Tuesday, October 25, 2011


We're going to get a shitload of emails from alleged sufferers of Fibromyalgia Syndrome telling us how wrong we are. They won't be answered.

I assess the needs of IHSS applicants. I do this 400+ times each and every year. I've interviewed literally 1,000s of people claiming to have all sorts of ailments from flat feet (THAT'S a permanent disability??) to terminal cancer to diseases you've never heard of in your life because they are so rare - but real.

If I had a $1 for every person who told me they can't work or clean their own homes because they have Fibromyalgia or some other related, vague syndrome or disorder, I'd be so fucking rich I wouldn't have to work as a civil servant anymore.

I see this diagnosis so much that I can't believe the CDC or WHO hasn't called for emergency epidemic protocols.

Everyone under the age of 60 who doesn't want to fucking work has Fibromyalgia Syndrome, Chronic Pain Syndrome, and/or Chronic Fatigue Syndrome. Often all three at the same time and often exacerbated by Depression and Anxiety.

Wanna know what all of these have in common?  They are all based on self-report. There is no blood test or x-ray that can definitively say "You have Fibromyalgia".

A patient goes into a low-income medical clinic that accepts Medi-Cal and tells the Doctor, who has already "treated" 30 people that day in an effort to bill Medi-Cal for as many office visits as possible, how she has this pain that travels to different parts of her body. Doctor listens for about 90 seconds, dx's her with Fibromyalgia, prescribes generic oxy and sends her on her merry way. Go back in 3-6 months for another office visit to renew the RX.

It's time to apply for IHSS.

She's approved for 60 hours per month of IHSS because the Social Worker doing the assessment doesn't have time to do a thorough, accurate interview to determine risk and need and would rather just grant the application because it's easier and faster. And hey, the more open cases we have, the more job security we have, right? Right.

She is approved. She hires her daughter, her co-addict, or her boyfriend to be her care provider. The care provider turns in timesheets for 60 hours a month at roughly $10.00 per hour. She and care provider split nearly $600/month.

You gotta love this system. She just added $300/month to her $845/month SSI/SSP making her total TAX-FREE income $1145/month. That ain't bad for someone who only has to pay $175/month rent thanks to HUD/Section 8 and who now gets her drugs for free through Medi-Cal.

But wait, now she has a bunion on her foot. She needs more IHSS hours because it's harder to walk.

Now she has constipation and needs more hours because she has stomach cramps.

Before you know it, she has given herself a raise of $100/month.

I've seen this same scenario play out over and over.

What is IHSS? Some basics.

IHSS stands for "In-Home Supportive Services". This program exists in many states under various names, but all of these state programs must follow certain guidelines set forth by the Federal government under Medicaid rules. In California, Medicaid is called Medi-Cal.

To be eligible for IHSS, one must meet all three conditions:

1. Be aged (age 65 or older) or have a permanent disability as defined by the Social SecurityAdministration,

2. Be eligible for Medi-Cal (with or without a Share of Cost), and

3. Need help at home to stay safe to avoid out-of-home placement.

If you qualify, you can hire someone (almost anyone you want) to work for you as your care provider. Medi-Cal (also known as the taxpayers) will pay that person to perform certain tasks for you to ensure your home is safe and you have essentials such as food, clean clothes, and medication.

The original intent of IHSS was to keep the elderly out of nursing homes. We agree with this idea that elderly persons whose only limitations are that they can't carry the laundry basket or drive to the grocery store to get food should not be placed in institutions, but rather be given limited help to enable them to remain in their own homes as long as possible. This arrangment is less expensive for taxpayers and gives a better quality of life in most situations. The program had/has good intentions.

The road to Hell was paved with good intentions.

Did you know that there are parents being paid to take care of their own children - children as young as 3 years old? Or that we pay wives to help their husbands shower and get dressed? I'll bet you didn't!

Did you know that boyfriend can hire girlfriend to be his care provider and she can get paid from taxpayer money to fix his breakfast (which she shares with him, but lies and says she doesn't) and pick up his Oxy from the pharmacy?

Did you know that you can get on IHSS without really needing it and then just split the paycheck with your care provider? Yep, happens all the time.

The disability lobbyists would have you believe that all IHSS recipients are frail, 90 year old widows who live alone or are quadriplegics who are wheelchair-bound for life. They parade  these people around the capitol to drum up sympathy when the gravy train is set to scaled back.

BULLSHIT. If this were reality, we wouldn't be bitching.

Ask anyone who works in IHSS doing assessments and just wait for the tirade about fraud, abuse, and waste. It will be forth-coming.

Why is California broke?

We know one reason: Welfare fraud.

Between the two of us, we have 30 years experience working in social services and we're tired of witnessing the rampant fraud and abuse of safety net programs.

Programs, such as IHSS, were designed to assist the most needy, frail citizens remains safe in their own homes to avoid institutionalization. This is a noble, necessary program that started off with the best intentions, but like every other welfare program, has become a tool for cons, addicts, and the laziest of the lazy to avoid legitimate work.

Think we're exaggerating? Keep reading. We'll give you actual examples of welfare and abuse.