a need for having a service animal
at the facility,
in light of, I guess, the health activities
that the person would be going through,
that they would not permit the service animal.
So, they locked her service animal in a bathroom
for 3 1/2 hours, and they took responsibility
for pushing the woman's wheelchair
and for situating her for treatment.
Again, this is impermissible.
Just because staff can do functions
for a person with a disability --
and maybe they can, maybe they can't --
but the person has a right to function independently.
They have a right to the service animal
unless some of the exceptions that we've talked about are met.
So, either the animal's out of control,
the animal is not housebroken,
or there is an actual risk of significant --
a significant risk to the health or safety
of other persons in the environment.
So...
CONWAY: And it's really important that a service animal
not be separated from the handler
for any other number of reasons.
You know, this is a relationship
between a human being and an animal
on which he or she relies to function independently.
And the longer apart --
first of all, you know, the animal may have
significant anxiety and separation anxiety.
And it can also deteriorate this relationship
that has, over the years, really been worked to develop.
It just doesn't end well
in almost all circumstances when there's a separation.
HANRAHAN: Okay, we want to spend some time on this slide.
We're trying to put together some of the legal standards
and the medical guidance that we've talked about
and make some very general, I guess, advice
as to what kinds of areas in healthcare facilities
animals generally may be able to go in
or generally not be able to go.
And you know how we like a little wiggle room
in the government.
All of these things really depend on the circumstances.
So, healthcare facilities are different.
Service animals are different from one to another.
But if you were to look at the legal standards
and the medical guidance together,
this is some sort of general parameters
for where we think, generally,
service animals could or couldn't go.
I want to talk about a couple of these, in particular.
Emergency rooms, for example.
We do get a lot of cases involving emergency rooms.
And our standard, again, would generally be
unless the animal presents
a risk to the health or safety of others
that cannot be mitigated or eliminated
by taking reasonable measures,
that the animal should be allowed access.
And, again, all of these judgments
need to be individualized.
They need to be based
on reasonable judgment, on medical knowledge,
and not on unsubstantiated concerns.
So, in an emergency room, for example,
if you look at the type of persons
that typically present to an emergency room,
they're persons that may have open wounds.
They may be bleeding.
They may have undiagnosed, transmissible conditions.
They may not look necessarily clean.
They may have parasites -- animals, as well.
And if the risk of transmission from the animal
is less than it is from persons, it would seem,
if the person is able to be in these different types
of conditions in an emergency room,
then the animal should not really pose any greater risk.
So, we haven't really found any circumstances
where an animal would be justifiably excluded
from an emergency room.
Also wanted to talk about treatment rooms.
We see a lot of cases involving doctors' offices,
and I'll just mention one.
We had a case involving a doctor
that had one treatment/examination room.
He was concerned about allergies.
He was concerned about germs.
He was concerned about exacerbating the conditions
of other patients who may use the same room.
He said that he performed a whole range of procedures
in this room, including -- and I will mention some of them --
skin biopsies, incision and drainage of wound abscesses,
minor surgical procedures,
nebulizer treatments for asthmatic patients,
and administration of vaccinations.
And, again, if you look back to the CDC guidelines,
they teach us that, if you have a room where
there aren't infection-control measures in place,
such as gowns or masks or gloves,
if you don't have special
ventilation requirements in place --
and this room did not have any of those features --
then, generally, the service animal
should be permitted access, as well as a person.
So, again, we found exclusion of the service animal
from this treatment room to be impermissible.
And let me just mention allergy clinics.
It might be surprisingly on a "Generally, Yes" list.
It's because they're --
even if an animal can't have complete access
to an allergy clinic because of certain circumstances,
it is generally possible to make some sort of accommodation
so that the person with a disability
that uses a service animal also has access.
But let me mention this one case.
We had an allergy clinic that started out
with a prohibition of service animals in total,
and then they agreed to allow this particular woman
to come with her service animal two days a week,
use a separate entrance,
and to wait in an area that did not have as much
of a patient population as their general waiting room.
Sounds like it might be reasonable,
but here is our concern --
this particular provider singled out service animals
and the allergens that animals might present with.
It did not take any steps
to limit the introductions of allergens that might --
or agents that might trigger a person's allergies,
such as colognes or perfumes or deodorant.
It did not seem to regulate things
such as the fiber in the carpets
or the types of cleaning solvents
that may be used in the doctor's office.
