Understanding ALS and Changing Transportation Needs
Amyotrophic Lateral Sclerosis (ALS) — sometimes called Lou Gehrig's disease — is a progressive neurodegenerative disease that affects motor neurons controlling voluntary muscles. As ALS progresses, a patient's mobility and respiratory status change significantly, and the level of medical transportation required evolves along with the disease.
At Delta Medical Transportation, we understand that no two ALS patients are alike, and we are equipped to provide appropriate transportation at every stage of the journey — from early ambulation with minor assistance to full power wheelchair transport to ventilator-dependent stretcher transport. Contact our team to discuss your specific needs. We serve patients across New Jersey — see our service area.
Transportation by Stage of ALS
Early ALS: Ambulatory Assist
In the early stages of ALS, patients may still walk but experience weakness in the legs or arms, fatigue, or balance instability. At this stage, ambulatory transport with driver assist — a helping hand to and from the vehicle — is typically appropriate. The key is a driver trained in safe guiding and patient assist techniques who understands that what looks like a minor stumble may be more consequential for an ALS patient.
Mid-Stage ALS: Power Wheelchair Transport
As ALS progresses, most patients transition to a power wheelchair for mobility. This stage requires a fully accessible wheelchair van with a hydraulic lift rated for heavy power chairs, secure tie-down systems compatible with complex seating systems, and drivers trained in proper power wheelchair securement. See our wheelchair van transport service for details on vehicle specifications.
Many ALS patients also begin using AAC (augmentative and alternative communication) devices at this stage. Delta's drivers are trained to interact respectfully with patients who use AAC devices, allowing appropriate time for communication without rushing.
Late-Stage ALS: Ventilator-Dependent Transport
In advanced ALS, patients typically require a ventilator for respiratory support — either non-invasive (BiPAP) or invasive (tracheostomy ventilator). Transporting a ventilator-dependent patient requires:
- Drivers with training in ventilator awareness (understanding alarm meanings, not interfering with the vent, knowing when to call 911)
- Battery backup verification before transport (vent battery must be fully charged)
- Positioning accommodation (many late-stage ALS patients cannot tolerate upright positioning for extended periods)
- Coordination with the patient's respiratory therapist regarding transport protocols
- Stretcher transport for patients who can no longer remain in a seated wheelchair position
See our stretcher transport service for information on transporting non-ambulatory and recumbent patients.
ALS Clinic Transportation in New Jersey
ALS care in New Jersey is largely provided through multidisciplinary ALS clinics, where patients see multiple specialists (neurologist, pulmonologist, physical therapist, occupational therapist, speech therapist, nutritionist, social worker, and assistive technology specialist) in a single visit. Major ALS programs in New Jersey and the surrounding region include:
- Robert Wood Johnson University Hospital ALS Center (New Brunswick) — one of the primary ALS multidisciplinary care centers in NJ
- Kessler Institute ALS Program (West Orange) — with strong rehabilitation support
- Atlantic Health System (Morristown Medical Center) — neurology and ALS support
- Hospital for Special Surgery and Columbia ALS Center — for NJ patients who travel to NYC for specialty care
Delta Medical Transportation serves all of these destinations from throughout New Jersey. View our service area.
Frequency of ALS Appointments
ALS patients typically attend their multidisciplinary clinic every 3 months. In addition, they may have separate appointments with pulmonology (monitoring respiratory function with FVC testing), physical therapy, occupational therapy, speech therapy, assistive technology clinics, and nutrition consultations. The total volume of transportation trips can be significant — standing orders and recurring scheduling with Delta Medical Transportation help manage this efficiently.
Insurance Coverage for ALS Transport
NJ Medicaid (NJ FamilyCare)
Medicaid-eligible ALS patients are covered for NEMT to all medically necessary appointments. As ALS progresses and transport complexity increases, the authorized transport level should be updated to reflect the patient's current needs. Work with your ALS care coordinator or social worker to ensure your transport authorization is current.
Medicare
Medicare Part A covers ambulance transport for ventilator-dependent patients when medical necessity criteria are met (the patient cannot be safely transported by other means). Medicare generally does not cover routine NEMT (wheelchair van transport) but many Medicare Advantage plans do include this as a supplemental benefit.
ALS Functional Rating Scale (ALSFRS) and Insurance Documentation
When requesting higher transport levels (from ambulatory to wheelchair to stretcher), insurance companies may request clinical documentation of functional status. The ALSFRS-R score from your neurologist's records is the standard tool for documenting ALS progression and supporting transport level escalation requests.
ALS Association NJ Resources
The ALS Association of Greater Philadelphia Chapter serves New Jersey residents. They offer care services coordination, equipment lending, and social work support that can assist with transportation navigation. Contact them at als-phila.org or through your ALS clinic's social worker.
Frequently Asked Questions
Can Delta transport a patient on a BiPAP or tracheostomy ventilator?
Yes. Delta Medical Transportation accommodates patients using BiPAP and tracheostomy ventilators. We require advance notification of ventilator use so we can confirm driver readiness and vehicle appropriateness. Contact us to discuss the specific ventilator model and patient requirements before booking the first transport.
My family member's ALS is progressing and they now need a power wheelchair. How do I update their transport authorization?
Contact your MCO's member services line (for Medicaid patients) or Medicare Advantage plan and request a transport level upgrade. You will need a new physician order specifying power wheelchair transport and possibly a note from the ALS neurologist documenting the functional change. Your ALS clinic social worker can assist with this process.
How long do ALS clinic appointments typically take?
Multidisciplinary ALS clinic visits are lengthy — typically 3 to 5 hours — as the patient sees multiple team members in sequence. Plan your return transport accordingly, and let Delta Medical Transportation know to expect a long wait so we can schedule the pickup appropriately.
Can a caregiver or family member ride along during transport?
Yes. Delta Medical Transportation accommodates one escort at no additional charge. For ALS patients who may need communication assistance or medical monitoring during transport, having a family member or personal care attendant present during the trip is strongly encouraged.
What if an ALS patient has a choking episode or emergency during transport?
Delta Transportation drivers are trained in CPR and basic emergency response. In the event of a medical emergency during transport, the driver will contact emergency services (911) immediately. Families are encouraged to provide an emergency action plan and contact information for the patient's primary ALS physician to be kept with the transport record.