BREAKING: State cracks down on Greensboro drug-treatment program for ‘serious exploitation’

United Youth Care Services in Greensboro has been providing housing for poor and homeless people with conditions that they have to use drugs and/or attend mandatory substance-abuse classes. The homes the participants are provided are often in disrepair and pose hazardous conditions to the occupants. (photo by Jordan Green)

United Youth Care Services, a Greensboro drug-treatment program accused of exploiting clients desperate for housing, has received notice that the state Department of Health and Human Services intends to revoke its license, while suspending admissions and imposing $6,000 fine.

A 60-page report completed by the state Division of Health Service Regulation on Aug. 26 contends that agency President Donald Booker and Clinical Director Sandra Grace “orchestrated an elaborate system of using clients with mental health and substance abuse diagnoses, to make their housing contingent on the facility obtaining Medicaid reimbursements for treatment services that were not properly documented, falsified or not provided.

“Former clients interviewed reported their addiction became worse while being provided services by United Youth Care Services Inc. due in part to the condition of the housing, and the threat of losing housing,” the report states. “Legal protocols for eviction were not followed.”

Stephanie Gilliam, chief of the Mental Health Licensure & Certification section at the Department of Health and Human Services, informed Grace in a Sept. 12 letter that the conduct uncovered by investigators constitutes a violation of a state rule ensuring that clients are protected from harm, abuse, neglect or exploitation, resulting in a $3,000 fine. The state is separately fining United Youth Care Services an additional $3,000 for serious neglect based on reports by multiple clients that “they were instructed to lie about drug use to ensure their continued access to housing services.” The report went on to say that “facility staff confirmed the client reports of false urine tests and inaccurate assessments.”

A woman who answered Grace’s cell phone told Triad City Beat: “There’s nothing we can do. We’re being victimized by the negative light shined on United Youth Care Services by the news media, which refuses to interview clients about the positive experiences they’ve had.” The woman, who declined to identify herself, said she was authorized to speak on Grace’s behalf.

The order to suspend admissions and fine against United Youth Care Services follow sanctions issued against Ready 4 Change, another Greensboro drug treatment program, earlier this month.

The Division of Health Service Regulation report indicates that Grace, along with an unnamed program director, encouraged staff members “to maximize billing on clients who had been authorized for payments by creating notes on clients that were sometimes not in groups, to create notes even though they did not provide the service, to sign notes that were written by other staff, and falsify diagnostic assessments. Clients were discharged from the program without referrals, and billing continued for services after discharge dates.”

Investigators spoke to one client who had 26 visits documented by the agency after they had been discharged.

“I had clients in [the] group say, ‘I’m not a user. I don’t snort coke but it’s on my plan (person centered plan),’” one unidentified former staff member told investigators, who added that the clients were told they needed to say that in order to remain eligible for housing.

“I do believe labs were falsified,” the former staff member told investigators.

Another former staff member wrote in an email to investigators: “This place is evil and is the opposite of mental health.”

SarahLewis Peel, a spokesperson at the state Department of Health and Human Services, previously told Triad City Beat that United Youth Care Services is the subject of an ongoing Medicaid-fraud investigation involving multiple agencies.

The state agency found that Booker and Grace exploited four out of seven current clients and three out of eight former clients whose cases were reviewed during the investigation.

“I don’t have a drug problem, I have a housing problem,” one unidentified client told investigators. The client said they were told they had to have a positive urine drug screen showing illicit drug use to stay in the housing program.

“They said they could fix the urine,” the same client said. “I was made to lie to get in the program. I don’t do drugs.”

A former staff member who was employed as a recruiter by the agency told investigators that Booker and Grace controlled the housing accommodations for drug-treatment clients.

“Medicaid paid for these rooms out there,” the former recruiter said. “They got rid of me ’cause I was trying to find out what was going on.”

The former recruiter also told investigators: “They do mix up urine so they can falsify the record and get Medicaid for them. They think the clients are stupid and don’t know.”

The former recruiter told investigators that administrators at United Youth Care Services “made up progress notes and assessments” to file in Beacon, a Medicaid managed care authority, so that they could get paid by Sandhills Center, the publicly funded local management entity and managed care organization that funnels Medicaid funds to local providers.

“If Beacon knew that, they would shut him down, come on,” the former recruiter said. “Why is it that Beacon don’t know this man is a fraud?”

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