Instead, they allowed patients and visitors to come and go,
really, unrestricted.
They only limited the allergens
that the service animal presented.
So, what we required as a settlement
was for the doctor's office to do a self-evaluation.
They needed to identify the types of restrictions
that would be put in place,
based on evidence from that self-evaluation.
They needed to identify ways that they could take
to try to reduce exposure of persons.
They were to let individuals coming into the allergy clinic
give them advice, recommendations
on steps that they could take
to reduce their exposure to allergens.
They needed to train staff on what the appropriate process was
and, also, to treat people fairly.
So, if there is a legitimate concern
about risk to other individuals,
there are steps that providers can take.
But, again, you want to have people
treated equally and fairly
and for these restrictions
to be really based on evidence and not supposition.
CONWAY: And let me add, too, that we have had similar kinds
of complaints that have been filed with us,
you know, and it's really, really important
that, yes, there are some legitimate reasons
where a service animal could be excluded from an area
or, you know, certain times of day,
but it really has to be based in reality,
and it really has to be based in what other practices,
because, on its face, things can sound very reasonable.
But when you see that, you know --
The case that Eileen was just talking about,
when there are no other steps taken
to limit whatever bad effect
some kind of an allergen would have,
they simply didn't do it.
So you really have to look at things in practice.
I mean, how do they really screen and protect patients
with all different kinds of allergies,
not just those with allergies
to, you know, dog dander or dog saliva?
HANRAHAN: Yeah, and on the "Generally, No" list,
I just wanted to mention, again,
one instance that we saw involving an operating room.
And these are generally areas
where, as you can see, that they would have
infection-control measures in place,
which is why they're on the list of the areas
that service animals generally could not access.
But we did have one involving an operating room
where the individual with a disability
and the service animal --
he wanted to be able to bring a service animal into the room.
He was getting a non-invasive procedure done to him.
And the facility took the position
that this is an operating room
that is also used for invasive procedures.
And in those circumstances, it is a sterile environment.
But at the time that it was being used
by this particular individual,
it was not a sterile environment.
So, as you can imagine, we do have some concerns about,
if this environment is not sterile
and the person is coming in using their street clothes
and the physician is operating using street clothes,
then what is the concern about having the service animal
on both circumstances?
So, that's why it's important to look look at the use
of the particular area in the facility.
Now I think we want to take some time
before we use up all of our time
to go over some of the questions and answers that we did receive.
We did try to answer some of them
as we were going through the presentation,
but we also have a couple that we'd like to share with you.
So, I am going to share the first of these four questions.
It's a question for Sally.
And the question is, "When an individual with a disability
becomes a patient in a hospital, does the person have a right
to keep his or her service animal with them?
Does it make a difference
if the individual has arranged for family or friends
to come in and care for the animal during their stay?"
CONWAY: And I think this is a real common question
that we get at DOJ, and I know you folks get this a lot.
I think -- The first is, is a resounding --
The first part of the question --
If you're an in-patient in a hospital
and use a service animal, do you have a right
to have that service animal with you?
And the answer is a resounding "yes,"
all capital letters -- Y-E-S.
And then, the follow-up question was,
does it make a difference if the individual
has arranged for somebody else to --
remember, we talked about earlier --
for the care and supervision of that animal?
And I think they're almost two separate questions.
The first is, do you have a right
to have that animal in with you?
And the answer is "yes."
And then you go to the care or supervision of the animal,
which never is the hospital's responsibility.
So, yes, if you have arranged for a buddy to come,
a family member, you know,
a volunteer that you were able to talk to.
The key is that it really doesn't matter
who takes care of that service animal,
as long as it's not the hospital itself.
They are not required to do it.
So, I think that it's almost two separate questions.
One is, yes, you have a right,
if you use a service animal because of a disability,
and, two, the hospital doesn't ever have an obligation --
They're not going to have that obligation
to feed, water, exercise, groom, take out to a grassy area.
So I think, yes, you have a right,
and you also have an obligation to ensure
that the supervision and care of that animal
is taken care of by someone other than the entity.
HANRAHAN: And here is a second question --
"Does a patient with a disability
who uses a service animal
have to be put in and pay for a private room in a hospital?
If the patient with a disability
is assigned to a nonprivate room,
such as two or four beds,
does the patient have to ask permission from their roommates
to have his or her service animal stay with them?"
CONWAY: This is a really good question.
I like this question.
