Former employees of Helping Hands Youth and Family Services - an area youth mentoring and counseling agency under investigation for allegations of Medicaid fraud - say the agency's directors overloaded them with clients and told them to report hours spent with children even if they had not actually been with the children for the full amount of time for which Medicaid was billed.
"They told us to make the notes fit," said Donna Jackson, referring to detailed notes mentors had to keep for reports that documented their daily interactions with children.
"We heard that a lot," said Jackson, a mentor who spent nearly a year with Helping Hands.
The reports were backup documentation for bills that Helping Hands sent to Medicaid. Those bills showed each mentor spent four hours per day with each child in the program.
However, each mentor was assigned to two children and the mentors were not allowed to spend time with the children in school. That meant there were not enough waking hours outside of the school day for mentors to meet the four-hour requirement.
Former mentor Carol Hunt said Truman Lewis, the agency's chief executive, and Norman Lewis, who was in charge of the Georgetown office, told mentors during meetings that "they didn't care how we do it, we just needed to show that we put in four hours with each child."
Truman Lewis and Norman Lewis are suspected of Medicaid fraud along with other members of the Lewis family, according to court documents.
Instead of helping children, Hunt said, the Lewises "seemed to be more concerned with how much money was coming in and how many clients they could get."
The Lewises did not respond to requests for comment.
Helping Hands has its corporate offices at a Charlotte, N.C., apartment where Truman Lewis lives, according to that state's corporation filings. Norman Lewis lives in Hemingway, according to court documents.
The agency's offices in Conway, Georgetown, Columbia and Rock Hill have closed.
Helping Hands - a for-profit company - is not related to Grand Strand-area nonprofit groups with similar names, such as Helping Hand of Myrtle Beach Inc., North Strand Helping Hand and Helping Hands of Georgetown.
Charles Prior, the director of the Helping Hands office in Conway, declined to comment on the investigation.
Neither Prior nor any of the mentors is named in any court documents.
The Internal Revenue Service is investigating Helping Hands and the Lewis family for possible Medicaid fraud, tax evasion and money laundering.
The IRS said in court documents that Helping Hands billed the Medicaid program for nearly $9 million in less than two years beginning in January 2009.
More than $6.2 million of those payments was generated by false billings, according to court documents. Truman Lewis and other family members used most of the Medicaid money to buy homes, luxury automobiles and personal investments, IRS investigators said in affidavits.
Meanwhile, in a separate case, Truman Lewis was indicted Tuesday in federal court on charges that he is a felon in possession of a firearm.
Truman Lewis was convicted in 2003 of felony cocaine possession with the intent to distribute. Federal agents found a 9mm Ruger pistol at one of his Charlotte homes last month while conducting a raid related to the Helping Hands case. Truman Lewis faces a maximum 10 years in prison on the firearm charge.
Apart from the firearm charge Truman Lewis is facing, no criminal charges have been filed in the Helping Hands case. Search warrants were executed earlier this year at the agency's offices and several homes owned by the Lewis family, and the IRS continues to investigate.
Part of the IRS investigation into Helping Hands centers around medical necessity forms signed by LaTasha McIlwaine, a licensed professional counselor in Charlotte. Helping Hands used the forms to prove to Medicaid that the children in its program needed the mentoring services.
McIlwaine was to evaluate each child and assess whether the child met the specific medical criteria for the behavioral health services Helping Hands purportedly provided.
Court documents show McIlwaine signed some medical necessity forms for children as much as six months after Helping Hands had already started billing Medicaid.
Reached by phone, McIlwaine said that she is not familiar with Helping Hands and does not know Lewis. He had been listed as one of McIlwaine's friends on her personal Facebook page. That Facebook page was taken down hours after The Sun News contacted her.
'We weren't qualified'
Jane O'Rear, a mentor at Helping Hands for most of 2010, said there was minimal screening of children accepted in the program.
Hunt said she believed some of the children did not need the agency's help - one client used Helping Hands as a free baby-sitter, she said - while in other cases the behavior problems were so severe that Hunt was "worried that we weren't qualified to be helping those children."
Most of the children initially were referred by school guidance counselors or case workers at state Department of Social Services offices in Horry and Georgetown counties. Court documents do not indicate that any of the school or DSS workers were involved in the alleged fraud.
"The guidance counselors would fill out the [referral] forms, then the parents would go to Helping Hands and say, 'Here's my form,' and they would say, 'OK, you're in,'" O'Rear said.
Hunt said information appeared to be duplicated on some of the medical necessity forms that purportedly documented the children's specific needs.
"You would look at the forms and they all stated the same goals for different kids," Hunt said. "For example, you might have one kid who was ADHD and another who was bipolar and the goals on the forms would be the same for both."
O'Rear and Jackson said the Lewises gave mentors a list of Medicaid terminology to use in the weekly reports that documented how they spent four hours per day with each child.
"They told us what they wanted us to say, because those notes had to be written a specific way," O'Rear said. "They could not collect from Medicaid unless we turned our notes in properly. That is what generated the money."
O'Rear and other mentors said they joined Helping Hands because they wanted to help children, and they stayed with the agency despite its problems because they needed jobs in a tight economy. Helping Hands paid its mentors $14 per hour but did not provide any benefits and did not reimburse mentors for expenses related to their jobs.
"If one of the children needed clothes, they got it out of my dollar," O'Rear said. "If you pick up a child and he says he's hungry, you feed him. It's just what you do."
Needing the job
The mentors said they were paid for the 40 hours they spent with the children each week, but not for the hours it took them to write weekly notes or attend mandatory meetings at the Helping Hands office.
"It would take a whole Sunday to do the reports," Hunt said. "And if I couldn't get my time in with the kids during the week, I made it up on the weekends. You wanted to leave the job, but you can't because you need the money to survive."
Helping Hands went through a series of layoffs throughout 2010 and doubled the number of children assigned to each mentor in July, the mentors said. The entire staff was laid off in October, the same time federal officials started investigating the agency's Medicaid bills, according to court documents.
Bank records included in court documents show Helping Hands billed Medicaid a steadily increasing amount starting in January 2009, when the agency received $13,500 from the federal program. By April 2010, Helping Hands was billing Medicaid for $1 million per month.
IRS investigators said in court affidavits that Truman Lewis and his family members used improper Medicaid payments to purchase at least 13 automobiles - including an $89,000 Bentley and a $55,900 Mercedes - as well as a home in Charlotte, a manufactured home in Georgetown, a manufactured home in Hemingway, a golf cart and at least five certificates of deposit totaling $562,000.
IRS investigators also say Helping Hands has failed to file any corporate tax returns, owes payroll taxes of at least $252,724, and the Lewis family has failed to report all of its income from the agency.