and implemented the requirements for both
state and local governmental services and
public accommodations/commercial facilities. There are three key provisions EMS agencies need to be aware of:
1. Beginning on March 15, 2011, only dogs
are recognized as service animals.
2. A service animal is a dog that’s individually trained to do work or perform tasks
for a person with a disability.
3. Generally, entities (including prehospital
providers) must permit service animals
to accompany people with disabilities in
all areas where members of the public are
allowed to go. 3
Service animals are defined as dogs that are
individually trained to do work or perform tasks
for people with disabilities. Service animals are
working animals, not pets. The work or task a
dog has been trained to provide must be directly
related to the person’s disability.
Examples of this type of work or tasks
include: guiding people who are blind, alerting people who are deaf, pulling a wheelchair,
alerting and protecting a person who is having
a seizure, reminding a person with mental illness to take prescribed medications, calming a
person with P TSD during an anxiety attack, or
performing other important duties. 3
It’s important to note that dogs (or any other
animal) whose sole function is to provide com-
fort, therapy or emotional support do not qual-
ify as service animals under the ADA. They
haven’t been trained to perform a specific job
or task, and therefore do not qualify as service
animals under the ADA. 3
There’s no federal legal obligation to allow
emotional support dogs to accompany a patient
in the ambulance. However, some state or local
governments have laws allowing people to take
emotional support animals into public places and
those laws may also apply to ambulance transport.
Although you should always abide by the
policies and protocols in place in your agency,
best practice would be to try and accommodate
an emotional support dog based on the overall
situation and available options.
The decision to allow the patient and dog to
remain together ultimately rests with the crew,
and is based on the patient’s need and ability to
control the animal, as well as the crew’s ability
to transport the dog safely.
ADA requirements for stores, restaurants, public
locations, hotels and even airlines differ from
ambulance requirements. Under the ADA, state
and local governments, businesses and nonprofit organizations that serve the public must
allow service animals to accompany people with
disabilities in all areas of the facility where the
public is normally allowed to go.
Stores, restaurants, public locations, hotels,
and even airlines are required to honor a much
broader definition of service/emotional support animal. Ambulances are only required to
accommodate service dogs, and ambulance
crews can legally deny transporting all other
types of animals.
When it’s not obvious what service a dog
provides, only limited inquiries are allowed.
Crews may ask two questions: 1) Is the dog a
service animal required because of a disability?
and 2) What work or task has the dog been
trained to perform? 4
Crews can’t ask about the person’s disability,
request medical documentation, or ask that the
dog demonstrate its ability to perform the work
or task. Crews may not require documentation
as proof that the dog has been trained, certified
or licensed before accepting it as legitimate service animal. Service animals aren’t required to
wear a vest or any other identifier indicating it
as a service animal.
Prehospital crews can refuse to transport a
service dog for any one of three primary reasons:
1. If the service dog will “fundamentally alter”
the crew’s ability to provide lifesaving care;
2. The dog is out of control and the handler
does not take effective action to control
3. The dog isn’t housebroken. 3
The patient is required to maintain control
of the service dog at all times. This means that
the service dog must be harnessed, leashed or
tethered, unless these devices interfere with the
service animal’s work or the individual’s disability prevents using these devices. In that case, the
individual must maintain control of the animal
through voice, signal, or other effective controls.
When the patient is unconscious or in a condition requiring critical lifesaving treatment and
the dog’s presence would compromise the care
or safety during transport, it’s best to make other
transport arrangements for the dog.
Note that the ADA doesn’t allow exclusion
of a service dog for allergies, personal bias, fears
or other reasons not covered above. 3 The ADA
doesn’t specifically define who’s responsible for
the service dog should it not be transported, but
best practices would certainly encourage prehospital crews to make every effort to reunite
the dog with the patient as soon as reasonably
possible (e.g., private car transport with family,
friends, law enforcement, etc.).
BALANCING CARE & LEGAL
Every EMS system, public or private, needs
to develop guidelines and logistical options to
assist their crews in rapidly assessing alleged
service dogs and the many other emotional
support animals that crews may encounter.
The ADA defines what we must accept
as a service dog, tells us clearly the limits we
can take to make that determination and also
when we can deny allowing the service dog to
be transported with their owner.
These ADA requirements aren’t suggestions for you to decide to comply with or not,
they’re legally binding and must be included
in your overall treatment plan.
Any time a crew opts not to allow a service
dog into their patient transportation plan, two
distinct issues could result: 1) The patient’s
emotional well-being may suffer and will likely
result in additional anxiety; and 2) refusing a
legitimate disability accommodation could
have legal repercussions.
When considering the emotional support
animal’s role during patient transportation
(i.e., any animal that doesn’t fit the ADA’s
Service animals not only provide assistance for
physical conditions, but they often also provide