Collision Course Part 3: Head On
Collision Course is a special Stateside podcast series about the breaking of Michigan’s no-fault auto insurance law and how it’s upending the lives of thousands of people, including one Detroit hockey legend. Click here to find the previous episodes.
Around 1,500 catastrophically injured people in Michigan have already lost home care services because of reforms to Michigan’s no-fault auto insurance laws. Red Wings hockey legend Vladimir Konstantinov may soon join their ranks.
His care company has told Vlad’s family and caretakers that they plan to cut his in-home care services on June 1—just a couple of weeks from now. That has left the Konstantinov family—and the families of thousands of other catastrophic car crash survivors—scrambling for a solution. But when and where help might come is still very much up in the air.
A job and a family
As a Red Wings hockey legend, Valdimir Konstantinov counts some of the biggest names in professional hockey as friends. But when it comes to the people who know him best, it’s his home health aides—many of whom have been caring for him for years. In Natalie Moroz’s case, it’s been nearly two decades. In the 17 years she’s been caring for him, Moroz said Vlad has become like family to her.
“If, you know, my schedule fell on any holidays, he's always willing to come,” she said. “...He always asks me: How's my husband feel? How he's doing? How's my daughter doing?”
Moroz is originally from Ukraine, where she worked as a doctor, and she is fluent in Russian. That means she’s able to talk to Vlad in his native language, which can be really helpful when working with someone who has a traumatic brain injury (TBI).
But caring for the hockey legend is still a very difficult job. For one, it’s physically demanding. Vlad needs help getting in and out of bed and in and out of his wheelchair. Like many people with TBIs, he can sometimes lose control of his emotions.
“You can't just come from outside and start this job. You have to be trained. Sometimes it has taken up to six months,” Moroz explained. “And if you're not following his schedule, you can have episodes of emotional stress, physical aggression, you know, throwing stuff, everything. He can hurt not just himself, but staff also.”
Moroz is reluctant to talk about what happens if Vlad’s care company ends his service. So is his wife Irina Konstantinov. It’s a scary situation, and there are no easy answers.
So, where does that leave Vlad and the approximately 18,000 other catastrophic auto crash survivors?
Option 1: The legal fix
The most obvious—but least likely—path forward is that something changes with the law.
The state Legislature or state courts could say that the law should not apply retroactively. They could order insurance companies to continue to pay for the care of people who were injured before no-fault reforms were passed in 2019. But, for many in Lansing, the conversation about no-fault reform is over.
There are a handful of state lawmakers who are trying to find a fix. State Representative Yousef Rahbi (D-Ann Arbor) is one of them.
“I will not stand silently by when my state is being driven to a state of moral dispassion,” Rabhi said in 2019 when the Michigan House was voting on the reforms to no-fault.
Rabhi is one of a hand full of legislators—both Democrat and Republican—who’ve proposed or supported bills to change auto no-fault. His bill goes the furthest: It would completely repeal the 2019 changes.
But Rabhi’s bill, and others like it, are stuck. State House and Senate leaders, who set the agenda in the Legislature, seem unwilling to take up the issue of no-fault reform again. Republican State House Speaker Jason Wentworth (R-Farwell) recently said “it’s time to move on from this issue.”
And so survivors, along with their families and caretakers, are also looking to a potential court decision to do what the Legislature won’t. The actual language of the 2019 reforms doesn’t explicitly state that these changes to the law apply retroactively. However, the state’s Department of Insurance and Financial Services issued an order that said the changes did impact those who were in catastrophic accidents before 2019, as well.
“This should never, ever have been permitted,” George Sinas told us. He is the general counsel for the Coalition Protecting Auto No-Fault—or CPAN. The organization is a coalition of consumer, medical, and disability groups.
Sinas, like other advocates for protecting the state’s old no-fault system, is pinning a lot of hope on a class action lawsuit that asks for the retroactive part of the new no-fault law to be struck down.
“The Andary case, which is going to be argued soon in the Court of Appeals, is going to address a few of these issues. And then from there, I'm sure it's going to go to the [state] Supreme Court,” Sinas explained. “And that's the only thing people have right now.”
Option 2: An NHL save
If the courts ruled in favor of the plaintiff in this case, people hurt in auto accidents before the law was changed would be able to keep the care they have. But lawsuits can take months–or sometimes even years–to work through the legal system. For many catastrophic care survivors, including Vladimir Konstantinov, that is far too long to wait.
Option 2: An NHL save
There is one potential solution that would allow Vlad to retain his home care—even if it wouldn’t do anything for other catastrophic crash survivors.
