Article in Society / Activism / Equal Rights
This will be my last article on being homeless on Maui. It shows that homelessness can kill you, and how broken and brutal our society is when it comes to the poor. I thank all that have read these articles and hope somehow they bring change that saves others from going through what I have. Aloha

The End Game

Delay, Deny, and Hope They Die

By Sanford L. Hill

Anyone who is, or has been, homeless or poverty-stricken has sought aid from their states version of Welfare (DHS) or Federal Disability insurance (SSI). Welfare is supposed to be the government safety net for the impoverished folk on the bottom rung of our countries social-economic ladder. It is meant to insure that these destitute people have the basic necessities of life. Anyone who thinks our needy are being taken care of is out of touch with reality. The welfare system in America is now broken and we see the fallout from that all around us.

The social service system is changing quickly as the funding is cut while the people who need help increases exponentially. This well documented change in assistance has been spun in so many directions that no one knows, or cares, what’s really going on unless they are affected by it.

The only welfare system I have used is the Hawaii Department of Human Services (DHS). I first used welfare in the early 1970’s when my wife got pregnant and then broke her back in a car accident. It gave us enough money for shelter, food, medical and utilities as well as our cost of going to community college on Maui. It was a real safety net that allowed us, and many others, to get back on our feet and become productive members of society. I’m sure I more than paid back my aid in taxes and jobs I created over the next forty something years.

The progressive safety net system of the 70’s was a product of the crazy humanitarian movement of the 60’s that believed war was not good for living things, there could be no peace without justice and the poor and disenfranchised needed to be cared for. The “peace and love” thing. We knew it was too idealist to succeed against the entrenched greed and ruthlessness of age old powers and beliefs that were in control. There is nothing like being homeless to prove how badly we lost.

In Hawaii now, getting Food Stamps and medical coverage is easy if you are poor in Hawaii. Getting financial aid is much more difficult, unless you have kids or are over 65 years old. It doesn’t matter if you are poor because of government and economic failure that has nothing to do with you. Or if there are no jobs and the ones available are slave-wage that will not pay for high living expenses that you also have nothing to do with. Poor who are not deemed disabled, or given a job, are forced into homelessness, criminality or become one of Hawaii’s “unattended deaths”.

In November of 2014 the Hawaii DHS took away my $348.00 a month in financial aid saying I was no longer disabled. Without the aid I would no longer be able to pay the $230.00 “program fee” that allowed me to live in squalor and misery at KHAKO. Serious thoughts of suicide returned as I knew I would not survive going back to living on the street. I was surprised by the CYRICA doctors finding because my medical condition had really deteriorated in the last six months including stage one cancer, deteriorating sleep disorders and psychiatric problems caused by my homelessness. This is all well documented in my medical records. It made no sense. I was having more sever medical problems, but the doctors the DHS hired say I’m getting better. I know other people who live at KHAKO who are much more able to work than me that are getting DHS or SSI financial aid. Welcome to the bizarre world of medical disability.

The only way one can receive financial aid (welfare) from the Hawaii DHS if you are under 65 years old is to be deemed disabled by a board of doctors hired by DHS, or have kids. Since I can’t have kids and won’t be 65 until 2016, I have to be ruled disabled. Which I was, until I wasn’t. Everyone from case workers to homeless people told me it happens all the time, and all I had to do was file a “Fair Hearing Appeal” to get back my DHS disability. So I did and went down disability rabbit hole that makes Wonderland seem normal.

Like Wonderland, the DHS/SSI disability world is a strange reality that one can easily get lost in. The confusing laws, rulings, and rhetoric only exist in the welfare world and affect only the very poor who are the least able to understand it. I have fallen down the welfare hole located at the bottom of the economic cliff so I can give you a good look at this modern reality.

Like Wonderland, the first thing you have to accept is that nothing is as it seems. It is not the job of DHS workers to find a way to get you aid. Their job appears to be to find ways to deny benefits. Like the IRS system, the policies and DHS law are complex and only understood by the DHS. When they make a mistake, you will have to correct it, which always seems to happen when your benefits are cut-off suddenly. Then you have to wait with no food or money until they correct it, taking as long as it takes.

