Agency accused of defrauding Medicaid and abusing clients

“They acted like we were walking checks,” said one client, describing her experience with United Youth Care Services, an agency that provides substance abuse treatment tied to offers of housing to people who are enrolled in Medicaid.

Recruiters for the agency found women desperate for housing and with limited finances, many of them either pregnant or with young children, and offered them what seemed like an invaluable gift. Not only would they receive shelter, but the agency also provided mental health counseling, substance abuse treatment, and childcare while the parents received services.

But the housing provided to clients of United Youth Care Services through a network of rundown apartment complexes and seedy hotels across Greensboro turned out to be infested with mold, bedbugs, frequent sewage backups and inoperable heating systems. The hotels and apartment complexes were plagued by rampant drug use. Clients were often denied keys to their rooms, leaving them exposed to theft and assault, and at the mercy of unscrupulous site managers.

As bad as the housing conditions were, many of the clients wagered that homelessness would be worse. They discovered that their Medicaid enrollment was a cash spigot for United Youth Care Services, and that if they failed to attend the therapy sessions, which count as billable units for the agency, they would find themselves subject to punishment, including lockouts of up to 72 hours, and possible eviction. Utilities shutoffs and rent hikes were also a common complaint.

Zalonda Woods, a former client who filed a fair-housing complaint against the agency with the city of Greensboro last month, has described United Youth Care Services’ substance abuse intensive outpatient program as “a fraudulent Medicaid scam.”

Allegations of false substance-abuse diagnoses

Eight former participants, including two who spoke on condition of anonymity, described an array of ploys UYCS allegedly used to establish and maintain false substance-abuse diagnoses so the agency could bill Medicaid. Some said that recruiters and intake interviewers encouraged them to exaggerate or lie about their substance use, or in some cases, they say staff falsified their paperwork with the clients’ cooperation. Others allege that staff tampered with urine samples to ensure that each client’s results showed up as positive. And one former client, Woods, said she wasn’t even aware that she was in a drug treatment program, but later discovered that her case file falsely described her as using cocaine and “drinking a gallon of liquor each day at the facility,” she said in a supplemental narrative provided to TCB.

“They told me to act like I was doing cocaine, but I wasn’t,” Dion M. Garner said. “I was just using weed and alcohol.” Garner is a former client of UYCS and mother of four who spent about a year at the Travel Inn in southwest Greensboro.

“I told ’em I did weed,” Garner continued. “They said, ‘Weed is not really an addiction.’ I had stopped using coke for a while. In order to get in, you had to be doing hard drugs. So, I started using coke again.”

Mia Zeigler, a former client who was forced to seek shelter at the Interactive Resource Center on June 13 after water and power were shut off without warning at Georgetown Manor apartments, recalled being told by a recruiter: “Lie to get your foot in the door.”

Zeigler said she told Donald Booker, the founder and president of the agency, and Richard Brian Graves, the program director: “All I do is smoke weed every day.” Their response, according to Zeigler, was, “That’s not enough.”

Lenora Bratcher, who left her housing placement at South Pointe Apartments in southwest Greensboro in April, said she smoked marijuana and used alcohol. She said she also told the intake interviewer accurately that she had a history of mental-health issues.

“They said, ‘Mental health ain’t enough,’” recalled Bratcher, who was seeking housing for herself and her 5-year-old daughter at the time. “Alcohol isn’t enough on its own. He said, ‘How much do you drink?’ I would tell him, ‘I could kill a fifth of liquor in 24 hours.’ He said, ‘That’s not enough.’ He said, ‘If you drink four bottles, that’s enough.’ He winks. I said, ‘Yes.’ I was in total agreement to it because there was no shelter at Urban Ministry, Salvation Army or Pathway.

“I’m not an alcoholic, sir,” Bratcher told TCB, “but I did what I did to get in — to receive housing.”

Two other former clients — one pregnant and the other with a daughter less than 2 years old — who spoke on condition of anonymity, also told TCB they lied at the instigation of recruiters so they could participate in the program and gain access to housing.

Bristling with anger at the indignity of having their water and electricity turned off, a group of residents from Georgetown Manor gathered outside the Interactive Resource Center on June 13, where a city parks and recreation bus brought them for emergency shelter. TJ Little, who is Mia Zeigler’s husband, said he was never formally enrolled in the substance abuse program at UYCS, but attended classes anyway.

“If you pee clean, they can’t use you,” he said, “so they’ll switch out your urine with someone who’s dirty.”

