McLaren et al v. Family and Child Services of Washington, D.C., et al

District of Columbia, dcd-1:2016-cv-00384

COMPLAINT against FAMILY AND CHILS SERVICES OF WASHINGTON, D.C., TONYA JACKSON-SMALLWOOD, GWENDOLYN MOSELEY-COLEMAN (Filing fee $ 400, receipt number 4616076192) with Jury Demand filed by KIRK W. MCLAREN, AZORA L. IRBY-MUNTASIR.

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8 UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA ____________________________________) THE UNITED STATES OF AMERICA,) THE DISTRICT OF COLUMBIA,)) ex rels.)) KIRK W. MCLAREN) 10109 Banchory Pl.) Bristow, VA 20136)) AZORA L. IRBY-MUNTASIR,) 1419 S. Street, SE) Washington, DC 20020))) Case No. Plaintiffs)) FILED UNDER SEAL v.) PURSUANT TO 31 U.S.C. § 3729, et seq.) FAMILY AND CHILD SERVICES OF) WASHINGTON, D.C. d/b/a FAMILY) MATTERS OF GREATER) DO NOT PLACE IN PRESS BOX WASHINGTON, D.C.,) DO NOT ENTER ON PACER 1509 6th St. NW) Washington, DC 20036)) TONYA JACKSON-SMALLWOOD) 11503 Little Bay Harbor Way) Spotsylvania, VA 22551)) GWENDOLYN MOSELEY-COLEMAN) 6304 Caryhurst Dr.) Fort Washington, DC 20744)) Defendants.)) 1 8 FALSE CLAIMS ACT COMPLAINT AND DEMAND FOR JURY TRIAL Qui tam Plaintiffs/Relators Kirk McLaren ("Relator McLaren") and Azora Irby-Muntasir ("Relator Muntasir") (collectively "Plaintiffs" or "Relators"), by and through their attorneys, on behalf of the United States of America and the District of Columbia complain and allege as follows: I. INTRODUCTION 1. This is an action to recover damages and civil penalties on behalf of the United States and the District of Columbia arising from false and/or fraudulent records, statements and claims made, used and/or caused to be made, used or presented by Defendants Family and Child Services of Washington, D.C. d/b/a Family Matters of Greater Washington, D.C. ("FMGW"), Tonya Jackson-Smallwood ("Defendant Smallwood"), and Gwendolyn Moseley-Coleman ("Defendant Coleman") (collectively "Defendants") in violation of the Federal False Claims Act (31 U.S.C. § 3729, et seq.) (the "FCA") and its D.C. counterpart, the District of Columbia False Claims Act (D.C. Code Ann. § 2–381.02, et seq.) (the "D.C. FCA"). 2. This action involves Defendants' false submission of claims to the Federal and Washington, D.C. Government in connection with FMGW's Mental Health Unit ("Mental Health Program"), Retired & Senior Volunteer Internship Program ("RSVP/DC") and Senior Works Program. 3. With respect to FMGW's Mental Health Program, Defendants FMGW and Smallwood engaged in a pattern of improper billing practices in order to fraudulently obtain Medicaid reimbursements based on inflated billing invoices. Specifically, FMGW (1) billed Medicaid for individual therapy sessions even though services were delivered in group sessions and (2) billed Medicaid based on incorrect social worker ratios. As a direct result of these 2 8 improper practices, federal and state health insurance programs have been caused to pay for mental health services that were never provided. 4. With respect to FMGW's RSVP/DC and Senior Works Programs, Defendants FMGW and Coleman fraudulently received federal and D.C. government funds based on false grant applications, false grant continuation applications and/or bi-annual progress reports. As a direct result of these improper practices, the federal and D.C. governments have been caused to divert funds from other legitimate senior social services programs and to pay for services that were never provided. 5. The FCA provides that any person who knowingly presents, or causes to be presented, makes, uses, or causes to be made or used, a false claim, record or statement to the government for payment or approval is liable for a civil penalty of up to $11,000 for each false claim submitted or paid, plus three times the amount of damages sustained by the government. 6. Similarly, the D.C. FCA provides that any person who knowingly presents, or causes to be presented, makes, uses, or causes to be made or used, a false claim, record or statement to the D.C. Government for payment or approval is liable for a civil penalty of up to $11,000 for each false claim submitted or paid, plus three times the amount of damages sustained by the D.C. Government. 7. Both the FCA and the D.C. FCA allow for any person having information regarding a false or fraudulent claim against the government to bring an action on behalf of themselves and the government and to share in any recovery. 8. Relators make these claims based on personal knowledge as former employees of Defendants and/or information and belief and diligent investigation including review of available documents and interviews of witnesses. 3 8 9. In addition, Relators seek recovery of damages for unlawful and retaliatory harassment and eventual termination of their employment as a result of their efforts to address the fraudulent conduct described herein. II. JURISDICTION AND VENUE 10. This Court has jurisdiction over the subject matter of this Federal False Claims Act action pursuant to 28 U.S.C. § 1331, 28 U.S.C. § 1367, and 31 U.S.C. § 3732(a), which specifically confers jurisdiction on this Court for actions brought pursuant to 31 U.S.C. §§ 3729 and 3730.1 11. This Court has personal jurisdiction over the defendants pursuant to 31 U.S.C. § 3732(a), which provides that "[a]ny action under section 3730 may be brought in any judicial district in which the defendant, or in the case of multiple defendants, any one defendant can be found, resides, transacts business or in which any act proscribed by section 3729 occurred." Section 3732(a) also authorizes nationwide service of process. 