Where NEMT vans can park at hospitals: loading zones, garage height, placards, and tickets

Start at the passenger loading zone

The pickup itself belongs in the hospital’s passenger loading zone. The ADA design standards, which govern new construction and alterations, require at least one accessible loading zone at an accessible entrance to every licensed medical care or long-term care facility where the period of stay exceeds 24 hours (ADA section 209.3). Hospitals, rehab hospitals, and nursing homes all fall under that line.

The zone is built for your vehicles. Section 503 sizes the pull-up space at no less than 96 inches by 20 feet, beside a marked access aisle of 60 inches or more that runs the whole length of the space. The pull-up space, the aisle, and the vehicle route in and out of the zone must have at least 114 inches of vertical clearance. That is 16 inches more than the ADA asks of the garage route to van parking spaces, covered below.

Two more rules help on a large campus:

• Long loading curbs. Where a facility has a stretch of loading zone, section 209.2.1 asks for one accessible loading zone in every continuous 100 feet of it.
• Valet and mechanical garages. A parking facility with valet service, and a mechanical access garage at its drop-off and pick-up areas, must also provide an accessible loading zone (sections 209.4 and 209.5).

Broker rules agree. When a van arrives at a destination, MTM Health’s Virginia provider handbook has the driver pull up so riders can get to the door safely, without crossing a street when that can be avoided, and the van has to stay where the driver can see it. Its infraction list includes “Failure for Vehicle to be Parked in Safe Location for Offloading/Loading.” The zone solves both problems for a curbside pickup. For riders waiting inside, the handoff and the unit phone number matter more than the curb, which hospital discharge transportation covers.

Garage clearance: 7 feet, 98 inches, and your van

Parking garages are where tall vans get stuck. The 2021 International Building Code, a model code that applies where a state or city adopts it, sets the clear height of each garage floor at not less than 7 feet (section 406.2.2). That is 84 inches.

The ADA asks for more only in one place. Van parking spaces, their access aisles, and the vehicle routes serving them need at least 98 inches of vertical clearance (section 502.5). The Access Board’s advisory note suggests signs at garage entrances showing the clearance and where the van-accessible spaces are. So a garage can be legal at 84 inches on most of its floors as long as the route to its van spaces clears 98 inches.

Compare that with your fleet:

• Lowered-floor minivans. BraunAbility lists its rear-entry NEMT minivan at 75 inches tall with the hatch closed, and its side-entry foldout minivan at 81 inches unloaded. Both clear a 7 foot garage.
• Full-size and high-roof vans. Heights vary by roof, conversion, and roof equipment. Measure each van to its highest point, including vents and antennas, and put the number on a label inside the windshield.

A driver who knows the number reads the clearance bar before committing to the ramp, not after.

How many accessible spaces a hospital lot has

Hospital lots carry more accessible spaces than most. Section 208.2.1 requires that 10 percent of patient and visitor parking serving hospital outpatient facilities be accessible, and section 208.2.2 raises that to 20 percent at rehabilitation and outpatient physical therapy facilities. Doctors’ offices and clinics outside hospitals use the general count table instead. At least one of every six required accessible spaces must be a van space (section 208.2.4), which is 132 inches wide, or 96 inches wide beside a 96 inch aisle (section 502.2).

Curb colors and signs near the entrance

Local rules decide how long you may stand at a curb outside the loading zone. California is a useful example because state law fixes what each curb color means, while cities set the hours and minutes (Vehicle Code 21458).

New York City draws the line with signs instead. Its Department of Transportation says a No Standing sign lets a driver stop to drop off or pick up passengers, a No Parking sign allows the same plus loading packages, and a No Stopping sign allows neither. Waiting is not allowed under any of the three, and double parking a passenger vehicle is illegal at all times.

Disabled placards and plates follow the rider

A rider’s placard is a privilege for that rider, not for your van. States put it in different words, with the same result.

California. The placard holder may let someone else use it only while in the holder’s presence or reasonable proximity, for the purpose of transporting the holder (Vehicle Code 4461). Displaying a placard issued to someone else for any other purpose carries a civil penalty of $250 to $1,000, or a misdemeanor with up to six months in county jail. California also issues special plates to an organization or agency that transports disabled persons, if the vehicle is used solely for that purpose (Vehicle Code 5007). Even then, section 4461(d) bars a vehicle with plates issued to another from parking in a disabled space unless it is transporting a disabled person.

While the rider is aboard, California’s privileges are broad. Vehicle Code 22511.5 allows parking for unlimited periods in time-limited zones and in metered spaces without paying the meter. It does not reach zones where the law prohibits stopping by all vehicles or reserves the space for special types of vehicles. Section 22507.8 bars anyone, placard or not, from parking on the lines of a disabled space or in the crosshatched aisle next to it.

Texas. The owner of a vehicle regularly operated by or for the transportation of a person with a disability may apply for a placard (Transportation Code 681.003). The vehicle may then use a disabled space for an unlimited period only while it is being operated by or for the transportation of that person (681.006). Meter fees are waived on the same condition, but the waiver does not cover a government-run garage or lot unless the local government extends it by ordinance or order. Parking in a disabled space without that authorization, lending a placard, or blocking an access aisle or curb ramp is a misdemeanor carrying a $500 to $750 fine for a first offense, and the registered owner is presumed to have left the vehicle there (681.011). For a fleet, that owner is the company.

The practical rule for drivers is short. The placard goes up as the rider boards and comes down at drop-off. A van waiting empty for a discharge parks in an ordinary space.

Tickets, garage fees, and who pays

Parking costs land in three places: the payer, the company, or the driver.

The payer. Garage fees bill under A0170, the HCPCS code for trip extras like parking and tolls, and each state or broker decides whether to pay it. The NEMT ancillary codes entry lists what some states pay. Where a payer covers it, keep the receipt with the trip.

The company. A garage fee paid on a route is a cost of the trip, and in California the employer must cover it. Labor Code 2802 makes an employer cover the necessary expenses employees run up while doing their jobs, so a driver who pays a hospital garage on a route gets that money back.

The driver. Passing tickets to drivers runs into wage law. Under 29 CFR 531.35, wages must be paid free and clear. The Department of Labor’s Fact Sheet 16 says no deduction may push pay under the minimum wage or eat into overtime pay, even when the employer’s loss came from the employee’s negligence, and having the employee repay in cash is no way around it. California adds Labor Code 221, which makes it unlawful for an employer to collect back any part of wages already paid. Before you deduct anything, read deducting damage from driver pay, and put the parking and ticket rule in writing next to your take-home vehicle policy if drivers keep vans overnight.

A hospital stop sheet for dispatch

Each hospital you serve deserves one sheet, built once and attached to every trip there. Collect these from the facility’s security or transport office and from your drivers’ first runs:

1. The entrance and loading zone for each department you serve: main lobby, outpatient building, dialysis, emergency discharge.
2. The posted clearance of each garage, and whether van spaces exist only on the ground level.
3. How long security lets a van stand in the zone, and the curb rules on the nearest street.
4. Where drivers wait during a discharge, and the unit phone numbers.
5. Garage fees, and whether the hospital validates parking for transport vehicles.
6. A security or parking contact for disputes and towing.

The address side of the same problem, such as campuses with many buildings and pins that land on the wrong door, is covered in pickup address problems.

Proof of the stop in HealthRide

Every HealthRide trip keeps a record with timestamps and GPS-recorded miles, along with recorded wait times on no-shows. When a hospital questions how long a van sat at its entrance, or a ticket arrives for a short pickup, the timestamps on that trip settle when the van pulled up and when it pulled away. Dispatch can also watch each van approach the hospital on the live map.