Monday, February 11, 2013

Army Issues Formal Service Dog Policy, Keeps Ban on Dogs for PTSD

Update: The following should be read in conjunction with a blog on the VA's final rules access rules issued in August 2015.   Secretary McHugh's reference to the Surgeon General's responsibility in the event of a change of VA rules should mean that the Army's policy is now under review. The Army's policy, however, was not developed through a formal regulatory process, unlike the VA's rules, so there is no clear time frame on when Secretary McHugh, the Surgeon General, or any post commander will take appropriate action.      

Army Directive 2013-01 (Guidance on the Acquisition and Use of Service Dogs by Soldiers), signed by John M. McHugh, Secretary of the Army, “sets forth policies and procedures for the acquisition and use of service dogs by wounded, ill and injured Soldiers with disabilities for whom a service dog is clinically indicated.” The Directive applies to all Soldiers “regardless of component or duty status.”

The Directive defines a service dog as “a dog individually trained to do work or perform specific tasks for the benefit of an individual with a disability.” Thus, the Army uses the general language of the Department of Justice in that agency’s implementation of the Americans with Disabilities Act. Unfortunately, that is the limit the Army is willing to go in accepting DOJ’s approach. Rather, the Army explicitly follows the VA’s lead as to dogs that might help individuals with PTSD or other psychological conditions:

“Currently, the U.S. Department of Veterans Affairs (VA) does not recognize service dogs for behavioral health conditions, and therefore psychological service dogs are not considered service dogs for the purposes of this directive.”

I had held out some hope that the Army might diverge from the VA on this issue because of some language in a letter that Secretary McHugh wrote to a trainer working with Wounded Warriors at Fort Bliss, Debbie Kandoll, which I discussed in a blog last December. It turns out I was wrong to have any hope.

The only dog that helps with PTSD which should be approved by the Army (or the VA) would be one that also has functions with regard to a physical disability. Thus, a Soldier with mobility impairments, who could use a dog that helps with balance, picking up dropped objects and similar physical disability-related functions, ought to be able to have a dog that also has functions related to a mental condition. Dogs can be dual-trained for several disabilities, and it ought not to be a problem for the Army that a service dog provides maximum effect for a Soldier.

Secretary McHugh goes on to state that if the VA policy changes, the “Surgeon General will review and propose amendments to this directive for my approval.” Thus, if Congress or anyone else can get the VA to listen to reason, there might be some hope.

Service Dogs in Training

The senior commander of a military installation is given the authority to admit trainers with service dogs in training “provided that the training is occurring under the auspices of a source accredited by a VA-recognized organization.” This means that the trainer must be affiliated with a nonprofit training organization holding full membership in either the International Guide Dog Federation (IGDF) or Assistance Dogs International (ADI).

McHugh does allow for the possibility that Soldiers may be involved in training service dogs:

“In some cases, the training of service dogs occurs as part of a medically supervised program wherein the trainer benefits from the act of training dogs for service to other individuals. The use of such medically supervised training programs and the granting of access rights to medical treatment facilities to such dogs in training are at the discretion of the commander of the applicable medical treatment facility. A Soldier is not authorized to train his/her own service dog.”

Veterans Dog Training Therapy Act

The wording in the preceding paragraph may be carefully crafted to avoid a potential conflict with Representative Michael Grimm (R-NY) and Representative Michael Michaud (D-Me), who have introduced a bill (H.R. 183, the Veterans Dog Training Therapy Act) to require the VA “to carry out a pilot program for the purpose of assessing the effectiveness of addressing post-deployment mental health and post-traumatic stress disorder symptoms through a therapeutic medium of training service dogs for veterans with disabilities.”

Although designed to help veterans with PTSD, the proposed legislation does not mandate the training of service dogs for PTSD. Given the VA’s policy, this might actually be impossible, at least in VA facilities. If the legislation gains traction (co-sponsors are slowly coming aboard), it must be hoped that the VA will reconsider its restrictive policy. That might very well result in the Army changing its policy, since this policy is explicitly based on the VA’s.

Facilities Access of Recognized Service Dogs

Secretary McHugh provides broad access for such service animals as his policy is willing to recognize:

“Service dogs will be given access to those Army facilities and spaces generally open to the public, including (but not limited to) installations, hospitals, treatment facilities, recreational facilities, barracks and other structures, as long as such access does not compromise public health (including infection control standards), safety, readiness, mission accomplishment, and good order and discipline.”

As to dogs not obtained from IGDF or ADI organizations, the Directive states that “Soldiers should be aware that dogs obtained from sources not accredited by VA-recognized organizations may not qualify as service dogs and may be ineligible for VA benefits.” One wonders how any exception could be possible. The Directive explicitly states that emotional support animals, therapy animals, and activity animals “fall outside the scope of this policy.”

The Directive states that “Soldiers for whom a service dog is recommended are not deployable.” Notice that this means that even if a Soldier has not received a service dog, and might be years from getting one, he or she is not deployable once a recommendation is made.

Requesting a Service Dog

Soldiers may request service dogs from their primary care managers. The primary care manager is then to assemble a multidisciplinary team to evaluate the request. The team is to include:

• Soldier’s primary care manager
• Command representative (an officer or senior noncommissioned officer) designated by the Soldier’s unit commander
• If a Soldier is assigned to an installation, an installation representative designated by the garrison commander
• Such other individuals designate by the primary care manager as necessary to make an informed decision, including possible a veterinarian or a unit medical provider.

