Lawmakers eye legislation to rein in commissary costs, medical debt for incarcerated people

By: - September 14, 2022 5:06 am

“NDOC has the highest medical copay in the country and we were the only state in the nation not to waive that medical copay during the pandemic,” said Nick Shepack, the deputy director of the Fines and Fees Justice Center in Nevada. (Nevada Department of Corrections photo)

Following a recent state audit that found prisons mark up the prices of commissary goods more than 40% and people leaving prison faced millions of dollars in debt, lawmakers are proposing legislation to rein in the high costs of incarceration. 

But any legislative efforts to limit costs, which are usually passed along to families, won’t come until the 2023 Legislative session. 

The interim Legislative Judiciary Committee in late August approved drafting a bill to discharge certain debts, like medical debts, owed to Nevada Department of Corrections by people once they are released from prisons, and impose new requirements on NDOC’s ability to markup commissary items and charge medical co-pays.

The proposal comes months after the state, which released an audit in February, found incarcerated people owed NDOC $10.4 million in outstanding and uncollected debt, including medical debt.

The report found one account had an outstanding balance of $189,000, and of that $162,526 came from “medical charges resulting from an altercation.” 

Jodi Hocking, the founder of prison advocacy group Return Strong, said she talked with one individual who had the $550 he had saved wiped from his account due to medical debt.

Because the state lacks regulations on inmate pay, those working in prison jobs are paid subminimum wages and already have a hard time saving ahead of their release.

“He had an accident in the rec yard and owed NDOC around $7,500,” Hocking said. “They took all the money on his debit card except the $25 the debit card will cost him in fees to have it anyway. They took all the money and sent it to medical collections. He’s getting collection notices on the balance of that amount of money as he’s trying to get his life back together. These aren’t unique stories.” 

According to the Prison Policy Institute, prisons typically charge between $2 and $5 for medical appointments. In Nevada, it’s $8. 

“NDOC has the highest medical copay in the country and we were the only state in the nation not to waive that medical copay during the pandemic,” said Nick Shepack, the deputy director of the Fines and Fees Justice Center in Nevada. “For many who have institutional jobs such as a barber or a law library staff, a single medical visit can cost more than half a month’s pay.”

Though the copay is higher than other states, Hocking said there are also issues of medical neglect, which starts with people putting in a request to see a doctor then waiting for months. 

Taniko Smith, a formerly incarcerated person who now works with Return Strong, said it used to be easier to get medical assistance before the pandemic. 

“I’ve dislocated all of my fingers in prison,” Smith said. “I never went to the doctor for it. It’s usually too late by the time they answer you.” 

If the medical issue is untreated or ignored and then becomes more serious or life-threatening, an inmate has to call a “man down” where medical assistance is brought to the cell. Return Strong said those copays cost $65 to $85. 

“What has happened is people will put in (medical) requests and those requests will not get responded to or answered,” she said. “Then, it’s months or years later and they will have to call a man down and now we’re charging the higher man down fee because (staff) didn’t see them when they required chronic care or a follow-up care.”

Markups from milk to Midol

The audit released this year also showed a 40% markup on most goods sold to people who are incarcerated, as well as visitors purchasing items for them. 

In a previous statement to Nevada Current, NDOC’s Deputy Director William Quenga said they were in the process of putting together a report on cost analysis and profit margins. He said that unlike other states Nevada self-funds the commissary program and that “profits from the commissary pay the salary of the staff to run it, as well as for indigent services.”  

“For years, those of us who had a loved one who’s incarcerated, we’ve always known something’s not right with Nevada’s commissary pricing,” Hocking said. “It’s so much higher than other states.”

The Fines and Fees Justice Center, which provided independent data to the judiciary committee, said records requests indicate the most recent markups might be around 60%, higher than what the audit reported. 

Examples they provided include:

  • The vendor price for a box of Playtex tampons costs NDOC $6.08 but NDOC sells it for $10.13; 
  • Midol, which costs $4.70 for a box with 16 tablets, is sold at $7.83; 
  • A three pack of boxer briefs is $9.10 but is sold at $15.17; 
  • Milk powder mix costs NDOC $3.54 and is sold for $5.90.

Smith said commissary items are needed in order to supplement diets. 

“In prison, we need packages. We need food. We need clothing,” he said. “They don’t feed you right. It’s not only nasty, but it’s not enough. When I first came to prison a long time ago, they used to feed you. You had three hot meals and it was a lot of food.” 

The extra costs are shifted to families, who either send money to incarcerated loved ones to purchase products or spend money purchasing items from the vending machines during visitations.

Though Nicole Williams, an advocate with Return Strong, recently received a pay bump as a human resource manager, she still is living paycheck to paycheck, which makes it harder to support her incarcerated loved one. 

She often has to decide between “pay a bill, put money on his books or save up for a quarterly package.”

“That 7% (wage) increase has helped me be able to send my loved one a little more money each month so he can buy commissary items and add money to his phone time so he can call and talk to his children and sick elderly money,” Williams said. “NDOC has increased store prices at least six times this year and me and other families are paying for it.”

Since the legislation won’t be introduced until 2021, families asked Gov. Steve Sisolak along with the rest of the Board of Prison Commissioners to address the commissary markups at the board’s August meeting. The board took no action on the issue. 

The proposed legislation to rein in commissary markups isn’t the first time prison advocacy and legal groups have implored lawmakers to address fiscal practices by corrections officials. 

After prison officials implemented a policy to deduct up to 80% from inmate bank accounts, lawmakers passed Senate Bill 22 to limit deductions from friends and family at 25% and money earned through jobs at 50%. 

“When we passed SB 22 unanimously, we decided we would protect families of the incarcerated financially,” Shepack said. “What our research has found since then is that the costs have shifted and are exorbitant in many areas.” 

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Michael Lyle
Michael Lyle

Michael Lyle (MJ to some) has been a journalist in Las Vegas for eight years. While he covers a range of topics from homelessness to the criminal justice system, he gravitates toward stories about race relations and LGBTQ issues.