The first part of the question is,
if you have a service animal
and you are going to be admitted to a hospital,
must you be limited in your choice of rooms
to a private room?
And I think that the answer is, generally, it's not --
Well, first of all, it would be no.
But, then, I'll say it's generally no.
It depends on the kinds of hospital,
and just sort of like the allergy clinic
that Eileen spoke of earlier.
So, that's a no.
You can't be required to do that
as a condition of being admitted to a hospital.
Then, the other question comes,
what if you're in a nonprivate room,
you know, what happens with the other patients?
And I think the first thing is that you, as a patient,
wouldn't be required to go around
and be asking permission of other patients if you --
You know, it really isn't your responsibility.
The responsibility is for the hospital
to in-patient you [chuckles] --
I think I've developed a new word --
to a room that would be appropriate
for your healthcare needs,
just like they would do any other.
And then, beyond that, they have a requirement
to modify their policies if it's necessary
to allow you to have that equal access.
Now, it's really going to depend on the roommates.
And, you know, who are the roommates?
Are roommates -- Do any of them have a disability?
And say that they have a really significant allergy
to dog dander or to dogs,
then what do you do?
And then I think the healthcare provider
has the obligation to see what other opportunities they have
to be able to meet both parties' needs.
And it may be -- Do you swap people around --
put them in a different room,
but under the same circumstances?
I think that you have to be really, really careful
to make an assumption
that because you use a service animal,
you don't have the same choices.
I'm the queen of bad analogies, but let me try one.
It would be like if you went to a hotel.
And if they said, "We are glad
to have you here with a service animal,
but there's only one kind of room
that we will allow you to use."
It really isn't a whole lot different
if you're talking in the healthcare context.
Now, the other question, again,
is the "generally" portion of this.
And say that there's a hospital that is chockablock full.
People are in the hallways.
There aren't any beds available because of the flu.
And there may not be
any other opportunities or other alternatives.
But they would still need to work with that
to see what they can do to make sure that you have
the same level of access as somebody else would have.
But, again, it's not a responsibility of the patient
to ask somebody if it's all right
if the hospital puts them in their room.
Remember, the hospital is the one who is controlling this.
And the hospital has to do whatever they can
to modify their policies,
to maybe shuffle people around if it's necessary.
But, remember, Eileen talked about, a little while ago --
We both talked about that any decision --
I mean, this borders
on the exclusion rule that we talked about.
And any decision that -- "Oh, somebody who uses
a service animal can't be in a room with other people,"
has to be made on current, objective medical information.
It can't be, "Well, down the road,
somebody might have some event."
But, again, it's really going to also depend --
Without going too much in the weeds,
it's also going to depend on,
what services is that hospital offering?
And if, for instance, it's a psych unit,
and there there are a couple of rooms set aside.
They're double rooms, you know, semiprivate rooms.
But they are set aside for treatment of people
who have incredible phobias about dogs.
HANRAHAN: And we're going to talk about this, too.
CONWAY: We are.
So, with all of that, I'm going to pause.
-I'm going to move forward. -HANRAHAN: Okay.
CONWAY: And I think it's your turn.
HANRAHAN: It is my turn.
It's your turn to ask the questions.
CONWAY: I will ask the questions.
I'll use my best Alex Trebek voice.
HANRAHAN: [ Laughing ] Oh, okay.
-CONWAY: Okay, Eileen. -HANRAHAN: Yes.
CONWAY: "Do patients with disabilities
have a right to have their service animal with them
if they are in a locked ward in a psychiatric unit?"
And the second part of this question is,
"Does the staff have to allow family or friends
to care for the service animal?"
HANRAHAN: And here's the tricky answer -- it depends.
So, we want to go back to those questions
that we've been asking ourselves
to see where service animals can and can't go.
So, let's look at the population.
And this is a little bit different
because you're probably not looking at a population
that is particularly susceptible to infection,
that has compromisable health conditions.
Now, they may, because we don't know necessarily
what the population in the psych ward is,
but at least we know that there are people
that are in there for mental-health conditions.
Now, Sally did bring up a circumstance
that you could have somebody who is in a psych unit
that does have a particularly strong phobia of dogs,
and that may even constitute a disability, perhaps,
depending on the phobia.
So, that is something that they would need to take into account.
But if you look at the types of issues
that we would be facing in a healthcare facility, generally,
first, we probably are not looking
at a significant risk of infection of some condition
from the service animal to a person,
so that probably would not be a basis
for excluding the service animal
from a locked unit on a psych ward.
