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TO BE PUBLISHED IN THE OFFICIAL REPORTS
 

OFFICE OF THE ATTORNEY GENERAL
 

State of California
 

JOHN K. VAN DE KAMP
 

Attorney General
 

OPINION :
 

:


 of :


 :


 JOHN K. VAN DE KAMP : No. 86-105


 Attorney General :
 : MAY 19, 1987


 RODNEY O. LILYQUIST :


 Deputy Attorney General :


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THE HONORABLE MILTON MARKS, MEMBER, CALIFORNIA SENATE, has requested
 

an opinion on the following question:
 

Are medical facilities, including hospitals, clinics and physicians'
 

offices, places where a blind person has a statutory right to be accompanied by
 

a guide dog? 


CONCLUSION
 

Medical facilities, including hospitals, clinics and physicians'
 

offices, are places where a blind person has a statutory right to be accompanied
 

by a guide dog to the extent of providing access equal to that of all or some
 

members of the general public.
 

ANALYSIS
 

Civil Code section 54.2, subdivision (a),1/ provides:
 

"Every totally or partially blind person, or deaf person, or
 

person whose hearing is impaired, or physically handicapped person,
 

shall have the right to be accompanied by a guide dog, signal dog,
 

or service dog, especially trained for the purpose, in any of the
 

places specified in Section 54.1 without being required to pay an
 

extra charge for the guide dog, signal dog, or service dog; provided
 

that he shall be liable for any damage done to the premises or
 

facilities by such dog."
 

The "places specified in section 54.1" cover a wide range of public
 

accommodations and facilities:
 

"Blind persons, visually handicapped persons, deaf persons,
 

and other physically disabled persons shall be entitled to full and
 

equal access, as other members of the general public, to
 

accommodations, advantages, facilities, and privileges of all common
 

carriers, airplanes, motor vehicles, railroad trains, motorbuses,
 

streetcars, boats or any other public conveyances or modes of
 

transportation, telephone facilities, hotels, lodging places, places
 

1. All references hereafter to the Civil Code are by section number
 

only. 

 

 

 

 

 

 

 

 

 

 

of public accommodation, amusement or resort, and other places to
 

which the general public is invited, subject only to the conditions
 

and limitations established by law, or state or federal regulation,
 

and applicable alike to all persons." (§ 54.1, subd. (a).)
 

The question to be resolved is whether medical facilities, including
 

hospitals, clinics and physicians' offices, come within the terms of section 54.1
 

and thus are places where a blind person has a right under section 54.2 to be
 

accompanied by a guide dog.
 

The places referred to in subdivision (a) of section 54.1 may be
 

categorized as follows: "All
 

[1] common carriers, airplanes, motor vehicles, railroad trains,
 

motorbuses, streetcars, boats, or other public conveyances or modes of
 

transportation,
 

[2] telephone facilities,
 

[3] hotels, lodging places,
 

[4] places of public accommodation, amusement, or resort,
 

[5] and other places to which the general public is invited."
 

To the extent that "other members of the general public" have access to these
 

specified facilities, a blind person has a statutory right to be accompanied by
 

a guide dog so as to have "full and equal access." Consistent with this
 

provision is the limited exclusion in section 54.1 for areas restricted "alike
 

to all persons."
 

If medical facilities are to be included within the places specified
 

in section 54.1, they must be either "places of public accommodation" or "places
 

to which the general public is invited." Neither of these terms is defined for
 

purposes of section 54.1. Both are somewhat ambiguous when standing alone. 


In interpreting the language of sections 54.1 and 54.2, we may rely
 

upon several well-established principles of statutory construction. The
 

fundamental rule to be applied is to "ascertain the intent of the Legislature so
 

as to effectuate the purpose of the law." (Select Base Materials v. Board of
 

Equal. (1959) 51 Cal.2d 640, 645.) Moreover, "every statute should be construed
 

with reference to the whole system of law of which it is a part, so that all may
 

be harmonized and have effect." (Moore v. Panish (1982) 32 Cal.3d 535, 541.)
 

Statutes relating to the same subject matter are to be read together insofar as
 

reasonably possible. (Fuentes v. Workers' Comp. Appeals Bd. (1976) 16 Cal.3d 1,
 

6-7.) 


Sections 54.1 and 54.2 were enacted in 1968 (Stats. 1968. ch. 461,
 

§ 1) as part of a legislative scheme (now §§ 54-55.1) giving various rights to
 

blind and other physically disabled persons. (See People ex rel. Deukmejian v.
 CHE, Inc. (1983) 158 Cal.App.3d 123, 131-132;Marsh v. Edwards Theatres Circuit,
 

Inc. (1976) 64 Cal.App.3d 881, 886-887.) The basic statutory goal is to grant
 

disabled persons "the same right as the able-bodied to the full and free use of
 

. . . public places." (§ 54.)
 