12. During the time period relevant to this Complaint, each of the Defendants resided and/or transacted business in D.C., and all of the violations of 31 U.S.C. § 3729 described herein occurred within this judicial district. 13. Venue is proper in this district because each of the Defendants can be found in, resides in, or transacted business in D.C. and a substantial part of the violations of 31 U.S.C. § 3729 described herein occurred within this judicial district. 28 U.S.C. §§ 1391(b) and 1395(a) and 31 U.S.C. § 3732(a). III. THE PARTIES 1 As the claims herein under the D.C. FCA arise from the same transaction or occurrence as the claims brought under the Federal FCA, this court has jurisdiction over the D.C. FCA claims as well. 31 U.S.C. § 3732(b). 4 8 14. Relator McLaren is a resident of Bristow, Virginia. Relator McLaren began working for the D.C. office of FMGW in October 2012 as the Chief Financial Officer ("CFO"), a position he held until he was terminated on August 26, 2014 in retaliation for raising concerns about financial improprieties at FMGW. 15. Relator Muntasir is a resident of Washington, D.C. From 2008 until 2014, Relator Muntasir was employed by the D.C. office of FGMW as the Volunteer Coordinator. Relator Muntasir was terminated in 2014 in retaliation for voicing concerns regarding the financial improprieties at FMGW. 16. Relators bring this action for violations of 31 U.S.C. §§ 3729 et seq., on behalf of themselves and the United States pursuant to 31 U.S.C. § 3730(b)(1) and on behalf of themselves and D.C. pursuant to D.C. Code §§ 2-381.01 et seq. Relators have direct and independent knowledge of the false records, statements and/or claims that Defendants submitted and caused to be submitted to Medicaid and of the fraudulent billing practices in which Defendants engaged. 17. Defendant FMGW is a non-profit organization that provides foster care, youth development programs, mental health/counseling services, and other activities for youth and seniors in the D.C. metropolitan area. FMGW was founded in 1882 and is one of the oldest, nationally accredited social service organizations in the Washington metropolitan area. FMGW administers seven social service and community programs within the District of Columbia. 18. Defendant Tonya Jackson-Smallwood is a citizen and resident of Virginia. Defendant Smallwood is the President and CEO of FMGW. Defendant Smallwood directed and participated in, or recklessly disregarded, the fraudulent conduct described herein. 19. Defendant Gwendolyn Moseley-Coleman is a citizen and resident of Maryland. Defendant Coleman is the Program Director of FMGW's RSVP/DC and Senior Works 5 8 Programs. Defendant Coleman directed and participated in, or recklessly disregarded, the fraudulent conduct described herein. IV. BACKGROUND Environment of Mismanagement, Fraud and Corruption at FMGW 20. FMGW's website features the optimistic slogan that it is "creating brighter futures for all ages." Specifically, FMGW purports to offer comfort to the most vulnerable citizens in the nation's capital by serving as "the role of 'family'" and "a support system for those that need it most at any stage of life" through the services it offers to the Greater Washington area. Under the guise of this mission, FMGW has been able to obtain funding and contracts to help those in need from the federal and D.C. governments over a period of years. 21. Unfortunately, FMGW's actual use of government funds has diverged widely from its purported mission. As early as 2011, staff at FMGW have engaged in practices to maximize and continue the flow of federal and state funds to the organization through the inflation and fabrication of data required to substantiate federal and D.C. grant funding. To evade detection of these practices, FMGW has a engaged a pattern of "losing" documents needed to support its award of government funding, especially with respect to the timesheets needed to justify the funding amounts. (Ex. 1, October 1, 2011 - September 30, 2012 Audit of FMGW by D.C. Office on Aging) 22. From October 2012 until August 26, 2014, Relator McLaren worked as the CFO of FMGW. As CFO, Relator McLaren was charged with helping to fix FMGW's financial problems relating to financial fraud and the mismanagement of funds, which was crippling FMGW's ability to help the community (including, but not limited to, the restrictions placed on the mental health clinic). From November 2008 until January 2014, Relator Muntasir was the 6 8 Volunteer Coordinator at FMGW for the RSVP/DC and Senior Works Program. In this position, she prepared the grant applications and progress reports, supervised the program volunteers and provided coordination and consultation for the volunteer functions. 23. In both of their capacities, these Relators became intimately familiar with the billing, sources of funding, and corresponding services offered by FMGW. Both Relators separately attempted to raise their disagreement with the billing and funding practices of FMGW with senior leadership in the organization, including Defendants Smallwood and Coleman. 24. However, rather than be rewarded for raising these concerns, Relator Muntasir and Relator McLaren were retaliated against and fired on or about January 2014 and August 26, 2014, respectively. Defendant Smallwood has fostered an environment of fear, isolation and retaliation among FMGW staff that challenge these behaviors and has placed in management positions individuals, such as Defendant Coleman, who perpetuate this unhealthy environment. As a result, FMGW has seen constant employee turnover and was even prohibited from taking on new patients due to violations in connection with its Mental Health clinic. At bottom, Defendant Smallwood's "leadership" has create an environment in which mismanagement, fraud and corruption has flourished. 