Transporting Vulnerable Populations

Ann Shanklin

Transportation provides a vital lifeline for vulnerable populations to access employment, education, healthcare, and community life. Your organization may transport disabled individuals, developmentally disabled children or medically fragile seniors, or it may transport individuals in wheelchairs or other special mobility devices. Regardless of the individuals being served, there are many factors that come into play when providing safe transportation to these more vulnerable populations. When reviewing your transportation programs, it may help to ask yourself the following questions:

• What written policies and procedures are in place to ensure client safety and protection against liability? How will they be enforced?
• What is the level of knowledge and training required for drivers, to ensure that clients are safely transported? Do your drivers know that smooth operation of the vehicle is extremely important in transporting individuals with disabilities?
• How do I demonstrate through my recordkeeping that my staff are trained to proficiency?
• Are your vehicles in good working order? Do they have proper securement equipment for mobility devices?
• What are the established safety standards and restraint systems for securing and transporting wheelchair bound clients?

To keep your clients safe, it’s essential to know the answers to these questions. Why? What could go wrong? Here are two examples from our claims files:

High-Risk Clients

The first example features a community support agency that provides transportation for seniors to medical appointments. One of their clients was known by the member to unbuckle himself when being transported. The driver on this occasion knew of the client’s behavior and had refused to transport him earlier that morning; the afternoon driver, however, was not aware of this client’s behavior. The driver secured the client, who later unbuckled himself and fell. He subsequently injured his knee, which required surgery.

The investigation into this incident also revealed that the van was not equipped with federally-mandated shoulder harnesses or lap belts, making the van illegal to transport wheelchair bound individuals. The agency narrowly avoided an attempt by the client’s attorney to recover enhanced damages which might have been awarded due to the possibility of being charged with a violation of the Americans with Disabilities Act. The claim cost $350,000 as a result of the injuries incurred.

Lack of Training

The second example features another community services center; where drivers transport clients with physical and mental disabilities to do errands, such as going to the laundromat. On the day of the incident, there were three clients on board in the van, one of whom was in a wheelchair. The driver for the nonprofit member had put the client, a 35-year old woman with a congenital brain disorder, on the lift and strapped the chair down with all four straps, as she usually did. In the middle of a left turn, the chair tipped over. She stopped and righted it, not noticing that the tie-down straps were loose. Meanwhile, the woman had hit her head and become unresponsive. The driver traveled back to the center immediately, where an ambulance was called. The client’s head injury resulted in a severe worsening of her condition. During the investigation, the driver stated that she had never received any training in how to properly tie down a wheelchair. The family of the client made a claim through their attorney and it eventually settled for $800,000.