UNLV is out nearly half a million dollars after a troubled nonprofit tasked with improving vaccination rates across Nevada couldn’t meet the financial obligations of a contract with the university.

Public records recently obtained by The Nevada Independent show UNLV’s School of Public Health accrued the debt, totaling more than $462,500, as part of its partnership with the nonprofit Immunize Nevada, which focused on immunization outreach. The records show UNLV ended the collaboration with Immunize Nevada on April 27. 

The grant funding had supported the Vaccine Equity Collaborative and other outreach, such as listening sessions, digital mapping and a community-based participatory research approach to developing vaccine communication strategies for communities hardest hit by COVID-19.

In a statement to The Nevada Independent, UNLV officials said the debt will not affect the university’s budget or student services. Officials said the university is contracting with the state to recover the money it spent.

“We remain committed to any future efforts by the state to continue the work of the collaborative and further our shared commitment to addressing health disparities in our region,” UNLV officials said. 

The partnership ended after state officials terminated millions of dollars worth of grant agreements with Immunize Nevada in March following a report revealing unpaid bills and “possible fraudulent activities.” The financial discrepancies included complaints from former employees that they hadn’t been paid and $292,000 Immunize Nevada received in state grant funding to reimburse vendors, which it never did. 

Nearly five months later, state officials say the grant money has not been repaid and former employees still have outstanding pay issues.

Immunize Nevada’s board members and Sherilyn Duckworth, the organization's director, did not respond to an email request for comment from The Nevada Independent on Friday.

Nevada’s immunization rate is the 44th lowest in the country. Vaccine rates among adults in Nevada are significantly lower than the national average, and routine immunization coverage for children across the country has slumped to a decadeslong low. The low and declining vaccination rates are taking place despite evidence that vaccines offer protection against serious illnesses and as the U.S. has experienced a rise in vaccine-preventable diseases, such as measles.

Health care professionals and legislators worry that the lack of infrastructure and cohesive vaccine messaging could exacerbate Nevadan’s vaccine hesitancy. 

In an April interim legislative meeting focused on vaccination rates, among other health care issues, Sen. Fabian Doñate (D-Las Vegas) raised questions about how the terminated relationship could hinder state strategies surrounding vaccinations, especially in rural communities.

“This is a critical need that we're experiencing post-COVID,” Doñate said. “It's definitely something that we need to prioritize.”

What happened with the partnership?

Immunize Nevada partnered with the UNLV School of Public Health’s Nevada Minority Health and Equity Coalition in 2021 to form and co-lead the Nevada Vaccine Equity Collaborative. The collaborative was a coalition of private and public organizations dedicated to promoting the equitable distribution of the COVID-19 vaccine throughout Nevada. 

The partnership was funded through a federal grant managed by the Nevada State Immunization Program. The agreement stipulated the state would reimburse Immunize Nevada for payments to UNLV. UNLV would pay for specific elements of the program and then give the reports of the services it performed to Immunize Nevada, which would then pay UNLV and receive a final reimbursement from the federal grant money.

A spokesperson for UNLV wrote in an email that the contract between Immunize Nevada and the university stipulated payment installments throughout the two-year grant term.

“It’s typical for contractors to perform services up front and later receive payment at various intervals from the grant administrator for work provided,” the spokesperson said.

Records show Immunize Nevada paid the university a portion of the $1.2 million offered by the grant, but problems arose when Immunize Nevada did not have enough cash to complete the final installments of the payments.

After the university canceled its agreement with Immunize Nevada, state officials said they established a contract directly with UNLV to fund the work that took place.

Along with entering into a new contract with UNLV, state officials said its immunization program is collaborating with medical societies to help educate providers about vaccines and is working with various immunization-focused groups, providers and community health care workers to understand and address vaccination gaps in Nevada.

One example of a collaborative effort officials pointed to was a June 13 event hosted by the California-based, not-for-profit health care company Dignity Health, which operates hospitals and ancillary care facilities in Nevada, California and Arizona. The in-person event which also had virtual attendees included more than 180 individuals representing government agencies, health districts, tribal health centers and other organizations. Attendees focused on immunization data and vaccination gaps by region. 

State officials said Dignity Health will summarize the meeting for the state’s Department of Public and Behavioral Health, centered on what an Immunization Coalition in Nevada should prioritize.

In the meantime, officials said the state’s immunization program is focused on ensuring people have access to information about vaccine clinics and other immunization opportunities.

Already, Northern Nevada Public Health and the Southern Nevada Health District have begun hosting their annual back-to-school vaccine clinics, offering the vaccines required to attend school alongside additional non-required but encouraged vaccinations, such as HPV, COVID-19 and flu.

“Every year, routine back-to-school vaccine clinics are offered through Community Health Nurse Service locations, Local Health Authorities, Federally Qualified Health Centers, Community Health Clinics and other community-based organizations,” state officials said in an email.

Recouping the grant funding and unpaid staff members

State officials with the Division of Public and Behavioral Health said in an email that it directed Immunize Nevada to repay the $292,000 in grant funding or show proof of payments to vendors in December 2023 and asked again in the grant termination letter it sent in March. 

Officials said they have yet to receive the funding, and the state is consulting with the deputy attorney general on its next steps. 

In April, Duckworth, the director of Immunize Nevada, was announced as the new executive director of a Nashville-based mental health nonprofit, National Alliance on Mental Illness (NAMI) Davidson County. Following inquiries from The Nevada Independent, NAMI Davidson County later removed the announcement from its website and confirmed that the nonprofit no longer employed Duckworth.

Duckworth did not respond to a question at that time from The Nevada Independent about whether the announcement marked the end of her time with Immunize Nevada or if she would be helping with a transition.

Duckworth is still listed as the registered agent for Immunize Nevada on the secretary of state’s business portal, SilverFlume, and state officials said they are still communicating with Duckworth through her Immunize Nevada email.

Immunize Nevada’s SilverFlume listing page indicates the organization’s address has changed from a Reno post office box to a residential apartment address in South Reno. Public records indicate the address is Duckworth’s.

State officials confirmed the division has been in contact with former Immunize Nevada staff members who were not paid and said the division provided information for the Office of the Labor Commissioner, where former staff can file a claim. 

“At this time, it is the understanding of the Division that Immunize Nevada staff have not been fully paid but the organization will receive its final reimbursement from the Division shortly,” officials wrote in a statement.