25. Now, FMGW's former CFO and former Volunteer Coordinator file this Complaint to shed light on the corruption and fraud that has been allowed to cultivate at FMGW with respect to its Mental Health, RSVP/DC and Senior Works Programs. V. APPLICABLE LAW Claims for Reimbursement under Medicaid 7 8 26. Medicaid is a public assistance program that provides payment of medical expenses for low-income patients. Funding for Medicaid is shared between the federal and D.C. governments. 27. Title XIX of the Social Security Act, known as the Medicaid Program, authorizes federal grants to the states for Medicaid programs to provide medical assistance to persons with limited income and resources. Although Medicaid is administered on a state-by-state basis, the state programs adhere to federal guidelines. 28. State Medicaid agencies conduct their programs according to a plan approved by the Centers for Medicare & Medicaid Services ("CMS"). To carry out the mandates of the Medicaid program, the State agency pays providers for medical care and services provided to eligible Medicaid recipients. Providers that wish to participate in the Medicaid program must agree to comply with certain requirements specified in a provider agreement. 29. Providers are only entitled to reimbursement for the actual care provided. 30. In D.C., providers for mental health services file Medicaid reimbursement claims through the D.C. Department of Behavioral Health ("DBH") (formerly the Department of Mental Health). 31. DBH is a District of Columbia agency tasked with providing prevention, intervention and treatment services and support for children, youth and adults with mental and/or substance use disorders, including emergency psychiatric care and community-based outpatient and residential services. 32. To help fulfill this mandate, DBH contracts with certain community based providers to provide mental health services and support. As part of this process, DBH certifies 8 8 each provider to ensure conformity to federal and District regulations and monitors quality of care. 33. Over the past several years, DBH has contracted with FMGW to provide mental health services to children and adults in the D.C. Metropolitan Area. These funds are largely matched by the federal government. 34. FMGW also receives contracts from Child and Family Services Agency ("CFSA") and the D.C. Office on Aging ("DCOA") to provide mental health care services in the D.C. metropolitan area. The medical claims that FMGW submits to these agencies are also reimbursed through the Medicaid program. Retaliation Under the False Claims Act & D.C. False Claims Act 35. Both the Federal FCA and the D.C. FCA prohibit adverse actions by employers against employees on the basis of whistleblowing under the statutes. 36. Section 3730(h) of the FCA protects employees, contractors and agents who have tried to stop violations of the FCA or who have done lawful acts "in furtherance of" an FCA action from unlawful retaliation by their employers. Prohibited retaliation includes discharging, demoting, suspending, threatening, harassing or using other forms of discrimination in the terms and conditions of employment against an employee. Relief under § 3730(h) includes reinstatement with the same seniority status, two times the amount of back pay plus interest, and compensation for any special damages, including litigation costs and reasonable attorney's fees. 37. Similarly, § 2–381.04(a) of the D.C. FCA protects employees, contractors and agents who have tried to stop violations of the D.C. FCA or who have done lawful acts "in furtherance of" a D.C. FCA action from unlawful retaliation by their employers. Prohibited retaliation under the D.C. FCA includes discharging, demoting, suspending, threatening, 9 8 harassing or using other forms of discrimination in the terms and conditions of employment against an employee. Relief under §2–381.04(a) includes, reinstatement with the same seniority status, two times the amount of back pay plus interest, and compensation for any special damages, including litigation costs and reasonable attorney's fees. VI. THE FRAUDULENT SCHEMES A. MEDICAID FRAUD 38. FMGW's Mental Health Program purports to provide mental health and counseling services to residents of the greater Washington, D.C. area who are in need of assistance. Specifically, the Mental Health Program claims to serve children and adults diagnosed with mental illnesses, as well as those who have experienced neglect, abuse, and multiple family separations. The Mental Health Program also claims to give support and counseling services to seniors suffering from loneliness and despair, spousal abusers and victims, and adults suffering from anxiety, depression and mental illness. All of these services are reimbursed through Medicaid. 1. Therapist Overbilling Scheme 39. FMGW has been awarded by DBH two contracts, titled Human Care Agreements ("HCAs"), for the provision of mental health counseling services. These contract numbers are RM-10-HCA-MHRS-119-BY4-SC and RM-15-HCA-MHRS-108-FMGW-BY4-SC. (Ex. 2, DBH Human Care Agreements) 40. Medicaid reimbursement to FMGW for counseling services is determined pursuant to the HCA's Section "B.4.4. Pricing Schedule." 