Opinion: Catastrophic care patients need help from Lansing
There is a growing healthcare crisis in Michigan — one where survivors of catastrophic car crashes have lost needed care, been separated from loved ones, forced out of their homes, and even died.
While its intentions may have been good, in 2019 the Michigan Legislature made a tragic mistake when it hastily rushed through a bill to reform the state’s auto no-fault insurance system. Today, thousands of Michigan’s most vulnerable residents are suffering, and legislators have only themselves to blame.
The 2019 reform package was sweeping, containing several elements aimed at lowering Michigan’s too-high auto insurance premiums. Some of them — including caps on Personal Injury Protection (PIP) benefits, new consumer protections and anti-fraud efforts — went into effect in 2020, and have had some modest success in reining in rates, although for many consumers those savings have been offset by the need to purchase additional liability insurance.
But another provision — which unfortunately flew under the radar due to the rushed process and lack of hearings — cut reimbursement for home health care provided by families or agencies by 45% and limited care hours provided by family members to only 56 hours per week, even when physicians prescribe 24/7 care. The results for survivors and their families have been nothing short of horrifying.
These provisions went into effect in July 2021 and have already decimated the industry that provides long-term residential and home care for accident victims. A study from the nonprofit health institute MPHI found that this government-mandated 45% cut had by October 2021 caused the elimination of 3,049 healthcare jobs, and 21 companies — including those that provide in-home care, residential care and rehabilitation services — had closed completely, forcing the discharge of 1,548 patients. Those numbers have only grown since, and it is only going to get worse. The study found that nearly 90% of providers said they would be unable to serve auto crash survivors within the next 12 months.
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More: Opinion: No-fault auto insurance reform has been a disaster for Michigan
Even now, the lack of competitive wages to hire and retain staff, along with the limitations on hours, has resulted in a lack of care for those who need it most. These survivors have suffered horrendous injuries, including traumatic brain injuries, spinal cord injuries and complete loss of mobility. Some need ventilators to breathe, and others need to be turned in their beds every few hours to avoid life-threatening sores.
These folks now have nowhere to go. Some have been dropped off at emergency rooms, which are already full due to the pandemic. Others — including those who have been living on their own for years with the help of in-home caregivers — have been forced out of their homes and shuffled back to the home of their parents or relatives who don’t have the highly-specialized skills needed to provide around-the-clock care for their loved ones.
So why do I care about this? A few years ago, the physical and mental condition of my husband who had been diagnosed with dementia was in a downward spiral necessitating 24/7 in-home care. Caring for a loved one at home is a full-time job, even when you have assistance from a home healthcare provider. I was so lucky to have that help — I cannot imagine going through that process if I had to do it on my own. But unless this immoral and unethical provision of the law is fixed, there will be no more long-term care providers available and families will no longer have peace of mind.
Recently, two bills were introduced in the state House of Representatives — HB 5698 and HB 5500 — that would go a long way toward alleviating this crisis. They create a reasonable fee schedule based on prevailing wages that will protect crash survivors, keep family and agency health care heroes employed, and not separate survivors from their families. They allow survivors to be treated by qualified family members and friends for a minimum of 112 hours per week and more if prescribed by their doctor.
Unfortunately, these bills have yet to receive a hearing. This is a moral test for our leaders — any legislator who claims to be guided by faith must see the importance of caring for our most vulnerable residents. As a proud member of the growing Michigan Interfaith Coalition — which represents 10 faith organizations and more than 35,000 voters advocating for a fix to the auto insurance law — I hope lawmakers will listen to our prayers.
I have worked in and around the Legislature for most of my adult life. I understand that legislators sometimes need to make tough choices. But this is an easy one — we can end Michigan’s catastrophic care crisis without overturning other cost-containing provisions of auto insurance reform. The time to act is now.
Gilda Jacobs is a former state senator and state representative who recently retired as the president and CEO of the Michigan League for Public Policy.
This article originally appeared on Detroit Free Press: Opinion: Catastrophic care patients need help from Lansing
