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How will attendant care benefits be affected by No Fault reform Senate Bill 248?

May 19, 2015 by Steven M. Gursten

I’ve received many e-mails in the past few weeks from very concerned auto accident victims who rely on attendant care nursing benefits. They want to know:

If SB 248 passes and becomes law, will the changes to attendant care be grandfathered in for those currently receiving attendant care the current law, or will it change under the new law?

An updated version of SB 248 (called “Substitute for SB 248) was recently pushed out of the House Insurance Committee and would limit home care reimbursements for family and household members who provide attendant care to the catastrophically injured. These changes include a new $15 an hour attendant care rate maximum, for 24 hours per day — regardless of the experience or skills of the person performing the in-home nursing care and the complexity of the care involved.

The latest question that I received on the Michigan Auto Law blog is from Rrider:

“The legislation still provides 24/7 (attendant) care of individuals injured in auto accidents. It would limit non-skilled family attendant care to $15 an hour, totaling up to $131,000 annually. Non-skilled. There is a reason that companies have packed up and left the state of Michigan, it is hard for new companies to come into Michigan and be profitable. Bottom line, an insurance company must be profitable, as does any business, in order to continue to be able to provide their product.”

I’ve been an outspoken critic against these proposed changes to our No Fault law. I know there are a lot of people who desperately need attendant care and family members who provide it that are waiting for clarification. Below is my answer:

“Respectfully, RRrider, you are mistaken. First, there’s a difference between the House and Senate bills. The $15 hourly maximum for in-home attendant care reimbursement under the Senate’s No Fault plan, Senate Bill 248, differs slightly between the Senate-passed version of SB 248 and the House Insurance Committee’s “House Substitute for Senate Bill No. 248” as ONLY under the House Insurance Committee’s version does the $15/hour cap NOT apply to skilled (i.e., licensed) family/household members who are providing in-home attendant care.

For instance, under the Senate-passed version, the $15 hourly cap applies to all family and household members who are providing in-home attendant care “regardless of whether the family or household member [who is providing the attendant care] is licensed or otherwise authorized to render the attendant care under … the public health code … or is employed by, under contract with, or in any way connected with an individual or agency who is licensed or authorized to render the care.”

On the other hand, under the House Insurance Committee’s version of SB 248, the $15 hourly cap does NOT apply if “the family or household member [who is providing the in-home attendant care] is licensed or otherwise authorized to render the attendant care under … the Public Health Code, or is employed by, under contract with, or in any way connected with an individual or agency who is licensed or authorized to render the care.” As to whether $15 is fair or not, someone who requires a very high level of attendant care, such as for wound care, there is no professional agency that will ever come in and provide professional care at a $15 rate, which means you pay as a taxpayer after these people are financially ruined and bankrupt and the cost of care is transferred to Medicaid.”

As to the question on whether attendant care will continue for auto accident victims currently receiving the No Fault benefit under SB 248, take a look at my recent blog post, “Will SB 248 make No Fault attendant care retroactive?”

What is attendant care?

Attendant care is a benefit provided by Michigan No Fault insurance that entitles injured accident victims to have nursing care while they’re at home recovering from injuries.

Attendant care benefits are also referred to as nursing services, and are defined by attorneys as “activities of daily living,” such as monitoring and supervision for safety reasons, administering medication, bathing, dressing, walking, styling/combing of hair, other grooming, help using the toilet, driving the patient, fetching things for the patient, carrying and lifting things for the patient and wound care.

Many people with catastrophic injuries, such as spinal cord injury and traumatic brain injury, rely on attendant care 24 hours a day.

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