2 This section sets forth that individual counseling services are charged at a base rate of $23.19 per 15 minute increment, while group counseling services are charges at a rate of $10.45 per 15 minute increment. 2 The payment amount is set forth in the HCA, but may be modified pursuant to a task order. 10 8 41. As early as 2011, FMGW engaged in a fraud scheme pursuant to which FMGW would bill group counseling services as individual counseling services in order to inflate the payments it received from Medicaid. Defendant Smallwood was not only aware of the overbilling scheme, but actively encouraged FMGW therapists to bill for services in this manner. 42. In January 2012, DBH conducted a partial audit of FMGW pursuant to which it found that "evidence that services billed to siblings were inaccurately documented (e.g. overlapping service times were altered, service for 12 hours in one day to one group of siblings)." (Ex. 3, February 1, 2011 – January 31, 2012 Audit of FMGW by D.C. Department of Behavioral Health) Specifically, the audit found "[a]ll counseling services were claimed as individual services. Review of the 3 records side by side found counseling services provided to all 3 consumers on same date, note indicates consumers all present during each other's session, service times are back-to-back." (Id. at 11.) 43. Despite the audit findings, FMGW continued to improperly bill for these types of counseling services. Relator McLaren has both direct and independent knowledge regarding the continued improper billing practices following the 2012 DBH audit. In connection with his duties as CFO, Relator McLaren repeatedly expressed his concerns to Defendant Smallwood about FMGW's Medicaid billing practices. Despite the notice from the audit and Relator McLaren, Defendant Smallwood did not institute corrective action to stop these practices at FMGW. 2. Improper Social Worker Ratios 44. FMGW has also been awarded four contracts with CFSA for the provision of mental health services. These contracts are CFSA-11-H-0052; CFSA-11-H-0053; DCRL-2014- H-0019B, and DCRL-2013-H-0039F. (Ex. 4, CFSA Human Care Agreements) Under the 11 8 contracts, FMGW committed to provide social worker services to individuals identified by CFSA. These services are Medicaid reimbursable. 45. Reimbursement under the contracts is contingent upon FMGW meeting certain performance indicators and maintaining a specified ratio of social worker-to-children. Specifically, Section B.9.1 of the contracts state that the "Provider will be compensated a portion of its allocated Combined Services item contingent upon attainment of a set of benchmarks or performance indicators outlined below." Section H.9.4.4.3 explains that these indicators include caseload parameters, which include that the "Provider of Therapeutic and Specialized Family Based Foster Care shall assign no more than twelve (12) cases to each Case Managing Social Worker."3 46. FMGW has also entered into numerous agreements with DCOA for the provision of mental health services. Under FMGW's agreements with DCOA, FMGW has contracted to provide social worker services to individuals identified by CFSA and DCOA. Compensation for these services is also based on FMGW meeting certain performance indicators and maintaining a specified ratio of social worker-to-children. These services are also Medicaid reimbursable. 47. In 2012, Defendant Smallwood cut the social worker staff from both the CFSA and DCOA contracts to levels such that FMGW was not in compliance with the specific social worker-to-client ratios set forth in the contracts. 48. Although DCOA learned about this non-compliance and sought a reimbursement of the funds paid to FMGW, CFSA was never notified or repaid. 49. Relator McLaren reported the non-compliance with both the DCOA and CFSA contracts to Defendant Smallwood on numerous occasions, but was ignored. 3 During certain times the ratio number has been modified or amended by Task Order to decreased the number from 12 to 10. See, e.g., Exhibit 4, Task Order CFSA-11H-0052, M02 dated February 1, 2011. 12 8 50. Relator McLaren received continued pressure from Defendant Smallwood to eliminate social worker staff. Relator McLaren refused to do so and was ultimately terminated by Defendant Smallwood on August 26, 2014. B. GRANT FRAUD 1. CNCS Grant Fraud (FMGW's RSVP/DC) 51. The Corporation for National and Community Service ("CNCS") is a federal agency that funds non-profit and faith-based organizations through its national programs geared towards improving the lives of Americans through community service and volunteering. 52. The Retired and Senior Volunteer Program ("RSVP") is administered under CNCS's Senior Corp initiative and helps connect people age 55 and older with volunteer opportunities such as organizing neighborhood watch programs, tutoring and mentoring disadvantaged or disabled youth, assisting victims of natural disasters, helping seniors live independently in their homes, and assisting veterans and military families. RSVP volunteers serve commitments ranging from a few hours to 40 hours a week. 53. FMGW's own RSVP/DC Program offers a range of volunteer opportunities to local seniors at government agencies, nonprofit organizations, churches, hospitals, and other businesses throughout D.C. Under this overarching program, seniors may also participate in the Senior Works Program, which helps seniors use their skills in community internships that may lead to paid positions. Funding for the RSVP/DC program comes from grants awarded by the federal government, D.C. Government and private sources. 