Wheelchair Securement Checklist for NEMT Drivers: A Printable Step Card

A loose strap or a belt in the wrong place can turn a hard stop into an injury. This checklist gives drivers the same steps, in the same order, on every wheelchair trip, and it gives you a record that each driver can do them. Each step is matched to the federal ADA rule or the state or broker rule behind it.

How to use this template

1. Print Part 2 as a card. Laminate it and keep one at each wheelchair station or on the driver’s visor, so the steps are in view at every pickup.
2. Do Part 1 before the first ride of the day. It checks each station’s straps, belts, and anchors. Do it with the daily vehicle inspection checklist, and pull a station from service until a failed part is replaced.
3. Follow your equipment’s instructions too. The federal 2 inch movement limit assumes the chair is secured the way the securement system’s maker describes (49 CFR 38.23(d)(5)). Keep the maker’s instructions in the van.
4. Use Part 3 to prove each driver’s skill. A trainer watches the driver secure a real wheelchair and rider in your own van, at hire, at each refresher, and after any securement complaint. Georgia requires proof of securement training before a driver with a confirmed securement failure can return to service.
5. Write every problem in Part 4. Note torn straps, broken fittings, and chairs that would not secure well, and file an incident report whenever a rider was affected.

The full explanation of each step is in the wheelchair securement guide.

The template

Part 1: Station check before the first ride

Item	Station 1	Station 2
Date, van number, and driver initials
Four tie-downs present, with no cuts, fraying, or burns
Each tie-down locks and releases
Floor track or anchors clean, and each fitting clicks in and holds
Lap and shoulder belt at the station, latches and releases
Straps and belts stored off the floor
Belt extender on board
Belt or strap cutter within the driver’s reach
Lift or ramp works. On a lift van, the van cannot move while the lift is out.
Clear floor space of 30 by 48 inches, nothing stored in it
Rear-facing station only: padded barrier behind the rider in place

Part 2: Securement steps on every trip

Step	What to do	Done
1. Park	Stop on level ground, out of traffic, with room for the ramp or lift. Shift to park and set the brake.
2. Board	Ask whether the rider prefers to face in or back on. Help on the ramp or lift as needed.
3. Place	Roll the chair to the center of the station, facing forward. Rear-facing only with a padded barrier. Never sideways.
4. Brake	Set the chair’s brakes, or turn off a power chair.
5. Hook	Attach four tie-downs, two in front and two behind, to solid frame points. Use the chair’s built-in securement points or brackets if it has them. Never a wheel.
6. Anchor	Clip each strap into the floor fittings for that station. Never a door or wall panel.
7. Tighten	Take out all slack, the way your system’s instructions say. On a forward-facing chair, the rear straps carry most of the crash load.
8. Test	Push the chair forward, back, and side to side. It moves no more than 2 inches.
9. Lap belt	Fasten the van’s lap belt low across the pelvis, not the stomach.
10. Shoulder belt	Bring the shoulder belt from above the shoulder, across the chest, to the lap belt at the opposite hip. Use an extender if it does not reach.
11. Separate	The chair straps hold the chair and the belt holds the rider. Never one belt for both, and never a belt around the backrest.
12. Stow	Stow bags, loose items, and any portable ramp so nothing can fly forward.
13. Final check	Look at all four hooks, the strap tension, and the belt once more. Then move.
14. Release	At the destination, park safely, release the belt and tie-downs, and help the rider off.
15. Put away	Retract or store the straps and belts off the floor.

Part 3: Driver skills check

Skill the trainer watched	Date	Pass or retrain	Trainer initials
Station check (Part 1) done correctly
Ramp or lift deployed, used, and stowed safely
Chair placed facing forward with brakes set
Four tie-downs hooked to the frame, none on a wheel
Straps clipped only into floor fittings
Movement held to 2 inches or less
Lap belt low on the pelvis, shoulder belt across the chest
Chair straps and rider belt kept separate
Loose items stowed before moving
Power chair or scooter secured, if the van carries them
Everything released and put away at the destination

Sign-off	Write the entry here in pen
Driver’s printed name and signature
Van or vans checked in
Trainer’s printed name and signature
Date
Next securement refresher due

Part 4: Securement problem log

Date	Van and station	Problem (strap, fitting, belt, or chair)	What was done	Incident report filed	Initials

The rule behind each step

The federal rules come from the ADA vehicle standards in 49 CFR part 38 and the service rules in 49 CFR part 37, which apply to private companies as well as public transit. The Access Board’s technical guide explains them. State and broker rules were current as of September 2026.

