CPAN survey finds vast majority of Michigan accident victims who receive in-home care are concerned about their future
Home care elements of no-fault reform will cause chaos for vulnerable patients
LANSING, Mich.—(April 29, 2021)—A new CPAN survey of Michigan auto accident victims and their home-based attendant caregivers—often family members—finds that the majority are deeply worried about how they’ll continue to function after impending cuts to reimbursement rates are enacted.
2019 changes to the no-fault insurance law which take effect this July limit reimbursement for in-home family-provided attendant care to 56 hours per week—even if the patient requires help and supervision around the clock. If the patient requires additional care beyond 56 hours per week, he or she will have to turn to a commercial agency. In addition to this hourly limitation, a new fee schedule cuts reimbursement rates for attendant care by 45% after July 1, 2021. This will have a devastating impact on both the family members and the commercial agencies that provide home health care. Family members will be unable to adequately be compensated for their services and commercial home health care agencies will be forced to lay off staff or close their doors entirely, leaving many patients without recourse to get the care they need.
CPAN’s survey found that the majority of provider respondents (56%) deliver home-based attendant care services to patients that need 24/7 care. Nearly half of accident victims have been receiving attendant care for more than five years and rely on routines that allow them to live with some measure of independence and dignity. Fifty percent of accident victims are cared for at home exclusively by family members.
There were 568 total responses to the survey, which gave users the opportunity to anonymously tell their heartbreaking stories.
“I had to quit my job in 2009 due to the severity of issues she encounters on a daily basis,” one caregiver said. “Things have worsened over the past couple years and I have to be with her 24/7 because NO ONE understands her or her reactions as I do. She has five types of seizures, a traumatic brain injury, is non-verbal, has left side hemiparesis and has over 50 allergies to medications… she requires my attention every second of the day. Her survival is crucial to my diligence and detail of her everyday care.”
Another caregiver added: “If we are limited to 56 hours of care a week, Angie will drastically lose her care… care that keeps her from injury or death.”
Said another: “Our family doesn’t want our daughter to go into a group home or other facility… my daughter would be extremely lonely without her loved ones nearby.”
A whopping 81% of patients said they are concerned that the services they receive are going to be affected by the 56 hours per week limitation, throwing vulnerable Michigan residents into chaos while they’re contending with a resurgent pandemic that continues to rage across the state.
“I have been providing attendant care to my brother for almost 14 years,” a caregiver said. “I made a decision to walk away from my career to help with his care. I knew family being involved was the key to him surviving. I am the one who changes his trach (tracheostomy tube) monthly. I am the one who drives him to all his appointments. I am the one who is there to wipe his tears when he gets depressed.”
In addition to issues with access to care, patients and family members are concerned about having to rely on commercial providers. In many cases, family-provided attendant care is best suited for the patient’s needs. Having to get additional care from a commercial agency would result in a disruption of the care system that the patient is used to and oftentimes does not provide the patient with the same level of care and dedication that a family member provides.
Another caregiver said: “My daughter requires all of her needs to be done by others. Hygiene, dressing, meds, feeding, positioning, everything. Many of these functions require two caregivers to [perform]. My wife and I want to provide care to our daughter and want to be compensated the same as anyone else would be. She is familiar with us and we provide the absolute best care available. We do use professional caregivers also. Problems we have with professional caregivers are, they don't show up, they are late, it could be a different caregiver every day, every time we have a new caregiver, they have to learn all the procedures for caring for our daughter. Our daughter is a human being not a robot without feelings. She deserves the most appropriate care at a reasonable price that is available, family provides that care.”
CPAN President Devin Hutchings said the survey was conducted to provide lawmakers and other decision makers with data around attendant care, since there is no database of individuals who receive home-based care stemming from auto accidents. Home-based care is an important tool in health care delivery and often critical for the progress in patient recovery.
Hutchings said our lawmakers need to understand the ripple impact of these changes on patients and the health care community in our state.
"As Michigan's watchdog for policyholders and accident victims, it is important to gather this information, especially as coronavirus is still spreading,” Hutchings said. “The cuts to home-based, family-provided care impacts not only current accident victims, but also anyone who needs care in the future. We will continue to fight to ensure that these vulnerable Michiganders receive the access to the care they need.”
Please see an additional fact sheet on the survey here.