54. In order to receive a RSVP grant, potential applications are required to:  Serve all counties in the geographic service area associated with the funding;  Support at least 80% of the numbers of the volunteers listed in Part 1 or Part 2 of Appendix A; 13 8  Meet National Performance Measure requirements and other criteria in this Notice; and  Minimize disruptions to current volunteers associated with incumbent project. (See, e.g., Ex. 5, Notice of Funding for FY 2013) Annual award amounts will vary and the maximum amount is fixed by the previous RSVP grant cycle. 55. Specifically, the National Performance measures require the grantee to have:  25% unduplicated volunteers in one primary focus area;  30% unduplicated volunteers in other community need priorities area;  All other remaining unduplicated RSVP volunteers must be in Other Focus Area or capacity building measures; and  10% of unduplicated workers must be in Output/Outcome pairs in primary focus area or other focus areas/capacity building (i.e. in Workplans that result in outcomes). (See Ex. 5, NOF, Appendix B) 56. FMGW applied for and received a grant from CNCS in 2007. FMGW was awarded two continuation grants under this application for fiscal years 2008 and 2009. 57. FMGW applied for and received a grant from CNCS in 2010. FMGW was awarded two continuation grants under this application for fiscal years 2011 and 2012. 58. FMGW applied for and received a grant from CNCS in 2013. Upon information and belief, FMGW is still receiving funds based on a continuation of this initial grant. 59. Pursuant to the above grants, FMGW was awarded the total following funds from CNCS from January 2007 until March 2016: Grant Period Funds Provided by CNCS 14 8 January 1, 2007 – December 31, 2009 $277,268.22 January 1, 2010 – March 31, 2013 $266,017.00 April 1, 2013 – March 31, 2016 $116,257 (as of September 30, 2014) 60. The above CNCS grants covered multiple year periods; however, the yearly renewal of those grant funds was conditioned on the grantee meeting certain requirements to substantiate continued funding. Award amounts are based, in part, on the number of volunteers participating in the program and the number of volunteer hours contributed. 61. Bi-annual progress reports are submitted to CNCS to ensure that the program requirements are being met. The progress reports set forth information regarding the program workplan/details, program goals, the planned number of volunteers to serve in a given program, the actual number of volunteers that participated in a given program and the cumulative hours budgeted for the grant period. 62. As Volunteer Coordinator, Relator Muntasir was responsible for writing the descriptions in the progress reports relating to programs, as well as monitoring the projects listed in the reports. Defendant Coleman, however, had final approval over the progress reports and would modify and/or fill in the section of the report relating to the number of volunteers that participated in a given project. 63. In 2009, FMGW, under the direction of Defendant Coleman, engaged in a pattern and practice of grant fraud, pursuant to which grant applications and/or progress reports containing false information were submitted to CNCS in order to secure federal funding. Specifically, the progress reports contained information regarding programs that never took place and/or inflated the hours worked by volunteers under the programs. 15 8 64. As part of this scheme, Defendant Coleman created or directed others to create timesheets that contained fabricated names for volunteers with fabricated hours. In some instances, Defendant Coleman used the names of RSVP board members on the fabricated time sheets. Defendant Coleman would then review and incorporate the fabricated volunteer names and hours into progress reports for submission to CNCS. At all times, Defendant Coleman was aware that the information in these progress reports were false. 65. Importantly, Defendant Coleman would fabricate the data in the "Vol Data Total Number of Cumulative Hours This Budget Period" and "Vol Data Total Number of active Volunteers Serving This Budget Period" that appear on the front page of each progress report. By inflating or fabricating the number of hours and volunteers, Defendant Coleman was able to secure greater funding from CNCS. 66. For example, the following progress reports contain inflated or fabricated information: a. RSVP Progress Reports for January 1, 2009 to December 31, 2009 period: i. Under the Tutoring and Child (Elementary) Literacy Program, FMGW claimed to provide tutoring for 4 hours a week, for 28 weeks for a total of 2,800 hours to D.C. public school students in the first through third grade. The progress report states that FMGW had 20 volunteers participating in the tutoring program. In fact, FMGW only had two volunteers who participated in this program. ii. Under the Community Based Volunteer Program, FMGW claimed to assign volunteers to assist at various D.C. Social Services Agencies. The progress report states that 100 volunteers participated in this program. In fact, this number was entirely fabricated. b. RSVP Progress Report for January 1, 2010 to December 31, 2010: 16 8 i. Under the Tutoring and Child (Elementary) Literacy Program, FMGW claimed to provide tutoring for 4 hours a week, for 28 weeks for a total of 2,240 hours to D.C. public school students in the first through third grade. The progress report states that FMGW had 23 volunteers participating in the tutoring program. In fact, FMGW only had two