Does Mississippi's $400 cost cap in commitment proceedings cover hospital and physician fees, or just court costs?
Plain-English summary
Harrison County's chancery clerk asked the AG to clarify how the $400 cost cap in § 41-21-79 works for civil commitment proceedings. Three questions: what does the cap include, does it apply to non-indigent respondents, and does the county still owe a county-owned hospital for prehearing care.
The AG worked through them.
What the cap includes. § 41-21-79's text lists costs incidental to court proceedings: "court costs, prehearing hospitalization costs, cost of transportation, reasonable physician's, psychologist's, nurse practitioner's or physician assistant's fees set by the court, and reasonable attorney's fees set by the court." The list is non-exhaustive ("including, but not limited to"). All these costs together are capped at $400. § 41-21-65(6) separately handles affiant fees and assessments; those cannot be charged under § 41-21-79.
Indigent vs. non-indigent. The cap is $400 in either case. If the respondent is indigent, the county of residence pays. If the respondent is not indigent, the costs are taxed against the respondent or their estate. The 2006 Blakley and 2001 Williams opinions are cited for the same point. The state may pay if state funds are available specifically for that purpose.
County hospital ownership. If the county is part-owner of the hospital that provided the prehearing care, the county still owes the hospital. The 1989 Aldy opinion treats county hospitals as separate governing authorities from the county itself. Parish v. Frazier, 195 F.3d 761 (5th Cir. 1999) confirms a county hospital is a political subdivision of the state. Under Article 4 § 100 of the Mississippi Constitution and the AG's prior opinions (Thomas 1999, McDonald 1996), neither the state nor any of its political subdivisions may forgive a debt. So the county cannot just write off what it owes its own hospital.
The opinion is most useful for chancery clerks who often face complaints from hospitals or providers that the $400 cap leaves them under-reimbursed. The cap is the cap, and a single billing must allocate within it.
What this means for you
If you serve as a chancery clerk handling commitment intake
When you bill costs in a commitment proceeding, run the total against the $400 cap. The $400 covers everything: court fees, prehearing hospitalization, transportation, attorney fees, physician evaluations. Allocate within the cap. If the respondent is indigent, the county of residence pays the $400 (or the actual costs, whichever is lower). If the respondent has assets, the costs are taxed against the respondent or their estate. Document the indigency determination.
If you operate a Mississippi community mental health center or hospital providing pre-evaluation services
Your reimbursement for commitment-related care from the county is capped, in combination with all other proceeding costs, at $400. If your actual costs exceed your share of $400, your options are: bill the respondent (if not indigent), seek payment from the state if state funds are appropriated, or absorb the loss. The cap is statutory and the AG opinion confirms its scope.
If you serve on a Mississippi county board of supervisors
For commitment costs of indigent county residents, your county is on the hook for up to $400 per proceeding. If your county is part-owner of a community hospital, you cannot waive the county's portion of the bill: § 100 forbids debt forgiveness by political subdivisions. Build the line item into the budget.
If you are a chancellor presiding over commitment proceedings
You set "reasonable" attorney's fees and "reasonable" physician/psychologist/nurse practitioner/PA fees within the cap. Allocating $400 across all the cost categories is constrained; you may need to set fees lower than what providers would normally charge to keep the total under the cap.
If you represent a respondent in commitment
For non-indigent respondents, the $400 in costs is taxable to the respondent or their estate. For indigent respondents, the county pays. The cap protects against open-ended liability for proceeding costs but does not insulate respondents from the deeper costs of commitment treatment, which are addressed under separate statutes.
Common questions
Q: Does the $400 cap include all sessions or per session?
A: The opinion treats the cap as applying to "the court proceedings" for a particular commitment. The statute text supports a per-proceeding cap. Repeat or extended proceedings can complicate the analysis.
Q: What if the actual cost is way more than $400?
A: The cap holds. Providers absorb costs above $400 unless there is a separate funding source (the state, a charity, or the respondent's resources). The opinion does not authorize the chancery clerk or the county to exceed the cap.
Q: Does this apply to all involuntary commitments?
A: § 41-21-79 sits in Mississippi's civil commitment chapter (Title 41, Chapter 21). It applies to chancery-court civil commitment proceedings. Other commitment routes (criminal-justice-related, juvenile, etc.) operate under different statutes.