Although she herself was not signed up for Medicaid, Calibra Brewington said she joined her mother, Latitia Burch, who is a client of United Youth Care Services, at Georgetown Manor. Brewington said she declined to attend classes or submit to urine tests, but she became acquainted with staff. She said one staff member, who’s name she doesn’t recall, told her about the practice.

“If you pee clean, they’ll switch it out, or just mix it with someone else’s,” Brewington said.

Zalonda Woods said in a supplemental narrative obtained by TCB that her caseworker showed her a synopsis in her file that “stated that I was an active cocaine user and an alcoholic with psychotic and paranoid delusions.” Woods went on to say, “All of those claims are false, and totally fabricated. I was never tested for cocaine use, nor do I use cocaine, nor did I receive a psychiatric evaluation warranting such diagnoses.”

Woods, who had two children — ages 8 and 14 — with her during her time at UYCS, said a caseworker, identified only as “Nicole,” “stated that if I claimed to not be on drugs, I would be terminated from the program, because they required us to attend treatment sessions so they could bill Medicaid for treatment.” She added that she saw multiple forms in her file where her signature had been forged, including at least one in which her name was misspelled. Woods said staff told her that the printer was broken, and she could not receive a copy of her file.

Reached by phone, Nicole told TCB: “I felt like we were trying to give Zalonda good services. I disagree.” Without elaborating, she abruptly ended the call.

A spokesperson for United Youth Care Services initially asked TCB to meet with agency representatives and its attorney at its offices on Monday, but then canceled the meeting. Enasha L. James, the spokesperson, said in a Facebook message on June 15: “No statement will be made until you are contacted by our attorney.” A short promotional video that James shared with TCB touts the agency’s 16-year history of providing “a medical and clinical approach to combat substance abuse.”

‘All of that is true’

One former employee of United Youth Care Services, Talencia Walker, backed up former clients’ accounts.

Walker, who left United Youth Care Services in February 2018 and now lives in the Baltimore area, said without hesitation after hearing a summary of the former clients’ allegations: “All of that is true.”

Walker said the falsification of clients’ substance-abuse status occurs during clinical assessments and continues as staff updates progress notes in the clients’ files.

United Youth Care Services advertises “SAIOP” — an acronym for Substance Abuse Intensive Outpatient Program — on its website. A manual published by the NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services in 2017 describes it as a “treatment program that operates at least 3 hours per day and at least 3 days per week and is on an individualized treatment plan.” The manual indicates that the billing unit is one event per day for a minimum of three hours.

The Sandhills Center, a “local management entity-managed care organization” that covers nine counties, including Guilford, is responsible for authorizing Medicaid payments for services to people with mental-health and substance-abuse issues.

Heather Odendahl, a communications specialist for Sandhills, confirmed that UYCS is one of the agency’s providers.

“We take that seriously,” she said. “If we are to get a report of waste, fraud or abuse, the protocol is that we look into it certainly, but we would have to keep that under wraps and confidential.” Odendahl went on to say that if Sandhills investigators find credible evidence of wrongdoing, they will turn it over to the NC Department of Health and Human Services for possible prosecution.

There’s little doubt that Sandhills’ staff is aware of the complaints against United Youth Care Services.

Brett Byerly, the executive director of the Greensboro Housing Coalition, said his agency has received “dozens” of complaints from former clients who come looking for housing who have disclosed details about United Youth Care Services’ substance abuse treatment program.

In 2016, Byerly said he submitted a formal complaint to Sandhills about United Youth Care Services.

“To the best of my recollection about the verbal complaint I made to Sandhills, to the quality-of-care folks, was in regards to concerns that we had from our experiences with clients that they had offered housing contingent on them having a diagnosis relating to substance abuse and them telling us that they did not have substance abuse issues,” Byerly said in an email to TCB. “In other words, they had to fail a drug test to be able to get enrolled in the program and get housing, but they weren’t actually using anything. Of course, it’s easy to take something and fail a drug test if your housing depends on it, which several reported that they did.”

Walker, the former employee, said she repeatedly reported UYCS to Sandhills for falsifying records, including client progress notes, in 2015-16, and that Donald Booker, the president, was refusing to pay her if she didn’t recruit new clients.

Walker, along with a number of clients, singled out Sandra Grace, the agency’s clinical director, as a key figure in falsifying clients’ diagnoses and enforcing participation in the therapy session.

“She’s saying they have drug problems when they don’t,” Walker said.

Walker said both Grace and Booker, the president, tell clients: “I’m just trying to help you out so you can get housing.”

Grace abruptly hung up on TCB when contacted by phone on June 15.

Court records show a history of conflict between Walker and other employees, including Grace. Walker said Grace bullied her, while Grace has complained that Walker harassed her.