Konstantinov’s attorney has been in contact with both the Red Wings and NHL. The team initially determined that the NHL insurance plan would not pick up the 45% of Vlad’s care not currently being paid by the Michigan Catastrophic Care Association. His care company asked the fund for reconsideration and is waiting for a response.
Sports journalist John U. Bacon told us he’s not optimistic about the chance that the professional hockey organization will come through for Vladimir Konstantinov, given how the NHL has handled injuries on the ice.
“To put it in context, the the NFL and its former players reached $1 billion settlement on head injuries. The NHL turns around and gives 18.9 million.”
That’s despite similar rates of head injury in both leagues. Bacon said that amounts to about $20,000 for each of the league’s 318 players, which is a drop in the bucket for the cost of care for someone who has been in a catastrophic accident. Bacon said most of the NHL’s support of Vladimir Konstantinov over the years has been symbolic. They retired his jersey. For a few years after the accident, the team kept his locker open and wore an honorary patch on their jerseys.
“But, and I guess it's in their defense, as long as the state's laws were different, they didn't really have to do much because Konstantinov was taken care of,” Bacon reflected. “Now, the question is, what happens now?”
Vlad’s family already has a fundraiser going on. And even a couple of months back, Vlad himself signed a bunch of photographs to help raise money for his own care.
We reached out to the NHL Players Association, which negotiates with the league on the players’ behalf. A representative from the union said they’re in contact with the family and “are working to determine how to address this challenging matter.”
There are a lot of questions to ask about why the NHL and Red Wings organization have not provided more direct support for Vlad. But that doesn’t change the fact that he is in this predicament not because of hockey, but because of a benefit under Michigan law that was taken from him.
And that brings us to the final option for Vlad and other catastrophically injured crash victims: nursing homes.
Option 3: The last resort
Longtime caretaker Natalie Moroz said that a nursing home is not the place for Vlad.
“He's a very high risk of aspiration pneumonia. Somebody needs to be next to him when he eats, when he drinks…You know, just 24/7, somebody needs to be with him.”
Theresa Ruedisueli agreed. She is the regional director of operations for Arcadia, Vlad’s home care company. Ruedisueli said that a nursing home would be unable to provide the individualized care that has allowed Vlad to make the kinds of gains he’s achieved since his 1997 accident.
“There is no possible way that the staffing shortages right now, and what I know to be census constraints in the nursing home, would get him even a tenth of the percentage of care that he's getting here.”
Nursing homes can have as many as 12 patients assigned to one caretaker. And for someone with a traumatic brain injury who’s a fall risk — or someone who is quadriplegic and needs a breathing tube — those staffing levels can be unsafe. Many nursing homes are also struggling to maintain safe patient to provider ratios. Beyond issues of safety, a patient like Vlad would have nowhere near the level of freedom they experience with at-home care.
“He's very spontaneous and his movements are very jerky. And if he's not monitored 24/7, he will have to be restrained,” Ruedisueli said. “Tied to a chair or tied to his bed. And that unfortunately the reality: he would have to be tied down.”
Follow the money
While many nursing homes would struggle to provide the level of care that many catastrophic crash survivors get at home, they have one big advantage: the price of care.
Vlad’s care team says it costs nearly $30,000 a month to pay for his in-home care. In Michigan, the average cost of care in a nursing home is under $9,000. That means nursing home placement creates a huge cost saving for insurance companies, especially if the person doesn’t live as long as they might at home. Some car crash survivors who were sent to nursing homes after losing in-home care have died.
Angelina Bourdage’s husband Jim was one of them. Like Irina Konstantinov, Bourdage couldn’t take care of her husband on her own. So when she lost in-home support, Jim was sent to a nursing home. He died three months later.
“He was actually put on a vent within 24 hours of leaving my care. He got sick and never regained health,” Bourdage told a chapel full of people gathered to memorialize those who have died since losing their care. She was one of the family members to speak at the service, which was held a couple months ago in Lansing.
“My family and I had to watch him die a very slow, very painful death. We weren't able to be with him in the end,” she said.
Bourdage isn’t alone in her grief. One doctor we spoke with told us five of his patients have died since losing care or moving to nursing homes.
The choices that catastrophic crash survivors and their families are facing might feel far removed from your own life. But if you own a car in Michigan, you’re a part of this story, too. That’s because you would have received by this point a $400 check from your insurance company.
Earlier this year, Governor Gretchen Whitmer announced that the Michigan Catastrophic Care Association–or MCCA–had a $5 billion surplus.
