Eastern Virginia Medical School Is Still at Odds With Norfolk on AIDS Care

Doctors at Eastern Virginia Medical School have rejected the city of Norfolk's latest offer, which they described as unworkable, for treating indigent AIDS patients. On April 11, after months of wrangling over billing methods and other issues, the Norfolk officials who administer federal Ryan White CARE money in the region cut off the school's funding under the program.

About 350 patients formerly treated at EVMS must now find new primary care doctors. Medical school doctors treat about 1,000 other area AIDS patients, including those served by Medicare and Medicaid.

Dr. Edward C. Oldfield, director of the infectious disease division at EVMS, said Norfolk's plan would dismantle the medical school's system of 11 clinics, which had allowed AIDS patients to obtain a range of medical and social services in one appointment. "It's hard enough to fight AIDS in a community as a team, but when you have another group of people trying to sabotage your work, it's impossible," he said.

Norfolk City Manager Regina V.K. Williams said she regretted that the city and EVMS could not reach an agreement. An April 16 offer from the city would have given EVMS about $750,000 to allow it to resume seeing patients even before a formal contract was signed, Williams said. She said she hopes to involve Norfolk Mayor Paul D. Fraim and EVMS President Dr. J. Sumner Bell in future talks.

Oldfield's rejection of the offer cited several problems with Norfolk's proposal, including:

• The plan provides no outpatient care in James City, Williamsburg and York County.
• Physicians must refer patients to the health department for STD treatment and Pap smears.
• City officials have not found a replacement for an experienced nutritionist whose Ryan White funding was eliminated.
• Ryan White patients may receive prescription drugs from only one pharmacy, which is closed nights and weekends and does not deliver outside Norfolk.

One former EVMS AIDS patient said she had been told the Norfolk Health Department cannot see her until the end of May; EVMS staff never made her wait more than a day or two, she said.

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