Aug. 15—LANSING — Nearly 700 patients were discharged by their providers and more than 1,500 healthcare workers have lost their jobs following reimbursement rate cuts mandated by Michigan's no-fault insurance reforms, which went into effect July 1, data shows.

Those figures, while alarming, are likely low, said Tom Judd, president of the Michigan Brain Injury Provider Council, which released the data on its online dashboard.

"These are numbers that have been confirmed from the providers and while they may sound high, it's really just a sampling," Judd said. "This dashboard is only the companies we know about."

The patient discharges and job losses are just the beginning of a domino effect looming for the approximately 6,600 auto crash victims receiving long-term care in the state, many of whom have critical care needs and severe traumatic brain injuries, Judd said.

The process of collecting the data is laborious — — Judd makes between five and 10 phone calls per week to providers who, through word of mouth or via social media, have reported they've laid off staff or discharged patients because of the reform's 45 percent rate cut.

Some of his leads have come from the Facebook page, We Can't Wait, which advocates for victims of car crashes, is public and has more than 5,000 members.

Often, Judd said, his call goes straight to voicemail.

"These are mission driven organizations that are trying to care for their people and hold on for as long as they can," Judd said. "A call back to me is not on their priority list so I know our numbers come nowhere near to showing the whole picture. It's worse."

Bob Mlynarek, co-owner of 1st Call Home Healthcare in Clinton Township, offered a blunt prediction for those needing the most specialized care following an auto injury.

"People will die," Mlynarek said. "Obviously, 45 percent is a killer. If they don't fix this, you're going to see the second big un-loading of patients between September and October and I don't know where they're going to go."

Nursing homes and adult foster care homes do not employ staff trained to care for quadriplegic patients, those with a tracheotomy or on a ventilator, Mlynarek said.

Salli Pung, the state's Long Term Care Ombudsman, said as much in a July letter to state Senate Majority Leader Mike Shirkey (R-Clarklake).

"These specialized services are not available in nursing homes or other long-term care settings, and the staff in these new settings have not been trained to meet the unique needs of these survivors," Pung said.

Mlynarek employs about 150 people to provide in-home services for 50 patients all of whom are victims of auto crashes, he said. He said 1st Call has not yet stopped caring for anyone, but is now losing about $40,000 per month.

"We made a commitment to our patients and our staff that we would take the losses for three months and try to keep pushing for a fix," Mlynarek.

In 2019 the state reformed auto insurance laws in an effort to save drivers money on premiums by no longer requiring unlimited personal injury protection.

Drivers now have a choice between $250,000, $500,000, unlimited lifetime PIP coverage or can opt out entirely if they can show they have other health insurance covering auto-related injuries.

Owners and staff of home health care agencies and residential rehabilitation facilities, as well as family members and victims of car crashes requiring lifetime care, complained the 45 percent rate cut for some services was unfair and would lead to a rationing of care.

A variety of legislation was proposed that, if passed, would have "grandfathered in" those patients who'd paid auto insurance premiums and made lifetime care claims prior to the 2019 passage of the reforms.

None of those proposals were given a hearing. Instead, the Michigan legislature agreed to appropriate $25 million toward anticipated funding gaps and Gov. Gretchen Whitmer signed the bill last month.

Jessica Stark, a staff therapist at The Lighthouse Neurological Rehabilitation Center in Traverse City, said the fund will not solve the problem and predicted patients who need the most care will suffer.

The application and approval process is cumbersome, she said, and funds wouldn't likely be released until next year.

"That pot of money is not going to make up the losses," Stark said, adding the reduced rates for residential stays will no longer be enough to pay for the one-on-one staffing patients with severe brain injuries require.

Of the 25 residents at Lighthouse, Stark said housing and care for all but two are paid for through no-fault insurance claims, and while the facility has not had to discharge anyone yet, they were no longer accepting some patients.

"Because of the rate cut, we have to be choosier on who we can staff," she said.

Judd and Mlynarek said conversations with legislative staff are ongoing — Judd sends all state legislators his weekly dashboard updates, for example.

Both were hopeful the dialogue could lead to a solution once legislators return from their summer break.