The Justice Center created this toolkit to provide information and resources for individuals receiving services, service provider agencies, staff, and family members to support the safety of people who require the use of a wheelchair during transportation. A printable copy of this page can be found below.
With an increased understanding of the steps involved in the wheelchair securement process, interactive training for staff, and comprehensive guidance provided in agency policy, staff, family/caregivers and agencies can work together to reduce accidents and injuries to people in care.
In 2018, there was an increase in the number of cases reported to the Justice Center that involved people in care who were not properly secured in their wheelchairs while riding in agency vehicles. Issues with incorrect placement of lap and shoulder belts, improper application of wheelchair tiedowns, and staff and people in care standing on platform lifts resulted in injuries to people in care. A systemic review of wheelchair securement led by the Justice Center also found that staff were not always trained on wheelchair securement practices and did not know the individual safeguards of people in care related to wheelchair securement and transportation.
A 2016 report submitted to the National Highway Traffic Safety Administration (NHTSA) stated that, in accidents involving people in care who use wheelchairs, one of the main reasons people in wheelchairs are injured is improper or incomplete use of lap/shoulder-belt restraints. If improperly secured, people may be thrown from the wheelchair or may slide under the lap belt. If the wheelchair is not properly secured, the wheelchair itself may tip over.
Additional information including policy guidance, what you can do, and further resources are available for download. Look for the Wheelchair Securement toolkit, available for download, below.
These case studies are offered for use in staff training and are loosely based on real Justice Center cases. The names of the people, settings, and other information have been changed.
Jenny lives in an individualized residential alternative (IRA). Although Jenny uses a walker in her home, she requires the use of a wheelchair when traveling. Her Staff Action Plan directs staff to ensure that she wears a seatbelt while in the vehicle. Jenny was going to the grocery store to help buy groceries for the week, so staff helped Jenny get into the wheelchair van.
First, staff secured her wheelchair on the platform lift. Then staff wheeled her into the van and secured her wheelchair with the floor four-point restraint system using two floor restraints for the back of the wheelchair and two floor restraints for the front of the wheelchair. The staff knew that Jenny didn’t like the shoulder belt so staff draped it behind her back. Jenny held her walker in front of her wheelchair during the drive to the store.
Jenny’s van was only a few blocks from the IRA when a dog ran into the street in front of the van, causing the driver to slam on the brakes. While Jenny’s chair stayed in place, she fell out of it and hit her face and head on her walker and on the van floor because she was not wearing a shoulder harness.
- Staff did not secure Jenny using the vehicle's lap or shoulder belt.
- Staff did not secure Jenny’s walker to prevent it from injuring Jenny or the staff during the accident.
- Jenny’s individual safeguards did not direct staff to use wheelchair occupant and restraint systems, only to ensure she wore her seatbelt.
Additional case studies are detailed in the toolkit, available for download, below. Look for the Could This Happen In Your Program.
This policy guidance was created by the New York State Justice Center for the Protection of People with Special Needs as a resource for provider agencies. It does not address every scenario that could occur and does not constitute legal advice. It is intended to be used as a guide that may be modified as needed. Agencies should also make sure policies include or address the specific considerations noted below.
- Include people receiving services in the training and education process.
- Require sensitivity training so that staff gain a deeper awareness of the experience of a person using a wheelchair, and of the related concerns and vulnerabilities.
- Require interactive staff training related to wheelchair securement and identify refresher training requirements.
Supports and Safeguards
- Identify all documents that detail individual transportation-related supports.
- Address requirements for passenger seat belt use.
- Use person-centered language in all service planning documents.
- Use consistent terminology to refer to wheelchair tie-down and occupant restraint systems.
- Address whether the use of postural supports is safe for transportation.
- Direct staff to secure equipment not in use and other loose objects.
- Address requirements for staff seating and placement in vehicles to maximize support available to people in care.
- Detail supervision requirements while people in care are in vehicles.
Additional policy guidance is available in the Wheelchair Securement toolkit, available or download, below.
Wheelchair securement toolkit