What the DHS says and what is does are often different. For example, when you call a DHS worker you will always get a recorded message telling you to leave your phone number and they will call you back. They almost never do. If it is something important with a dead-line you have go to the welfare office and wait to be helped. Mainly times it’s just that the computer sent you a letter that’s meaningless. Of course if you do anything that is incorrect: Boom, benefits canceled, off with your head.

Of course, like most problems we have, it begins with legislation that makes no sense. The following is the law that solely determines if a person is disabled and receive DHS financial aid. Hawaii Administrative Rules S17-659-2 defines disabled as follows:

““Disabled” means an individual is unable to engage in any substantial gainful employment, at least thirty hours of work per week, for a period of more than sixty days form onset of disability, because of a physical impairment, mental impairment, or combination of a physical or mental impairment.”

First, let’s get real here. Is working at a slave wage job “substantial gainful employment”? Not to those working the job. It is survival work that does not cover the cost of living. The only ones who gain substantially from this work are the owners of the business who profit from the low cost of labor. “Substantial gainful employment” is a completely subjective term. I’m sure the DHS/SSI people who decide what this means have a completely different perspective then me or other poor people do. If the poor where to decide what employment is substantial and gainful instead of well off people with a selfish agenda, a lot more folks would be receiving Hawaii DHS financial aid.

Most people believe that it is the DHS that decides if a person can receive financial aid. It’s not. DHS has hired a large corporation named Cyrica to give a medical opinion on whether an individual is “unable to engage in any substantial gainful employment, at least thirty hours of work per week, for a period of more than sixty days form onset of disability, because of a physical impairment, mental impairment, or combination of a physical or mental impairment.” By law, the DHS must follow Cyirca’s ruling, There are no exceptions. The fate of Hawaii’s poorest citizens to get a tiny amount of state aid ($348.00) is arbitrarily made by a large for Profit Company. For many poor, including myself, this money is the difference between living in dilapidated homeless shelters/public housing or on the street.

I say arbitrarily because there is no way a board of doctors can medically determine if a disabled person can work 29 or 30 hours a week at hypothetical jobs that may, or may not, exist in reality. The ruling is made by a board of Cyrica doctors you’ve never met based on a 10 to 15 minute medical exam by a Cyrica MD and whatever medical records your medical provider sends, which you also have no control over. Even if your MD sends a letter stating that you cannot work because of a medical condition, as mine did, they can just ignore it. This flawed system cost the state (taxpayers) more money every 6 months than if they just gave every needy person $350.00 a month. Instead Cyrica, doctors, social workers, consultants, legislators and others make off like bandits. The poor and taxpayers lose out.

Cyrica provides no specific medical evidence why you can work 30 hours a week at some theoretical substantially gainful employment. This is an important fact. Maybe one can only work 29 hours a week, in which case they would be eligible for aid. The Cyrica doctors can only guess based on incomplete evidence that they may not even be medically qualified to give an opinion on. That guess could mean living on the street for someone like me: Possibly Life or Death. Cyrica gets paid well no matter what happens to me and other poor. There is no accountability for their actions.

Living in a homeless shelter gives me a real good reading on who receives and is denied DHS/SSI benefits. There are many people here much healthier than me who receive DHS/SSI checks. They know how to play the system. Some will even make themselves sick by chain smoking, overeating or even injuring themselves. My roommate has repertory problems but continues to chain smoke. Can one work 30 hours a week with lung problems? Pay the Cyrica doctors to guess. It’s sad that people have injure themselves just to get money to live while others profit from the suffering.

