Maine Boots Autism Provider After $16M in Medicaid Billing, Allegations of Fraud and Abuse Emerge

From neglect to sexual extortion, reports of shocking nightmarish mistreatment come to light. Paradise Residential Care is not the only adult autism provider facing heinous allegations.

Maine health officials have terminated a Portland-area autism residential care company from the state’s Medicaid program, citing “serious deficiencies” in its operations, after the company billed taxpayers nearly $16 million in three years while charging more than twice the national average for the same service.

In a March 9, 2026 letter to clients, Maine DHHS said Paradise Residential Services LLC was “no longer authorized to deliver MaineCare-funded services.” The state said it would continue temporary payments while the clients — Mainers with severe intellectual or developmental disabilities — transition to new providers.

Federal records show that Paradise was consistently in the 95th percentile for residential care billing among all residential care providers nationally, with per-beneficiary monthly billing of more than $33,000 — or nearly $400,000 annually per patient.

Paradise was incorporated on January 31, 2020, with $75,000 in startup capital. The purpose of the company was to operate group homes for individuals eligible for Maine’s Section 21 Medicaid waiver — the program that funds 24/7 in-home care for adults with intellectual disabilities or autism.

Source: Maine Secretary of State

From the very start, Paradise exhibited billing characteristics that would have drawn the attention of anyone who examined the company’s finances.

The company billed $2,126,503 to MaineCare in 2022, serving 12 clients. By 2024, it was billing $7,942,326 across 237 clients. Total billings over the three-year period reached $15,856,478 — a 273.5 percent increase in three years.

Thanks to the release of claims-level data by CMS this year, it’s possible to compare Maine’s autism providers to businesses across the country that provide the exact same service.

Paradise billed the T2016 habilitation code — the standard per-diem code for group home services across the country — at between 2.07 and 2.09 times the national average every year. The company ranked in the top 5 percent of all U.S. autism group home operators by cost per claim in each of the three years for which records are available. The national average cost for T2016 per client per month is $16,106. Paradise averaged between $33,372 and $33,742.

Lindsay Hammes, the press secretary for DHHS, declined to comment on the letter to Paradises’ clients, citing “ongoing litigation.”

The agency is led by Commissioner Sara Gagné-Holmes, who was appointed by Gov. Janet Mills (D). Both Gagne-Holmes and Mills have been locked in a bitter dispute with the federal government over how Maine administers its Medicaid program, known in Maine as MaineCare.

The Centers for Medicare and Medicaid Services (CMS) have released a report alleging more than $46 million in improper payments in Maine’s child autism services for just 2023.

That report doesn’t even address adult autism services, known as MaineCare Section 21, the larger and more expensive program in which Paradise and its peer companies bill almost exclusively.

Separately, the U.S. House Oversight Committee is aggressively investigating whether Maine DHHS illegally sought reimbursement from the federal government for Medicaid services provided to non-citizens.

Paradise did not respond to a phone call seeking comment from Paradise CEO Jocelyne Ininahazwe and CFO Juste Arakaza.

When we attempted to interview Ininahazwe at the Paradise office in Portland Thursday morning, she drove off in a Mercedes E300.

Maine Wire Reporter Jon Fetherston contributed to this reporting.

Paradise Lost: The $8 Million Asylum Seeker Autism Company

Interviews with two former Paradise employees shed light on how Ininahazwe and Arakaza, along with some early investors, built a multi-million dollar Medicaid company using primarily Central African migrant workers and cutthroat tactics.

Appolonnia Sheppard, the former Chief Operating Officer (COO) for Paradise, started in 2023 and eventually quit the company in protest over its practices.

“I used to go home like crying every day. It was so horrible,” said Sheppard.

“The very first thing I saw was when I first got into the house, they had a client there who had not had a shower for nine months because they had a hot water heater in front of the shower, and she couldn’t get in. She was in a wheelchair,” said Sheppard.

Sheppard said Paradise hired almost exclusively from the population of so-called “New Mainers” — the thousands of Central African asylum seekers who arrived in the Portland area in two waves, first in 2019 and then again in 2022. The reliance of migrant labor, the majority of whom spoke no English, created friction with clients.

