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  • Writer's pictureLisa Seitles

Perspective/Type 1 Diabetes


Courtesy photo Casey’s service dog Elvis.

I envision my 8-year-old son Casey and his soon-to-arrive diabetes alert dog, Elvis, going everywhere together, like the inseparable boy and dog in a Norman Rockwell painting. But this loving, loyal animal won’t just be Casey’s companion; he will be working to keep Casey healthy and safe. Elvis is a highly trained, disciplined service animal with duties directly related to Casey’s physical impairment. Casey has Type 1 diabetes (T1), an “invisible” disability that substantially limits his endocrine system.


Elvis is trained to use his amazing sense of smell to alert Casey (or a caregiver if Casey is unresponsive) when his blood glucose (BG) is dropping dangerously low or rising dangerously high. In T1, the pancreas has lost its ability to produce insulin, which then dysregulates the body’s elaborate and near-instantaneous feedback system for keeping BG in the normal range. Not even today’s highly sophisticated technology for controlling BG, such as Casey’s electronically-linked insulin pump and continuous glucose monitor, can replicate a working pancreas. Elvis will provide Casey another layer of protection by detecting worrisome BG trends sooner than does this technology and by serving as a potentially life-saving backup system when it periodically fails.


The Americans with Disabilities Act (ADA, http://www.ada.gov) defines a disability as a physical or mental impairment that substantially limits one or more major life activities. It defines a service animal as a dog (of any size or breed) that has been individually trained to do work or perform tasks directly related to the individual’s disability (miniature horses may be allowed when extra strength is required). Federal law classifies service dogs as medical devices, just as it does wheelchairs and insulin pumps. As such, federal law gives Casey the right to bring Elvis with him virtually everywhere the public may go, even where pets aren’t allowed.


Understanding the rights and duties of handlers and their service dogs is important, because even well-intentioned individuals who don’t know the laws and etiquette on service animals can cause undue hardship for both handler and dog. Many people are naturally attracted to dogs, but it’s important that they do not distract a service dog lest they inadvertently interfere with its ability to do its job. If your disability isn’t apparent, people will generally assume your dog is a pet and treat it as such, perhaps by trying to speak to or pet it, give it a treat or make eye contact. All distract the dog from doing its job

(https://serviceanimalquestions.org/tool/4/playbook). Service dogs need not wear a vest signifying they are service dogs, which protects the handler’s privacy but leaves the general public not knowing that service dog etiquette might apply. Elvis will therefore wear a vest with badges providing helpful information: Type 1 Diabetes Insulin Dependent, Diabetic Alert Service Dog, Do not Pet, Do not Distract, Do not Separate Dog from Handler, and Emergency Medical Info Inside. These badges will help keep Casey safe as well as help the public understand that Elvis is working.


But what are Casey’s legal rights and duties as Elvis’s handler and, conversely, of the various establishments he might want to patronize with Elvis? A profusion of anti-discrimination laws cover service dogs in public places: three federal laws, 50 states’ laws and regulations enacted by myriad local jurisdictions. States and localities are bound by federal law, but may add their own layers of law, especially on matters of public health and safety, including penalties for injuring or interfering with the work of service animals

(https://www.animallaw.info/topic/table-state-assistance-animal-laws). Entities that allow the public entry but deny full access to individuals with service dogs may be prosecuted for discrimination. That’s why Elvis’s vest sports yet another badge: Access Required by Law No Exceptions.


Yet other federal laws confer the right to have service dogs in housing and employment, but we focus here on the three that guarantee equal access to public spaces: the Americans with Disabilities Act (ADA, as amended in 2008), the 1973 Rehabilitation Act (Section 504), and the 2021 Air Carrier Access Act (ACAA). The ADA and Section 504 give individuals with disabilities the right to bring a service dog, without extra charge or fees (except for damages), into virtually any space where the public is allowed (except private membership clubs and religious organizations). For example, restaurants, shops, theaters, hotels, college dormitories, public and private schools, public and private transportation, hospitals (except sterile areas), emergency shelters and programs and services provided by state and local governments (https://adata.org/factsheet/ disability-rights-laws-public-primary-and-secondary-education-how-do-they-relate; https://www.ada.gov/resources/ service-animals-faqs).


These entities may ask a service dog’s handler only two questions: is the animal required because of a disability? What work or task has the animal been trained to perform? They may not ask what disability you have, for proof the dog has been certified, professionally trained or licensed as a service animal (none of which is required), or for it to demonstrate ability to perform its job. Nor may they treat you less favorably than someone without a service animal or isolate you from others. Allergies to dogs and fear of them aren’t permissible reasons for denying entry to a service dog, but may require the entity to distance affected parties in equally appealing areas. A service animal must be under the control of its handler at all times, either through physical means like a leash or harness, or through voice commands or hand signals if a handler’s disability prevents using a tether or a tether interferes with the dog safely and effectively performing its tasks. Entities may rightly ask you to remove your service dog (but not you yourself) from their premises if it isn’t house-trained, doesn’t respond to your commands, poses a direct threat to health and safety, or interferes with core functions of the facility.


The 2021 ACAA requires air carriers traveling to, from, or within the United States to place service dogs in passenger cabins with their handlers, but its requirements differ somewhat because of the special nature of air travel. Airlines may require service dogs to remain leashed (voice commands “not sufficient in an airplane setting”) and to fit on your lap or in your foot space. If unable to fit at your feet, the airline must offer you another seat within the same class of service, if available, that can accommodate your service dog. Carriers may also require you to complete a health, behavior, and training form and, for flights eight hours or more, a relief attestation form (https://www.transportation.gov/individuals/aviation-consumer-protection/final-rule-traveling-air-service-animals).


These service dog laws are invaluable for allowing individuals with disabilities to more safely and successfully access their communities. The staff and websites of the Regional ADA Centers, such as ours (https://www.northeastada.org), can also answer specific questions on everyday matters that either individuals with service dogs or the entities they patronize might have.


Lisa Seitles

Hammonton


Lisa Seitles and her husband Sam are the owners of READ Preschool and Camp Tuscaloosa. They have four children and are active members of the community.

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