Wheelchair Securement Training for NEMT Drivers

Passenger injuries during NEMT are rare, but the ones that do happen almost always involve improper wheelchair securement. Four-point tie-downs, when used correctly, hold a wheelchair through the same crash forces as a bolted-in vehicle seat. Used incorrectly, they turn a 400-pound chair into a projectile.

The four-point standard

Every wheelchair must be secured with four independent tie-down straps: two forward (attaching to the chair frame near the front, running down and outward to floor anchors ahead of the chair) and two rearward (attaching to the frame near the back, running down and outward to anchors behind the chair). Straps must be tight enough that the chair does not move more than two inches in any direction.

Where to attach — and where NOT to

• Attach to structural frame members only
• Never attach to wheels, footrests, armrests, brake handles, or accessory brackets
• Never attach to a battery pack or motor housing on a power chair
• Never cross straps in an X pattern

Occupant restraint

The wheelchair tie-down does not restrain the person. A separate lap belt goes across the pelvis (not the abdomen). A separate shoulder belt runs from the pelvis strap up over the chest and shoulder — never across the neck. Both must anchor to the vehicle, not the chair.

Pre-trip inspection

• Straps free of cuts, fraying, and chemical damage
• Ratchets clean and moving freely
• Hooks not bent or missing safety latches
• Floor anchors clean and free of debris
• Lift or ramp operates smoothly with no unusual sound

Training programs to look for

PASS (Passenger Assistance Safety and Sensitivity) from CTAA is the industry-standard curriculum. Q'Straint and Sure-Lok both offer manufacturer training on their tie-down systems. Every driver should complete both a general course and hands-on training on the specific equipment in their vehicle.