Monday, November 11, 2013

AKC Test Qualifies Emotional Support Animals for VA Study: Is the VA Considering New Policies on Service Dogs and ESAs?

In a "Sources Sought/Request for Information" posted on the federal business opportunities website, FedBizOpps.Gov, where government contracts are announced, the Department of Veterans Affairs says it is looking for suppliers of dogs “to determine the efficacy of service dogs in the treatment of Posttraumatic Stress Disorder (PTSD).”  The study began two years ago, but is now to be revised and expanded to include emotional support dogs as well as service dogs. 

The dogs for this study must be provided by nonprofit 501(c)(3) organizations, in accordance with Public Law 111-84, the defense appropriations act of 2009.  At § 1077, that legislation provided that the Secretary of Veterans Affairs was to begin “a three-year study to assess the benefits, feasibility, and advisability of using service dogs for the treatment or rehabilitation of veterans with physical or mental injuries or disabilities, including post-traumatic stress disorder.”  The appropriations act allows the VA to “reimburse partners $10,000 for each dog provided to a veteran who enrolls in the study and successfully completes a training program offered by one of the partners.” 

Public Law 111-84 stated that the VA was to partner with 501(c)(3) organizations that “are accredited by, or adhere to standards comparable to those of, an accrediting organization with demonstrated experience, national scope, and recognized leadership and expertise in the training of service dogs and education in the use of service dogs.”  As I noted previously, the VA has generally chosen to ignore the “standards comparable to those of” language in the appropriations act and prefers to designate full member organizations of Assistance Dogs International as the sole source of service dogs for veterans.  (ADI candidate members are not acceptable to the VA, as stated at 77 Fed. Reg. 54372, middle column.)

Assistance Dogs International Public Access Test

In the Request for Information, the VA indicates that it is now going to be conducting a “revised study” and that for this study service dogs “will be required to meet Assistance Dogs International (ADI) Public Access Testing criteria.”  This wording is curious, in that it appears to allow for the possibility that a dog could meet the ADI’s Public Access Test, which is posted online by ADI, without necessarily being administered by anyone affiliated with ADI.  That, however, does not square with what ADI indicates on its website (last checked 11/11/2013), where the organization states that the “test was designed to be administered by professional Assistance Dog Trainers,” and cautions:

“Administering this test by non members of Assistance Dogs International is not authorized by Assistance Dogs International nor would completion of this test be considered certification by Assistance Dogs International.” 

ADI also places a copyright notice on its Public Access Test, meaning that it might claim a copyright violation against someone printing out and using the test without its permission.  I venture to note, in any case, that most therapy dogs, including mine, would have no problem passing the Public Access Test. 

American Kennel Club (AKC) Community Canine Standard

The reason for writing this blog are the references in the VA’s Request for Information regarding emotional support dogs.  Emotional support dogs are not mentioned in the 2009 defense appropriations act.  Neither are they mentioned in 38 U.S.C. 1714, which provides that the VA may provide “service dogs trained for the aid of persons with mental illnesses, including post-traumatic stress disorder.”  Two current House bills deal with veterans' service dog issues but also do not mention emotional support animals (H.R. 183 and 2847, both of which are hold-overs from the 112th Congress and neither of which has a good shot of passing at the moment). 

The VA states that “emotional support dogs will be required to meet the new American Kennel Club (AKC) Community Canine© standard, which is an advanced extension of the AKC Canine Good Citizen© testing.”  Many therapy dog handlers in the United States, including me, have dogs that have qualified as Canine Good Citizens. 

The AKC announced in the akcgazette of July 2013 (vol. 130, no. 7), that its Board had “VOTED to approve the creation of an advanced CGC testing program called AKC Community Canine.”  Dogs that pass the test are awarded the title of “Community Canine (CMC).” The test was officially available on October 1, 2013.  That I could find, the AKC website does not seem to indicate that the organization sees this particular test as a means of verifying that a dog qualifies as an emotional support animal.  Rather, the organization describes the title as testing a dog’s skills in natural settings, rather than in a ring isolated from real world situations.