Along with sections 54-55.1, the Legislature has enacted statutory
 

schemes giving handicapped persons access to and use of public buildings
 

constructed with public funds (Gov. Code, §§ 4450-4458) and public buildings
 

constructed with private funds (Health & Saf. Code, §§ 19955-19959). Also to be
 

noted is the Unruh Civil Rights Act (§ 51), prohibiting all forms of arbitrary
 

discrimination by a business establishment. These various legislative schemes
 

have been construed together. (See People ex rel. Deukmejian v. CHE, Inc.,
 

2. 86-105
 
 

 

 

 

 

supra, 150 Cal.App.3d 123, 131-135; Marsh v. Edwards Theatres Circuit, Inc.,
 

supra, 64 Cal.App.3d 881, 887-890; 58 Ops.Cal.Atty.Gen. 512, 513-515 (1975); see
 

also Marina Point, Ltd. v. Wolfson (1982) 30 Cal.3d 721, 731.) As stated in
 

People ex rel. Deukmejian v. CHE, Inc., supra, 150 Cal.App.3d 123, 135: 


"The prohibition against discrimination of the handicapped
 

within Civil Code section 54 et seq., the enactment of Government
 

Code section 4450 et seq. and section 19955 et seq., . . . reflect
 

a legislative sensitivity to the hardships suffered by those
 

afflicted with a wide range of physical disabilities. They are part
 

of an expanding legislative effort to attain 'the commendable goal
 

of total integration of handicapped persons into the mainstream of
 

society . . .' ( In re Marriage of Carney, supra, 24 Cal.3d 725,
 

740.) The Legislature has declared '[i]t is the policy of this
 

state to encourage and enable disabled persons to participate fully
 

in the social and economic life of the state. . . .' (Gov. Code, §
 

19230, subd.(a).) These legislative responses are designed to
 

lessen their entire burden, by guaranteeing equal and full access to
 

public buildings, facilities, and accommodations, without
 

jeopardizing their safety."
 

With respect to public buildings constructed with private funds, the
 

Legislature has defined "public accommodations or facilities" as "a building,
 

structure, facility, complex, or improved area which is used by the general
 

public and shall include auditoriums, hospitals, theaters, restaurants, hotels,
 

motels, stadiums, and convention centers." (Health & Saf. Code, § 19955.)
 

"Hospitals" is further defined in the same statute as "includ[ing], but is not
 

limited to, hospitals, nursing homes, and convalescent homes." This statutory
 

scheme also specifically covers "[a]ll . . . offices of physicians and surgeons
 

. . . ." (Health & Saf. Code, § 19955.5.)
 

In 65 Ops.Cal.Atty.Gen. 72, 73-75 (1982), we examined the language
 

of Health and Safety Code section 19955, pointing out that hospitals have the
 

characteristic of "being public," being "generally available to the public," and
 

"made continuously available to the general public and whose economic viability
 

cannot survive without their being so available." 


In O'Connor v. Village Green Owners Assn. (1983) 33 Cal.3d 790, 796,
 

the Supreme Court observed that with respect to the Unruh Civil Rights Act,
 

hospitals "are clearly business establishments, to the extent that they employ
 

a vast array of persons, care for an extensive physical plant and charge
 

substantial fees to those who use the facilities." 


We are not presented here, however, with whether a blind person has
 

a statutory right of access to medical facilities -- that is acknowledged. The
 

issue is whether such person, while in the facilities, has a statutory right to
 

be accompanied by a guide dog. 


In Lyons v. Grether (Va. 1977) 239 S.E.2d 103, a blind
 

person filed suit against a physician who refused to treat her (she had an
 

appointment for the treatment of a specified infection) unless her guide dog was
 

removed from the waiting room of his medical office. The Virginia statute was
 

in all material respects identical to sections 54.1 and 54.2. The court
 

concluded:
 

"We are persuaded by plaintiff's argument as applied to the
 

facts alleged in this case. It fairly appears from the face of the
 

motion for judgment that defendant's office was a place to which
 

certain members of the public were invited by prior appointment to
 

receive certain treatment at certain scheduled hours. . . .
 

3. 86-105
 
 

 

 

 

 

 

 

Accordingly, . . . we hold that, under the facts alleged here,
 

defendant's office was within the intendment of the White Cane Act
 

. . . ." (Id.)
 

We believe that medical facilities, including hospitals, clinics and
 

physician's offices, would normally be considered "places to which the general
 

public is invited" if not also "places of public accommodation."2/ As we have
 

previously concluded and has been recognized by the courts, medical facilities
 

may generally be characterized as business establishments dependent upon members
 

of the public for their economic viability. The critical issue is whether all
 

or some members of the general public are invited to the facility for business,
 

professional, or other services. Another way of stating the issue is whether all
 

members of the general public are invited under all or some conditions. (See In
 

re Lundgren (1987) 189 Cal.App.3d 381, 388.)
 

For purposes of sections 54.1 and 54.2, it is irrelevant that some
 

groups of the general public are excluded from the facility. A claim that the
 

facility is unavailable to healthy persons would not, for example, render the
 

statutory scheme inapplicable. Similarly, the facility would not be exempt if
 

the invitation were extended only to those members of the general public who have
 

a particular disease or were referred to the facility by another physician. (See
 

Club Ramon, Inc. v. United States (4th Cir. 1961) 296 F.2d 837, 840; Lerner v.
 

