Oregon Secure Transport in 2027: The OHA Certificate, County Letters, Custody Rules, and Driver Files

Secure transport is a narrow, tightly regulated part of Oregon NEMT. You carry a person in a mental health crisis who is in legal custody, so you need state approval before the first ride and a paper trail for every one.

The volume is small: Cascades West Ride Line, the brokerage for Linn, Benton, and Lincoln counties, counted 77 secure rides among 48,340 completed rides in the ride report in its July 2026 advisory committee packet. The share is far higher at night, on weekends, and on holidays: secure rides were 56 of Ride Line’s 529 after-hours trips in the second quarter of 2026, about 11 percent. As of October 2026, its after-hours instructions send facilities and hospitals that need a secure ride in any of its three counties to one company.

What Oregon secure transport covers

Oregon’s civil commitment law lets three kinds of officials start a custody for a mental health crisis, and an approved secure transport provider is the company that drives the person:

• A peace officer who believes the person is a danger to self or others (ORS 426.228). The officer can hand custody to you.
• A licensed independent practitioner (LIP) who holds the person at an approved health care facility for up to 12 hours for transport to a treatment facility (ORS 426.231).
• The county community mental health program (CMHP) director, or a designee, who can direct you to take a person into custody or move a person between facilities (ORS 426.233).

OAR 309-033-0432 covers these three kinds of custody, and it also covers people on diversion, an intensive treatment period of 14 days, extendable once to 28, offered instead of commitment. You may deliver a person only to a hospital or nonhospital facility OHA approves under OAR 309-033-0530. A ride into a Psychiatric Emergency Services facility also needs an ambulance service license.

The Oregon Health Plan calls the same service a secured transport: an NEMT ride for the involuntary transport of a member in danger of harming self or others. To see how Oregon’s vehicle, training, and restraint rules compare with Colorado’s and Minnesota’s, read behavioral health transportation. The protected transport entry explains the term other states use.

How to get OHA approval

OHA’s Behavioral Health Division approves secure transport providers, and its civil commitment coordinators in Licensing and Certification regulate secure transport services. The rule, last amended December 20, 2022, builds approval on county letters:

1. Meet the CMHP director in the county where you are based. OHA’s community mental health program directory lists each county’s program. The director writes your first letter and will later direct your rides.
2. Send OHA a letter of application. The rule asks for no form, only a letter to the Division. Describe your service area, vehicles, staff, hours, and policies.
3. Get the home county letter. The director of the county where your company is located writes to that county’s governing body, the county court or board of commissioners, formally identifying you as authorized to provide secure transport for the county and anywhere in the state as needed.
4. Get a recommendation from each county you will serve. The director of each county where your vans will be used sends the Division a letter recommending approval, with a copy to that county’s governing body.
5. Fit out the vans. The rule’s list starts with a secured rear seat separated from the driver by a safety shield, guarded windows, a washable and unbreakable rear area with no inside handles or locks and nothing a rider could use to cause harm, and wrist and ankle restraints, preferably soft. It also wants a working cell phone or other communication device, a flashlight, a first aid kit with gloves, traction devices when needed, and working lights, signals, wipers, horn, mirrors, heat, and ventilation.
6. Write your policies and train your crew on the records and restraint rules below.

If OHA approves, the Division issues a certificate of approval. You renew it every two years by applying again, and the Division reviews you each time.

What happens on a custody ride

Every ride starts with someone who has legal authority, and that authority’s paperwork travels with the person. When an officer hands you custody, the officer gives you the written report, and when the director sends you, the director prepares it. The report goes to the treating practitioner at the facility and states the reason for custody, the date, time, and place it began, and the name of the CMHP director with a phone number that reaches the director at all times. On an LIP hold, the LIP’s written statement says the LIP examined the person within the past 12 hours and that a practitioner with admitting privileges at the receiving facility agreed to the transport. That statement authorizes you to drive the person to the facility it names.

The director’s authorization under ORS 426.233(3) lets you:

• Accept custody from a peace officer.
• Take custody when the director tells you to.
• Drive the person to the approved hospital or facility the director names.
• Hand custody to another authorized provider or a peace officer.
• Move a person between approved facilities when the director directs it.
• Stay with the person at the facility until an LIP decides whether to admit.

Handoffs from an officer can happen at any location that fits ORS 426.140, the statute that keeps people in custody out of jails except in narrow cases. If the drive will take more than an hour, the officer or you must, if possible, get a certificate from an LIP who examined the person within the past 24 hours, saying the trip will not harm the person’s physical health (ORS 426.228 and OAR 309-033-0230). Each director must also adopt written procedures naming the approved facilities or a 24-hour way to reach the director, and must send a copy to every approved secure transport provider each time they change. Keep the current copy for every county you serve in each van.

If the LIP at the facility releases the person, the law has the officer or director return the person to where custody began unless the person declines. An authorized provider does those duties when the officer or director has not, so you may be asked to make that return trip. The Oregon Health Plan assumes a member going home is no longer in crisis, so a secure return trip needs the treating professional’s written reasons.

