Emotional Support Animal Recommendations Require Bona fide Provider-Patient Relationship
A bona fide provider-patient relationship should exist between a licensed healthcare professional and an individual seeking an emotional support animal (ESA) for therapeutic benefit prior to the issuance of a recommendation letter in Colorado. This bona fide provider-patient relationship is defined in the mental health, medical and nursing practice acts.
Healthcare professionals must first establish whether a disability exists and if found, determine whether there is sufficient information for a recommendation for an ESA to provide a therapeutic benefit for that disability. In order to make such determinations, licensees must be both sufficiently familiar with the patient and the patient’s disability; and legally and professionally qualified to make this determination.
Nursing and mental health law (Section 12-255-133(3)(a) and 12-245-229(3)(a) Colorado Revised Statutes) further clarifies that “a licensee shall not make a determination … unless the licensee has met with the patient in person.” Registered nurses are permitted to issue ESA recommendations but must be under the direct supervision of a licensed physician.
Physicians shouldn’t make a determination unless having “met with the person or by telemedicine,” according to 12-240-144(3)(a), C.R.S.
Healthcare practitioners under the purview of Division of Professions and Occupations must follow all applicable laws for those seeking an assistance animal.
An ESA is an animal that provides a therapeutic benefit, such as emotional support, comfort, or companionship, to a person with a mental health or psychiatric disability. An ESA is not considered a Service Animal and ESA users don’t receive the same accommodations as service dog users.
ESAs don’t perform specific tasks related to the person’s disability, instead, it is the presence of the animal that relieves the symptoms associated with the serious mental health condition. This condition is documented by a properly formatted prescription letter.
Mental/Behavioral Health Parity Information
Mandatory Reporting Reminder
Did you know you are a mandatory reporter? Under Colorado law, more than 40 professions are required to report suspected child abuse and elder abuse. These professions include many regulated through the Division of Professions and Occupations (DPO) at DORA, such as:
- Physicians (including physician assistants and physicians in training),
- Podiatrists,
- Dentists and dental hygienists,
- Chiropractors,
- Nurses (including registered nurses, licensed practical nurses, and nurse practitioners),
- Nursing home administrators,
- Occupational therapists,
- Optometrists,
- Physical therapists,
- Pharmacists,
- Veterinarians,
- Mental health professionals (including psychologists, social workers, professional counselors, marriage and family therapists, registered psychotherapists and all candidates for licensure),
Online trainings help mandatory reporters recognize and report abuse, neglect and exploitation. Licensees of the regulatory boards at DPO may accrue credit towards continuing education and continuing competency requirements for completing the trainings (should they exist for their profession).
Section 19-3-304, C.R.S. outlines the persons required by law to report child abuse and/or neglect. To assist mandatory reporters, a training is available on the Colorado Department of Human Services website at http://coloradocwts.com/mandated-reporter-training.
Section 18-6.5-108, C.R.S outlines the persons required by law to report abuse and exploitation of at-risk elders and at-risk adults with intellectual and developmental disabilities. Further information and an online training can be found on the Colorado Department of Human Services website.
If you have further questions regarding these requirements, please contact the Colorado Department of Human Services.
For questions regarding mandatory child abuse reporting, please contact the Office of Children, Youth, and Families' Child Welfare Training System at 800-390-9619 or support@coloradocwts.com.
For questions regarding mandatory reporting of at-risk elders and at-risk adults with intellectual and developmental disabilities, please contact the Office of Community Access and Independence's Division of Aging and Adult Services at cdhs_aps_questions@state.co.us.