Q: Can the county pay the hospital from a different fund to avoid the cap?
A: The cap is on charges to the proceeding, not on what the county can pay generally. A county can support a county-owned hospital in other ways under separate authority. The McAdams opinion is about not being able to waive the debt the county already owes.
Q: What about state funds?
A: § 41-21-79 says "unless funds for those purposes are made available by the state." If the state has appropriated funds specifically for these costs, those can supplement the indigent county-of-residence obligation.
Q: How does the indigency determination work?
A: The opinion does not lay out a procedure. Counties typically use a standard indigency screening based on income and assets. The county or its court personnel make the determination.
Background and statutory framework
Mississippi's civil commitment process is in Title 41, Chapter 21. It places primary responsibility for proceeding costs on the respondent (if non-indigent) or the county of residence (if indigent), with a statutory cap to prevent open-ended liability. The cap was set at $400 in the current version of the statute.
Mississippi's prohibition on debt forgiveness sits in Article 4 § 100 of the state constitution: "No obligation or liability of any person, association, or corporation held or owned by this state, or levee board, or any county, city, or town thereof, shall ever be remitted, released or postponed, or in any way diminished by the legislature, nor shall such liability or obligation be extinguished except by payment thereof into the proper treasury." This applies in full to inter-entity county debts (county to county hospital) per the 1996 McDonald and 1999 Thomas opinions.
The cap structure pushes high commitment costs to fall on providers or to be absorbed in other ways, which has been a recurring point of friction in Mississippi mental health policy.
Citations
- Miss. Code Ann. § 41-21-65(6) (affiant fees and assessments)
- Miss. Code Ann. § 41-21-79 ($400 cost cap on commitment proceedings)
- Miss. Const. Art. 4, § 100 (prohibition on debt forgiveness by political subdivisions)
- Parish v. Frazier, 195 F.3d 761 (5th Cir. 1999) (county hospital is a political subdivision)
- MS AG Op., Aldy (Aug. 9, 1989) (county hospital and county are separate governing authorities)
- MS AG Op., Blakley (Aug. 25, 2006) (costs borne by respondent or county of residence)
- MS AG Op., Williams (July 6, 2001) (hospital may collect from individual unless indigent)
- MS AG Op., Thomas (Nov. 19, 1999) (state and political subdivisions cannot forgive debt)
- MS AG Op., McDonald (Nov. 8, 1996) (Article 4 § 100 prohibits inter-entity debt forgiveness)
Source
- Landing page: https://attorneygenerallynnfitch.com/divisions/opinions-and-policy/recent-opinions/
- Original PDF: https://attorneygenerallynnfitch.com/wp-content/uploads/2022/11/J.McAdams-November-7-2022-Statutory-Cap-on-Costs-Incidental-to-Court-Proceedings-in-Commitment-Proceedings.pdf
Original opinion text
November 7, 2022
John McAdams
Harrison County Chancery Clerk
Post Office Drawer CC
Gulfport, Mississippi 39502
Re:
Statutory Cap on Costs Incidental to Court Proceedings in Commitment
Proceedings
Dear Mr. McAdams:
The Office of the Attorney General has received your request for an official opinion.
Background
According to your request, your office receives the sworn statements requesting psychiatric
treatment for persons thought to be suffering from mental illness, and your office subsequently
arranges the requisite prescreening evaluations with a physician, psychologist, or nurse
practitioner. Often, the costs of custody and pre-evaluation screening exceed the $400.00 cap
placed on "costs incidental to court proceedings" as set forth in Mississippi Code Annotated
Section 41-21-79. You present the following questions for our consideration.
Questions Presented
1. Does the $400.00 cap in Section 41-21-79 of the Mississippi Code strictly refer to the court
costs associated with the court proceedings necessary to initiate the process, or is the
$400.00 inclusive of the prehearing hospitalization costs, cost of transportation, reasonable
physician's, psychologist's, nurse practitioner's or physician assistant's fees, and
reasonable attorney fees?
2. Does the $400.00 statutory cap apply to both non-indigent and indigent respondents?
3. Is the respondent's county of residence responsible for paying the prehearing
hospitalization costs, cost of transportation, reasonable physician's, psychologist's, nurse
practitioner's, or physician assistant's fees when the county is a partial owner of the
hospital?
Brief Response
1.
