ROBERTSON, JUSTICE, FOR THE COURT:
This case presents important questions of first impression in this state regarding state power versus individual rights: whether, under what circumstances, and with what procedural safeguards, may the state demand of the estate
of one involuntarily civilly committed to the Mississippi State Hospital (MSH) at Whitfield reimbursement for all or part of the cost of care and treatment there rendered? We hold that under carefully limited circumstances the state has the power to require such reimbursement, that the legislature has by appropriate enactment vested this power in Mississippi Hospital Reimbursement Commission and in the chancery courts of this state, and that the estate of the deceased incompetent has been afforded full due process. We affirm the order of the court below directing reimbursement.
On December 18, 1979, Ernest B. Covington, then 66 years of age, departed this life intestate. On January 22, 1980, Bernard W. N. Chill, Sr., appellant here, petitioned the Chancery Court of the First Judicial District of Hinds County, Mississippi for appointment as Administrator of Covington's Estate. In routine fashion, the order of appointment was entered and the administrator fully qualified for the issuance of letters of administration. In due course notice to creditors was published.
On March 3, 1980, the Mississippi Hospital Reimbursement Commission (MHRC), claimant below and appellee here, probated a claim against the Estate of Ernest B. Covington in the amount of $46,373.72. The claim was based upon care and treatment services rendered to Covington by MSH beginning July 1, 1962, and continuing through and including the date of Covington's death. Administrator Chill contested the claim. After plenary trial on the merits, the Chancery Court on September 11, 1981, released a memorandum opinion allowing MHRC's claim in the amount of $16,230.80, or 35% of the amount originally claimed. An appropriate decree was thereafter filed on September 29, 1981.
Administrator Chill timely perfected his appeal to this Court, challenging in its entirety this final decree. The case has been thoroughly briefed by the parties, and the Court has received oral argument. The important issues tendered are now ripe for decision.
Ernest B. Covington entered this life in the year 1913. He apparently served approximately one year in the United States Army. At the beginning of the year 1951, he was married and the father of two children. He was employed as a bus driver in the City of Jackson. Beginning in that year and continuing for the next 28 years, little went well.
On March 30, 1951, Covington was involuntarily committed
to the Mississippi State Hospital at Whitfield, Mississippi via proceedings had in the Chancery Court of the First Judicial District of Hinds County, Mississippi. According to the record, Covington had made threats of physical harm to various persons. The commitment papers reflect that he was examined by two physicians as then required by law and assigned a diagnosis" paranoid psychosis ". The diagnosis made by the professional staff at MSH was" Schizophrenia, paranoid type ". Between April 6, 1951, and May 11, 1951, Covington received electroshock therapy 16 times.
It is not clear from the record whether Covington was released, escaped, or, as suggested at oral argument," simply walked off ". In any event, Covington was back on the streets of Jackson in early July of 1953. On July 7, a new civil commitment proceeding was instituted, again in the Chancery Court of the First Judicial District of Hinds County, Mississippi. The examining physicians gave a diagnosis of schizophrenia, paranoid type, and the Chancery Court promptly entered the commitment order.
The voluminous record of Covington's experiences at MSH was introduced in the court below. Suffice it to say that in the early years of his commitment, Covington vehemently and consistently demanded that he be released. The hospital progress notes on Covington reflect constant fears that he would be given more shock treatments - as he ultimately was. After several years the MSH staff described Covington as possessing" terrific hostility "and a" great potential for homicide "and ordered a prefrontal lobotomy, which was performed on January 18, 1957.
A progress note of February 21, 1962, says of Covington:" He remains quiet most of the time and causes no real disturbance. However, it is felt that he is still potentially quite dangerous. He refuses his medication much of the time and it is suspected that he doesn't take it at times when he appears to do so. "A progress note of January 20, 1964, indicates that Covington had been taken off electric shock treatments for approximately three months, but that his attending physician had decided to resume shock treatments" once weekly or twice weekly ". By October of 1964, Covington was being shocked once weekly and" at this time is being considered for another lobotomy ".
