Like many five year olds, Annabelle Marsh loves make-believe games. Today, she's playing "Day Care," even though she's never been to a day care herself.
Annabelle is quadriplegic, after a catastrophic car crash in 2021 left her with a C3 spinal cord injury. She can't move her dolls herself, so her nurse today is doing that for her.
"She's so funny," her mother, Brandi Marsh, says to me, then calls over to Annabelle. "What happened to your last day care, sweetie?"
"It shut down," replies Annabelle. "Because the kids were being mean to their baby!"
Over the soft whoosh, whoosh, of Annabelle's ventilator, Marsh explains that since her daughter was hurt so young, this life is normal for her. It's normal to be in a wheelchair, unable to breathe without mechanical assistance. Normal to have all sorts of medical equipment next to her dolls, games, and books. Normal to have to be fed by hand, and carried upstairs for her bath.
But for Brandi, this new life is a nightmare. A single mom, she only sees her other child, a ten-year-old boy, on weekends, because he had to move in with his dad after the accident. As a petite woman, lifting her daughter is a struggle. She has no time for her son or for herself. When she doesn't have help, she’s her daughter’s sole caregiver, sometimes working 24-hour shifts. She's utterly exhausted, all the time.
"I have to change her catheter every three hours," she said. "Then, she's got medicine all through the night, spread out so she doesn't spasm all night. I have to reposition her because of bed sores. It's ... it's hard, and I get nervous I'm gonna make a mistake. Her life is in my hands."
That’s not overstating it. Brandi only has a minute or two to call 911 and start manual bagging when Annabelle’s trach gets plugged or the ventilator shuts down. Marsh often has a nurse in the home, and occasionally an aide, but it’s not the 24/7 care that Annabelle’s doctor ordered.
The worst moments are when her son has to help save his sister's life. These events terrify him. Once, he had to put on sterile gloves, and get a new trach kit put together, while his mother manually bagged Annabelle. Another time, he had to run to the neighbors to get help. Afterwards, they found him in a nearby field, sobbing.
"He's like 'Mom, when you die, I'm going to have to do this by myself. I'm going to have to do it for the rest of my life, and that makes me mad at you." Marsh pauses, wiping away tears. "He still has so much trauma to work through, you know."
"They (legislators) need to see what's happening. They won't feel the same way about it. I mean, this could be their grandkid or their daughter or their sister's kid."
— Brandi Marsh, mother of a five year old who was catastrophically injured in a car crash in 2021.
Annabelle was nearly discharged from the hospital with no care team, other than her mother. That's because agencies wouldn't take her on, after they found out she was a car crash survivor. Fee caps in the 2019 no fault law mean home care agencies can charge only 55% of what they were charging prior to 2019. For the overwhelming majority of companies, it's not enough to cover the cost of the care, so they either closed, or stopped taking auto accident patients.
Luckily for Annabelle and her mother, Advisacare Home Care and Hospice agreed to take her case, at a loss. Advisacare CEO Kris Skogen says his company has to strictly control how many auto accident patients they take, and offset those cases with other kinds of patients, so they don't go bankrupt. He says they have to turn people away every day.
"It’s just been brutal," he said. "There’s all these people that need help, and we’re doing what we can to help the most desperate ones."
"It's just been brutal. There's all these people who need help, and we're doing what we can to help the most desperate ones. We plead with Lansing to fix this before somebody has to die."
— Kris Skogen, CEO of Advisacare
Skogen says it's been extremely difficult to hire staff after the law passed, so it's not possible for the company to provide 24/7 care for Annabelle, even though she clearly needs it. Meanwhile, roughly three people a day in Michigan suffer catastrophic injuries in car crashes. And many can't find an agency to help them. So it’s just mom and dad, or siblings, struggling to care for a loved with catastrophic injuries.
Read our guide: What you should know about car insurance after no-fault overhaul
"How any human being can permit this to continue, another day, another week, another month, is just .... disgusting," Skogen said. "We plead with Lansing to fix this before somebody has to die."
Actually, an independent health care research group confirmed that at least seven people have died after their agencies shut down, or discharged them as patients.
Crash survivors and advocates have been going to the state Capitol nearly every week since the law passed in 2019, to urge state legislators to fix the no fault law.
Brandi Marsh says if any of these legislators don't understand yet what the law is doing to people, they're welcome to come spend a day with her and Annabelle.
"They need to see what's happening," she said. "They won't feel the same way about it. I mean, this could be their grandkid or their daughter or their sister's kid or what have you. And people shouldn't be left behind at all. Nobody should."
At Marsh's request, we're not naming her car insurance company because she’s afraid they might retaliate against her daughter. But we did contact that company about Annabelle’s situation. We did not get a response.