So why does the VA see such a function for the test?  It may be, that as with choosing ADI to bless service dogs, the VA has chosen the AKC to consecrate emotional support dogs.  There are differences here from the service dog situation, however.  By saying that only an ADI organization can create a service dog, the VA has allowed that organization and its full members to hold a monopoly on training service dogs for veterans.  The AKC tests, on the other hand, are administered by a broad system of evaluators for dogs trained by anyone.  In New York State alone there are more than 400 AKC Evaluators according to a search engine provided by the AKC, many within a short drive of where I live in Ulster County.  The Evaluators charge a small fee, but are generally only marginally remunerated for performing the tests.  Many tests may be parts of other testing programs, such as for therapy dogs.  If there is a monopoly, it seems to be a fairly harmless one. 

Comparing the ADI Public Access Test, the AKC Tests, and Therapy Dog Qualification  

Many animals that qualify under the AKC tests might be trained at levels, at least as to behavior in public settings, not much different from what is expected of service animals.  The following table roughly attempts to correlate the testing requirements of ADI’s Public Access Test, the AKC’s CGC and Community Canine tests, and a standard therapy dog test.

Therapy Dog Test
Vehicle requirements: remaining until release, waiting beside, under control while another dog walks past.
Two handlers get within 10 feet, but dogs should show no more than casual interest in each other and neither dog should go to the other or its handler.
Dog walks past distraction dogs within 2 feet while on trail, sidewalk, hallway, etc.
Dog performs group sit-stay and down-stay; dog and handler meet another dog and dog remains in handler’s control.    
Dog stays in relative heel position, calm around traffic, stops when individual comes to halt.
Dog remains in control while walking with handler, but need not be perfectly aligned with handler.
Dog remains under control while handler fills out paperwork, visits with another person. 
Dog remains under control at entry table for testing.
Dog waits at door until commanded to enter, waits inside until able to return to heel position.
Dog remains with handler while walking.
Dog enters/exits a doorway or narrow passageway in a controlled manner.
Dog walks through hospital environments without being distracted under control of handler; dog remains at sit, stand, or down stay on command before door to facility. 
Dog within “prescribed distance” of individual; ignores public, remaining focused on individual; adjusts to speed changes; readily turns corners without being tugged; maneuvers through tight quarters.
Dog walks through pedestrian traffic under control in public places passing close to at least three people; dog stays at heel during right turn, left turn, and about turn.   
Dog walks on loose leash in natural situation, does not pull, makes left and right turns, stops, goes at fast and slow paces;  dog walks on loose leash through a crowd.
Dog moves through people in hallway; dog remains calm upon approach of several people at once; dog makes left and right turn and about-turn after encountering distractions.   
Dog responds to recall command on 6-foot lead, does not stray away or seek attention from others or trudge slowly; remains under control and focused on individual; comes within prescribed distance on recall and comes directly to individual.
Handler walks 10 feet from dog, faces the dog and calls it; handlers may use “stay” or “wait” command or simply walk away to put dog in place. 
Dog performs recall on 20 foot lead. 
Dog commanded to stay and handler moves to end of 20 foot lead, turns around, and on command recalls the dog.
Dog responds promptly to sit command; remains under control around food, not trying to get it and not needing repeated corrections; dog remains composed while shopping cart passes; dog remains at sit-stay while petted by stranger.
Dog accepts friendly stranger without showing resentment or shyness; dog accepts petting from friendly stranger; dog accepts being groomed by evaluator; dog responds to sit and down commands and remains in place on 20-foot lead.    
Dog performs sit-stay in group of 3 other people with dogs; handler leaves dog on 20 foot lead, picks up item, returns to dog. 
Dog performs sit-stay in group; handlers leave the dogs and move to end of 6 foot leads and wait for evaluator’s command to return to dogs; also a group down-stay; dog is readily accessible for petting by patient; can approach wheelchair.   
Dog responds to down command; remains under control around food; remains in control while child approaches (but child should not taunt dog or be overly dramatic)

Dog obeys “leave it” command around food on floor or ground. 
Person with walker offers dog a treat, but handler instructs dog to leave it and dog must do so; dog passes food on floor and must walk a straight line and leave it; dog remains calm around playing children.   
Dog should remain composed during noise distractions.
Dog should be confident with distractions such as dropping a chair, rolling a crate dolly, having a jogger run in front of the dog, etc. 

Dog keeps on straight line walking past distractions, including person on crutches, person running, bicycling, rollerblading; loud noises from dropping something such as can filled with rocks, vacuum cleaner.
Dog is unobtrusive and out of way of patrons and employees in restaurant; dog ignores food and remains quiet.