Second, you want to look at the type of program
that the unit has.
They probably have a program
that may include certain group activities,
probably some therapy, maybe group therapy.
They may even go off-site for some activities.
These are generally types of activities
that a well-behaved service animal
should be able to participate in without disrupting the program.
Again, it's going to depend
on the particular program that a facility has
and assuming that we have
a well-behaved and clean service animal.
But I would say that, generally, we would think
that, unless there's some particular circumstance --
and, again, this is going to depend
on the particular program --
but that, probably, a service animal
should be permitted access to a locked unit on a psych facility.
And the other question is interesting,
and this is a little bit different than, perhaps,
the healthcare facilities that we've been talking about,
where you actually have a locked unit
and whether family members or friends
can come and take care of the animal,
take the animal out of the unit and bring it back.
So, I think one of the things that we would like to look at --
You know, and, again, we want to generally start
with saying that, yes, the person with a disability
can turn to family and friends to help care for the animal.
One of the things we want to look at, though,
is maybe there are parts of the programs
or parts of the activities
that are going on at different hours of the day --
they may have meetings that take place at nighttime.
So there may be a need on the part
of the person with a disability to look at the scheduling issue.
But that should be something
that folks should be able to accommodate.
So, they don't want to disrupt the program
and, perhaps, have somebody from the outside coming in
when, maybe, patients are having a group discussion
or they're doing a touch-base with staff in the unit
in the evening or in the early hours of the morning.
So, that may be one issue to think about.
Another may be we'd want to make sure
that the security is not compromised
by having somebody come and go,
but you would think that the staff in the facility,
in the same way they may let staff come and go
from the locked unit,
that they should be able to accommodate persons --
individual with the disability's family
that may need to come and go at different times.
I think just because we don't have visiting hours
that may mesh up with the animal's needs
should not be a bar because we would expect hospitals
and other types of hospitals to also allow persons
to come and take care of the service animal,
even though it may not be during recognized visiting hours.
So, I think we would generally say, yes,
the service animal should be given access,
and the service animals -- or the family
of the individual with the disability
should be able to work out
some kind of arrangement with the facility
that would allow them to take care of the animal
without changing the program.
And, again, you would have to look at the particular program.
I know we say this,
but it's really because it does make a difference
what the circumstances of the case are,
but we want to at least be able
to give some general guidelines here
and for people to kind of know the types of issues
that they would need to think about
when they're in these circumstances.
CONWAY: So, saying it depends
is a legitimate thing to say for us.
I know you guys are all going, "Oh, they said, 'It depends,'"
but everything is so fact-specific, right?
HANRAHAN: It is, but, again, you know,
I think we do want to leave at least with the idea
that, for these situations that we've talked about,
we don't see, in the question that's posed,
any reason for why a service animal should be denied access.
So, unless you find something out,
you know, in the circumstances,
that lends one to think differently,
you know, from what we know, it sounds like
it should be something that's possible to arrange.
CONWAY: Right.
And I'm going to ask you your second question.
And I think this one really involves a really good example
of the human cost of discrimination.
So, the question is, "Does this law apply
to facilities or area within hospitals
that house family members
of patients in the hospital overnight,
so that they can be closer
to their hospitalized family member?"
It can also be an off-site place
where folks can go and stay.
"May they deny access
to family members who use service animals?"
HANRAHAN: And I think the first answer is a very clear yes --
the law does apply to these areas within hospitals
because the law applies
to all of the operations of the hospital --
and we talked about all of those areas early on --
and, second of all, also does apply
to these types of facilities.
The ADA clearly applies to places of public accommodation.
Whether Section 504 would apply
would depend on whether the entity gets federal funding.
And it may or may not,
but the ADA almost certainly would apply.
So these types of facilities are covered.
And the question about whether they may deny access
to a person with a disability,
to a family member who uses a service animal --
I would say is really a no.
I don't know if we even need to put a "generally" in there.
One hesitates not to, but I think, you know,
these facilities are accepting
sort of average members of the population.
We're not looking at the types
of health conditions that individuals may have
that make us more cautious
about looking at access of service animals
to burn units or hospital operating rooms
or to certain care areas in a hospital.
You're really looking at what's more like a hotel
or, you know, just a housing facility.
So, we would say, yes, the person should be able
to go there with their service animal
unless there is some particular reason
why a particular service animal is inappropriate
for...inclusion.
