Frank Macias removed his watch and pushed down his sleeve to show lawmakers the limited movement of his wrist, which never healed properly because of inadequate care. (Legislative hearing screengrab)
Frank Macias only wanted a fresh start and a chance to rebuild his life after serving 18 years within the Nevada Department of Corrections. Nearly $8,000 in medical debt, which stemmed from a broken wrist he got while incarcerated in Northern Nevada, made that prospect a challenge.
Macias saved up $400 in prison, an already small amount to begin anew, but medical debt swallowed all but $25 right before he was released.
He told state lawmakers on Wednesday he was essentially told “here’s $25 you can start your life over with. We’re taking the rest out of your account and well, good luck.”
Not to be deterred, Macias began working at a law firm and remade his life after incarceration. Then in September last year he received a letter saying he had 30 days to pay back the remaining $7,200 medical debt balance or it would be sent to collections.
“That’s an impossible task,” Macias said. “You could put on a cape and call yourself Superman. It’s not going to happen … This task is just insurmountable at that point in time.”
Senate Bill 88, heard Wednesday at a Senate Judiciary Committee meeting, seeks to discharge medical debt from those incarcerated once they leave prison.
The bill, presented by Las Vegas Democratic state Sen. Melanie Scheible, came from recommendations out of the interim Judiciary Committee. It is the latest effort by lawmakers to bring reforms to the prison system.
The legislation, if passed, would take effect July 1.
Democratic state Sen. Rochelle Nguyen of Las Vegas suggested an amendment to the bill to make it retroactive. Scheible agreed with the idea saying that it would ensure “people like Mr. Macias could benefit from this policy and be able to move on with their lives.”
The Nevada Fines and Fees Justice Center said there is about $13 million in outstanding debt currently owed by formerly incarcerated individuals released from Nevada prisons. People released in 2024 accounted for roughly $2 million of that debt.
Nick Shepack, the Nevada state director of the Fines and Fees Center, said the overwhelming majority of the debt is never collected.
The department spent about $6,000 last year to attempt to collect medical debt, he said.
“When we look at the collection rates for the last two years, it was just over $6,000 each year,” Shepack said. “So last year, they came out with a whopping $174.91 in profit … Most years, we’re looking at some sort of a deficit.”
Russ Alfono, a medical administrator for NDOC, told lawmakers there isn’t dedicated staff seeking to collect medical debt and most of the $6,000 was spent on administrative processing and postage.
The debt itself has overwhelming consequences for people leaving prison.
“These are individuals who are just starting to rebuild their lives, and then one of the first things they receive is a threatening letter from the place that they just left,” Shepack said, explaining it is wholly unrealistic to expect people just released from the system to come up with thousands of dollars to pay back medical bills charged to them by the state while incarcerated.
Macias, who is now a policy advocate for the prisoner advocacy group Return Strong, broke his wrist while incarcerated and was sent to a medical facility in Ely for care.
The doctor instructed him to come back in two weeks after the swelling went down in order to properly put a cast on his wrist.
“I did not return back to the hospital for about three and a half weeks, close to a month later,” he said, not explaining the delay. “By then, my bones began to reset themselves. The only option left was to re-break it, have surgery and place screws on it.”
However, corrections staff rejected the recommendation for surgery and instead instructed the doctor to put a cast on the wrist as is, Macias said.
Macias removed his watch and pushed down his sleeve to show lawmakers his wrist that never healed properly because of inadequate care. He was told he would likely need to have corrective surgery one day.
Though Macias didn’t receive the recommended treatment, it still resulted in nearly $8,000 in debt.
Macias said he has talked with other formerly incarcerated people who face similar experiences but don’t know who to turn to.
“I had extraordinary people behind me, but what happens to the individuals that don’t have that, that don’t have anybody?” Macias asked.
NDOC Director James Dzurenda told lawmakers the department official position on the bill isis neutral,, but he agreed that when incarcerated people leave prison with medical debt it obstructs the correction system’s goal of preventing recidivism.
“I do believe that something like this will help me to complete my mission with the agency,” he said of the legislation.
The bill didn’t receive any opposition. The committee took no action at Wednesday’s hearing.