volunteers who participated in this program. ii. Under the Community Based Volunteer Program, FMGW claimed to assign volunteers to assist at various D.C. Social Services Agencies. The progress report states that 40 volunteers participated in this program. In fact, this number was entirely fabricated. c. RSVP Progress Report for January 1, 2011 to March 31, 2012: i. Under the Tutoring and Child Elementary Program, FMGW claimed to provide 20 volunteers to provide one-on-one intense tutoring for 28 weeks for a total of 11,200 hours to D.C. public school students in the first through third grade. In fact, the number of hours provided and numbers of students were entirely fabricated. ii. Under the Community Based Volunteer Program, FMGW claimed to assign 55 volunteers to assist at various D.C. Social Services Agencies. FMGW claimed that this resulted in between 4,800 to 9,800 hours of work. In fact, the numbers of hours amassed and volunteers were entirely fabricated. iii. Under the Other Human Needs Program, FMGW claimed to provide volunteers to serve in administrative support capacities to assist the Department of Human Services and social workers in connection with the foster care program. The progress report states that ten FMGW volunteers provided approximately 1,526 volunteer hours. The numbers of hours amassed and volunteers were entirely fabricated as this program never occurred. d. RSVP Progress Report for April 1, 2012 to March 31, 2013: 17 8 i. Under the Tutoring and Child Elementary Program FMGW claimed to provide 20 volunteers to provide one-on-one intense tutoring for 28 weeks for a total of 11,200 hours to D.C. public school students in the first through third grade. In fact, the number of hours provided and numbers of students helped were entirely fabricated. ii. Under the Companionship/Outreach Program FMGW claimed supposed to visit two D.C. nursing homes and assist with activities such as bereavement outreach, counseling, active listening, light chores, errands, and meal consumption. In fact, the number of volunteers listed and the number of individuals helped were entirely fabricated. (Ex. 6, RSVP Progress Reports) 67. In addition to the fraudulent statements above, Defendant Coleman would improperly apply funds intended to support the CNCS RSVP grant programs to fund programs, in connection with services FMGW was supposed to host for the D.C. Office on Aging. 2. DC Office On Aging Grant Fraud 68. The D.C. Office on Aging ("DCOA") is a D.C. agency tasked with promoting the welfare of D.C. residents over the age of 60 be providing them with advocacy, health, education, employment, and social services. To accomplish this goal, DCOA funds a network of community-based non-profit and private organizations so that they can provide a full range of services to all Wards of D.C. The DCOA administers grants funded through the Older Americans Act (OAA) (42 U.S.C. § 3001, et. seq.), other federal funds, and D.C. appropriated funds. 69. DCOA's grants are awarded on a competitive basis, with possible continuation years based on the DCOA's determination of satisfactory progress during the initial year of the grant. 18 8 70. FMGW receives funding from the DCOA for its Senior Works and Golden Washingtonian Club programs. 71. FMGW's Golden Washingtonian Club program seeks to promote the contributions of seniors in D.C. and to bring seniors together socially. In order to do this, the Golden Washingtonian Club holds the following annual events: (1) Salute to Centenarians; (2) the Ms. Senior America National Pageant; (3) Mayor's Holiday Celebration; (4) the Ms. Senior District of Columbia Pageant; (5) Senior Day; and (6) the Senior Expo. 72. FMGW's Senior Works program seeks to create volunteer service opportunities for seniors in an effort to fill the underemployment gaps. Volunteers are reimbursed by a stipend to offset the costs of their meals and transportation. A large part of the grant funding request for the Senior Works program is based on the need to pay the volunteers stipends. The stipends are calculated as follows: [number of workers] x [number of hours] x [number of weeks] x [rate of pay]. 73. FMGW and Defendant Coleman engaged in a pattern and practice of grant fraud, pursuant to which Defendant Coleman created fake vendor invoices for catering services with respect to the Golden Washingtonian program. With respect to the Senior Works program, volunteer hours were fabricated in order to meet the "generated volunteer hours" presented in the grant applications/reports. VII. RETALIATION Azora Irby-Muntasir 74. On or about August 7, 2008, Relator Muntasir began working as a temporary assistant for FMGW in its RSVP program. 19 8 75. In November 2008, Relator Muntasir accepted a full time position with FMGW as the Volunteer Coordinator. In this position, Relator Muntasir was responsible for the grant applications and progress reports and supervising program volunteers. 76. During her time as Volunteer Coordinator, Relator Muntasir received several salary increases. In 2011, she received the Chief Executive Officer Award for excellence for her assistance with the 2011 Recognition Luncheon. (Ex. 7, Chief Executive Officer Award Presented to Relator Muntasir) 77. In 2012, Relator Muntasir expressed concerns about the false grant reports to Dolphene Williams, the former supervisor for Defendant Coleman. 