For years, we've heard from political ideologues and ambitious district attorneys about how much waste, fraud and abuse there is in state programs like Medi-Cal. Whenever there is a case in which a low-income recipient is charged or convicted, the right-wing cheering section is quick to applaud and point to the case as proof of rampant fraud.
But where was the applause when Attorney General Kamala Harris recently announced a $241 million settlement in a case of Medi-Cal fraud by Quest Diagnostics, the state's largest provider of medical laboratory testing?
The settlement resulted from allegations that Quest systematically overcharged the state's Medi-Cal program for more than 15 years and gave illegal kickbacks in the form of discounted or free testing to doctors, hospitals and clinics that referred Medi-Cal patients and other business to the labs. Here's what AG Harris said:
It's a sentiment you'll see at many a Democratic rally. But, not so much with the Republicans. Shane Goldmacher's got this one:
Flanked by people in wheelchairs and protesters in green union T-shirts, the Republicans echoed Democratic talking points in opposing Gov. Jerry Brown's proposal to slash in-home care for hundreds of thousands of elderly, blind and disabled.
"Why is Paul Cook here?" the GOP assemblyman from Yucaipa began, asking the question on everyone's mind.
Because, Cook said, slashing the care program would actually drive up costs, forcing the frail into more costly nursing homes. Sure, he was "never going to convince" some of his GOP colleagues. But he was ready to fight for the unionized program that most Republicans made a favored bogeyman for government largesse. (LA Times)
Asm. Silva (R-OC) goes on to say that, hey, in fact cutting this program would end up costing more than it saves in the long run. Wow, that makes sense. There's some partisanship I can believe in.
Even lifelong Republicans who recognize the importance of the IHSS program are voting for Jerry Brown for Governor.
Check out these comments from Meg Whitman's own website:
"I'm being forced to vote Democrat for the first time in my life.... I am shocked that a Republican would make me go to the Dem side, but I have been informed that you intend to do away with or seriously cut "I.H.S.S." K. Jones, Roseville
Whitman's continued attacks on the IHSS homecare program are turning even staunch Republicans against her.
Here's another post on the Whitman web site from Cheryl Rose, a homecare provider and lifelong Republican.
Kenneth Jones, a homecare provider from Roseville, mounts a strong defense of the IHSS program and says that Whitman's attacks on the program will force him to vote for Jerry Brown for governor.
Not wishing to be overshadowed by the aggressive anti-fraud tactics in Stanislaus County (California's War on the Elderly and Disabled: A Dispatch from the Front Lines) Sacramento County District Attorney Jan Scully is publicizing the exploits of her own "fraud squad" in the struggle against what she claims is "massive fraud" in the In Home Supportive Services (IHSS) program.
UC Berkeley's Center for Labor Research and Education recently analyzed the effect of proposed cuts in California's largest health and human services programs. The results are staggering. Here are just some of them:
"Cutting in-home care services by $1 billion - reducing spending on the very old, the very young, the poor and the disabled is one of the perennial proposals to save state funds - would mean the loss of more than 215,000 full-time-equivalent jobs in the next year...For every dollar spent by the state government on in-home supportive services, we get $2.47 from the feds....Cutting in-home services by $1 billion (also) would result in an estimated loss of $359 million in state and local taxes, so the actual savings would be much less than projected...."
My name is Tyrone Dickens and I am a union healthcare worker.
I have worked as a homecare provider in San Francisco for almost six years. My work involves cleaning, cooking and caring for patients in their homes who cannot do these things for themselves. For some of my homecare consumers who don't have family any more, I am the only companion in their lives.
This week I have attended a civil lawsuit in which the officials of the union that currently represent me are suing the former leaders of my local union, leaders that I elected and that I still support. I know that may sound confusing, but I think I can explain it clearly so that you can understand.
An editorial from Saturday's Sacramento Bee: High-tech fix won't stop IHSS fraud
In an effort to cut what Gov. Arnold Schwarzenegger claims is rampant fraud in the state's In-Home Supportive Services Program, the Department of Social Services is pushing a pilot program to assess the efficacy of an expensive high-tech system to fingerprint and photograph care providers and their recipients.
The MorphoTrak device, which the state is testing in three counties, including Sacramento, has been used by the military in Iraq. It can fingerprint, snap a photo and transfer data instantaneously. The machines cost up to $5,000 a copy. If deployed statewide, the state would need 600 to 1,000 of these devices potentially. But let's hold on a minute.
Before the state commits to buying this expensive equipment and building yet another expensive police bureaucracy that treats all IHSS recipients and their caregivers as potential criminals, it needs to perform a far more thorough assessment of the potential for fraud within IHSS and the best way to address it.
Here's the latest "high tech" weapon in Gov. Schwarzenegger's war on 450,000 elderly, blind and disabled Californians.
