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UNLV suspends pediatric HIV program, leaving patients in the lurch

Dismissals and lawsuits are aggravating controversy over UNLV’s suspension of an HIV program for children and pregnant mothers. The introduction of legal action adds a layer of opacity to a situation that was already confusing — and is putting children’s health at risk, according to the adults who care for them.

“Everybody is saying, ‘We feel you, we hear you,’ but nobody is doing anything,” says Elena Ledoux, the close friend of a family with a patient in the program who speaks on their behalf in order to protect their privacy. “If the university doesn’t reopen this clinic, the kids are doomed.”

The program, which UNLV refers to as the Maternal-HIV program, is part of a constellation of providers and services funded by federal grants through the Ryan White HIV/AIDS Program. Services range from medical visits and prescriptions to food stamps and psychological counseling. The grants began under the Ryan White Comprehensive AIDS Resources Emergency, or CARE, Act of 1990, explaining the name of the Nevada Care Program, which encompasses that constellation of providers and services.

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UNLV’s Maternal-HIV program was funded by a specific Ryan White grant geared toward helping women, infants, children, and youth whose healthcare access is limited by socioeconomics and other factors. Since 2006, it had operated under the auspices of the Reno-based University of Nevada School of Medicine, with care delivered locally through the UNLV School of Community Health Sciences. The recent opening of the UNLV School of Medicine caused the program — and the grant — to be transferred there. Similarly, the two physicians running the program, pediatrician Echezona Ezeanolue and pediatric nurse practitioner Dina Patel, had “been with the school of community health sciences, but working in the Nevada Care Program,” according to Shawn Gerstenberger, who is both dean of the UNLV School of Community Health Services and acting dean of the UNLV School of Medicine.

Practically speaking, this means expectant moms and kids with HIV got their Nevada Care Program medical treatment at UNLV’s clinic, where they’d see “Dr. Eze,” as they call Ezeanolue, and Patel … until September 15, anyway. That’s when the Maternal-HIV Program was suspended, Gerstenberger says. Beyond that, not much is clear. He declined to explain the suspension or answer questions about Ezeanolue and Patel.

What’s obvious to Ledoux and others who depend on the program is that they’ve been given the runaround. They say that they didn’t learn of the suspension until showing up to the clinic for checkups and prescription refills, and couldn’t get answers from anyone they called at the medical school or university to find out why the program was shuttered or where they should go to receive similar care. UNLV’s public statement about the program, which said it was subject to an administrative audit, was dated October 20, 2017.

Local media and Nevada System of Higher Education officials got wind of the controversy when Ledoux and other parents showed up at NSHE Board of Regents’ October 19 meeting and used the public comment period to air their complaints. Board chair Kevin Page expressed surprise at the situation, and Gerstenberger and UNLV President Len Jessup told the Las Vegas Review-Journal that paperwork irregularities had raised red flags and caused the Maternal-HIV program’s suspension and administrative audit. In days following the meeting, complaining parents received referrals to get their prescriptions refilled and see other doctors. Gerstenberger told Desert Companion  on October 26 that, by then, all the program’s clients should have received either a call or letter referring them to a case manager.

Ledoux says the case manager was friendly and helpful, but her referrals — either to generalized pediatricians or adult HIV specialists — won’t replace the specialized, pediatric HIV care the children were getting from Ezeanolue and Patel. And a solution only seems to be getting further away. Last Thursday, October 26, attorney Jacob Shafter filed a petition on behalf of “Jane Doe” (a minor patient) in state district court meant to compel UNLV to immediately revive the program.

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Shafter’s argument was, essentially, that the state of Nevada can force the university, as a state entity, to abide by its agreements. But the following day, UNLV’s lawyers had the case removed to federal court, arguing that the basis for Shafter’s claim was “Jane Doe’s” being denied due process, which is a civil rights violation. As part of her case, UNLV attorney Susan Carrasco O’Brien told the judge that the program was not suspended, because services were still being offered to patients. On Monday, October 30, Shafter sent out a press statement claiming that Ezeanolue and Patel had been put on leave from UNLV and escorted off campus.

UNLV declined to “comment on personnel maters,” and Ezeanolue couldn’t be reached for comment. Gerstenberger did say, “We apologize for any inconvenience this may have caused patients. Getting patients the care they need and deserve is our number one priority, and we are putting tremendous time and effort into that.”

This doesn’t comfort Ledoux. “The critical piece that everybody is overlooking is that kids are going to die,” she says. “If any child dies or becomes HIV infected, I want the public to know why."