Dog remains calm in crowds and obeys command to leave food alone.
Dog remains under control when lead is dropped.



Dog taken by another person and dog’s partner can move away without aggression or undue stress.
Another person takes dog and handler goes out of sight for 3 minutes; dog should not bark, whine, or pace unnecessarily. 

Helper takes hold of dog’s leash but handler can put dog at stay before; handler moves out of sight; dog can move within confines of lead. 
Dog loads into vehicle on command.



Handler praises dog when dog does well; dog consistently relaxed, confident, friendly; partner consistently has dog under control.


Good presentation of handler and dog.

The differences are relatively minor.  ADI looks at dogs getting in and out of vehicles.  This recognizes that a disabled handler is often going to need to be able to get a dog into and out of a car without any physical effort.  People who travel with dogs to any degree will teach them to jump in and out of a vehicle, as I and most people I know have done with our dogs.  There is also an emphasis on going through doors in the ADI test.  People with disabilities may have trouble going through doors, and will need to be confident that, if they cannot go through a door simultaneously with the dog, the dog will catch up or wait for them. I do not know anyone with a therapy dog who has any difficulty with this. 

Potential Significance of the VA’s Approach to Emotional Support Animals

The VA provides a table regarding the distinctions between service dogs and emotional support dogs, indicating that, although emotional support dogs qualify for accommodations in housing and air travel, they do not qualify for entry into places of public accommodation.  The table is reproduced below:


Service Dog
Emotional Support Dog
General Definition
A dog that is individually trained to perform work or tasks for the benefit of a person with a disability.
A dog that provides comfort or
support for a person with a
disability, but does not have any individualized training to perform work or tasks.
Reasonable Accommodation in Housing?
Yes. Housing provider may ask for documentation that owner has a disability and there is a disability-related need for a service animal.
Yes. Housing provider may ask for documentation that owner has a disability and there is a disability-related need for an emotional support animal.
Reasonable Accommodation in Places of Public Accommodation and Public Entities?
Yes. Public accommodations and public entities may not ask for documentation, but can ask if the animal is a service animal and what it is trained to do.
No.
Reasonable Accommodation for airline travel?
Yes. Airline may ask whether the animal is a service animal and what it is trained to do.
Yes. Airline may ask for a signed note from a licensed mental health professional, not more than 1 year old, that states that owner has a psychiatric disability and a disability-related need for an emotional support animal.

While this may be a serviceable summary of the general requirements of the Departments of Justice, Transportation, and Housing and Urban Development, it must be noted that the definitions of those agencies make no mention, and would often be inconsistent with the tests that the VA is using to qualify service and emotional support animals.  The VA knows this.  An article posted on a VA website states that:

"One assistance dog advocacy organization, Assistance Dogs International (ADI), has promoted definitions of assistance dog and service dog that are widely cited and accepted by many service dog trainers, but the definitions are not universally used among laypeople or healthcare personnel nor are they aligned with definitions that appear in Federal or state laws." L. Parenti, A. Foreman, B.J. Meade, and O. Wirth (2013). A Revised Taxonomy of Assistance Animals. Journal of Rehabilitation Research & Development, 50(6), 745-756

So why was this table included in a Sources Sought/Request for Information? It may have been a way of indicating to prospective emotional support dog providers that they should not expect that dogs they supply would qualify for the access that service dogs receive.  This raises the question, however, of what exactly the VA may be planning for emotional support dogs that are used by veterans with PTSD. A VA webpage on “Dogs and PTSD” also describes the difference between the two types of specialized dogs, but says that generally “a regular pet can be an emotional support dog if a mental health provider writes a letter saying that the owner has a mental health condition or disability and needs the dog’s help for his or her health or treatment.”  Certainly this does not suggest the level of training or obedience required for an AKC Community Canine. 

Is it possible that the VA is considering a change in policy that would allow emotional support dogs to live with veterans in VA or VA-supported facilities, but only if the dogs have a level of training that will avoid their becoming problems for VA administrators?  Could emotional support dogs travel in buses and vans that serve VA hospitals?  Would emotional support dogs have access to VA hospitals where therapy dogs are already being used? 