78. In August 2013, Relator Muntasir again raised concerns with Dolphene Williams and Massata Johnson, the former executive assistant to Defendant Smallwood, about the fake vendor invoices. Relator Muntasir also raised concerns to Defendant Coleman regarding the use of false volunteer numbers and/or information in connection with the grants from CNCS and DCOA. 79. Following her articulation of these concerns, Relator Muntasir had her first poor performance review in December 2013. (See Ex. 8, Relator Muntasir Performance Review) She was subsequently fired the next month in January 2014. Kirk McLaren 80. On or about October 2012, Relator McLaren was hired by Defendant Smallwood for the position of Chief Financial Officer at FMGW as a contract employee. 81. Approximately a month later, Relator McLaren was promoted to a full-time employee position. 20 8 82. Beginning in 2012, Relator McLaren worked to bring FMGW's finances back in order by reducing costs and renegotiating government contracts. 83. In recognition for his performance, in November 2012, Relator McLaren received a 6% pay increase. (Ex. 9, Performance Pay Increase from the CEO) 84. During the same period, Relator McLaren complained directly to Defendant Smallwood about financial irregularities at FMGW, including the improper social worker-to- children ratios and the therapist billing scheme. In response, Defendant Smallwood became upset. 85. On or about September, 2013, Relator McLaren received a performance review where he was rated mostly "Outstanding" and "Exceeds". The only category where he got a "Needs Improvement" rating was in "Interpersonal Communications". (Ex. 10, Performance Review 10/1/12 – 9/30/13) 86. Specifically, the performance review criticized Relator McLaren for being "publicly and privately insubordinate", "creat[ing] conflict", and "hindering the CEO [Defendant Smallwood]". (Ex. 10, Performance Review 10/1/12 – 9/30/13) 87. On or about May 2014, Defendant Smallwood began ignoring Relator McLaren's communications concerning FMGW's financial mismanagement issues. 88. In response, Relator McLaren left a voicemail for FMGW's Treasurer requesting a meeting. The Treasurer agreed to this meeting but Relator McLaren never heard from him again. Shortly thereafter, Defendant Smallwood instructed Relator McLaren and other staff that they were not to speak with board members without Defendant Smallwood's consent and presence. 21 8 89. On or about summer of 2014, Defendant Smallwood stopped attending weekly status meetings with Relator McLaren, a routine that had been in place since Relator McLaren began working at FMGW. 90. Approximately a few weeks later, Relator McLaren was fired by Defendant Smallwood on August 26, 2014. COUNT I Substantive Violations of the False Claims Act: Medicaid Fraud 31 U.S.C. §§ 3729(a)(1)(A), (B), (G) and 3732(b) 91. Relators re-allege and incorporate by reference the allegations made in paragraphs 1 through 90 of this Complaint. 92. This is a claim for treble damages and forfeitures under the Federal FCA, as amended. 93. Based on the acts set forth above, Defendants FMGW and Defendant Smallwood knowingly presented and caused to be presented to the United States Government false and fraudulent claims, records, and statements in order to obtain reimbursement for mental healthcare services provided under Medicaid. 94. Based on the acts set forth above, Defendants FMGW and Defendant Smallwood knowingly made or used false records and statements to conceal, avoid, and/or decrease its obligation to repay money to the United States Government that it improperly and/or fraudulently received. Defendants also failed to disclose to the United States Government material facts that would have resulted in substantial repayments to the federal government. 95. The United States Government, due to statements and claims made, submitted or caused to be made or submitted by Defendants, including their failure to disclose material facts 22 8 that would have reduced government obligations, has not recovered Medicaid funds that would have been recovered if the truth were known. 96. By reason of the Defendants' false claims, records, statements and omissions, the United States Government has been damaged. COUNT II District of Columbia False Claims Act: Medicaid Fraud D.C. Code Ann. §§ 2-381.02(a)(1) and (a)(2) 97. Relators re-allege and incorporate by reference the allegations made in paragraphs 1 through 90 of this Complaint. 98. This is a claim for treble damages and penalties under the D.C. FCA. 99. Based on the acts set forth above, Defendants FMGW and Defendant Smallwood knowingly presented and caused to be presented to the D.C. Government false and fraudulent claims, records, and statements in order to obtain reimbursement for mental healthcare services provided under Medicaid. 100. Based on the acts set forth above, Defendants FMGW and Defendant Smallwood knowingly made or used false records and statements to conceal, avoid, and/or decrease its obligation to repay money to the D.C. Government that it improperly and/or fraudulently received. Defendants also failed to disclose to the D.C. Government material facts that would have resulted in substantial repayments to the D.C. Government. 101. The D.C. Government, unaware of the falsity of the records, statements and claims made, submitted or caused to be made or submitted by Defendants, including their failure to disclose material facts that would have reduced government obligations, has not recovered Medicaid funds that would have been recovered if the truth were known. 23 8 102. By reason of the Defendants' false claims, records, statements and omissions, the D.C. Government has been damaged. COUNT III Substantive Violations of the False Claims Act: Grant Fraud 31 U.S.C. §§ 3729(a)(1)(A), (B) and 3732(b) 103. Relators re-allege and incorporate by reference the allegations made in paragraphs 1 through 90 of this Complaint. 