Off course the ones who really profit from the broken safety net are the slave wage companies that offer the only other way to survive, besides being a criminal or the military. My KHAKO case worker used a 70 year old lady’s slave wage job sweeping up at McDonalds as an example of what I could do. Of course taxpayers subsidize the low McDonalds pay with enough benefits to keep her alive and able to work. It is the bust-ass work of the slave-wage earners that helps make the affluent even richer. This is not just an American problem, it is the dark side of the human species that is deeply entrenched.

After being denied my only source of income, $350.00 a month from the DHS, I filed for what is called a “Fair Hearing” to challenge the DHS disqualification decision. During the Fair Hearing appeal you have the choice of continuing your financial aid. But, if you lose the decision, you have to pay DHS back the money you got. The 50/50, odds of winning are the best odds in the DHS appeal system, according to Legal Aid Society. So, I figured, roll the dice-what are they going do if I don’t pay them back? Break my leg.

This DHS Kangaroo court is presided over by a supposedly impartial “Administrative Law Judge” hired by the DHS to rule whether DHS is acting correctly according to law. The hearing is a bizarre high-breed of a legal court, (motions, sworn testimony, legalese, evidence) and the fairy tale DHS law system were the judge must rule only on whatever the Cyrica Doctors say. I’ve been evolved in real court and trials and believe me, this “Fair Hearing” is way down the rabbit hole. I cannot imagine how poor folks with much less education than I have deal with this hearing. It is probably like trying to appeal a Jim Crow law in the south in the 1950’s. The DHS laws are vague and stacked against you and the judge can interpret them anyway he wants. You can only be affected by these unjust laws if your poor.

Since the Fair Hearing is a quasi-legal affair, you are allowed to have a lawyer represent you. There is no way I could afford one so I went down to Legal Aid. Like other NGO providers to the needy, they have nice offices and love getting people to apply for help for funding reasons. Of course, after their expenses, Legal Aid does not have the resources to handle but a small fraction of the request for help. They couldn’t represent me, but would help with advice and getting some documents from the DHS . I did get a few minutes advice over the phone from a Legal Aid attorney and a hilarious 13 page pamphlet on “Testifying at Your Disability Hearing”.

Remember most people at a DHS “fair hearing” are the poorest of the poor with physical or mental disabilities desperately trying to get $2088.00 for 6 months living expenses: Way below the poverty line and you must be reevaluated every 6 months. The appeal process alone cost way more than $2088.

I feel I need to share my hearing experience and let you decide if anything in this rabbit hole is FAIR. The Legal Aid pamphlet says: “This process is complicated and technical, and it doesn’t necessarily involve common sense”, and that “disability determination is what we call “hypothetical” determination. It has very little to do with the real world”. Just like the Jim Crow laws of the South before desegregation.

So I set off walking from the bus stop to the hearing office in the hot sun on January 30 2015. The hearing court was located in a strip mall not far from the beach. Another wealthy property owner profiting from the misery of the poor: I’m sure the rents not cheap. The office is nice with lots of DHS workers milling about. Exhausted from the walk, I’m led into a large conference room with a long meeting table and big screen teleconferencing monitor hanging from the wall. I felt alone.

After a few minutes the hearing judge, Steven Royal, a private attorney from Oahu, and Mrs. R Tokunaga, the DHS appeals unit supervisor, walked in and seated themselves. The Judge at the head of the table and myself and the supervisor on either side. The judge called Dr. Kubo, the CYRCA medical consultant on a speaker phone. These people have done thousands of hearing and knew the game inside an out, It was their job and they are well paid for it.

I have been in many high powered legal and business meeting like this and usually I’m not intimidated. But, this Fair hearing did not feel “informal” or “non-confrontational”, and I definitely felt intimidated as I had no idea what was really going on. It seemed like formality: “Trust us, we gave him a Fair Hearing and decided our decision was correct”. It’s not our fault he doesn’t understand the law.

