Some public transit services allow disabled individuals to ride for free. Some may also allow an attendant caregiver to ride for free with the disabled individual.
An individual with ALS suffering from limb weakness should always be seated while riding on a bus. Insufficient grip strength makes holding onto grab bars unrealistic, while leg weakness makes standing for a long periods of time difficult.
Modern buses have low floors and retractable access ramps that permit wheelchairs to enter. Not all bus stops are suited for wheelchairs, as they may have sections of grass or dirt where the ramp would typically be deployed. The driver may have to reposition the bus to a more suitable loading point before extending the ramp.
Buses may have distinct stop request buttons in the seating area for disabled people. These buttons should be pressed instead of the buttons found elsewhere on the bus. Many buses have distinct notification systems for the driver, which informs them whether they should use the retractable access ramp at the next stop or not.
Buses can be subject to acceleration, braking, and cornering forces that are large enough to cause a wheelchair to slide along the floor, or even flip over. Many buses have tether points that can be used to secure the wheelchair from moving more than a small amount. Such tethers should be used when present.
Trains typically have entrances and rail cars designated specifically for those with disabilities. These should be used when there is any level of disability, or when a wheelchair is in use.
Some cities have a dedicated transit service for those with disabilities severe enough that riding on a conventional bus or train is not practical. These typically are a door-to-door service, which is booked in advance.
Accessing these alternate services typically requires a formal application to be submitted, with supporting documents from a qualified physician to demonstrate a clear need. ALS patients are often qualified to use these services somewhat in advance of when they will truly need them, to get ahead of disease progression.
These transport services have specific policies related to when rides can be booked, area of coverage, and so forth. The bus may leave if the individual is not ready and waiting when it arrives at the point of origin.