Schectman (D.Minn. 1964) 228 F.Supp. 354, 355-358; Lerner v. Club Wander In, Inc.
 

(D.Mass. 1959) 174 F.Supp. 731, 732-733; 65 Ops.Cal.Atty.Gen. 106, 109-1l0
 

(1982).)
 

In sum, medical facilities are normally made available to all or some
 

members of the general public for business and professional services. For these
 

reasons an able-bodied person may enter the facilities; under sections 54.1 and
 

54.2, a blind person may be accompanied by a guide dog within the facilities for
 

the same purposes. The legislation was intended to grant equality of right, and
 

we so construe it.3/
 

Not all parts of a medical facility, however, may be open to the
 

general public. (See People v. Brown (1979) 88 Cal.App.3d 283, 290; People v.
 

Schad (1971) 21 Cal.App.3d 201, 209; People v. Kemick (1971) 17 Cal.App.3d 419,
 

421-422.) In Perino v. St. Vincent's Medical Center (Sup.Ct. 1986) 502 N.Y.S.2d
 

921, a New York trial court considered whether a blind person accompanied by a
 

guide dog could be denied access to a hospital delivery room when his wife gave
 

birth to their child. The New York statute was similar to sections 54.1 and
 

54.2, except that it apparently did not provide for "conditions and limitations
 

established by law, or state or federal regulation, and applicable alike to all
 

persons." The court concluded: 


"A delivery room of a hospital, as well as the labor room and
 

maternity ward, are not places to which the general public is
 

normally invited or permitted, as those places are commonly
 

perceived. Normally, they are restricted to the expectant mother
 

2. While the term "places of public accommodation" has been found
 

applicable in a variety of contexts (see Roberts v. United States Jaycees
 

(1984) 468 U.S. 609, 615; United States v. Medical Society of South Carolina
 

(D. S.C. 1969) 298 F. Supp. 145, 152; Vidrich v. Vic Tanny Intern., Inc.
 

(1980) 102 Mich.App.230 [301 N.W. 2d 482, 484]; 65 Ops.Cal.Atty.Gen. 72,
 

supra, 72-73), "other places to which the general public is invited" would
 

seemingly have an even broader meaning.


 3. As previously mentioned, hospitals, clinics, and physicians' offices
 

must be built so as to be accessible to handicapped persons (Health & Saf.
 

Code, §§ 19955, 19955.5); we do not believe that the Legislature intended for
 

something less "equal" with respect to blind persons with guide dogs. 


4. 86-105
 
 

 

 

 

 

and father and the attending physicians and nurses. They are not
 

considered public places, not only because social custom and
 

practice do not accept them as such, but also because reasonable
 

health measures dictate that they not be open to the public.
 

Ordinarily, labor, delivery, and nursery units of hospitals are
 

closed units, and the hospital may set appropriate restrictions
 

governing entry into these units. (10 N.Y.C.R.R. § 405.8(A)(4).)
 

It cannot be [said] that the general public is normally or
 

customarily invited or permitted to be present at or to view the
 

delivery of a child at a hospital, surgery, or the like." (Id., at
 

p. 922.)
 

Whether a blind person may be accompanied by a guide dog in a particular area of
 

a medical facility would depend upon the individual circumstances.
 

Finally, we note the language of section 54.1 allowing restrictions
 

on access and use of public places where "established by law, or state or federal
 

regulation, and applicable alike to all persons." The only reported case
 

discussing this limited exclusion is Marsh v. Edwards Theatres Circuit, Inc.,
 

supra, 64 Cal.App.3d 881, 890-891, in which the Court of Appeal concluded that
 

local fire regulations applicable to all persons could form the basis for
 

excluding access to and use of public places by handicapped persons. 


The Marsh court relied upon cases interpreting the Unruh Civil Rights
 

Act in reaching its conclusion. This legislative enactment is broadly worded but
 

allows the exclusion or denial of services where "conditioned or limited by law
 

or which is applicable alike to persons of every sex, color, race, religion,
 

ancestry, or national origin." Courts have upheld exclusions from this statutory
 

scheme where the particular person's conduct was objectionable (see Koire v.
 Metro Car Wash (1985) 40 Cal.3d 24, 30-32; O'Connor v. Village Green Owners
 

Assn., supra, 30 Cal.3d 721, 741; In re Cox (1970) 3 Cal.3d 205, 217) and in
 

unique situations involving peculiar types of facilities or services (see Koire
 

v. Metro Car Wash, supra, 40 Cal.3d 24, 31 [suggesting that a child may be
 

excluded from an adult bookstore]; Wynn v. Monterey Club (1980) 111 Cal.App.3d
 

789, 796-798 [compulsive gambler denied entrance to a gambling club]). Each
 

situation must be examined individually to determine the applicability of this
 

limited exception.
 

In answer to the question presented, therefore, we conclude that
 

medical facilities, including hospitals, clinics and physicians' offices, are
 

places where a blind person has a statutory right to be accompanied by a guide
 

dog to the extent of providing access equal to that of all or some members of the
 

general public.
 

* * * * *
 

5. 86-105