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Duggan’s No Fault reform to slash family attendant care 66%

October 2, 2017 by Steven M. Gursten

For the most seriously injured car crash victims who need attendant care based on a doctor’s 24/7 prescription for safety, Duggan-Leonard want to cap attendant care at 2 days max

Attendant care

The most critically injured car crash victims — the 1% of all car accident victims — those who receive around-the-clock, in-home, family-provided attendant care, would see their attendant care slashed by 66% if Detroit Mayor Mike Duggan and House Speaker Tom Leonard (R-DeWitt) get their way under House Bill 5013, also known as the Driver’s Choice Insurance Reform plan, that was introduced in the Michigan Legislature last week.

Attendant care for the most catastrophically injured is one of the shining lights of Michigan’s auto No Fault insurance system. These are the people who would be “warehoused” in often substandard Medicaid facilities in other states (after blowing through all their personal savings and being forced into personal bankruptcy because of medical debt).

But, Duggan and Leonard, as part of their Driver’s Choice Insurance Reform plan, want to slash medically required attendant care to less than 2 1/2 days per week.

In other words, auto accident victims who depend on receiving attendant care in their homes from loving and caring family members will be left without medically necessary, doctor-prescribed attendant care for approximately 4½ days out of the week.

Duggan, Leonard want to cut 112 hours from attendant care coverage

In HB 5013, Duggan and Leonard propose that:

“An insurer is not required to provide coverage for more than a cumulative 56 hours per injured person per week of attendant care in the home if the attendant care is provided” by a family member/relative, household member or business/social friend from before the car accident. (HB 5013, Page 31)

Under our state’s existing auto No Fault Law, if a doctor has prescribed 24/7 attendant care for a car accident victim who’s receiving in-home, family-provided care, that works out to 168 hours per week of coverage via No Fault attendant care benefits.

Duggan and Leonard want that knocked down to only 56 hours per week — a slashing of 112 hours or 4.6 days per week, i.e., 66%.

Duggan, Leonard’s slashing of attendant care is devastating to safety and health of those who depend on No Fault most

Neither Duggan nor Leonard nor any of the other supports of the Driver’s Choice plan have bothered to explain why 56 hours is the magic figure.

No one has shown there’s a problem with in-home, family-provided attendant to car crash victims whose doctors have prescribed it. No one has said why this, as opposed to anything else, would be the most effective solution to whatever the problem may be. And no one has said how this proposal would benefit drivers and auto accident victims.

The best explanation that I can come up with, as an auto accident attorney who has litigated and helped people with attendant care cases in Michigan for the past 23 years, is that Duggan and Leonard are doing this because the insurance companies want it.

It must be emphasized that this type of medically necessary attendant care is not a cost driver of No Fault car insurance. All of these types of attendant care cases go well beyond the existing $550,000 cap that already exists under our No Fault law. Once the cost of these medical claims go beyond $550,000, they are paid as part of the Michigan Catastrophic Claims Association’s (MCCCA) catastrophic claims fund. The MCCA is the $170 assessment that Michigan drivers pay into, so that the costs of medical care are taken off the insurance companies’ books (and thus are not required to be financially reserved).

In other words, these claims are NOT a driver of high auto insurance costs in Michigan. Because of the catastrophic severity of these auto accident injury claims, the $550,000 cap that we have now is often blown through in the first few days or weeks after the injuries and everything after the first $550,000 is paid by the MCCA. This is the ½ of 1% or so of auto accident claims that require this type and level of attendant care. The people who require this type of long-term 24/7 attendant care often have severe spinal cord injuries or severe traumatic brain injuries. All of these costs are borne by the MCCA.

What the insurance companies hate most are the small attendant care claims. These are the couple of weeks of attendant care that are often prescribed after a big surgery, when people can’t dress themselves or bathe themselves, or sometimes even brush their own teeth. Often, after a couple weeks, these people get better and attendant care is stopped.

The 56-hour attendant care target that Duggan and Leonard are pushing does not discriminate on the level or severity of medical need for attendant care. There is no tier system to distinguish based on the underlying medical injury.

Attendant care restrictions punish family attendant care providers

What did these car crash injury victims — who depend on in-home, family-provided attendant care — do to deserve this?


At least nothing that Duggan or Leonard or anyone else has tried to explain.

Of the three types of attendant care available — residential, agency-provided and family-provided — in-home, family-provided attendant care is the only one targeted by the Duggan-Leonard plan.

Plus, of the three, family-provided attendant care is the least costly. According to the MCCA’s most recent Annual Report to the DIFS Director (for the Fiscal Year ending on June 30, 2016), family-provided attendant care is 16.26% of the annual MCCA assessment whereas agency-provided AC is 22.36% and residential care is 23.83%.

Duggan-Leonard attendant care restrictions punish attendant care providers’ sacrifice and love of family

Duggan and Leonard are using attendant-care providers’ kindness, sacrifice, and love for injured family members against them.

They’re slashing No Fault attendant care benefits for in-home, family-provided attendant care because they’re gambling that auto accident victims and their family members who are caring for them won’t turn to one of the costlier alternatives — residential care or agency-provided care — to make up for the 4½ days that are no longer covered.

So, if Duggan and Leonard have their way, we all pay a lot more for residential care or agency-provided attendant care that often is less dependable and of lower quality than the attendant care provided by family members.

People who are make enormous sacrifices and are willing to devote themselves and much (and, in many cases, all) of their lives to caring for family do so because they are more concerned with their loved ones and the care they need.

As such, they’re more likely to keep on providing the attendant care their family member needs — even without compensation from No Fault — if that means not having to put their loved one in a residential facility or having strangers provide the care.

Shame on Duggan and Leonard. Instead of punishing these attendant care providers, they would do well to try to emulate them.

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