“They promised a lady they could do sign language. This poor lady couldn’t communicate with anyone. But she had all staff that not only couldn’t speak sign language — they can’t even speak English,” said Sheppard.

Carol Waig, the former Training Director at Paradise, said she attempted to blow the whistle on Paradise in October 2025.

“Paradise, when I first got there in May of 2024, they had that audit going on... they had deficiencies,” said Waig. “Some of [the deficiencies] were with training, and some of them were with HR... they gave us 10 names, and out of those 10 names, not one of them was a complete. We failed that audit.”

Although she described an operation that would never have passed an honest review, there’s no record of Paradise having received a Notice of Violation from DHHS among the 183 Notices of Violation the state turned over in response to a Freedom of Access Act request.

Waig said she met with state officials in 2025 to provide evidence of systemic problems at the company. She met in person with three senior state employee and provided a thumb drive with documentation. Waig said the senior director for OADS who attended the meeting arrived 10 minutes late, took no notes, and never followed up.

The state is now enhancing scrutiny of MaineCare agencies amid ongoing pressure from the Trump Administration and nationwide exposure of industrial scale Medicaid fraud — fraud committed disproportionately by “New Americans.”

Even as Mills insists via her U.S. Senate campaign that her administration has aggressively policed fraud, the Paradise letter is yet another example of what appears to be a scramble by DHHS to enforce rules where previously they’d turned a blind eye.

Waig and Sheppard both said Paradise wasn’t properly conducting background checks on new hires, training employees as state law requires, or properly filling out immigration checks.

“The background checks weren’t being done, the I-9s weren’t being signed,” Waig said. “I kept bringing it up to their attention, and they’d say, ‘Oh, [Ininahazwe] knows what she’s doing.’”

The I-9 is a document employers must use to ensure that employees are legally present in the U.S. and authorized to work. Employers are required to submit such documents by the the Immigration Reform and Control Act of 1986.

Direct Support Professionals (DSPs), the workers at autism group homes, are supposed to complete training courses offered by the state over the Internet via the Maine College of Direct Support (ME CDS).

When an employee has not undergone a background check, passed the state-issued training courses, or proved that they are eligible to work legally in the U.S., billing Medicaid for their labor is fraud.

The same goes for when the employees are sleeping, drunk, or when the patient is out of the house with family — all occasions in which Paradise allegedly continued to bill Medicaid.

“When we had clients go away, you’re not supposed to bill. So if they’re going to their mothers for the weekend, you don’t bill for that. They did. They never, ever reported anybody going away,” said Sheppard.

Paradise’s striking growth occurred at a time when Maine was in the grips of a migrant crisis that stretched Portland’s social services to the breaking point. Suddenly, as if coordinated by some unseen force, African migrants arrived in southern Maine by the thousands, at one point turning the Portland Expo building into a de facto refugee camp.

“Paradise Residential would not hire anybody unless they came from Burundi or Rwanda,” said Waig. “For the most part. They may have had a couple [U.S. citizens] in there, but they were accidents.”

The former employees painted a picture of a company with a single-minded focus on profit maximization, regardless of what was best for clients or required under the law.

Ininhazwe and Arakaza had complete control of the company’s Maine Integrated Health Management Solution (MIHMS) account, the account MaineCare agencies used to process claims.

“I wasn’t allowed to see MIHMS, which is the system that they bill for all the clients. I wasn’t allowed to go in there at all,” Sheppard said. “[Arakaza] kept it very close and did all the billing, and I wasn’t able to see anything of what was going on.”

But Sheppard saw enough to know that Paradise was trying to game the system to earn more money for every patient.

“With Paradise, whoever is doing the billing, they force you to get the highest amount of staffing on everyone, even if it’s not legit. And I tried to explain to them, you don’t just get two on one [staff-to-client ratios] on everyone,” she said. “There’s only certain clients that need two on one, and it’s, you know, high behavioral or high medical. But they want it on everyone, and if you don’t get it, they’re really mean to you about it.”

In instances where a MaineCare Section 21 company gets approved for a higher staff ratio on a given client, their billing can increase substantially. The federal Medicaid data show Paradise’s monthly billing per client reached $41,530 (or $498,360 annualized) in March 2024, a pattern consistent with attempts to increase staffing ratios.