We were all sworn in and the hearing began. The first thing the DHS supervisor stated was a part of the DHS law I didn’t know about. By law, the DHS has to follow CYRCA’s finding on my disability. This hearing was to determine if DHS followed the law. I thought, that DHS made the final determination on a person’s eligibility for aid. In fact, by law you can only get DHS financial aid if CYRCA determines you meet the vague, hypothetical criteria of what the law says “disabled” means, as I wrote about earlier. I felt like Opera’s character in the movie “Selma” trying to register to vote in the south. There is no way to win because DHS followed the Jim Crow DHS law, and they have known it all the time.

I figured the only chance I had was to convince the judge that CYRCA was wrong. I brought the DVD that had all my medical records that CYRCA had used to determine disability and should convince any doctor that I could not have worked 30 hours a week. I also brought in forms for a 100 days of medical excuse from work that my doctors had issued over the six months being examined as well as a letter from my sleep doctor explaining the seriousness of my disorder. None of my doctors are crazy enough to give a medical opinion on the exact number of hours I can work a week at a hypothetical job.

I tried to give my evidence to the judge, but he said “he wouldn’t touch them”. The judge is not a doctor and he does not have the authority to overrule the law that says that the DHS must deny me aid if CYRCA says I’m not disabled based on CYRCA’s hypothetical guess on my ability to work 30 hours a week. My head is spinning. I know most people reading this cannot follow what I’m saying. Most poor folks just give up and hope the judge has mercy on them, because that’s the only chance they’ve ever have. You see the burden of proof is on the poverty stricken plaintiff who cannot afford to have their doctors at the hearing or a legal representative who understood DHS law-Not that it would matter.

The judge told me to fax any new medical evidence to CYRCA to be reviewed. So much for the “Fair Hearing”. Does anyone think the Doctors at CYRCA are going to admit they made a mistake based on any type of evidence? The “Fair Hearing” decision is solely based on what the defendant’s doctors think of the plaintiff’s evidence. I could bring in doctors, lawyers, it wouldn’t matter because the judge is not going decide if my doctors or CYRCA has the correct medical opinion of whether I can work more or less than 30 hours a week. The judge relies on CYRCA to interpret any medical evidence. CYRCA is not an independent judge. They are a for profit company being paid by the state to be an expert witness for DHS and their doctors have a number of reasons not to reverse themselves, including getting paid.

If I don’t like the judge or CYRCA’s decision, the only option you have is to take them to Circuit Court, and they know that’s probably never going to happen. For one thing, DHS did follow the law, just as the voter registrars followed the Jim Crow laws in the south that kept black people from voting. Until the poor oppressed folks rise up and much of the rest of the country demand equal justice, the laws will not change. It is not in the interest of the politicians and their wealthy benefactors to make slave wage people equal. Never has been.

I could sue CYRCA directly for malpractice, incompetence, discrimination, maybe even fraud, if I could find an attorney to do it. Legal Aid, which is funded by the government to provide legal services for the poor, sent me a letter stating that they could not represent me. They say they do not have the resources to help all the poor that need it. Again there is some unknown, well-paid, person, using a unknown system to decide who among the needy gets legal assistants. Again, I think one of the biggest problems the homeless have is not having any legal recourse when abused by the safety net systems that are supposed to help them, including Legal Aid.

I had hoped at the time that the CYRCA doctors would be honorable enough to grant me disability after reviewing the open and shut medical evidence my doctors provided. In hindsight I now realize that the CYRCA medical board doctors, Todd Kubo MD and Raymond Thompson MD, where going to cover their own ass and reject any evidence my doctors provided. CYRCA”s response to the medical evidence the judge gave them at my “Fair Hearing” proves that. I won’t bore you with all the misleading, twisted and medically incompetent content of the CYRCA doctors response, but hear is one example of the judges ruling based solely on that response:

“Dr. Kubo stated that the board (CYRCA) is aware of claimant’s medical condition. However, although RLS affects a person’s sleep, it should not have a direct impact on physical functioning while awake. Thus, the functional capacities listed by Dr. Kau on Oct 3, 2014 were not rebutted. Consequently, the boards (CYCRA) position remains the same. Claimant was capable of working 30 hr. a week at the time of his examination on Oct 3, 2014.”