Without any authority from the Legislature, the Schwarzenegger Administration is planning to purchase up to $5 million worth of military/security cameras to take pictures of the 465,000 seniors and people with disabilities who receive In Home Supportive Services (IHSS) homecare.
The "MorphoTrak" cameras are currently being used in Iraq and other military locations. According to their manufacturer, they are also recommended for, among other things, "border crossings, gang enforcement, and airport/maritime security." The camera itself costs $4,200, plus hundreds of dollars more for docking stations and other equipment.
Most everyone has heard the saying about the frog in the pot on the stove. The heat is raised ever so slowly that the frog doesn't really notice.
Of course, the frog eventually dies in boiling water.
It's similar to the Chinese "death by a thousand cuts," or the term "creeping normalcy," which refers to major changes that are accepted as normal when they happen slowly.
This all came to mind last week when I read that the local Easter Seals in Humboldt County is closing. Another small cut in our community life, partly due to state budget "trimming." A few more area residents experiencing a diminishing of their quality of life.
I thought more about this when I went to do a swim work-out at the Arcata Pool. I was remembering my first two years going there on specific nights when patient, caring swimming instructors worked with developmentally disabled youth. They had a great time.
I realized that I hadn't seen them there in a long time.
Later, while shopping at Wildberries, I noticed a table asking for donations to save HSU's Natural History Museum. I looked across the street to the darkened windows of this facility that has been such an asset to the community and Humboldt County.
It's closed now, except for special occasions. Quality of life. Community. Cuts.
Driving back to Eureka, I thought about a person I hadn't seen at a work meeting that day. She's always been an active asset to our community and was frequently seen around town.
In her electric wheelchair. She has a disability and she's a senior. She couldn't get out of bed that day because she can't find an IHSS (In-Home Support Services) care provider. Now she's worried because the Governor has proposed cutting that program altogether and that she might be forced into a nursing home.
Another disabled person I know, who lives in his own apartment thanks to the IHSS program, says he would prefer dying to ending up in a care facility. It's a matter of quality of life. One more little cut. One more devastated life.
This made me ponder the phone message that I saved at work, from a woman in Orick who was despondent over further state cuts to her meager SSI.
She said that she'd been having to choose between heat and food over the last winter even before recent cuts. I thought of the blog comments I'd seen referring to "deadbeats" to "get a job." I note the state's unemployment rate, which will increase significantly if Arnold gets many of his cuts. I thought of the disabled acquaintance who wants to start working through Calworks, also proposed for elimination, and the number of local jobs not available to the disabled because the work sites are not accessible.
These people certainly notice that stove's been turned up.
The next day a co-worker told me about an agency consumer with schizophrenia who had her prescribed meds eliminated due to MediCal cuts. She's now in the hospital and not in her own apartment. Quality of life? Hardly. Not to mention a greater cost to the community.
Another degree or two or five on the stove.
I looked at the newspaper that day and read about Eureka City budget deficits and necessary cuts that are partly due to the state "borrowing" money from local governments. Sacramento won't ask for an oil extraction fee, but your local taxes will subsidize those corporations' right to a hefty profit.
Cut a policemen here, close a zoo there. Quality of life. Cuts.
I heard about a community in California that is now charging $300 for 9-1-1 calls. Pay up, or your life is forfeit. The commodification of CPR.
I read about 900 teaching positions being slashed in the Bay Area and of police and fire jobs being cut. I thought of protesters yelling about high taxes, but then complaining about the potholes in the road and the slow response by the police to their calls.
I talked to a friend who can't afford to continue in college and heard someone complain that they took time off to take care of business at a state agency, only to find it closed that day.
Notes to the Eagles "Hotel California" played somewhere in my head, but Don Henley was singing "They're killing them off at the Hotel California. It's so very clear, the common good is long gone here."
Feel the temperature rising yet? Is the water tepid or just lukewarm? Is that just another paper cut on your finger?
Grover Nordquist once said of government that he would like to "get it down to the size where we can drown it in a bathtub." Would he be referring to government that's for and by the people?
Grover would cheer the Golden State plan being enacted: golden for the chosen few and a rain (trickle down?) of fool's gold for the rest.
I think of Arnold, with his budget cuts year after year after year. I hear E-Meg regurgitating "no taxes, more cuts, no taxes, more cuts" and signing a no tax pledge during the greatest recession since the Depression. Sure, let's turn government into a business appendage and run it properly! Just like Enron and Exxon-Mobil and Bank of America, right?
I think of Republican legislators refusing to even discuss raising any taxes and cowed (majority?) Democrats forced to make "the hard decisions" of cutting the budget (just a few more cuts on the arms and legs; just a few degrees up on the stove, just ONE more time).
