Changes in worker comp hurt disabled

Tuesday, Sept. 14, 1999 | 10:55 a.m.

"I've been advertising for a personal care aide at $9.48 per hour for six weeks and I get plenty of calls," said Rick Cline of Reno, a paraplegic. "The minute they find out they have to pay $375 before they get their first paycheck and then pay another $375 a month later, they hang up."

State officials say Cline's problem is only the beginning of difficulties caused by the privatization of the state's workers' compensation system.

Previously, the state billed employers monthly, but as of July 1, lump-sum premiums are due in advance from the aides, now considered independent contractors. The insurance covers injuries the aides might incur on the job.

Cline says the cange change prices personal care aides right out of the market and denies him basic support. He said Medicaid's option, if he's unable to hire a new aide, is placement in a care home or unnecessary hospitalization.

"Not only will these options be more costly than facilitating my home health care with (an aide)," he said, "these bleak alternatives impose significant hardships upon the disabled and their families."

State and workers' compensation officials said they are sympathetic to Cline's plight, but there's little they can do to help him.

"It's a business decision," said Douglas Dirks, director of the Employers Insurance Company of Nevada, the privatized version of what was the State Industrial Insurance System before July 1. "There may be a charity, a program, that can help these people, but we're not it. We went from a paternalistic government system to a private marketplace. We are a business now."

About 150 personal care aides now work in Nevada. They help people with disabilities to bathe, dress, get into wheelchairs, eat and take care of other bodily functions and mobility problems.

Medicaid rules say aides must be covered by workers' compensation insurance. Aides work part-time and make about $9,000 per year. But to the workers' compensation system, they are independent contractors - small businesses.

Aides employed before July 1 still pay monthly premiums as in the old system. But when new aides are hired or current aides renew their contracts, they will face the same problem with large deposits as Cline and his potential helpers.

"This is serious," said Jon L. Sasser, a Reno lawyer involved with disability issues. "The bottom line is that the state now has a service that will soon be worthless. This will put more people in institutions."

Sasser, state and Medicaid officials and the insurance commissioner's office have been working to find a way around the dilemma, but the best they've come up with is a reduced premium of $228 followed by nine months of payments - including an extra $130 in interest and fees.

"We have to come up with a more humane approach," Sasser said. "It's a slight improvement but we need a better solution."

State Sen. Randolph Townsend, R-Reno, said he's aware of the problem with the aides. He said something must be done so Cline and others like him can hire part-time help and avoid institutional care.

Townsend said Cline's case is on the agenda for an Oct. 14 meeting of a legislative committee.