Public Restroom Access and Irritable Bowel Syndrome (IBS)
UPDATE 5/10/2013: As of April 2013, IBS Impact received information on additional restroom access laws in Maryland and Maine. Please see the May 10, 2013 post.
UPDATE: As of August 2012, Massachusetts became the thirteenth U.S. state to enact a restroom access law. See the August 20, 2012 post for details and a link to the full text of the law in that state.
Because IBS can cause frequent and/or unpredictable need to use a toilet, quick and plentiful access to public facilities is a major concern expressed by many people with IBS. Thus, it’s somewhat surprising that existing laws or resources that may be useful in some countries aren’t often discussed in the IBS community. A post last month by a blogger who goes by the online name of Felicia Fibro spurred exploration of this topic. Here is some information that may assist IBS Impact readers in some U.S. states, the U.K. and Australia.
Felicia, who identifies herself as having fibromyalgia and IBS, posted a video interview she did with Ally Bain and Ally’s gastroenterologist. (Scroll to January 16.) Ally has Crohn’s disease, a type of inflammatory bowel disease (IBD). Several years ago, as a young teenager, Ally had an accident in a store after her request to use the employee restroom was refused, despite her explaining repeatedly that she had an urgent medical need. After that humiliating experience, Ally resolved to do something about it, contacted her state legislator and helped to write and pass a bill to address similar situations. The details of the incident and progress of her efforts have been blogged frequently by the About.com IBD Guide. In 2005, the Restroom Access Act, known popularly as “Ally’s Law,” was signed into law in Ally’s home state of Illinois. Since then, with continued public advocacy by Ally and others, similar laws have been enacted in eleven other states: Colorado, Connecticut, Kentucky (part 1 and part 2), Michigan, Minnesota, Ohio, Oregon, Tennessee, Texas, Washington and Wisconsin. While the exact language describing eligible medical conditions varies in each state, irritable bowel syndrome is specifically mentioned by each of the current twelve states.
There are other minor differences, so please click the linked states above to view the text of the law for a particular state. In general, the laws are similar to the model set by Illinois. Most are also named the Restroom Access Act. Most say that a “retail establishment” must give access to an employee restroom if there is no public restroom immediately available, there are at least three employees (in one case, two) working at the time, and the facility itself or its location will not pose a safety hazard to the person or security risk to the business. A few states narrow or expand the types of businesses covered or specify regular business hours only. A few states do not explicitly require proof of a medical condition. In most states that address the issue of proof, a physician’s note is sufficient. Some states also accept notes from certain other types of licensed health providers. One state requires a specific form for this purpose. Many states permit an identification card from a national non-profit organization representing an eligible condition.
Please note– this type of card is not currently available from any U.S. organization concerned with IBS, although if there’s enough interest, it might be an advocacy issue to pursue. For U.S. readers who also have IBD, which is a separate condition from IBS, such cards are available to members of the Crohn’s and Colitis Foundation of America or from the Foundation for Clinical Research in Inflammatory Bowel Disease. Those with interstitial cystitis, a bladder condition that commonly overlaps with IBS, can obtain a card through the Interstitial Cystitis Association. The Association page linked here includes public restroom and travel advice for those with IC, but also appears helpful for conditions with similar restroom needs. The About.com IBD page linked in the second paragraph of this post also has useful tips.
The IBS Network, formerly The Gut Trust, in the U.K. also offers a card to its members, as does the Irritable Bowel Information and Support Association of Australia. There appear to be no specific legal protections associated with them; they’re simply a tool to communicate one’s needs to others quickly. According to The IBS Network’s website, the organization has an ongoing advocacy campaign to prevent the closure of public toilets in many cities. From anecdotal information, it appears that some U.K. residents with IBS benefit from “RADAR keys,” which unlock disability-accessible public toilets. The keys, as well as a guide to places where they can be used, are sold by the Royal Association for Disability Rights (RADAR),which recently merged with two other cross-disability advocacy organizations to form Disability Rights U.K.
Bills similar to “Ally’s Law” have been introduced over the years in more U.S. states, but as information isn’t centralized, the current status of each state is difficult to confirm. As of this date, legislation is known to be currently pending in New York. Readers who are aware of further details about states or countries not mentioned in this post are invited to comment on this blog.
IBS Impact applauds Ally’s initiative. Her success in making these laws a reality is especially impressive, as she was just fourteen years old when she began her quest. It’s hoped that other youth and adults will follow suit to change the system for digestive disorders like IBS. As Ally points out in Felicia’s interview, “It’s important to speak out… so that people know they’re not alone.” The IBS Network’s goals are also worthy, and readers in the U.K. should seek out more information on how to support them.