In the letter the judge is referring to, My doctor, who is the head of the Kaiser sleep department for the State of Hawaii, wrote that she had been treating me for SEVER RLS, Insomnia and sleep apnea since 2008. Among other things, she wrote, “The amount of distress caused by his underlying RLS has been considerable with profound impact on his quality of life both DAY and night”. Work is part of life and my sever sleep disorder, especially the opiates and sleeping pills I take daily to control it, have a profound impact on it, both day and night. If this isn’t a strong rebuttal, I don’t know what is. But the judge refused to read that letter and his decision was based solely on CYRCA’s medical response to it, which any competent doctor will say is wrong. My case is rested-NO FAIR HEARING.

I am using this specific, boring, example of what happened to me to try and give a glimpse of what the poorest of the poor must deal with daily. Remember, All these resources are being spent by the State of Hawaii to keep a destitute person from getting $348.00 a month. Most of the Doctors and bureaucrats make that much in a day. Again, one must ask why so much money is being spent to deprive the poverty-stricken of any kind of meager aid. After reading Hawaii Administrative Rules Title 17, which provide the General Assistances laws it’s obvious: page after page of statutes that force the impoverished to take minimum (slave) wage jobs or be denied government aid. The laws are there to force the poor to work for slave-wages. The government will provide food (SNAP), Medical aid (Medicaid), and homeless shelters to keep slaves healthy enough to work. When you really look at it, the welfare system is designed to provide the wealthy with slave labor.

So what is “Wage Slavery”? The use of the term "wage slavery" is a rhetorical device to draw parallels between modern work and the historical institution of slavery, specifically to chattel slavery where one person owns another person as property. The concept of wage slavery suggests that even where the conditions of chattel slavery do not apply, wage earners may live in conditions that for all practical purposes are identical to the conditions of under chattel slavery. In both cases the slave owners win.

London School of Economics professor David Graeber says: “That private and public bureaucracies, employ thousands of people to make us feel bad about ourselves. Bureaucrats pushing paper decide what we and our work are worth. But somewhat ironically, Graeber suggests, it’s those bureaucrats who perform the most meaningless work of all.” In many cases they have no idea they are just slave traders forcing the poor to work for slave wages.

Since being ruled against at the Fair Hearing, I have been found eligible for DHS again, then discontinued because I supposedly did not follow my treatment plan, Which my doctor have said is not true. Again, what the doctors who are treating me documented has been overruled by Cyrica. I have to file for another “Fair Hearing. It would be funny if it was not life or death for me.

If that was not enough, my medical condition has deteriorated. I’m currently recovering from web implant surgery to correct a problem from other surgery I’ve had in the last year. It is very painful and made much worse having to live in a homeless shelter.

But it will all end soon. If you’re poor on Maui you must win a government lottery to afford housing. I lost in the Dept of Housing and Urban Development HUD lottery for housing assistants last month. It was my last chance to find a way to rent a place before I’m kicked out of KHAKO transitional housing. Despite the thousands of dollars I’ve paid KHAKO and the millions they receive from Government and private funds, the best KHAKO can do after 2 Years is “transition” me back to the being homeless 0n the street where I will not survive. KHAKO has failed to find me a place to live in 2 years. KHAKO kicked out a 70 something year old lady last month who had stay her 2 year limit. This is just the tip of the problem. Yet, KHAKO is considered one of the best homeless shelters in Hawaii. Mainland homeless and ex-cons love it. Local poor people and taxpayers lose out again.

I know that homelessness is a complex problem, but to kick an elderly, sick, sheltered homeless local person back to being unsheltered on the street goes against every homeless solution I’ve ever heard of. This is made worse by the fact that many KHAKO homeless who will take my place are young, healthy, employed or going to college (ever heard of a dorm). Some are just using KHAKO as a cheap way to visit or move to Maui. It doesn’t make sense that I’m being kicked out. I must be missing something.

