ADA requirements for NEMT vehicles and service: what 49 CFR Parts 37 and 38 require
Private NEMT companies fall under DOT's ADA rules in 49 CFR Part 37. New vans and buses must be accessible unless your service as a whole gives riders with disabilities equivalent service. Accessible vehicles must meet Part 38: lifts with a 600 pound design load, ramps with a 30 inch clear width, and a 30 by 48 inch securement space with a seat belt and shoulder belt.
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Who the ADA transportation rules cover
DOT’s ADA rules in 49 CFR Part 37 apply to public and private transportation providers, and a private NEMT company is squarely inside them. Part 37 calls a company like yours a private entity primarily engaged in the business of transporting people. Because riders book trips instead of catching a bus on a fixed route, your service is a demand responsive system.
Three duties follow from that status:
- Nondiscrimination. You may not discriminate against a person with a disability in providing service. That includes making reasonable modifications to policies, providing auxiliary aids, and removing barriers under the Department of Justice rules at 28 CFR 36.301 to 36.306.
- Accessible vehicles. New vans and buses you buy or lease must be accessible, or your service must provide equivalent service.
- Service rules. Your drivers must use the lift and securement equipment, help riders, and be trained to do both.
Your broker and state rules can add more. Virginia’s NEMT standards, for example, require vehicles to comply with 49 CFR Part 38, Subparts A and B, before they are approved, and require four working securements and a lap and shoulder belt at every wheelchair station.
Which vehicles must be accessible
The purchase rule is 49 CFR 37.103. It applies when you buy or lease a new vehicle for demand responsive service.
| Vehicle you acquire new | ADA requirement |
|---|---|
| Automobile (sedan, standard car) | Not covered by the purchase rule |
| Van with fewer than 8 seats, including the driver | Accessible, unless your system as a whole provides equivalent service |
| Van or bus with 8 or more seats | Accessible, unless your system as a whole provides equivalent service |
“Equivalent service” is defined in 49 CFR 37.105. Service for riders with disabilities, including wheelchair users, must be in the most integrated setting appropriate and equal to the service other riders get on:
- Response time
- Fares
- Geographic area of service
- Hours and days of service
- Availability of information
- Reservations capability
- Any limits on capacity or service availability
- Restrictions or priorities based on trip purpose
In NEMT the question rarely comes up, because brokers assign trips by service level and wheelchair trips go to accessible vehicles. If you run private-pay rides with sedans only, check that wheelchair users can book comparable service through you.
Part 38 lift requirements
Part 38 sets the technical specs for accessible vehicles. These are the lift rules from 49 CFR 38.23(b) that matter most when you inspect or buy a van.
| Lift item | Requirement |
|---|---|
| Design load | At least 600 pounds |
| Platform clear width | 28.5 inches at the platform surface, 30 inches from 2 to 30 inches above it |
| Platform clear length | 48 inches, measured from 2 to 30 inches above the platform |
| Side barriers | At least 1.5 inches high where the platform extends past the vehicle |
| Outer barrier | Must stay raised whenever the occupied platform is more than 3 inches above the ground |
| Platform speed | No more than 6 inches per second when lifting or lowering a rider |
| Handrails | On two sides, moving with the lift, with the grip between 30 and 38 inches above the platform |
| Interlock | The vehicle cannot move unless the lift is stowed |
| Emergency operation | A backup method to lower an occupied lift and stow an empty one if power fails |
| Boarding | Must allow riders to face inboard or outboard, and must accommodate standees |
Part 38 ramp requirements
Ramps must meet 49 CFR 38.23(c).
| Ramp item | Requirement |
|---|---|
| Clear width | 30 inches |
| Design load | 600 pounds for ramps 30 inches or longer, 300 pounds for shorter ramps |
| Side barriers | At least 2 inches high |
| Surface | Continuous and slip resistant, no bumps over 1/4 inch |
| Maximum slope to the ground | 1:4 |
| Slope to a 6 inch curb | 1:4 if the floor is 3 inches or less above the curb, 1:6 if up to 6 inches, 1:8 if up to 9 inches, 1:12 if higher |
| Attachment | Firmly attached, with no gap over 5/8 inch |
Securement and occupant restraint requirements
Securement rules in 49 CFR 38.23(d) cover the space, the strength, and the belts.
| Securement item | Requirement |
|---|---|
| Number of locations | At least one on vehicles 22 feet or shorter, at least two on longer vehicles |
| Clear floor space | 30 by 48 inches, as near the accessible entrance as practicable |
| Strength, vehicles under 30,000 pounds GVWR | 2,500 pounds forward force per securement leg, 5,000 pounds per mobility aid |
| Movement | No more than 2 inches in any direction under normal driving |
| Orientation | Forward facing, or rearward facing with a padded barrier, on vehicles 22 feet or shorter |
| Occupant belts | A seat belt and shoulder belt for each securement location, never used in place of wheelchair securement |
The regulation sets the minimum. For how to actually tie down a chair and belt the rider, see our guide to wheelchair securement standards and the wheelchair securement checklist.
