IMGMA Q/A: Service Animals

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by Rob Low

Republished with permission from Idaho Medical Group Management Association (MGMA). Original article appeared in Idaho MGMA’s April 2018 e-newsletter.

Question: What are “Service Animals”, and to what extent (i) must they be allowed on health care facility premises, and (ii) can they be refused or removed from premises?

Answer:  Under the Americans with Disabilities Act (ADA), “Service Animals” are defined as dogs that are individually trained to do work or perform tasks for people with disabilities. This means the dog must be trained to take a specific action when needed to assist the person with a disability (e.g., a dog which is trained to guide a blind person, alert a deaf person, pull a wheelchair, alert a person with diabetes that his or her blood sugar is too high or too low).  The ADA also recognizes that, in some instances, a person with a disability may use a miniature horse that has been trained to do work or perform tasks for people with disabilities as a service animal. Under the ADA, service animals 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. However, the ADA does not require service animals to wear a vest, ID tag, or specific harness. Read more

Withdrawing Care for Developmentally Disabled Persons: New Idaho Standards

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by Kim Stanger

Recent amendments will allow guardians and those treating developmentally disabled persons greater discretion in withholding or withdrawing artificial life-sustaining treatment, thereby avoiding situations in which developmentally disabled persons were forced to suffer painful, extended procedures which may be considered inhumane.

The Former Standard. Under Idaho law, the guardian or personal representative of an incompetent person may generally authorize the medically appropriate withdrawal of treatment for the patient. (I.C. §§ 39-4504(1) and 39-4514(3)). In the case of developmentally disabled persons, however, the former law prohibited guardians and physicians of developmentally disabled persons from withholding or withdrawing artificial life-sustaining treatment unless the treating physician and one other physician certified that the person had a terminal condition such that the application of artificial life-sustaining treatment would only serve to prolong death for a period of hours, days or weeks, and that death was imminent regardless of the life-sustaining procedures. (I.C. § 66-405(7)-(8)). Unfortunately, this standard looked only at the length of the patient’s life without considering the pain that the patient may be forced to endure in the meantime. Because of advances in medicine, healthcare providers are often able to keep persons alive for months or years, but at a terrible cost in suffering to the patient and their loved ones. Application of the former standard sometimes resulted in heartbreaking situations in which developmentally disabled persons—often with little or no cognition—were relegated to an existence that offered nothing more than perpetual pain or discomfort instead of allowing the medically appropriate withdrawal treatment. By so doing, the standard deprived developmentally disabled persons of rights that were offered to others. Read more