I think we wanted to add this particular example
to just sort of give you a little bit of background.
And it was by an individual
who was going to one of these facilities.
Her mother had been staying in a hospital
and was in very poor health.
She went to one of these facilities
with her service animal and was denied access,
as a result of which, she went home,
which was a fairly long drive.
And when she did receive a call from a family member
to come to the hospital quickly,
she was unable to get back to the hospital in time
to say goodbye to her mother.
And so, as Sally said, this is --
You know, for me, it's just such a compelling example
of why these laws are so critical,
so necessary, and so important.
People should not be put in a situation
where they lose an opportunity such as this.
And, you know, the law is here to provide for this.
This is why we have these laws, why we're here,
why we want to be able to talk with you to inform recipients,
and there are many recipients that want to do the right thing,
many covered entities that, you know,
don't always know what the law is,
but they want to serve people.
And that's their business. They want to serve people.
But at the same time, it's so important to be educated,
whether one is a covered entity
or one is a person that uses a service animal,
so that you know your rights,
so that you can assert your rights,
and, you know, you can educate others.
So, you know, again,
it's really sort of a heart-tugging kind of example.
And we've seen cases like this sometimes.
But, you know, this is -- this is why you're there.
This is why we're here.
So, we just need to work together
and make sure that, you know, we bring society along
so that these types of things don't, unfortunately, happen.
So, I guess I'll get off my little soapbox here and...
CONWAY: Yeah. But it's true.
And one thing is that I think --
I think, because, you know, this is a federal regulation.
These are federal regulations.
And I think they see it as the federal government.
And people don't necessarily see how it affects the person,
you know, who may be their relative,
or, you know, another human being.
And very often, it's seen in regulatory language
and cold and stark and prescriptive.
But these human stories are very understandable.
And I think that they go a long way
to help people understand why it's so important
that equality and the same opportunity
and that the fundamental principles of the ADA
and the Rehabilitation Act are so critically important.
It isn't just a federal law,
although it needs that to ensure it,
but I think these stories
and especially this one -- this got to me, as well --
it's really important that people understand
what it really means if you're denied access.
HANRAHAN: And on that note,
I am afraid we may have overstayed our time,
but we just want to go quickly through these last three slides,
really, to tell people
about opportunities that you can take
if you think that you have been discriminated against.
Most covered entities are required
to have either an ADA or Section 504 coordinator
that should be able to answer questions for you.
That information should be posted.
Most facilities are required to have a grievance procedure
so that you can file an internal complaint.
You can file a discrimination complaint
with either of our agencies.
Sally's office enforces Titles II and III of ADA,
although the healthcare facilities are delegated
to HHS for enforcement.
And we both enforce Section 504.
So, you can file with either agencies.
The same standards apply.
And we will do an investigation where we have jurisdiction.
Or you can also file a private lawsuit.
And I leave the rest to you.
CONWAY: All right.
And that's pretty much it for that slide.
If you don't -- Any time you're not sure,
it never hurts to file with both agencies -- never hurts.
Be aware of any filing deadlines.
So, for Title II for the ADA,
you're really looking at 180 days
from the last date of known discrimination.
So, you don't want to blow that, because then you will have lost
your -- really, essentially, lost your right to file.
HANRAHAN: Let me just very quickly --
and we don't need to spend any time on it.
We do investigate discrimination complaints.
We have down there the website for the agency.
And you can sort of peruse your way around the website
and, also, can telephone contact numbers,
and you actually will get a person at the 1-800 number.
CONWAY: And now we're on the DOJ Resource slide,
and exactly what Eileen said --
we do investigations and provide technical assistance.
If you have questions that you think of after this
or you would like to download information,
go to www.ada.gov.
That's the Department's ADA website.
And, also, feel free to give us a call.
You can call our actual ADA specialist,
who, like Eileen's office,
they're actually human beings that answer the phone,
at the numbers below, on the slide.
And please know that all your calls are confidential.
So, don't be afraid to ask questions.
There aren't any stupid ones
except for the ones that you don't ask.
HANRAHAN: And, so, thank you to Joan.
Thank you to all of you
for listening and for hearing us talk.
We're very happy to have been here with you.
It's an important issue,
and we hope you will contact us if you have any questions.
We are happy to do any follow-up.
And with that, we will sign off. Thank you.
CONWAY: Thank you.