New clients were so valuable to Paradise that they even employed a special employee to lure disabled Mainers away from other agencies. The company also used devious tactics to retain clients who were dissatisfied with their care or the quality of the housing.

“What they do when a client wants to leave for the bad care is they bribe them. ‘Oh, you want to go on a trip. Oh, you want more money.’ That type of thing,” said Sheppard. “[Arakaza] was constantly paying for, like, the clients’ nails to keep them happy. I get it. You do little things for clients. But he wasn’t doing it because he cared. He was doing it because he didn’t want them to leave.”

“I’d see them in [Arakaza’s] office, and then next thing I know, they’re telling me that them and their boyfriend are going on a trip next year. And I was like, what the hell? And then I talked to him, and he’s like, ‘Yeah, you know, we’ve got to keep them.’ And I was like, that’s insane. That’s so illegal. And so immoral,” she said.

Sheppard said non-English speaking staff at Paradise — especially women — were often mistreated in ways that would violate state and federal law. She described dealing with the Department of Labor when the owners withheld pay from employees in order to force them to turn in paperwork used to bill Medicaid.

Both Sheppard and Waig described another case where a senior employee at Paradise with close ties to the CEO engaged in a sexual coercion scheme targeting young noncitizen DSPs. A senior Paradise employee was, they said, caught paying female DSPs out of his pocket for shifts, and then telling them they would only get their money in exchange for sex.

“He would hire them without going through HR, without going through training. He just hired them, put them on the schedule, put them to work. They would have sex with him, right? And then the minute they stopped having sex with him, he took their hours away,” said Waig. “You’ve got young women coming over here with the intent to have a better life, and you’ve got their own countrymen pimping them out.”

Sheppard and Waig said the victims of the scheme went to Human Resources to complain, but they were later cowed into silence.

“The women backed down… They all went and talked to the women, and they were too scared to say anything, because all these new Americans are in the same church together,” Sheppard said.

The For-Profit Autism Industry

In addition to paying themselves large salaries through their businesses, the leadership at Paradise devised a clever real estate strategy to maximize profit from the MaineCare system, according to property records and the accounts of former employees.

According to the former employees, Arakaza, the finance officer, and Ininahazwe, the CEO, made more than $150,000 each via salaries. Plus they owned properties where the disabled clients were placed, a dynamic that allowed the company’s owners to transfer massive amounts of cash from the MaineCare agency directly into their bank accounts for rent.

Sheppard and Waig said the monthly rent Paradise paid to itself ran as high as $4,000 per month for properties that, in their view, would never have commanded the same price on an open market due to poor quality.

The real estate strategy is plainly visible in Registry of Deeds property records, including the use of a revocable trust under the Ininahazwe’s name, an LLC under the Arakaza’s name, and a real estate agent related to the company’s CEO.

A review of property records shows that Arakaza owns at least three Maine properties worth more than $1.4 million, while Ininhazwe owns the Maine properties plus a separate residence in Surprise, AZ, where former employees say she’s recently been living full-time. Nijimbere owns two properties, one in Westbrook and one in Auburn, with a combined value of more than $850k. Nshimiyimana also owns multiple properties.

In Sept. 2023, for example, after Paradise’s MaineCare cash flows had accelerated into the millions of dollars, Ininahazwe transferred her personal residence and a second property to an entity called “Jocelynes Revocable Trust.”

On November 12, 2024 — the year his company billed nearly $8 million to MaineCare — Paradise CFO Arakaza transferred three properties to Ninta Service LLC.

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On March 9, 2022, the Maine Drug Enforcement Agency arrested Kelly-Klaus Sahabo on two counts of trafficking crack cocaine. Firearms were seized. Sahabo is Jocelyne Ininahazwe’s son.

The Maine Drug Enforcement Agency (MDEA) released this picture following the Sahabo search warrant.

On June 1, 2023 — 14 months after the arrest — Sahabo purchased 79 Ross Road in Old Orchard Beach for $477,777 with a 5 percent down payment. The property is now held under a trust called “Jocelynes RET TBD Trust.”

When The Robinson Report visited the Paradise Residential office in December, a Mercedes Benz G-Wagon sat in the parking lot, bearing the vanity license plate, “Kelly K”.

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This story is the first installment in a series that will examine Maine’s for-profit autism industry.