Doors, lighting, and signs
The rest of Part 38’s bus and van subpart covers the path from the curb to the securement area. For vehicles 22 feet long or less:
- Door height. At least 56 inches of clearance between the top of the door opening and the raised lift platform or highest point of the ramp.
- Interior height. At least 56 inches along the path from the lift to the securement location.
- Surfaces. Slip-resistant floors in aisles and securement areas, and a contrasting color band on step edges and on the boarding edge of ramps and lifts.
- Lighting. Lighting on the lift or ramp and outside the door, so riders can see where they step or roll.
- Signs. A sign designating each securement location.
Service rules your drivers must follow
The vehicle is half of ADA compliance. The other half is how your staff operate it. Part 37 sets these rules for public and private providers:
- No special charges to riders with disabilities for required services (37.5(d)).
- No attendant requirement. You cannot require a rider with a disability to bring an attendant (37.5(e)).
- No insurance excuse. You cannot refuse a rider because your insurer conditions coverage or rates on it (37.5(g)).
- Refusal only for conduct. You may refuse a rider who is violent, seriously disruptive, engages in illegal conduct, or is a direct threat, but not because a disability causes appearance or involuntary behavior that bothers others (37.5(h)).
- Keep equipment working. Lifts and securement devices must be kept in working order and repaired promptly (37.161).
- Use the securement system. You may require the rider to let you secure the chair, but you may not deny the trip because it cannot be secured satisfactorily (37.165).
- Recommend, never require, a transfer. Suggesting a move to a vehicle seat is fine, but the rider decides (37.165(e)).
- Help when needed. Staff must help with ramps, lifts, and securement, leaving their seat if necessary (37.165(f)).
- Standees may use the lift or ramp to board (37.165(g)).
- Service animals, oxygen, and time. Permit service animals and portable oxygen, and give riders enough time to board and exit (37.167).
- Trained staff. Train personnel to proficiency for their duties (37.173).
Put these rules into your driver training and your written policies.
Lift certification under federal vehicle safety standards
Lifts installed in vehicles are also covered by NHTSA’s safety standards. FMVSS No. 403 sets performance requirements for platform lifts, and FMVSS No. 404 covers how they are installed in vehicles made on or after July 1, 2005. Each lift is certified as a public use lift or a private use lift and labeled to match. Buses, school buses, and multipurpose vehicles over 10,000 pounds GVWR must use a public use lift. On a smaller van, check the label and the manufacturer’s rated load before you carry heavy power chairs.
A quick ADA check for each vehicle
- Confirm the lift or ramp label, rated load, and interlock work.
- Measure the securement space and count four working tie-down straps per station.
- Check that a lap and shoulder belt is installed at every wheelchair station.
- Test lighting on the lift or ramp and outside the door.
- Confirm each securement location is marked with a sign.
- Log the inspection and fix anything broken before the vehicle takes a wheelchair trip.
Our guide to NEMT vehicle requirements covers the state and broker items that sit on top of these.
Matching riders to the right vehicle in HealthRide
HealthRide matches wheelchair, stretcher, and oxygen needs to vehicles that can carry them, using the seat and wheelchair capacity you set for each vehicle. Vehicle inspections and credential expiration dates are tracked in the same place, with reminders before anything lapses. See fleet management for the details.
Frequently asked questions
- Do NEMT sedans have to be wheelchair accessible?
- No. The vehicle purchase rule for private transportation companies, 49 CFR 37.103, does not cover automobiles. It covers new vans and larger vehicles, which must be accessible unless your system as a whole provides equivalent service. You still cannot turn away a rider with a disability who can use a sedan, and your broker contract decides which service levels you must offer.
- Can I refuse a rider whose wheelchair will not fit my tie-downs?
- No. Under 49 CFR 37.165(d) you may not deny transportation because a wheelchair cannot be secured satisfactorily by your securement system. You may require the rider to let you secure the chair. You may decline only if the chair and rider together exceed your lift's specifications, or if carrying it is shown to be inconsistent with legitimate safety requirements.
- Can I charge more for wheelchair riders?
- Be careful. Section 37.5(d) bars special charges to people with disabilities for services the rule requires or that are needed to accommodate them. Medicaid and broker rates for wheelchair vans are set by the payer and are not charged to the rider. If you set private-pay prices by service level, have an attorney review them against this rule.
- Do drivers have to help with wheelchair securement?
- Yes. Section 37.165(f) requires your staff to help riders with securement systems, ramps, and lifts when needed or requested, and to leave their seat to do it. Section 37.173 requires staff to be trained to proficiency so they operate the equipment safely and treat riders with disabilities respectfully.
- Can a rider bring portable oxygen or a service animal?
- Yes. Section 37.167 requires you to permit service animals and prohibits you from barring a rider who travels with a respirator or portable oxygen, consistent with DOT hazardous materials rules. Secure the tank so it cannot move during the trip.
- Does the ADA require riders to use WC19 wheelchairs?
- No. WC19 is a voluntary RESNA standard, not a legal requirement, and it covers wheelchairs built to serve as vehicle seats. The University of Michigan wheelchair transportation safety program notes that transportation cannot be denied because a rider does not have particular equipment, and most wheelchairs in use are not WC19 compliant.
