Much of Nevada’s Latino community has been forced into using unlicensed medical personnel because they can’t affordable licensed physicians, the Las Vegas Review-Journal reports.

The issue came to the forefront of Nevada medical policy debate after the death of Elena Caro, who died as a result of botched cosmetic surgery performed without a license. According to the Latino Research Center of the University of Nevada, none of the state’s legitimate health care providers offers cosmetic surgery.

Not only is the state short on medical personnel in general, it’s especially short on Latino doctors who can speak Spanish and who share their patients’ cultural background, said Larry Matheis, executive director of the Nevada State Medical Association. According to Matheis, when he was making a presentation about a media campaign to educate Latinos about the dangers of visiting unlicensed doctors, the legislators present didn’t seem aware of—or concerned with—the underlying causes of the problem.

The Clark County Department of Social Services is underfunded—and thus understaffed—because of a drop in property tax revenue, which has resulted in a wait of up to 18 days for some medical services, said Timothy Burch, the department’s director. (Clark County, which encompasses the city of Las Vegas, contains nearly three-quarters of Nevada residents.) As a result, people in need of medical help must resort to emergency room care or to unlicensed medical services.

Former Nevada Attorney General Frankie Sue Del Papa chairs a state task force to investigate the state’s reliance on unlicensed medical personnel. She says her task force is looking into the availability of medical services.

To read the Review-Journal article, click here.