Step	Rule or guidance
Four tie-downs at each station	49 CFR 38.23(d)(1) sets the strength: 2,500 pounds per leg and at least 5,000 pounds per chair on vehicles rated under 30,000 pounds. The Access Board notes four-point systems are common in demand response service. Virginia requires four fully working securements per station, and New Jersey a four-point, forward-facing system.
Frame, never a wheel	Access Board guide; Minnesota Rules 7450.0300; N.J.A.C. 8:40-5.6(b)
No doors or wall panels	Wisconsin Trans 301.65(3) bars any attachment to a door. Minnesota Rules 7450.0400 bars interior paneling as an anchor point and requires a metal fitting that locks into any floor track.
2 inches of movement	49 CFR 38.23(d)(5). New Jersey mobility assistance vehicles: 1 inch.
Forward or rear-facing, never sideways	49 CFR 38.23(d)(4) allows forward-facing, or rear-facing with a padded barrier 38 to 56 inches off the floor and 18 inches wide. The Access Board says side-facing securement is not permitted under any circumstances.
Lap and shoulder belt at every station	49 CFR 38.23(d)(7), which also bars using the belt in place of chair securement. Virginia requires a belt mounted to the vehicle and made for wheelchair riders.
Lap belt on the pelvis, never around the backrest	Access Board guide
One belt never holds both chair and rider	Access Board guide; Wisconsin Trans 301.65(5)
The chair’s positioning belt is not enough	Louisiana Medicaid Services Manual, section 10.4
Secure before the van moves	Virginia DMAS; Georgia section 907.12; Texas plans (UMCM 16.4); Minnesota Rules 7450.0700; Wisconsin Trans 301.65(1); MTM Health’s standard agreement
Belt extender on board	Virginia (one on newer vehicles, two on older ones); MTM Health’s standard agreement
Belt cutter within reach	Virginia DMAS
Stow loose items and ramps	Wisconsin DHS 105.39(3)(c); 49 CFR 38.23(c)(7) for portable ramps
Straps and belts off the floor	Virginia DMAS; Minnesota Rules 7450.0700
Help with securement and leave the seat to do it	49 CFR 37.165(f)
Respect the rider’s boarding direction	DOT guidance in 49 CFR part 37, Appendix D, unless only one way works or a direct threat requires another
Keep equipment working and repair it promptly	49 CFR 37.161
Train each driver to proficiency	49 CFR 37.173

The Access Board updated its guidelines for buses and vans in 2016, but those updates are not yet part of DOT’s enforceable vehicle standards. The standards in force are the ones in 49 CFR part 38. For the gear itself, see wheelchair tie-down and occupant restraint systems.

What the ADA lets you require, and what it forbids

The ADA rule in 49 CFR 37.165 covers how drivers use the equipment on every ride.

• You may require securement. A rider can be required to let you secure the wheelchair.
• You may not refuse the ride. You may not deny a trip because the chair cannot be secured to your satisfaction. DOT’s guidance says to do the best you can with your equipment and the chair.
• You may not force a transfer. You may recommend that a rider move to a vehicle seat, but the rider decides.
• Heavy chairs ride if the lift can take them. You must carry a chair and rider larger or heavier than the design standard when the lift and van can hold them. You may decline when their combined weight is more than the lift is rated for, or when carrying the chair is shown to be inconsistent with legitimate safety requirements. See bariatric transportation.
• Large chairs ride if they fit. DOT’s guidance says a chair bigger than 30 by 48 inches that fits on the lift and in the securement area must be carried, unless it would block an aisle and get in the way of a safe evacuation.
• Scooters usually count. The ADA defines a wheelchair as a mobility aid with three or more wheels that is usable indoors (49 CFR 37.3), so a three-wheel scooter that is usable indoors counts as a wheelchair. Georgia’s manual (July 1, 2026) asks scooter riders to move to a passenger seat, which is a request, not a condition. See mobility scooter transport.
• Wheel clamps alone do not meet the rule. The Access Board says a system of only wheel clamps or rim pins cannot hold many power wheelchairs or three-wheel scooters.