I think of the state's citizens saying that just 500 cuts aren't enough, but PLEASE don't kill the patient--clinging to their "have our cake and eat it too" belief system while the cupboards are laid bare and the landlord laughs all the way to his barely taxed mansion. Oh no! Prop. 13 was ONLY about saving grandma's little house in the neighborhood (wink, wink). We can't EVER touch that!
So one more Easter Seals closes. One more senior becomes homeless. One more person can't go to college. The death by a thousand cuts, creeping normalcy, frog in the pot--it's all the same. Elimination of checks and balances, destruction of the common good and civil society, wiping out government "by the people," reign by the unregulated chaos of free markets on steroids growing into corporate monopolies, and the entrenchment of a new aristocracy mouthing platitudes to the democracy that they've bought and sold out.
But...but...we want to save the poor frog, the people whisper. Then they turn away as the forces of corporate rule wielding their subsidiary government arm turn up the heat another notch. They never notice that it's most all of us inside the pot.
And that many are already scalded. And that we'll all soon join them.
The good Governor Schwarzenegger is pretty fond of his own abilities. I mean, if it were all up to him, those boxes would have been good and blown up by now. Yet that damned meddling legislature is always getting in his way. Oh, and the people have the temerity to refuse his power plays.
But that doesn't mean that he's given up on taking power for himself. The most glaring example is the "seating Abel Maldonado" without getting confirmation thing. We'll see how this turns out, but at this point, he seems like somebody who wants to grow his power at every turn. The courts have served the job of backstop for the separation of powers, but is this really where we want to be? A legislature that has to go running to the courts every week to get approval for its very existence?
The St. Abel issue isn't the only one. Take this instance of Arnold unilaterally deciding that a law is inconvenient:
Gov. Arnold Schwarzenegger had no legal authority to disqualify everyone with a felony record from working in the program that provides in-home care to 430,000 low-income elderly and disabled Californians, a judge ruled Thursday.(SF Chronicle)
The actual law states that felons are ineligible for ten years. You can see why this regulation is in place. These are people who are vulnerable, and we want them to steer clear of possible con artists and all that. But Arnold's recent stunt of cutting off all convicted felons has nothing to do with that. Rather, it's some sort of crazy budget issue. He's trying to save money by firing any IHSS workers who currently have a client and have a criminal record, and then hoping that they won't be able to find a replacement for a while. You know, save a few bucks while the disabled person has no care and has to go looking.
It's all about instability. Instability breeds confusion, which causes less people to take advantage of state services. It's a really crappy, and cowardly, way to try to save money. Arnold, if you're going to try to make cuts, do them honestly, and let the people know what you are doing. Come tell the recipients of IHSS care that they are going to have to go to a more expensive residential facility. Oh, right those facilities don't exist. So, how about this, Governor, why don't you just go ahead and tell these people that you wish them well as they struggle to survive.
And maybe if you toss in a copy of Terminator 2, all will be forgiven.
State Controller John Chiang has released a study by his department which shows a number of instances of fraud in the IHSS program in Fresno and San Diego Counties. Of course, our fearless "fraud-fighting" governor was quick to take credit for these findings.
I can't believe he had the nerve to try to hook onto the Controller's investigation. Here's why:
The Controller said that the instances of fraud found in his investigation are likely due to inadequate numbers of social workers and case workers needed at the county level to properly administer the IHSS program. Yet, Gov. Schwarzenegger wants to cut funding for these positions in his budget proposal.
In his totally self-serving news release praising the Controller's action, the governor referred to IHSS as: "this important program for Californians that rely on these resources." This, of course, is the same program that he wants to eliminate completely or cut by 90 percent.
The definition of the Jewish word: "chutzpah" is unmitigated gall. My favorite example has always been the story of the man who killed his mother and father and then threw himself on the mercy of the court because he was an orphan. But Arnold is providing us with many new examples this year.
When Arnold came to Sacramento, riding a populist wave that was based, in substantial part, to a populist anti-tax message, he promised to "blow up the boxes." In the 6+ years since then, not only did he dig a deeper hole in the budget with his "car tax" cut, but he also managed to further mangle an already broken system.
But structural concerns pale in comparison to the toll in lives that we may face in the next few years if something substantial isn't done to curb his recent budget plan. One key item that will send the state reeling? The in-home support services (IHSS) cuts. Arnold's current plan is that if the state gets a bunch of money from the feds, he'll cut 87% from IHSS. If the state gets nothing, he'll completely eliminate IHSS. The depth of the tragedy this would entail is really quite hard to imagine.