There are few happy moments that followed. Suffice it to say that on July 9, 1979, some 26 years after his second commitment, Covington was described as" quiet, withdrawn, . . . sits almost immobile with schizophrenic posturing. He covers his face and eyes with his hands and sits this way for long periods of time. . . . His voice is a very constant monotone when he speaks and if not prodded, stimulated and assisted in meeting his basic personal needs, these would be virtually
totally neglected by him. "On December 18, 1979, Covington died peacefully.
The claim at issue has been asserted under the authority of the Mississippi Hospital Reimbursement Commission Act, which became law on July 1, 1962. See Miss. Code Ann. 41-7-71, et seq. (1972). This Act begins in Section 41-7-71 with an important declaration of policy. It provides, in pertinent part, that free hospitalization and treatment shall be available to Mississippi residents at various state institutions where those individuals are not financially able to afford such hospitalization or treatment. The statute goes on to provide, in pertinent part, that
" no person shall be deemed entitled to free hospitalization or treatment offered by any such state institution who shall possess a sufficient estate or be entitled to receive sufficient income to cover all or a part of his or her maintenance and support as a patient or inmate of any institution, or who has a person or persons legally chargeable with his or her support who is or are financially able to pay for the maintenance and support of the said person as a patient. "[Emphasis added]
Section 41-7-73 then makes it clear that the Mississippi State Hospital at Whitfield is an institution within the meaning of this Act.
The Act then creates the Mississippi Hospital Reimbursement Commission, appellee here, and empowers it, inter alia,
" to assess and collect charges from patients, patients' estates and from all persons legally liable for the cost or care of such patients in any state institution. "
Section 41-7-79 further provides, in pertinent part, that
" The Commission shall investigate or cause to be investigated the financial ability of each patient, his or her estate, and all other persons legally liable for the cost or care of the patient, and the charges assessed shall be in accordance with the ability of
the person assessed to pay. . . . The commission shall adopt policies which will not work an undue hardship on any patient or person legally responsible for such a patient. . . . [Emphasis added]
The statute then empowers MHRC to institute suits against persons legally liable to collect for care and treatment rendered patients at state institutions. It is under this statute, Section 41-7-79, that MHRC probated the claim which has given rise to the instant appeal.
The evidence at the hearing below established without contradiction several important matters. First, without doubt, Ernest B. Covington was a patient at the Mississippi State Hospital from July 7, 1953, until his death on December 18, 1979. He was certainly a patient for the period July 1, 1962 to December 18, 1979, the period for which claim has been made here. Second, Covington was severely mentally ill during most, if not all, of this period of time. Third, the State of Mississippi through the personnel and facilities at the Mississippi State Hospital did in fact render care and treatment to Covington during all of this period of time. Finally, without doubt, the sum originally claimed by MHRC, let alone the much lower sum actually allowed by the Chancery Court, was substantially below the actual cost to the State of Mississippi of the care and treatment rendered to Covington.
By virtue of his having been a veteran, Covington was entitled to and did receive certain benefits from the Veterans Administration. These benefits were received into a guardianship created by decree of the Chancery Court of the First Judicial District of Hinds County, Mississippi. Deposit Guaranty National Bank of Jackson, Mississippi served as guardian through 1974 when it resigned. Thereafter, Bernard W. N. Chill, Sr., appellant here in his capacity as Administrator, was appointed guardian and he served in that capacity until Covington's death.
Over the years out of the funds received from the Veterans Administration into the guardianship, an aggregate of $7,438.00 was paid by the guardian to MSH for the care and treatment of Covington. These payments were made $80.00 here, $100.00 there, over a substantial period of time. MHRC claims that, pursuant to its regulations adopted in accordance with 41-7-79, Covington's estate owed $53,811.72. After giving credit for the $7,438.00 paid over the years, MHRC in fact claims $46,373.72.
At the time of his death, Covington's estate had accumulated some $25,000.00. Presumably, most, if not all, of this money came from the Veterans Administration. Pursuant to order entered June 10, 1980, the Chancery Court set aside the sum of $5,000.00 for Mrs. Carrie Crittendon Covington as her widow's allowance. Additional sums have been paid out of the estate for attorneys fees and legal expenses, primarily to finance the instant litigation. In this context, the Chancellor determined that
"This estate is liable for a part of the claim probated by the State of Mississippi through the Hospital Reimbursement Commission and that a payment of Thirty-Five (35%) percent of the claim filed, or ...