Driver files and the other records the rules require

OAR 309-033-0435 and 0437 turn into a records system. Set up these files before your first ride:

• Client rights policies. Written policies promising considerate and respectful care, reasonable privacy, confidential records, and a vehicle free of known hazards.
• Complaints in the driver’s file. Keep a copy of every formal complaint or misconduct report against an employee, or a detailed summary of it. Investigate, write a summary of what you found and any action taken, put it in that driver’s file, and send a copy to the Division.
• Abuse reports. Report suspected abuse under Oregon’s reporting laws for children, for adults with mental illness or developmental disabilities, and for older adults and people with disabilities.
• A hands-off rule during outside investigations. When law enforcement, OHA, ODHS, or their designee opens an investigation into alleged abuse or a death, you may not interview witnesses or review evidence beyond the first report without the Division’s prior approval. You may still decide whether the person is safe, whether a crime may have occurred, and what immediate personnel steps keep people safe. Once the outside investigation ends, you may investigate for personnel action on your own.
• Criminal records checks. Get criminal offender information on every employee who transports a person in custody or on diversion, under OAR chapter 407, division 7, which runs checks through the ODHS and OHA Background Check Unit.
• Restraint logs. Use mechanical restraint only in an emergency, check circulation, and write down each check. An injury from restraint needs immediate written notice to the Division.
• Training records. Four hours of training every year, current first aid and CPR, and a safe driving course within 90 days of hire. The behavioral health transportation guide lists what the annual training must cover.

CCOs and brokerages must verify that you meet these rules before they pay for a secured transport, so keep the files ready to show. For incident forms and a filing routine, see the NEMT incident report form and preventing rider abuse.

Carrying minors

Children add a second rulebook. OAR 309-033-0425, adopted December 20, 2022, lets you carry a person under 18 only if you are contracted to provide secure NEMT, and your trips must follow ODHS’s secure transportation rules, OAR 419-480-0010 to 419-480-0120. State law exempts secure NEMT providers from the ODHS license for secure transportation of children (ORS 418.241), so your ads and promotional materials must say, where readers will notice it, that OHA authorizes your secure transportation, that ODHS has not licensed you, and why you are exempt. The same law puts the state’s licensing notice, with your exemption, in each vehicle you use for these trips.

For each child, OHA’s rule asks for:

• A service agreement listing the services, the fee, physical limits, allergies, and any medications to give on the trip, the child’s special needs and comfort instructions, the route if asked, an inventory of belongings, and your plan for meeting the child’s needs.
• A trip record with the child’s name and date of birth, the trip dates, the parent or guardian’s contact details, a copy of the signed consent to transport, and a signed release of information.
• Incident reports of any injury in the child’s record, with a copy to the parent or guardian. Report a critical incident, elopement, or possible abuse to the protective services agency, OHA’s Health Systems Division, the receiving agency, and the parent or guardian.

You also need policies on employee conduct, health privacy, how you meet the child’s medication, lodging, food, bathroom, and personal needs on the trip, contacting parents when an emergency changes plans, round-the-clock roadside help, and how you accept referrals and hand the child over. Each child rides in an age-appropriate safety seat or a belt the child can work without help, and no one smokes or vapes near the child. The ODHS rules add that drivers pass a background check with no preliminary hiring, take a safe driving course within 90 days and every three years, and that the child can see out at least one window.

Who pays for secure transport

The payer depends on the rider:

• Members of a coordinated care organization. The CCO pays secured transports as NEMT under OAR 410-141-3940, after it verifies you meet the division 33 rules. The ride must go to a Medicaid-enrolled facility OHA recognizes as able to treat the crisis. One extra attendant may ride at no extra charge when medically appropriate, and a CCO may pay for rides to and from a court or commitment hearing when no other source covers them.
• Open card members. The fee-for-service brokerage pays under OAR 410-136-3120, as amended January 1, 2024, on the same terms with one difference: it may not pay for rides to or from a court or commitment hearing.
• Custody rides the county directs. Under ORS 426.233, the CMHP in the county where you are directed to take custody is responsible for the cost of a custody ride or a transfer between facilities, up to the amount the state provides for it. The same law has you bill the person, insurers, and anyone else responsible, the way you bill other riders.

OHA’s provider guide, updated December 22, 2025, lists code A0434 for secured transport and says every NEMT ride needs prior authorization from the brokerage. For an urgent ride after the brokerage’s hours, ask it for retroactive authorization within 30 days. What a CCO or brokerage pays you is set in your contract, so get its rate sheet before you buy a van.

Some plans go further. Greater Oregon Behavioral Health’s manual (revised July 2025) lets Eastern Oregon Coordinated Care Organization members who are not on any hold ride secure when they appear to be a danger. EOCCO or GOBHI authorizes each one, and you receive the member’s informed consent and the treating professional’s written reasons for the secure ride. See GOBHI.

How to find secure transport work

The CMHP director is your main client, because the director decides who drives people in custody in that county. Hospital emergency departments, psychiatric units, and crisis centers also need secure rides, and each CCO’s brokerage books secured rides for its members, as Cascades West Ride Line does with its own secured ride type. For the rest of Oregon’s NEMT rules, permits, and brokerages, see the Oregon state guide.