Frank Macias emerged from the Nevada Department of Corrections after nearly 18 years, feeling a mix of relief and apprehension about reintegrating into society. However, just weeks into his new life, he received a letter indicating that he owed over $7,000 in medical debt from a broken wrist. The notice demanded payment within 30 days or it would be sent to a collection agency. With only $25 to his name upon release, Macias was overwhelmed.
“When I received that letter, it was like my heart dropped. I couldn’t imagine how that was possible,” he recalled. “After all, I gave them nearly 18 years of my life, and they still want to attack me. I felt attacked.”
Now 47 and a legal assistant at the LJU Law Firm in Las Vegas, Macias took matters into his own hands. He became an advocate for legislation to protect others in his situation from being burdened with medical debt upon release.
In collaboration with state Sen. Melanie Scheible, the Fines and Fees Justice Center, and Return Strong Nevada, Macias helped to pass Senate Bill 88, which cancels any medical debt incurred by inmates while in prison upon their release. The Senate passed the bill mostly along party lines, with the Assembly voting unanimously to approve it. Governor Joe Lombardo signed the bill into law on June 10.
Before SB 88, the Nevada Department of Corrections was actively pursuing the collection of medical debts from those who were formerly incarcerated, which not only wasted department resources but also exacerbated the challenges of re-entry into society for these individuals. It has been estimated that before the new legislation, formerly incarcerated individuals collectively owed around $13 million in medical debt. However, the department was only able to collect an average of $6,000 per year while incurring similar costs in collection efforts. In fact, last year, the department reported a meager profit of just $175 from these collections.
Nick Shepack, Nevada state director of the Fines and Fees Justice Center, testified during the bill’s hearing about the nearly impossible situation former inmates faced regarding repayment in a timely manner. Failure to address such debts led them to collections, where high levels of interest and additional fees further deteriorated their financial standing.
“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, and the debt just balloons,” Shepack stated.
Macias experienced this precarious situation firsthand. A few weeks after his release, he received the medical debt letter while trying to adjust to life outside. He was busy figuring out how to secure a driver’s license, find a place to live, and rebuild his credit.
Macias is fortunate in securing his job at the law firm and was able to afford a two-bedroom townhome, but his efforts to rent were thwarted due to his poor credit and criminal record. He relied on family support upon release, but acknowledged that many individuals in prison do not have the same help available to them.
Fortunately, with the passage of SB 88, Macias no longer owes the medical debt. The law cancels both existing and future medical debt for those who are released from prison. Nonetheless, Macias expressed concerns regarding whether the Department of Corrections would notify credit bureaus about the changes to his debt status. He is actively reaching out to ensure they are informed.
The need for medical debt cancellation is underscored by Nevada Department of Corrections Director James Dzurenda’s remarks, highlighting the link between such debt and increased risks of recidivism. “I do believe that something like this will help me to complete my mission with the agency,” Dzurenda said during the bill’s hearing.
Since the legislation went into effect, the department has ceased actively collecting medical debts from former inmates at the time of their release. However, if a released individual faces new charges and is reincarcerated, the medical debt will be reinstated.
The number of inmates incurring medical debt during their time in prison can fluctuate. For instance, Nevada Department of Corrections reported 85 inmates had medical debts in May, which increased to 112 by July. According to the Department, medical service providers will continue to be compensated; thus, there will be no significant loss of revenue for the state.
Officials explained that the inmate welfare fund, which collects funds from prison commissary purchases and family contributions, reimburses medical claims, allowing times of care and treatment to be assigned to inmates’ accounts as required by state law.
Macias incurred his medical debt from a broken wrist suffered while playing football. Upon discovering the extent of his debt, he was informed that 85% of his commissary savings were deducted to address the outstanding balance.
The passage of SB 88 has been viewed as a long-awaited shift towards justice for individuals released from the prison system, according to Jodi Hocking, founder and executive director of Return Strong. The organization had been working with Macias and others, identifying medical debt as a significant barrier to re-entry since 2021.
Jodi Hocking stresses the need to eliminate obstacles that hinder the successful reintegration of formerly incarcerated individuals back into their communities. “It’s not about absolving them from their responsibilities, it’s that if we’re choosing prison and incarceration to solve social problems, then they shouldn’t be independently paying for it,” she noted.
Macias’s trajectory reflects a story of transformation. Originally a corporate tax adviser in his 20s, his life took a turn in 2007 when he faced serious charges related to attempted murder and robbery. He acknowledges that several poor decisions led to his incarceration, but emphasizes the lessons learned and the transformations made during his prison time.
“My anger as a young man got the best of me,” Macias reflected.
Throughout his time in prison, Macias was committed to self-improvement, earning a paralegal license while becoming knowledgeable about Nevada law. Hocking remembers first meeting Macias four to five years ago, noting his exemplary character, strong desire for change, and positivity.
Since his release, Macias has aimed to use his educational background in law to assist others who are incarcerated, ensuring they can successfully reintegrate into society.
Despite the progress made with SB 88, challenges remain for individuals returning to society, particularly regarding the treatment of debts while still incarcerated. Hocking has received numerous complaints from families regarding the Department of Corrections withdrawing money from inmates’ accounts in anticipation of collecting debts before they are released, potentially complicating their re-entry.
“It looks like what’s happening is they’re trying to collect as much money as possible while they’re still in prison because they won’t be able to collect it when they come out,” Hocking commented.
Macias himself anticipated leaving prison with close to $400 but instead found that most of his funds were redirected to cover his pre-release medical debt.
“There’s no reinforcing structure to help ease people back into society, to help them slowly reintegrate,” Macias argued.
Looking ahead, Macias remains hopeful that he can assist others while continuing to adapt to his new life and overcoming barriers.
“We all make mistakes. That was one of my biggest mistakes in my life,” he said, reflecting on the events that led to his incarceration and recognizing the journey he has taken since.
“Everything had to happen for a very specific reason,” he continued. “I’m here now, just by God’s good grace.”
image source from：reviewjournal
