This white paper was co-authored by the experts at Driverge Vehicle Innovations, National Interstate Insurance, and Vanliner Insurance. Through our collaboration, we hope you learn some best practices to enhance your operation's safety culture.

Overview

It is highly likely that outside of your work or business you know someone who uses a wheelchair or mobility device, perhaps even within your own family.  In fact, many NEMT drivers start their career because of personal experiences with family and friends.

Just as you would ensure the utmost safety and compassion when transporting those closest to you, you should extend the same level of care to every passenger. Understand that the person you are transporting is someone's mother, father, child, or best friend and deserves to be treated with the same respect and concern you would offer to your own loved ones.

Yet…Injuries most frequently occur due to motor vehicle accidents or improper securement, or while boarding or unloading passengers. Fortunately, as a professional driver, there are things you can do to significantly reduce the likelihood of such incidents - adhere to safe driving practices, ensure that passengers are properly secured, and be thoughtful during the loading and unloading process.  

Remember – although the vehicles and equipment were designed to keep passengers safe, how the driver uses the equipment and how they treat the passengers are ultimately most important!

This white paper will cover essential information for NEMT & paratransit drivers, including the most common types of incidents, the importance of following your company’s securement policy, handling best practices, and key considerations for drivers when encountering passengers who refuse securement.

Common Incident Types

Studies show that many passenger injuries occur when vehicles are parked, primarily during the process of boarding or unloading passengers using a lift or ramp. Incidents, such as a passenger tipping over or sliding out of their wheelchair, can create lasting trauma and fear of future transportation for both the passenger and driver, even if the passenger is not physically hurt. 

In more severe cases, such incidents can result in serious injury or even death. Beyond the personal impact, these events can lead to job loss, lawsuits, drivers being named in media articles, and other consequences that can cause significant financial harm to a company, and potentially even leading to it going out of business.

Seat Belt & Shoulder Harness Policy

Policies are essential for helping ensure you as the driver understands company expectations. It is crucial that you know all of the policies and the acceptable practices and behaviors for both you and your passengers.  Even if you have experience in the industry, thoroughly read and study your company policies, and participate in training programs.  Know that the way your employer does things may be different than other companies you may have worked for.

Understanding Key Responsibilities as a Driver

Following your company’s policies is important, but it is equally, if not more important, to understand key responsibilities listed in the Americans with Disabilities Act (ADA).  The ADA is the law in the US which protects those with disabilities, giving them equal access to things like transportation. 

• If your company has a policy that requires all passengers to use seat belts and secure mobility devices, and your vehicle has compliant securement systems in accordance with the ADA, securement of the mobility device (such as a wheelchair or scooter) and the passenger can be required. The requirements must be consistent for all passengers. For instance, if non-ADA passengers (ambulatory) are only required to wear a lap belt, then ADA passengers are only required to wear a lap belt. However, for the passenger’s safety, we encourage the wearing of both the lap and shoulder belt in every case. If a passenger refuses to comply with the securement requirement, you are permitted to decline service.
• Service cannot be refused due to a mobility device being challenging to secure. The ADA requires operators to use their best efforts to secure the device, consulting with the owner of the mobility device as needed. It is also recommended to contact your employer for additional guidance.

WHEELCHAIR & PASSENGER HANDLING BEST PRACTICES

As a professional driver, you should be able to demonstrate proper handling, onboarding and securement of passengers using mobility devices at any given time.  If you feel unsure or not confident about your ability to properly onboard or secure passengers, seek out or ask your employer for additional training.

Manual Wheelchair

Ramp Guidance

Avoid Forcing Wheelchairs onto the Ramp

Communication

• Understand you are behind them often so speak clearly and loud enough for them to hear you.
• Before you begin pushing your passenger, or before operating the power lift, make sure the passenger is ready.  Even using a countdown may be helpful in keeping your passenger calm.
• When pushing your passenger, your head will most likely be above theirs.  Be sure you are not talking over them, but talk down so they can hear.
• When in a conversation that lasts more than a few seconds, get down to the eye level of your passenger.  Either crouch down or get down on one knee and give them good eye contact.  This tells them you care without you ever having to say so.  This also can lessen any anxiety the passenger may have.
• Speak clearly and to the point.  Some passengers may not understand when you are being silly or sarcastic.
• Clearly explain what you are doing any time you are getting close to the passenger, and especially when you have to touch, lean on, or rub against. You want to avoid the passenger getting upset or surprised because they weren’t expecting what you were doing.  Remember the way you secure a passenger may be different than other drivers your passenger may have encountered.
• When driving over speed bumps, railroad tracks, potholes or extra bumpy roads, alert your passengers beforehand – as much as possible.  When we as drivers go over those types of bumps, we are sitting on several inches of padding on our driver seat.  However, our passengers in manual wheelchairs may be sitting on a very thin seat which can be very uncomfortable.  Also, they may be experiencing chronic pain or have recently had surgery and those bumps can be painful.
• If you have to take a different route to your destination due to a road closure, traffic or detour, please alert your passenger as soon as possible.  If they are familiar with a typical route and you take a turn they weren’t expecting, that can cause anxiety or panic.

About Driverge Vehicle Innovations

Driverge Vehicle Innovations is one of the country’s leading builders of commercial accessible vans, shuttles, transporters, vocational and work vehicles. With their commitment to safety, the Driverge Training Team also boasts certified professional trainers who have trained 1000’s of drivers across the US and Canada. With manufacturing facilities in Ohio, Kansas, South Carolina and California, Driverge provides vehicle conversions to numerous industries and government agencies, including healthcare, wheelchair transport services, fleet management, hospitality, rideshare and other vocational markets. Driverge is a Ford Pro Upfitter, Mercedes-Benz eXpertSOLUTIONS Upfitter and Ram Commercial Q-Pro supplier. Driverge acquired commercial equipment upfit company U.S. Upfitters in 2022, which operates facilities in Illinois, Wisconsin, Maryland and Colorado. Driverge Vehicle Innovations and MobilityWorks together make up WMK, LLC, established in 1997 and recognized on the Inc. 500|5000 list of Inc. Magazine’s fastest-growing privately held companies, as well as Newsweek’s list of America’s Greatest Workplaces.

The information presented in this publication is intended to provide guidance and is not intended as a legal interpretation of any federal, state or local laws, rules or regulations applicable to your business.  The loss prevention information provided is intended only to assist policyholders in the management of potential loss producing conditions involving their premises and/or operations based on generally accepted safe practices.  In providing such information, National Interstate Insurance Company does not warrant that all potential hazards or conditions have been evaluated or can be controlled.  It is not intended as an offer to write insurance for such conditions or exposures. If you have any questions or issues of a specific nature, you should consult appropriate legal or regulatory counsel to review the specific circumstances involved. The liability of National Interstate Insurance Company and its affiliated insurers is limited to the terms, limits and conditions of the insurance policies underwritten by any of them. National Interstate Insurance Company, 3250 Interstate Drive, Richfield, OH 44286.  5147-NIS-157 (07/25)