Skip to Content

Policies and Procedures Operation Manual for NEMT

A policies and procedures operation manual for NEMT is a codified document that explicitly states all the vital policies, procedures, SOPs, best practices, and rules that employees of a NEMT business are expected to follow and adhere to.

Note that a non-emergency medical transportation business is most effective and successful when managers and owners understand how employees determine the safety behaviors expected of them. NEMT businesses can reduce accidents and passenger injuries by implementing effective preventive measures via policies and procedures well-tailored to control all types of exposures.

Note that new employees must read the manual when they join the organization so they can understand the NEMT business compliance and risk management requirements. Note that these manuals are also used as a reference whenever an issue occurs – they serve as a guide that can help confused employees make the right call when necessary.

Putting together a policies and procedures operation manual for a NEMT business is a challenging but necessary task. The manual ensures that everyone involved acts in a legal, ethical, and compliance-conscious manner. Note that every company has its policies that depend on the management style and objectives of the organization.

In addition, certain policies and procedures are necessary not because of what the organization wants, but because the organization is legally required to comply with those laws and regulations.

Critical Elements of a Policies and Procedures Operation Manual for NEMT

Many NEMT operators who are successful in managing their fleets safely, efficiently, and profitably, have a company safety policy and procedure that includes the following critical elements:

  1. Driver Hiring Criteria and Procedures

Just like other businesses operating commercial fleets, it is important for NEMT businesses to only work with qualified drivers. Here are some vital items to consider adopting as official driver qualification standards and practices.

Note that these practices should be reviewed on a regular basis to note compliance with company policies and any applicable government laws or regulations. The driver selection criteria and hiring process may include, but are not limited to:

  • Minimum age restriction of 23 years
  • State driving history free of serious violations. They should have no more than two moving violations or a combination of one moving violation and one accident within three years
  • An application that states previous employment and experience driving a commercial vehicle for a minimum of two years
  • Extensive background check including credit and criminal background check
  • Put together a profile of critical values and skills required to successfully and safely perform job duties
  • Carry out interviews to ensure applicants have compatible safety values, work ethic, and interpersonal skills needed to interact with fellow employees and passengers
  • Confirmation of employment, qualifications, and safety record with previous employers utilizing all available information for all previous employers
  • Pre-employment physicals and controlled substances testing
  • Conduct detailed road tests to evaluate skills and knowledge related to safely performing vehicle inspections, knowledge of defensive driving techniques, operation of passenger entry/exit devices, especially lifts and restraint systems.
  1. Employee Safety Training

After an applicant must have completed the hiring process, the next step should be to start in-service training. Note that in-service training gives room for new employees to start aligning with the company’s safety culture.

This is an opportunity to buttress what safety means to the business and allow the employee to learn the company’s expectations concerning safe driving, employee accountability measures, and the authority they have to ensure a safe environment.

To be effective, the training should be developed to teach new skills or knowledge during in-service or periodic refresher classes, including but not limited to:

  • Company safety and health policies and procedures review
  • Defensive driving training course
  • Passenger safe handling procedures, including:
  • Use of specialized equipment such as wheelchair lifts
  • Ramps
  • Seatbelts or wheelchair securement
  • In-transit passenger monitoring procedures
  • Emergency procedures for accidents or injuries
  • Testing to ensure the effectiveness of training programs
  • Drug and alcohol testing
  1. Monitoring and Measuring Driving Performance

Once in-servicing is completed, the new employee will have to move onto the next phase of employment, on-the-job training (OJT), including employee observation and feedback. Note that management is tasked with monitoring individual and group driving performance. Some necessary policies and procedures in this element include:

  • Supervising employees to ensure drivers follow company policies, applicable laws, and government agency regulations
  • Putting together a process to note employees engaging in at-risk driving behaviors and unsafe patient handling
  • Carrying out driver interventions to prevent unsafe driving
  • Establish initial evaluation of driving skills and knowledge during the hiring process
  • Provide effective training to address any known deficiencies
  • Follow-up coaching sessions
  • Ongoing performance evaluation process based on clearly defined and communicated driving performance standards including:
  • Minimum of an annual review of moving violations and accident involvement
  • Customer feedback on driving behaviors
  • Observations conducted both announced and unannounced by supervisors/managers
  • Quality of pre/post-trip vehicle inspections
  • Use of onboard telematics devices to track driving behavior
  1. Maintenance Inspection and Repair Procedures

Have it in mind that NEMT business managers that are quite successful in maintaining their vehicles and keeping them in good operating condition tend to implement a detailed set of vehicle inspection and repair procedures.

Note that the advantages achieved by this are safe transport of employees and passengers while reducing funds invested in maintenance and operating costs. Some important vehicle maintenance inspection and repair procedures include:

  • Vehicle specifications are well-tailored to meet the requirements of fleet operations
  • Creating vehicle inspection intervals depending on manufacturer’s recommendations
  • Asking drivers to conduct daily pre and post-trip inspections and submit a driver vehicle condition report to maintenance or supervisory personnel
  • Maintaining inspection and repair files for the life of the vehicle or while owned or leased.
  • Periodically analyzing maintenance records to note component failure or life cycle trends.


It is necessary to note that the policies and procedures operation manual will vary from one company to another, and there is no general template for businesses to simply copy and use.

Therefore, to put together a policies and procedures operation manual, it is important to first understand the legal needs and requirements of your NEMT business and also ensure you create proper workflow management which allows people to collaborate efficiently.