Homeless are constantly being told they need to be responsible for the bad choices they make. I want to know who is being held responsible for the bad choices that cost our country trillions in unnecessary wars, financial bailouts and mismanaged government that is causing unbelievable suffering, especially for the poor. It seems the people who made these bad choices are doing just fine. Ironically, they buy vacation homes on Maui that were part of the home rental market forcing more poor into homelessness.

I have lived in a one room slum at Ka Hale A Ke Ola (KHAKO) homeless “resource” center that I pay $250.00 a month for, plus doing “chores” for two years now. I’m forced to share my room with a scary, violent, homeless street person from Seattle who likes being homeless here better. My severe, expensive, medical conditions, some of which is directly caused by homelessness, are being paid for by taxpayers. I’m assigned case worker after case worker who have done nothing for me, but do get paid well. Yet, the County of Maui just forgave a $4 million dollar loan to KHAKO that “disappeared” over the years. Why doesn’t the news media investigate that?

All this talk about getting people off the street and into shelters to help them is complete BS. The “supportive services” I’ve received have been a total failure in helping me with my financial, housing and health problems. My situation is worse than when I entered the KHAKO program 2 years ago. KHAKO’s solution is to use the police to force me back to being unsheltered on the street, even though they know that would be dangerous to my health.

Over 500 unsheltered homeless people die each year in Hawaii because of mismanagement, incompetence and fraud by the people paid to help the poorest of the poor. DHS, HUD, Maui DHHC, the homeless industry and yes the legislators, all have blood on their hands and have all failed me. There is no reason to solve the homeless problem with so many people making a good living off it. They will keep coming up with new “studies”, plans and programs to make you think they are doing their job, which the media goes along with. The homeless have no voice or political influence.

Sheltered and unsheltered homeless live a brutal 3rd world life whether you believe it or not. We are the collateral damage of the bad choices made by our government and economic system over a long period of time. I will probably suffer a slow, silent, “unattended death” on the street. This is real life and death for me and many others.

As I wrote 2 years ago when I started these articles, I wasn’t sure how this would end. Now I’m pretty sure it will end with my death. Something I thought was possible, but did not really think would happen. At this point it would be the easy way out. I do not want to die, but can take it no longer and see no way to avoid it at this point. What will trigger my death, I can’t say. It could be that KHAKO is kicking me out and I can’t be homeless on the street again. It could be because I’m completely broke because DHS and Cyrica suspended my disability even though I did everything they required of me. It could be because my roommate is continuing to harass me and KHAKO does nothing about it. I could be because my family and friends deserted me. It could be the physical pain from my operation that my PCP has failed to manage. The real reason is probably all of the above and the documentation is all around me. I hold all of the people above partially responsible for my death. They have my blood on their hands and know it. I am another victim of homelessness and the cruelty of man. My body will be thrown in the garbage with the other poor victims.

I hope that at least KHAKO, Maui DHS, and Cyrica will be investigated for the role their incompetence and negligence played in my death so others will not be forced to suffer and die like me, but they probably won’t. This didn’t have to happen. They can’t say they didn’t know. Lucky, I’m a peaceful man, I could have justified a lot of violence, may be the next victims will take a few of the guilt with them.

I feel I was knowingly force into this death march by people who had power over me because of my medical and economic condition. The evidence is all around in files, video, on the web for anyone to find ( This systematic genocide of the poor is real and must be stopped. Hopefully, these articles will remain at Best Thinking as a true testament to the reality of homelessness in America during the beginning of the 21st century.

I’d hope to put these articles together as a real book, but it seems America is not ready for an unsanitized look at homelessness, even on glamorous Maui. Since I know you can’t take it with you, I throw my homeless story out into the universe with the hopes it will help bring about change somehow. At least I tried: I wish I could have done more. "'

ALOHA, Sanford L. Hill

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About the Author 

Sanford L Hill
I am a renegade, renaissance, Hawaii surfer poet who loves to think, experiment, and create radically outside the box. Born and raised in H

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