104. This is a claim for treble damages and forfeitures under the Federal FCA, as amended. 105. Based on the acts set forth above, Defendants FMGW and Defendant Coleman knowingly presented and caused to be presented to the United States Government false and fraudulent claims, records, and statements in order to obtain money from federally funded grants awarded through CNCS. 106. The United States Government, unaware of the falsity of the claims, records, and statements submitted or caused to be made or submitted by Defendants, has not recovered the funds that would have been recovered if the truth was known. 107. By reason of the Defendants' false claims, records, and statements, the United States Government has been damaged. COUNT IV Substantive Violations of the D.C. False Claims Act: Grant Fraud D.C. Ann. §§ 2-381.02(a)(1) and (a)(2) 108. Relators re-allege and incorporate by reference the allegations made in paragraphs 1 through 90 of this Complaint. 109. This is a claim for treble damages and forfeitures under the D.C. FCA. 24 8 110. Based on the acts set forth above, Defendants FMGW and Defendant Coleman knowingly presented and caused to be presented to the District of Columbia, false and fraudulent claims, records, and statements in order to obtain money from D.C. funded grants awarded through the DCOA. 111. The District of Columbia, unaware of the falsity of the claims, records, and statements submitted or caused to be made or submitted by Defendants, has not recovered the funds that would have been recovered if the truth was known. 112. By reason of the Defendants' false claims, records, and statements, the District of Columbia has been damaged. COUNT V Unlawful Retaliation, 31 U.S.C. 3730(h) 113. Relators re-allege and incorporate by reference the allegations made in paragraphs 1 through 90 of this Complaint. 114. This is a claim for damages under section 31 U.S.C. § 3730(h) of the Federal FCA for relief from retaliatory actions. 115. Based on the acts set forth above, Defendants FMGW, Defendant Coleman and/or Defendant Smallwood have retaliated against Relators within the meaning of section 3730(h) for their conduct in furtherance of this action and efforts to stop further violations of the Federal FCA. 116. The retaliation against Relator Muntasir and Relator McLaren consisted of harassment and discriminatory behavior which culminated in their terminations from FMGW in January 2014 and August 26, 2014, respectively. 117. Because of this conduct, Relators suffered pecuniary and other damages, including loss of pay. 25 8 118. Furthermore, Relator Muntasir, a senior citizen and, thus, one of the individuals that FMGW was purported to be serving, was forced to draw on her emergency savings and retirement funds earlier, including social security. COUNT VI Unlawful Retaliation, D.C. Code § 2–381.04(a) 119. Relators re-allege and incorporates by reference the allegations made in paragraphs 1 through 90 of this Complaint. 120. This is a claim for damages under § 2-381.04(a) of the D.C. FCA for relief from retaliatory actions. 121. Based on the acts set forth above, Defendants FMGW, Defendant Coleman and/or Defendant Smallwood have retaliated against Relators within the meaning of § 2-381.04(a) for their conduct in furtherance of this action and efforts to stop further violations of the D.C. FCA. 122. The retaliation against Relator Muntasir and Relator McLaren consisted of harassment and discriminatory behavior which culminated in their termination from FMGW in January 2014 and August 26, 2014, respectively. 123. Because of this conduct, Relators suffered pecuniary and other damages, including loss of pay. 124. Furthermore, Relator Muntasir, a senior citizen and, thus, one of the individuals that FMGW was purported to be serving, was forced to draw on her emergency savings and retirement funds earlier, including social security. PRAYER FOR RELIEF WHEREFORE, Relators/Plaintiffs pray for judgment against the Defendants as follows:  That the Court enter judgment against Defendants in an amount equal to three times the amount of damages sustained by the United States as a result of the 26 8 Defendants' actions, as well as a civil penalty against each Defendant for each violation of 31 U.S.C. § 3729;  That each Relator be awarded the maximum amount allowed pursuant to 31 U.S.C. § 3730(d);  That this Court enter judgment against Defendants in an amount equal to three times the damages the District of Columbia has sustained because of Defendants' actions, plus civil penalties for each violation of D.C. Code § 2-381.02(a);  That each Relator be awarded the maximum amount allowed pursuant to D.C Code § 2-381.03(f);  That each Relator be awarded the maximum amount allowed pursuant to 31 U.S.C. 3730(h);  That each Relator be awarded the maximum amount allowed pursuant to D.C. Code § 2–381.04(a);  That each Relator be awarded all costs and expenses of this action, including attorneys' fees; and  That the United States, the District of Columbia, and Relators receive such other relief as the Court deems just and proper. JURY DEMAND Relators hereby demand trial by jury. 27 8 Dated this 23rd day of February, 2016. Savaria Harris (DC-974910) DLA Piper LLP (US) 1251 Avenue of the Americas New York, NY 10020 Tel: 212.335.4500 Fax: 212.335.4501 E-mail: savaria.harris@dlapiper.com Attorney for Plaintiffs Kirk McLaren and Azora Irby-Muntasir 28