In an affidavit filed with a Guilford County criminal magistrate in February 2018, Walker alleged that during an agency function in early September 2016, Grace “grabbed my neck and began to choke me until my neck swolled up and my eyes were blurring.” Two weeks later, Walker said Grace assaulted her at her desk by placing her index finger on her temple and shoving it twice, and then laughing and saying, “What you going to do?” A magistrate signed off on a criminal charge, but the charge was subsequently dismissed by the Guilford County District Attorney.

Grace, in turn, filed a civil suit against Walker to obtain a restraining order, accusing her of harassing phone calls and texts. Under a section of the complaint headed “Other relief sought,” Grace wrote, “Not contact any client affiliated with the employer in efforts to drive clients away, refrain from retaliatory efforts with governing agencies (Sandhills) and licensing boards to get back at agency or any staff.”

In her complaint against Walker, Grace wrote, “She has a mental illness and refuses help.”

In an order enjoining Walker from contacting any of Grace’s clients, then-Judge Avery Crump — who is now the district attorney for Guilford County — validated the statement that Walker “has a mental illness” as a judicial finding.

“I’m not a mental case,” Walker told TCB. Regardless of whether the characterization is true or not, Walker questioned the legality of Grace making the assertion.

“Sandra diagnosed me, which she can’t do,” Walker said. “That’s illegal; she’s a colleague. It’s not on any record. I didn’t choose her as my therapist.”

Another judge, Angela Foster, later declined to issue a permanent no-contact order, finding that Grace failed to make her case. Grace also took out a criminal charge for misdemeanor harassment against Walker. That charge is still pending.

Judge Crump’s order did not apply to licensing boards or governing agencies, and Walker promptly filed an ethics complaint against Grace with the NC Substance Abuse Professional Practice Board, airing her accusations of assault. In April 2018, the board notified Walker that after investigating the allegations it was dismissing the complaint.

Barden Culbreth, the board’s executive director, signaled the reason for dismissal in an email to Walker even before the ethics committee had completed its investigation.

“On the face of it, this appears to be a dispute between employees of an agency,” Culbreth wrote on Feb. 18, 2018. “This is the reading so far from the board’s attorney. Do you have evidence of her mistreatment of clients?”

Drugs, discourtesy, curfew, keys and assault

In interviews with TCB, former clients of United Youth Care Services alleged a wide array of mistreatment, ranging from discourtesy and exposure to drugs to dangerous housing, and even assault.

In a February 2019 email to Barden Culbreth, the executive director of the NC Substance Abuse Professional Practice Board, Talencia Walker said clients had filed a total of 32 complaints against United Youth Care Services with Sandhills in the past year. Walker promised to send Culbreth a video of a client briefly complaining about Grace in connection with an alleged assault by a site manager at his apartment.

In the video, dated Sept. 16, 2016, which Walker shared with TCB, a 64-year-old man describes the site manager pushing him into his bathtub while the two men were arguing over a personal search. The client says he was fishing his phone and cigarette lighter out of his pocket when the staff member insisted on doing the search himself.

“I said, ‘No, you won’t, man. Just leave me alone,’” the client recounts in the video. “So, I was standing right there by the end of the bathtub, and he just pushed, tried to stick his hand in my pocket, and pushed me over the side. I fell back in the bathtub. He caught me and pulled me back up. ‘You all right?’ I said, ‘No, I’m not all right, didn’t you just push me in the damn bathtub?’”

The client said he was in trouble with staff for missing an appointment, explaining to Walker that he’d had to go to Burlington to pick up his two young sons after their grandmother notified him that she couldn’t watch them.

“That’s when site manager called Sandra, told Sandra: ‘This ain’t gonna work. He got to go,’” the client recounts. “So, she came over here raising hell about me missing an appointment. I told her, ‘It was an emergency with my kids.’”

Former clients interviewed by TCB said security agents cursed at clients and acted unprofessionally.

“They make us leave the apartment at 8, but the class didn’t start until 10,” Dion Garner said. “They’re banging on the door early in the morning telling you to get out.”

Clients who said they signed up for the program not because they needed treatment for substance abuse but because they needed access to housing said the residential setting, if anything, increased their exposure to drugs.

Demetris Lee, a warehouse worker who said she didn’t have adequate income to pay for housing, recounted, “They put me in a dingy hotel. I smoke weed, but these are heroin addicts.”

Lee said clients typically have to sign in for curfew — 10 p.m. on weekdays and 11 p.m. on weekends.

“The security men come around with pants sagging,” Lee said. “They smoke weed just like I do. Why would you hire someone who smokes weed? I have to sign a form for this guy every night.”

