Wheelchair Securement & Lift Operations

1. Wheelchair Securement&Lift Operations Provided by RLS & Associates Inc.

2. Course Purpose You will learn: • Americans with Disabilities Act • Different types of disabilities • Lift operations • Proper securement techniques

3. Americans with Disabilities Act(ADA)

4. Americans with Disabilities Act The purpose of the Americans with Disabilities Act of 1990 is to: • (1) to provide a clear and comprehensive national mandate for the elimination of discrimination against individuals with disabilities; • (2) to provide clear, strong, consistent, enforceable standards addressing discrimination against individuals with disabilities; • (3) to ensure that the Federal Government plays a central role in enforcing the standards established in this Act on behalf of individuals with disabilities; and • (4) to invoke the sweep of congressional authority, including the power to enforce the fourteenth amendment and to regulate commerce, in order to address the major areas of discrimination faced day-to-day by people with disabilities.

5. Basic Parts • Cite: 49CFR37 Transportation Services for Individuals with Disabilities • Cite: 49CFR38 Accessibility Specifications for Transportation Vehicles

6. Employee Training • Requirement to train personnel to proficiency • Operate vehicles and equipment safely • Provide level of service as required • Treat individuals with disabilities in a respectful, courteous way

7. Lift and Securement Use • All “Common Wheelchairs” and their users must be transported • Common Wheelchair defined as: • Not exceeding 30” wide • Not exceeding 48” long, when measured 2” above ground • Does not weight more than 600 lbs. occupied • Securement system MUST be used to secure wheelchair (paratransit) • Cannot deny service on basis of difficulty in securing wheelchair

8. Lift and Securement Use • Must permit standees to use lift to enter vehicle • Each securement location must have a 3-point passenger restraint system • Can only require passenger restraint if ALL passengers are required to use

9. Lift and Securement Use • Transfer from wheelchair to vehicle seat can be recommended, but not required • Where necessary or requested, drivers must assist with use of: • Securement System • Ramp • Lift • This assistance is required even if the driver must leave his/her seat to do so

10. ADA Questions & Answers • May a transit operator require common wheelchairs be secured to the vehicle? • Yes • What kinds of securement equipment must be provided • Two part securement system • May a transit operator deny boarding to a rider whose common wheelchair is difficult to secure • No • Does a wheelchair user have to use the seatbelt and shoulder harness • No - unless

11. ADA Questions & Answers • What if the accessibility equipment is missing or not working • Must maintain • Does a wheelchair need brakes in order to use public transit • No • Can a transit operator require a person to transfer from a wheelchair to a vehicle seat • No

12. Maintenance of Lifts • Regular and frequent lift maintenance program must be developed and instituted • Drivers must report non-operating lifts by the most immediate means available • Every effort must be made to repair lifts before the next day of service • If vehicle with inoperative lift is on route with headways > 30 min., must provide alternate transportation

13. Mobility Aids and Life Support Systems • Service animals must be allowed to accompany passengers • Passengers must be permitted to travel with life support, including: • Respirators • Portable Oxygen • Can only deny if to transport would violate rules concerning the transportation of hazardous materials

14. How can you help

15. Persons With Disabilities Take the time necessary to allow passengers with disabilities to board comfortably and safely: • Be courteous • Patient • Accepting The invisible barriers that continue to stand in the way of persons with disabilities: • Negative attitudes • Fear • Stereotyping • Lack of knowledge

16. Appropriate Terminology Use • Disabled • Non disabled • Congenital disability • Does not speak Instead Of • Handicapped • Able-bodied • Birth defect • Mute or dumb Language plays a powerful and important role in shaping ideas and attitudes creating either a positive or insensitive view of people:

17. Appropriate Terminology Proper Usage • Hearing impaired • Partially sighted • Speech impaired • Blind • People who are... • Persons with… Avoid Using • Victim • Afflicted with • Cripple • Invalid • Wheelchair bound • Confined to a wheelchair

18. Consider This When we are very young, we depend on others for basic levels of care. Often as we age, we are again dependent on others. For this reason, people in the disabled community consider others as “temporarily abled.”

19. Visual Impairments People can be born blind or become blind later through an accident or disease. When transporting a visually impaired person: • Introduce yourself • Offer assistance • Use normal tone of voice • Clear concise instructions • Respect guide dog • Use care in giving directions • Notify the individual if you are leaving

20. Hearing Impairments Persons with severe hearing impairment rely upon their eyes for signals which represent ideas. When you transport a person with a hearing impairment: • Introduce yourself • Speak clearly and distinctly • Provide a clear view of your mouth • Use normal tone • Speak directly to the person • Careful of facial expression

21. Cognitive disabilities The range of a persons disability may be classified as mild, moderate, severe, or profound. When you transport a person with developmental disabilities: • Introduce yourself • Do not talk down to the person • Offer assistance, but do not push it • Give directions one step at a time • Do not assume the person is sick • Be patient • Treat adults as adults

22. Seizures There are several different types of seizures convulsive seizures or grand mal seizures are the most recognized, and the easiest to control with medication. They should be allowed to run their course naturally. What should you do? • Stop the vehicle • Leave the person in the seat belt if possible • Protect them • Don’t loosen any tight clothing • Roll them to one side • Stay with them • Help re-orientate the person • Notify dispatch • Do not put anything in their mouth

23. Seizures Keep in mind there are several different types of seizures. There are three types of minor seizures: • Absence seizure – staring into space, rapid eye movements, eyes rolling back into the head. • Simple partial seizure – tremors or trembling along one side of the body, sensory distortions and hallucinations. • Complex partial seizure – inappropriate behaviors such as aimless walking, pulling at clothes and smacking lips.