Crash-tested chairs and chairs that are hard to secure

Some wheelchairs are built to be used as a seat in a moving vehicle. A September 22, 2021 study briefing posted by the U.S. Access Board describes chairs that meet the RESNA WC19 standard: they are designed to stay upright in a 30 mph frontal crash, to provide four standard securement points, such as slotted brackets, for tie-down hooks, and to take a lap belt anchored to the chair that stays in place in a crash. When a chair has those points, hook there. See WC19 wheelchairs.

For a chair without built-in securement points, hook solid frame members. Minnesota’s rule says a frame-attached device must hold the chair without damaging the frame, and attach at 3 or more well-spaced points, or at 2 widely spaced points when the wheels or frame rest against a solid stop that meets the state’s approval rules (Minnesota Rules 7450.0300, 7450.0400, and 7450.0500). Tilt and recline chairs and lightweight transport chairs need extra care. See Broda chairs and transport chairs. Write any chair that would not secure well in Part 4, and tell dispatch so the next driver is ready.

State and broker rules on top of the ADA

Program	What it adds
Virginia fee-for-service (DMAS, updated May 26, 2026)	Before starting the vehicle, drivers secure every wheelchair and wheelchair rider. No member rides without a lap and shoulder belt fastened. A seat belt cutter within easy reach of the driver.
MTM Health, Virginia (handbook approved August 10, 2026)	A substantiated complaint about wheelchair or stretcher securement is a Level 2 infraction worth 2 points per instance, which can bring required retraining, a vehicle reinspection, or loss of payment for the trips. Moving before a passenger is secure is a Level 1 infraction worth 1 point.
Georgia (DCH manual, July 1, 2026)	A tie-down meeting ADA standards at each station. A driver with one confirmed failure to secure a member’s wheelchair is removed from service until the provider sends the broker proof of securement training (section 907.16).
New Jersey mobility assistance vehicles (N.J.A.C. 8:40, readopted effective September 25, 2023)	A four-point, forward-facing system that holds the frame, never the wheels, within 1 inch. Vehicles first licensed after February 17, 1998 have forward-facing positions only. A rider seatbelt on the wheelchair, with no hook-and-loop closures, stays on until the rider leaves the chair at the destination.
Minnesota (Rules chapter 7450)	Frame-attached devices never attach to a wheel. Each bolts to the vehicle at 2 or more points. The driver makes sure the chair is secured before moving and that devices are retracted or stored when not in use.
Wisconsin (Trans 301.65 and 301.66)	Each chair secured before the vehicle moves from the parked position, never to a door, and every rider secured to the wheelchair during the ride.
Louisiana (manual sections 10.3 and 10.4, issued July 14, 2025)	The broker’s vehicle inspection photographs a wheelchair secured at its base and the shoulder and lap belt fastened. Drivers at companies with wheelchair vans take securement training in person.
MTM Health standard agreement (Pennsylvania copy, January 1, 2023)	Every wheelchair and mobility device secured, and every rider in a wheelchair or scooter secured, before the vehicle moves. Drivers refuse to start or continue a trip when a member will not wear a seat belt properly.

Check your state guide and each broker’s page, such as MTM Health, for the rules on your trips.

Training and refreshers

Federal rules require every company that runs demand response rides to train staff to proficiency on its vehicles and equipment (49 CFR 37.173). A card is a reminder, not training. Teach securement on your own vans, with your own straps and a real wheelchair, and sign Part 3 only after the trainer has watched a full securement and release.

Program	Securement training rule
Louisiana (issued July 14, 2025)	Wheelchair securement and PASS at least every 2 years, in person for drivers at companies with wheelchair vans
Texas Medicaid health plans (UMCM 16.4)	Training on lifts and tie-down equipment within 30 days of hire and every year after
Minnesota (Rules 8840.5910)	A ramp, lift, and securement demonstration before the first ride, and 2 hours of securement training every 3 years
Wisconsin (DHS 105.39)	Instruction on every ramp, lift, and restraint device you use, before the driver carries riders

For the full course list, see NEMT driver training. For new hires, securement is one line of the driver onboarding checklist.