The basic requirements for NEMT vehicles in the United States vary from one state to another. In the United States, safe, reliable, and convenient non-emergency medical transportation has become a necessity for almost every community. A growing number of people tend to have transportion needs that can barely be met by family, friends, public transportation, or even an accessible vehicle company.

When looking to start this business, one of the most vital things you need, if not the most important, is a vehicle. Truth be told, not just any old vehicle will do. Since you’ll be transporting a population primarily made up of elderly and disabled folks, you will need well-designed vehicles.

You will need to find ADA-compliant vehicles that align with your business needs and insure all of them, along with every driver you have on the payroll. When starting, it is recommended you purchase one or two reliable vehicles until your clientele base grows a little. You can choose from a wide range of styles and sizes, including minivans, full-size vans, and buses.

Since you will most often be using a wheelchair-accessible vehicle, you will need a few extra wheelchairs. In addition, you will need walkers, gurneys, and oxygen tanks. When looking for the perfect vehicle for your NEMT Services, the most important thing to look out for is accessibility.

Just like it was noted above, your patients will often be those residing in nursing homes, assisted living facilities, and other environments that make them vulnerable. It is necessary to make sure your vehicles can accommodate a wide range of people.

What are the Basic Requirements for NEMT Vehicles?

While these requirements will vary from one state to another, there are basic requirements all NEMT vehicles are expected to meet. Here are basic requirements for NEMT vehicles in the United States.

a. NEMT vehicles and all components are first expected to meet state, federal, local, and manufacturer’s safety and mechanical operating and maintenance standards.

b. NEMT vehicles are also expected to comply with the Americans with Disabilities Act (ADA) Accessibility Specifications for Transportation [1], 49 CFR § 38, Subparts A and B. NEMT brokers are most often mandated to supply all transportation providers with a copy of the ADA vehicle requirements and inspect for compliance.

c. All NEMT vehicles will have to be equipped with adequate and functioning heating and air-conditioning systems.

d. Safety belts will have to be provided for all passengers. Securement belts are expected to be provided and installed for each wheelchair position.

e. Every NEMT vehicle is expected to utilize age and weight appropriate infant and child safety seats provided by the parent or guardian when transporting children through the age of seven (until 8th birthday).

f. Newer vehicles made with longer lap/shoulder belts will need to have a minimum of one (1) seat belt extension. The extension is available for passengers with a large girth that prevents the passenger from fastening the vehicle’s standard seat belt equipment.

Older vehicles manufactured with shorter lap/shoulder belts shall have two (2) seat belt extensions available. Have it in mind that a passenger should never be transported without a lap/shoulder belt fastened.

g. For use in emergencies, each vehicle will have to be fitted with at least one seat belt cutter within easy reach of the driver. Exceptions to this requirement must be approved in advance and in writing by the necessary department in the State.

h. Every NEMT vehicle is expected to have an accurate speedometer and odometer.

i. Every NEMT vehicle is expected to have two exterior rearview mirrors, one on each side of the vehicle.

j. NEMT vehicles will have to be driven with headlights on during vehicle operation.

k. All NEMT vehicles are expected to be equipped with an interior mirror for monitoring the passenger compartment.

l. The exterior of the vehicle will always have to be clean, free of broken mirrors or windows, excessive grime, rust, major dents, body damage, damaged bumpers or paint damage that detracts from the general appearance of the vehicle.

m. Also note that the interior of the vehicle is expected to be clean, free from torn upholstery, floor, or ceiling covering; free from damaged or broken seats, and free from protruding sharp edges. The interior will also need to be free of dirt, oil, grease, and litter.

n. NEMT vehicles are expected to be free of hazardous debris or unsecured items and shall be operated within the manufacturers’ safe operating standards at all times.

o. NEMT vehicles, at least, are expected to have the NEMT business name and telephone number displayed on both sides of the exterior of the vehicle. The business name and phone number will have to appear in permanently affixed lettering that is a minimum of three inches in height and of a color that contrasts with its surrounding background.

p. Note that to comply with HIPAA requirements, the word “Medicaid” or “FAMIS” may not be displayed on the vehicle or in the name of the business.

q. The vehicle license number, the dispatch toll-free and Voice/TTY number(s), and the complaint procedures will have to be vividly displayed on the interior of each vehicle. This information shall also be available in a written format in each vehicle for distribution to passengers and clients upon request.

r. Smoking, including Vapor and E-cigarettes, are not allowed in ALL NEMT vehicles at all times. All NEMT vehicles will need to have the following signs posted in all vehicle interiors, easily visible to the passengers: (1) “NO SMOKING” (including Vapor and E-cigarettes) and (2) “ALL PASSENGERS WILL USE SEAT BELTS.”

s. All NEMT vehicles are expected to carry a vehicle information packet containing vehicle registration, insurance card, and the broker’s accident and incident procedures and forms. If leased, the packet shall include the vehicle lease agreement.

t. All NEMT vehicles will need to be provided with a first aid kit that includes at least the following unexpired items:

i. Three sizes of adhesive bandages

ii. Antiseptic cleansing wipes

iii. Dressing pads

iv. Oval eye pad

v. Conforming gauze bandage

vi. Triangular bandage

vii. Triple antibiotic

viii. Insect sting relief pads

ix. Cold pack

x. Cotton-tip applicators

xi. Latex gloves

xii. Scissors

xiii. Sterile eyewash

u. Every NEMT vehicle is expected to contain a functioning GPS device or current map of the jurisdiction.

v. Every NEMT vehicle will need to be equipped with a working fire extinguisher (Class A, B, C) that shall be secured within easy reach of the driver.

w. Brokers are expected to ensure that NEMT providers with “Taxi” license plates are in compliance with state and local ordinances for taxis and are currently licensed by the local taxi authority, if one exists, in the jurisdictions in which they operate.

x. Insurance coverage for all NEMT vehicles shall be verified and maintained during the contract period under state and local regulations and contract requirements.

y. Wheelchair Vehicles will have to be equipped with a “Spill Kit” including liquid spill absorbent, latex gloves, hazardous waste disposal bags, scrub brush, disinfectant, and deodorizer.

z. Each wheelchair van will need to have four fully functional securements per wheelchair station on the vehicle and the interlock system needs to be in working order. All wheelchair vehicles are expected to have a lap and shoulder belt that is mounted to the vehicle and installed at every wheelchair station.

The lap and shoulder belt system will need to be specifically made for the securement of wheelchair riders. The wheelchair van also will have to comply with the Americans with Disabilities Act (ADA).