“What were we going to do with that surplus, we were asking ourselves. Well the answer was pretty simple: We’re going to give it back to Michiganders,” the governor said when she announced the refunds earlier this year.
The MCCA is the big pot of money drivers pay into through their insurance premium. It sets aside those fees to pay for the care of the most catastrophically injured car crash survivors. The massive surplus in the fund was due, in part, to the fund’s investments. But it also was paying out less money for accident survivors after no-fault auto reform slashed the amount of money insurers have to pay for care.
And it was out of that surplus that Michigan drivers received their $400 checks. It’s been called “blood money” by victims and their advocates. Some people have chosen to donate their checks to the Brain Injury Association of Michigan, which says it will use the money to help crash survivors. If drivers don’t cash their checks, the money will go to the state’s unclaimed property fund.
“Every week, my company gets six to seven phone calls for all over the state for care for auto crash survivors."
While all Michigan drivers are getting $400 checks, the promise of lower car insurance premiums has yet to be realized. The latest Insure.com report says Michigan is right back up to No. 1 most expensive in the nation for car insurance, after briefly dropping to No. 2. And most people can expect big rate hikes — some as high as 12% — this summer.
Insurance companies say they recalculated their costs after people started driving more once the pandemic eased. Those rate hikes could be especially high for Detroiters.
While the 2019 law allowed people to choose a lower tier of medical coverage, many Michigan drivers are still paying for unlimited personal injury protection. But given the cuts to home care providers and other services for catastrophic care survivors, it’s not clear what paying for that top tier of coverage would buy you if you were to be in a life-altering accident today.
“Every week, my company gets six to seven phone calls for all over the state for care for auto crash survivors,” Theresa Ruedisueli with the Arcadia care company told us.
These are new inquires—for people who have recently been in serious crashes.
“And we go through our due diligence, we call the adjusters, we ask for a single client agreement," she said. "We ask for a reasonable and customary rate to be agreed upon prior to our agreeing to start care and every single time we're told no. So what happens then?”
Since this new law, there are at least 96 companies that aren’t accepting patients with auto insurance funding.
What’s next for Vlad?
Where does that leave Vladimir Konstantinov?
A legislative fix seems unlikely. The legal battle over the 2019 changes could take months or years to work its way through the courts. Even if the NHL were to step up to fill in the gap for the cost of Vlad’s care, that wouldn’t do anything for thousands of other Michiganders who have survived catastrophic crashes.
But survivors, along with their loved ones and their caretakers, are not giving up. They are rallying, and protesting, and telling their stories in an effort to find a solution.
"This ain’t about Vladimir Konstontinov. It's about all the Vladimir Konstantinovs. So what are we going to do about it?"
“He deserves the care he has now," said Angela Martin, one of Vlad’s caretakers. "It's an issue that it shouldn't even be a question, and I hope that he gets to stay where he is and I get to continue working with him."
Vlad’s wife Irina Konstantinov isn’t standing down, either.
“We are trying everything right now to find the way because we're not a type of people to just sit and cry," she said. "We will be looking into everything and everything and we will never give up.”
Vlad is probably the most well-known of the catastrophic car accident survivors. When he was first injured, Red Wings fans and teammates pulled together to support him. After the team won another Stanley Cup in 1998, they brought Vlad out onto the ice in his wheelchair and placed the trophy in his lap.
The team was all smiles, but former Red Wings player and Vlad’s friend Darren McCarty, said it was a markedly different mood than the win the year before.
“I remember sitting in the [locker] room looking around and guys were happy. Don't get it wrong, but everybody was spent,” he said. “We wanted to stop, but it was more like, man. You know, we did it. We did. You know, we accomplished just for Vladdie.”
Vladimir Konstantinov was a champion on ice. A bruiser in a showdown during play. He survived a catastrophic injury in a horrific car accident. He overcame the odds in his recovery from a traumatic brain injury. Today, he faces another type of fight. And winning this one is critical to his future, and the future of all of the around 18,000 catastrophic car crash victims in the state.
“We're not just talking about Vladdie here, right?,” McCarty said. “Vladdie’s going to get the attention to the subject at hand, but it’s all the people that are getting affected. This ain’t about Vladimir Konstontinov. It's about all the Vladimir Konstantinovs. So what are we going to do about it?”
That’s a question we can’t answer, yet.
Collision Course is a production of Michigan Radio
Today’s episode was reported by Tracy Samilton and April Baer.
It was produced by Rachel Ishikawa and Erin Allen.
Our executive producer is Laura Weber Davis.
Our theme music is by Brad Gowland.
Additional music from Blue Dot Sessions.
A special thanks for Vladimir Konstantinov and his family.