An even bigger question involves the U.S. Army.  As I have noted before, the Army and the VA have always seemed to be joined at the hip with regard to service dog policies. A major source of pain for enlisted Army personnel with service dogs trained for PTSD has been that the Army has put a ban on dogs for PTSD, stating in Army Directive 2013-01, signed by Secretary of the Army John McHugh, that the “psychological service dogs are not considered service dogs” by the Army.  If the VA is considering recognizing emotional support dogs, will the Army also take this step?  If so, could soldiers live on base with emotional support dogs, and perhaps fly them on military transports?  Presumably they would not be able to take them into base canteens, on the analogy to the ADA requirements with regard to service animals, but even this is not clear. 

Conclusion

Is the idea of using an American Kennel Club standard to determine qualification of an emotional support animal a good one?  It has the advantage of being readily available, and the AKC website says that the cost includes a $20 processing fee.  Test-giving organizations may also charge a fee for conducting the test.  AKC Approved CGC Evaluators administer the test.  When I and Chloe took our therapy dog test, we had such an Evaluator, who was also a therapy dog tester. AKC evaluators will not be hard to come by anywhere in the U.S.  In my case, though going back over five years, the Evaluator charged nothing for the CGC aspect of the test beyond what was forwarded to the AKC, which then sent me and Chloe a certificate. 

This is a much less radical degree of privatization than has occurred with service dogs under VA and Army rules, and could be justified in contexts where an emotional support animal must be firmly in a handler’s control.  There is the additional policy question of whether some greater access to public accommodations and public transportation should be granted a dog with such a high degree of control by a handler, though without specifically individualized training for a disability.  This would require a major policy shift by the Department of Justice, however, and seems unlikely.  Still, it has to be acknowledged that the VA, whether seeking to or not, has brought forth a new idea that might provide a mechanism for dealing with the problem of bogus service animals in public accommodations and transportation.  

There is another policy question that must be asked.  If the VA thinks that testing can qualify dogs to be either service or emotional support dogs, why does the agency not insist that ADI open up its Public Access Test to non-members?  The test would seem to be sufficiently similar to the AKC tests that it could be administered by AKC Evaluators or other neutral testers.  Testing would not need to be restricted to dogs trained by ADI organizations, which would significantly expand the potential sources of service dogs for veterans.  Alternatively, the VA and the Army could ask the AKC to develop a public access test for service dogs, taking into account issues appropriate for service animals, such as getting into and out of cars and going through doors separately from handlers. Solutions exist to the current bottleneck created by VA and Army policies.  It is only a matter of making the effort to find and implement them.   

But I have expressed optimism that the VA and the Army would take intelligent directions in their canine policies before, only to be disappointed, so I advise readers to remain skeptical.  

Thanks to Michael Arnold and Leigh Anne Novak for suggestions that vastly improved this piece.    

Additional Notes.  It has been brought to my attention that, on September 23, 2013, Senator Charles Schumer of New York requested an update on the VA study of service dogs for veterans. He stated: "I feel strongly that the VA should provide service dogs to eligible Veterans with PTSD."  This undoubtedly increased the pressure on the VA to do something, but it does not explain why emotional support animals are suddenly in the picture.  

Someone suggested to me, I think with some degree of cynicism, that the VA may accept that psychiatric service dogs are really only emotional support animals, i.e., that it is impossible to individually train a dog to do work or tasks for a non-physical disability.  While I prefer to believe that this level of ignorance does not control thinking inside of the VA, neither can I rule it out.   

An anonymous commenter below correctly refers to the Clinical Trials site maintained by NIH with reference to the study discussed above.  The site contains several pages devote to a study that is labeled: Can Service Dogs Improve Activity and Quality of Life in Veterans with PTSD? (SDPTSD).  The description of the clinical trial defines an emotional support dog as one "that has earned AKC Good Canine Citizen certification and provides emotional support and comfort to the Veteran."  Curiously, the definition of service dog does not mention ADI, saying only that this is "an assistance dog specifically trained to perform tasks that are specific to the person's disability and has public access privileges."  The final clause presumably refers to the access rules of the Department of Justice.  Why ADI is not mentioned here is not stated. 

2 comments:

  1. John, as usual, very in-depth analysis, but a visit to clinicaltrials.gov should clear up the emotional support dog mystery.

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  2. I believe the previous commenter was referring to the likelihood that emotional support dogs (human-animal bond with limited public access) would be studied as a control to the service dogs (human-animal bond plus ADA tasks plus extensive public access). This would better scientifically define any benefit received by the veterans in the study.

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