24. Neuromuscular Conditions • Cerebral Palsy is the result of damage to the nerve tissues of the brain. Mobility problems are caused by imperfect muscle control. • Decreased sense of balance • May have extensive spasticity • Experience problems in communicating • May be fully capable intellectually and should be treated as such • Multiple Sclerosis is a chronic degenerative disease of the central nervous system (brain and spinal cord). • Extremes of strength • Mobility • coordination

25. Neuromuscular Conditions • Muscular Dystrophy is an inherited disease that causes increasing weakness in the muscles. • Difficulty in walking • Speech problems • Poor vision

26. Other Disabilities Impairments Continued Stroke occurs when the blood supply to a part of the brain is cut off. The person may: • Have difficulty walking • Paralysis to one side • Difficulty speaking • Difficulty understanding what you say • Difficulty judging distances • Visual impairment Spinal Cord Injury or disease affecting the spinal cord. The level of damage will determine what movement or feeling remains: • May have partial or complete paralysis of both legs • May have partial or complete paralysis of both arms and legs • Paralysis on one side • Loss of skin sensation

27. Other Disabilities Impairments Continued Arthritis is a long-term condition causing pain and stiffness of the joints. It can occur in young people as well as older people. • May have difficulty walking • Maybe unable to walk • May have difficulty with hand functions Hidden disabilities can be one or a combination of impairments, such as epilepsy, heart or lung problems, diabetes, cancer or kidney failure. • May appear non-disabled • May have difficulty climbing steps • May be unable to walk short distances

28. Mobility & Accessibility Wheelchairs provide mobility for persons with paralysis, muscle weakness, lack of coordination, nerve damage, and/or stiffness in joints. When you transport a person who uses a wheelchair: • Do not automatically hang on a persons wheelchair • Offer assistance, but do not insist • Talk directly to the person

29. assistive Walking Devices

30. Assistance One arm assist and two arm assist are two very simple, but incredibly helpful techniques for assisting passengers to a standing position. Make sure the person is steady before walking

31. Using the lift

32. Inspection It is very embarrassing to arrive at your first stop and find that you do not have the necessary tie-downs to secure a wheelchair or that the equipment is inoperable. • You must have four retractors w/proper floor anchorage fittings • Pull out retractor and inspect webbing • Ensure retractors are locking • Ensure metal parts are not cracked or damaged • Ensure all hardware (nuts/bolts) are secure • Ensure floor anchorages are clean and clear of all dirt and debris

33. Inspection Cont. • One lap belt assembly or lap shoulder belt combination • Check shoulder belt anchorages for proper securement and operation • Inspect lap/shoulder belt webbing for damage or contaminates • Check buckles for damage and proper operation • Check pin connector bushing to ensure it is not broken, cracked or missing • Inspect any other parts of the securement system and accessories that may not be specifically indicated, but are pertinent to safe operation • Webbing Loops • Belt cutter Any parts in question should be immediately reported and replaced. Do not mix securement (manual/retractors)

34. Lift Operations • The lift must always be operated from the ground. • Greet your passengers • Offer assistance • Communicate • Back onto lift • Set the wheel locks • Have the passenger place their hands in their lap • Hold onto the wheelchair while in operation • Raise the lift three inches off the ground and check the toe plate • Raise to floor level • Push chair in as far as you can with control & set wheel locks • Push into vehicle and set wheel locks Never leave a wheelchair sitting on the platform unattended

35. Lift Operation • Park in a suitable location • Open doors and secure • Press unfold button until lift reached floor level

36. Boarding a passenger • Assist passenger onto lit & set wheel locks • Ask passenger to turn off the power on a power chair • Make sure wheelchair clears the outer barrier

37. Boarding a passenger • Locate passenger or standee on the center of the lift

38. Boarding a passenger • Make sure the passengers feet and footrests are clear of the folded outer barrier

39. Boarding a passenger • Push the UP button on the lift control • Make sure the outer barrier folds and locks • Keep an eye on the passenger while the lift is rising

40. Boarding a passenger • Raise the lift to floor level • If possible assist the passenger off lift and into the vehicle, clear of bridge plate • Set wheel locks • Partially fold the lift so passenger cannot fall off lift while driver goes around to secure

41. Manual Lift Operations • Remove cover from pump panel • Remove pump arm from cover • Insert pump arm into bleeder valve & turn • Once lift is deployed place pump arm tighten the valve. • Insert the pump arm into the pump opening

42. Manual Lift Operations Manual operation in case of power or equipment failure only

43. Manual Lift Operations

44. Manual Lift Operations

45. Manual Lift Operations

46. Manual Lift Operations • Manual operation of the lift is only to be used in case of power failure

47. Securement

48. Securement There are many different brands, styles and models of wheelchairs many of which are challenging to secure.

49. Securement Inspect the chair for anchorage points during the loading process.

50. Sport Chair Design Handle Grips  Axle Position  Tilt Bar  Cambered wheels