If IHSS is eliminated, there simply would not be enough institutional beds in the state to handle all of these cases. People will literally die in their homes, or because financial support is also being cut, more likely in the streets. And in that respect, Arnold is just like his hero, Ronald Reagan. Reagan dumped millions of people in the streets, and Arnold is attempting to do the same thing
For Capitol insiders, it's easy to chalk it up as a bluff when Gov. Arnold Schwarzenegger proposes terminating welfare-to-work and in-home care for the disabled if California doesn't get billions in federal money he's requested.
But it's no chess game for a welfare-to-work mother seriously trying to find a job, or a person in a wheelchair whose living stipend has already been slashed twice in one year.(SacBee)
And the dumbest part of this? IHSS actually saves the state money.
If Darden moved to a nursing home, the state couldn't take away these benefits because federal law prohibits withholding services critical to the health of the disabled. At the same time, the state acknowledges that the public cost of institutionalizing disabled people is far greater than if they live in their own homes.
There is a certain set of core services that a government is expected to provide. If Arnold has his way, California will not be in the business of providing care to the disabled, and leave survival of the fittest to do its best to the state.
Arnold's legacy? Just look to the streets in 3 years and see for yourself.
(Steve's work with IHSS providers is critical for California's disabled. - promoted by Brian Leubitz)
A homecare provider from San Diego told legislators yesterday how she and her client--a qaudriplegic Vietnam veteran--were threatened and harrassed by a fraud investigator from the state.
Nancy Jo Riley of San Diego testified that she and her client were "randomly selected" for a fraud investigation last October as part of a new "anti-fraud" initiative by the state. According to Ms. Riley, the agent from the Department of Health Care Services (DCHS) first threatened in a phone call to cut off all IHSS unless she and her client met with him immediately. At the subsequent meeting, the investigator asked her and her client a long series of "humiliating" questions. He then said he could not understand why a person with a severe disability like his should be subject to a fraud investigation in the first place. He also said that her client, whose hands are frozen in a fist-like position because of his disability, would "probably" be exempted from new fingerprint requirements for homecare consumers.
Several legislators expressed outrage over this intrusion, which Ms. Riley described as a "raid" and a violation of her Fourth Amendment rights against unreasonable searches and seizures. Her testimony came shortly after a representative from DCHS had denied at the same hearing that his department was conducting fraud investigations.
For the last time, thankfully, our governor is trying to sell us a pig and a pony...excuse me, I mean a pig in a poke.
The overriding theme of his State of the State message was "jobs, jobs, jobs." Oh really? Frank Mecca, executive director of the California Welfare Directors Association, took a closer look:
"The Governor says he wants to create jobs, but devastating cuts to the social safety net have killed jobs and dimmed the employment prospects for tens of thousands of California families and children. The Governor's cuts to child care and support services for CalWORKS families will diminish the chances of finding work for almost 40,000 families, and his threatened elimination of the In-Home Supportive Services program will put 350,000 people out of work instantly and increase California's unemployment rate from 12.3 to 14.2 percent..."
Members of a coalition that supports the popular In Home Supportive Services (IHSS) homecare program have turned their focus toward legislative Democrats, many of whom supported cuts in the program last year.
In a letter to Democratic State Senators and Assemblymembers, coalition members urged them to:
...stand up to the governor, help reform our state's broken revenue system, and make decisions on IHSS based on its merits, not on sound bites used to disparage consumers and home care workers...It's time for Democrats to be accountable and to act like Democrats.
In case you missed it, here's the heart-warming story of Sara Granda, who was paralyzed from the neck down in an auto accident in 1997, but has gone on to get three college degrees and just passed the State Bar Exam.
Gov. Schwarzenegger should be commended for going to bat for her so she could take the bar exam. But it's ironic that if Sara needed home care under the state's In Home Supportive Services (IHSS) program, our governor would be demanding that she be fingerprinted, receive unannounced home visits from government agents, and otherwise be treated like a common criminal.
We last heard from ambitious Sacramento County District Attorney Jan Scully in July, when she was a cheerleader at Gov. Schwarzenegger's infamous fraud news conference.
As you may remember, that's where the governor made the outrageous claim that the fraud rate in the state's In Home Supportive Services (IHSS) program is 25 percent or more. Following the news conference, the Sacramento Bee accused the governor of: "Spouting misleading rhetoric about waste and fraud" , while the San Jose Mercury-News called his allegations: "phantom claims."
Nevertheless, it appears that Ms. Scully had so much fun at the governor's dog-and-pony show, she decided to have one of her own yesterday to proclaim what she termed:"a new day" in Sacramento.
With all the concerns about the state budget deficit, here's an interesting question:
One year of care for a client in the In Home Supportive Services (IHSS) homecare program costs the state around $13,000 a year, while one year of nursing home care for the same individual costs taxpayers $60,000 and year and up.
Yet every year, it seems, the IHSS program faces serious budget cuts while nursing homes are fully funded. Why is that? Suggestions welcome.