The statutory cap of $400.00 on costs incidental to court proceedings in Section 41-21-79
includes, but is not limited to, the following: court costs, prehearing hospitalization costs,
cost of transportation, reasonable physician's, psychologist's, nurse practitioner's or
physician assistant's fees, and reasonable attorney's fees.
2.
The statutory cap applies to both indigent and non-indigent respondents. The total that may
be charged for all the costs incidental to the court proceedings is $400.00, and it either will
be paid by the respondent, or by the respondent's county of residence if the respondent is
indigent.
3.
If the county of the respondent's residence is responsible for the prehearing hospitalization
costs, the county is still responsible despite being a partial owner of the hospital. Otherwise,
it would amount to an unconstitutional forgiveness or waiver of debt.
Applicable Law and Discussion
Section 41-21-79 reads as follows:
The costs incidental to the court proceedings including, but not limited to, court
costs, prehearing hospitalization costs, cost of transportation, reasonable
physician's, psychologist's, nurse practitioner's or physician assistant's fees set by
the court, and reasonable attorney's fees set by the court, shall be paid out of the
funds of the county of residence of the respondent in those instances where the
patient is indigent unless funds for those purposes are made available by the state.
However, if the respondent is not indigent, those costs shall be taxed against the
respondent or his or her estate. The total amount that may be charged for all of the
costs incidental to the court proceedings shall not exceed Four Hundred Dollars
($400.00). Costs incidental to the court proceedings permitted under this section
may not be charged to the affiant nor included in the fees and assessments permitted
under Section 41-21-65(6).
You state that clarity is needed regarding the meaning of "costs incidental to the court proceedings"
in Section 41-21-79. The plain language of the statute lists the main costs incidental to court
proceedings, including, but not limited to: "court costs, prehearing hospitalization costs, cost of
transportation, reasonable physician's, psychologist's, nurse practitioner's or physician assistant's
fees set by the court, and reasonable attorney's fees set by the court. . . ." Id. Because the list is not
an exhaustive one, it is for the county to determine if any costs not included in this list may also
be incidental to court proceedings.
The statute does not limit the application of the $400.00 cap to indigent respondents. Thus, it is
the opinion of this office that the $400.00 cap applies to both indigent and non-indigent
respondents. If the respondent is indigent, then the county of his or her residence pays for the costs
incidental to the court proceedings, up to $400.00. See MS AG Op., Blakley at *2 (Aug. 25, 2006)
(opining that costs incidental to the court proceedings be borne by either the respondent or the
county of his or her residence); MS AG Op., Williams at 1 (July 6, 2001) (stating that a hospital
may collect costs from the individual unless he or she is indigent, then the hospital should bill the
county for the expenses). Section 41-21-79 does make provision for payment of costs for an
indigent respondent by the state if such funds are available for that purpose. If the respondent is
not indigent, then the respondent is responsible for the costs incidental to the court proceedings,
up to the $400.00 cap.
Finally, you ask if the county of respondent's residence is responsible for paying the prehearing
hospitalization costs, reasonable physician's, psychologist's, nurse practitioner's, or physician
assistant's fees when the county is part owner of the hospital. This office has previously opined
that a county hospital and the county "are separate and distinct governing authorities with respect
to community hospital affairs . . . ." MS AG Op., Aldy at 1 (Aug. 9, 1989). Moreover, a
community or county hospital is a political subdivision of the State. Parish v. Frazier, 195 F.3d
761, 764 (5th Cir. 1999). This office has previously opined "that neither the state or [sic] any of its
political subdivisions is authorized to forgive a debt." MS AG Op., Thomas at 2 (Nov. 19, 1999).
Even when the debt is owed by one county entity to another, this office has opined that Article 4,
Section 100 of the Mississippi Constitution of 1890 prohibits the forgiveness or waiver of a debt
by the state or its political subdivisions. MS AG Op., McDonald at 1 (Nov. 8, 1996) (reviewing
debt owed by county nursing home to county-owned hospital). Therefore, the county of
respondent's residence is still responsible for the applicable costs despite being part owner of the
hospital.
If this office may be of any further assistance to you, please do not hesitate to contact us.
Sincerely,
LYNN FITCH, ATTORNEY GENERAL
By:
/s/ Misty Monroe
Misty Monroe
Assistant Attorney General