The team will consider whether a service dog is appropriate for the Soldier and if it could live with him or her in barracks or family housing. The form to be used for a memorandum of a recommendation is attached to the Directive and reproduced here.

If the multidisciplinary team does not reach a consensus, the primary care manager “will refer the team’s recommendation, together with its rationale or viewpoints, to the Deputy Commander for Clinical Services (DCCS) of the servicing military treatment facility for review.”

The final decision is not made by the multidisciplinary team or the Deputy Commander for Clinical Services. Rather, the recommendation is sent up “through command channels to the first colonel or GS-15 in the Soldier’s chain of command for decision.” Each commander in the chain of command is to document his or her recommendation as to whether the Soldier should receive a service dog.

If the first colonel/GS-15 approves the request for a service dog, the decision is final. The officer is to specify any limitations on the use of the service dog. If the officer disapproves, he or she must provide a written rationale for the decision.

Soldiers must obtain their own service dogs, but the Directive notes that “Army approval is no guarantee that a VA-recognized source will provide a service dog.” This, of course, presents a problem at a number of Army posts, which are often not near to service dog training organizations that are full members of IGDF or ADI.

Dogs Acquired before Policy’s Effective Date

The Directive allows for the possibility that Soldiers may have obtained service dogs, even psychological service dogs, before the policy was made final. A Soldier “may keep the animal provided he/she complies” with general requirements for Soldiers having service dogs, but the animal may not remain categorized as a service animal:

“Commanders, in consultation with the Soldier's current medical provider, may refer such cases to the multidisciplinary team to evaluate whether a Soldier's continued or ongoing possession of a dog remains clinically indicated. If not, the Soldier may be allowed to retain the animal as a pet. Note: solely for the purposes of reviewing cases involving a previously acquired, clinically indicated (and documented) psychological service dog, commanders and the multidisciplinary team will not apply the VA accreditation requirements of this policy in making its recommendation.”

Thus, although a pre-existing psychiatric service dog may be briefly grandfathered under the policy, Secretary McHugh has provided a procedure for removing it from service dog categorization and related benefits and access provisions.

Army Surgeon General to Provide Further Guidance

Further guidelines will be issued by the Army Surgeon General within nine months, who is to create a registry of Soldiers with service dogs, together with the diagnosis of each Soldier with a dog. Presumably, these diagnoses will not be solely psychological, since the service animals that will be approved have to be for physical disabilities. The Soldier’s “utilization rate” for a dog will be assessed periodically.

Conclusion

The civilian implementation of the Americans with Disabilities Act has seldom involved this kind of resistance, and the Departments of Justice, Transportation, and Housing and Urban Development long ago accepted the possibility that people have the right to use trained dogs for psychological benefits. There is no reason why this approach should not be accepted wholeheartedly by the Veterans Administration, which is supposed to be helping veterans reintegrate and function as full members of society. There is also no reason why the Army could not do so as well, given its decision that Soldiers with service dogs are not deployable, meaning they will mostly be employed on posts, often at desk jobs. (Animals can easily be integrated into a broad range of workplace environments, as discussed in Service and Therapy Dogs in American Society, Chapter 11: Taking Service and Support Dogs to Work.)

The Army’s continued resistance to service dogs for Soldiers with PTSD and other psychological traumas and conditions is already a source of sadness on many posts, and has sparked arguments that the Army is resisting an approach that may reduce suicides. It is to be hoped that Congress will listen to these cries for help, since it is evident that the Army command will not.

An email can be sent to the House Committee on Veterans' Affairs on the Committee's website.  As the Committee considers the proposed Veterans Dog Training Therapy Act, it should also consider the appropriateness of the VA/Army policies on service dogs.

Thanks to Leigh Anne Novak, Bart Sherwood, Debbie Kandoll, and Frances Breitkopf for comments.

4 comments:

  1. This kind of bureaucratic insensitivity and stupidity--I don't like using that word, but it's true--is so misguided. It's reminiscent of the long term shortsightedness of the American military about using dogs in the past, when other countries recognized their value.
    When it comes to the terrible truths about the suicide rate, is this rejection of dogs for emotional purposes somehow a reflection of the "tough guy" image and attitude that prevails in the military? Maybe being a tough guy is important when fighting a war, but it can be self-destructive once a soldier is out of service.

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  2. this bullshit is why i'm glad, I'm getting out of the damn army!! before they changed it I was allow to have my dog as an emotional service dog and now i can't!! shouldn't i be grandfathered in??

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  3. Currently receiving a Service Dog now. I have been asked to provide an example DA4856 (counseling form) on the use of my dog on base and to provide guidance on his restrictions.
    Any suggestions on where to look for references?

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    1. Apparently this form, a Developmental Counseling Form, is being used because the applicant's explanations for the issues and questions on the form will provide a basis for evaluating the value of the service dog. I had not heard of this approach, though the idea of asking an employee to fill out the same form as an employer uses in evaluating an employee is a very old practice that I myself have encountered in prior lives. I will send out several emails to see if anyone has any suggestions or additional information.

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