Three former clients, including one who spoke on condition of anonymity, singled out another employee for using drugs and for buying drugs from clients.

Before she moved to South Pointe Apartments, Bratcher and her daughter were placed at Regency Inn & Suites, located off 16^th Street across the highway from the Pyramids Village shopping center.

“People were selling drugs and selling marijuana,” Bratcher recalled. “Crack. Cocaine. Molly. Pills.”

Two clients, including one who spoke on condition of anonymity, went as far as to say that staff encouraged clients to use drugs.

“Some of the teachers are telling us to smoke crack, weed, molly, whatever — drugs,” Mia Zeigler said.

Lee, the only current client who spoke to TCB, said she doesn’t have a key to lock her door at South Pointe Apartments, where she is a current resident. Before she left South Pointe in April, Bratcher said she lived without a lock on her door, and her vacuum, shoes and clothing disappeared. Every one of the residents displaced from Georgetown Manor due to the June 13 utilities shutoff said they did not have keys to their own apartments.

Latitia Burch, one of the residents at Georgetown Manor, said that Leo, the rent collector, constantly gave her a hard time about having her children with her.

“They said we couldn’t have kids because they’re bringing in pedophiles,” she said.

Clients also said the free childcare services offered while they attend therapy is substandard. Zalonda Woods and another client, who spoke on condition of anonymity, said the children don’t get enough to eat in the childcare program, and Woods said she complained to management about workers smoking marijuana while on the job.

Mold, raw sewage, fire, no heat, power shutoffs

Accounts provided by clients that are backed up by reports by city code inspectors indicate that a rotating array of facilities operated by the agency in four out of five city council districts over the past three years are rife with extensive violations.

In May 2018, a city inspector cited a former assisted-living community that the agency commandeered on Old Battleground Road for broken windows, missing smoke detectors, mouse holes, inoperable air conditioning and heating, and clogged gutters.

Following a zoning meeting in late June of that year, code inspector J. McClintock met with the city’s planning manager and deputy city attorney to discuss the facility. City officials determined that the building was operating as a group care facility. Under city ordinance, such facilities are limited to 30 occupants. McClintock’s notes indicate that the finding generated a notice of violation based on the facility exceeding the limit.

Mia Zeigler, who stayed at the Old Battleground Road location, recalled, “There was an electrical fire…. They rushed us to a hotel.”

After the city shut down the Old Battleground Road facility, Zeigler said she was moved to South Pointe Apartments. The apartment was covered in mold, Zeigler said, and that she suffered a miscarriage there.

“The plumbing, the sewage and all that spitting out from other people’s feces in my tub overflowing,” Bratcher recalled of her time at South Pointe. “My daughter and I had to wear boots. Our clothes got molded and we had to throw them away.”

Five tenants who spoke to TCB provided an overlapping litany of complaints about conditions at South Pointe, including lack of heat and running water, worn and dirty carpets, and roaches.

Terri Buchanan, a code inspector, documented two cases of apartments at the complex without heat during the past winter. In one case, opened on March 15, Bratcher wrote: “Reported heat when out back in December and it caused a fire causing all outlets in the home to not work and there is no electricity in the living room. The dishwasher hasn’t been working since they moved in. In May, feces was coming out the sinks.”

Buchanan’s notes also reflect that she directly observed raw sewage on the playground in May 2018.

“No matter how much I would bleach the apartment down I would smell the mold,” said one former client, who spoke on condition of anonymity. “I pulled down the blinds; there was mold everywhere. Inside the wall. I woke up one day; I couldn’t talk, my vision was blurry…. My daughter had a bad cough. My roommate had two daughters. They went to the hospital, and got papers saying they had mold. That’s the only reason they were able to move out of the apartment.”

Numerous clients complained in interviews with TCB about food spoiling because of staff shutting off the power, either as punishment for not attending classes or paying rent, or sometimes for no apparent reason at all.

“This isn’t the first time you turned out the lights,” Latitia Burch lamented the day residents were displaced from Georgetown Manor. “It’s not the first time you turned off the water. You’re supposed to be getting money from Medicaid.”

Residents had called a man named Leo, who collected their rent. The response was less than satisfactory.

“Leo says, ‘It’s not my problem that they cut off your water,’” TJ Little recounted that night. “How’s it not your problem if you’re collecting my rent?”

Reached by phone the next day, Leo told TCB: “I don’t know why all hell broke loose. A few tenants thought they were thrown out. Those are probably the ones stirring up shit.” He suggested that the shutoff was an accident, saying, “My boss lady had the units turned off that wasn’t occupied, and they turned off all the units.” After being told he was being quoted, Leo angrily hung up the phone.

Residents said they have been told that their housing and drug treatment services are separate — an assertion also made by the caseworker named Nicole and by a second employee who spoke to TCB on condition of anonymity.

“That’s a lie,” Talencia Walker said.

A sign in one of the vacant units at Georgetown Manor explicitly makes the connection: “Attention: If you are not attending class daily, rent is $350 no exceptions! Per Ms. Delores!!!” Another sign reads, “All clients MUST go to class or get off the premises during class hours per Ms. Delores!!!”

Considering that Georgetown Manor residents were required to sign an agreement with an entity called “Daily Living Source LLC,” “Delores” appears to be Delores Jordan, who is listed as an official on the company’s articles of incorporation, on file with the NC Secretary of State office.

In 2017, the Charlotte Observer identified Jordan as the operator of a hotel where families with children, including people with disabilities and those who were simply desperate for housing, were exposed to “unsafe and squalid” conditions. The same year WBTV News reported that Jordan was housing people with mental-health and substance-abuse issues at an Econo Lodge in Gastonia. City officials shut the program down.

A message to Jordan on Facebook for this story went unreturned.

While Georgetown Manor residents were warned their rent would be raised if they didn’t attend classes, Zalonda Woods received a letter in March ordering her to vacate her apartment at South Pointe, written on behalf of “United Youth Care Foundation Inc.” — a slight variation on United Youth Care Services. Woods said that in February clients had been told that their housing provider was changing from United Youth Care Services to New Day Transitional Housing Program.

‘They don’t get paid if we don’t show up’

Former clients of United Youth Care Services said it didn’t matter if they were sick, they had work or there was inclement weather; agency staff constantly reinforced that it was essential that they attend classes.

“You had to be there every single day, Monday through Friday, even snow days and hurricane days, when the county was out, when school was out,” Lenora Bratcher said. “They don’t get paid if we don’t show up.

“If you had the flu, you still had to come to the group meetings.”

One client who spoke on condition of anonymity mentioned another client who showed up an hour early for class, signed in, and then immediately headed off to work.

“I just been going to work, sir, and ain’t been thinking about that class,” Demetris Lee, who is currently a client, told TCB. “If I can just sign that paper so they can bill Medicaid….”

Lee was one of four clients, including one speaking on condition of anonymity, who said clients faced a 24-hour lockout as punishment for not showing up for class.

On occasion, former clients said, conduct by staff could be described as heartless.

Mia Zeigler said she cooked for United Youth Care Services. After one shift at the agency’s office on Fourth Street, she said she was so worn out that she soiled herself. She said she begged someone to drive her back to her hotel so she could change her clothes, but they told her she would have to wait until the end of the evening class.

“I witnessed this organization evict a woman with babies in her arm, sending them out in the rain simply because her Medicaid ran out,” Zalonda Woods wrote in her statement. “The staff laughed at her while she cried.”

Talencia Walker, the former employee said simply: “They treat clients like garbage.”

Bratcher said staff, including Sandra Grace, the clinical director, constantly told clients if they complained to Sandhills, the agency would get shut down and they would have nowhere else to go.

“Everybody was scared about losing our housing,” Bratcher said. “‘If Sandhills shut us down, you won’t have nowhere to live.’ That’s how they kept us silent.”

Bratcher said during a group meeting she counseled other clients to get mail sent to their address, so they could establish a legal record of residency. That way, the agency couldn’t throw them out without undertaking a proper eviction proceeding.

Bratcher said she was discharged from the program in January, although she was supposed to continue through June.

“Sandra Grace told me I had to go because I was a threat to the business,” Bratcher said.

When Zalonda Woods refused to sign an agreement stating that she would adhere to certain housing rules, she said she was told to meet with Grace, who she said was regarded as “the enforcer” of the rules.

“When I spoke to her about the form I was asked to sign, Sandra Grace insinuated that a DSS complaint could be made against me because my housing is unstable,” Woods said in her written statement. “I took this to mean that she was threatening to remove my children from my care because I refused to participate in their fraudulent Medicaid scam. She said that security personnel were in my home waiting to ‘get the word’ to throw my things out if I did not agree to sign their document.”

Many clients said they want to see United Youth Care Services shut down.

“I do not feel that the staff… behave in ethical ways towards people with disabilities,” Woods said in her fair-housing complaint. “I believe they should immediately cease operations as a healthcare provider, treatment program and housing provider. Additionally, I believe they should admit to falsifying documents and diagnoses, take corrective action to clear up false statements in persons’ files, and offer damages to people whom they have harmed, including my family.”