Families charged for care of defendants in state hospitals

DALLAS -- Keith Laney has lost nearly everything.

His wife, Deanna, beat their three young sons with rocks -- killing two and permanently impairing the third.

And now he could be forced to pay for her care.

Deanna Laney was acquitted of murder by reason of insanity in April, so instead of being sentenced to prison, a judge committed her to a state hospital, where she could remain for the rest of her life.

Unlike prison, the cost of confinement in a state mental hospital isn't totally covered by the state in Texas. The state pays for the poor, but it requires other patients or their families to pay what they can, based on insurance, income, benefits and property.

Wisconsin and North Carolina also charge criminally confined patients, but experts at several mental health associations interviewed by The Associated Press said they did not know how many other states charge such patients.

"We can definitely say that Texas is not alone," said David Miller, senior policy associate at the National Association of State Mental Health Program Directors. "We know other states do it. I just don't think it's an indicator that anybody has tracked."

The Laneys lived comfortably, according to testimony during her trial. Keith Laney is an air compressor repairman. Their house was paid for and they owned a hobby farm with a cabin.

But now that Deanna Laney has been committed to the North Texas State Hospital for treatment, her hospital costs are $462 per day, nearly $14,000 per month. The state will determine how much her husband will have to pay after reviewing his assets.

Most health insurance plans pay for state hospital services, but it was unclear whether the Laneys have health insurance. Of the 23 patients in Texas state hospitals in 2003 who had been acquitted of murder by reason of insanity, 19 were indigent and not charged, two were covered by Medicare and two had Veterans Affairs benefits, the Department of Mental Health and Mental Retardation says. No individual patients or relatives were charged.

No conviction

Keith Laney has declined to give interviews since the May 2003 beatings that killed 8-year-old Joshua and 6-year-old Luke. Another son, Aaron, now 2, survived but his sight is impaired and doctors say he will never live independently.

In contrast to Deanna Laney, Andrea Yates, the Houston woman who drowned her five children in 2001, was convicted of capital murder and sentenced to life in prison, where treatment for her mental illness is free.

Courts in various states are split on the issue, said Michael Perlin, a professor at New York Law School who has written about the matter. Some reason that patients should pay because the overriding purpose of their hospital stay is treatment. Others believe patients shouldn't have to pay because the state has ordered them to the hospital, largely to protect the public.

Connecticut courts have struck down statutes requiring people acquitted by reason of insanity to pay for their own care, arguing there are no reasonable grounds to differentiate them from "ordinary prisoners."

However, Perlin said there has never been a significant public debate on the issue.

"I think most of the people are indigent so the bills come in and they just ignore them," he said. "In cases where people are not indigent, they don't want to challenge it because doing so would result in a court case. A lot of people would not want to call into attention that their relative was institutionalized for this purpose."

Sandra Ross, a spokeswoman at the hospital where Deanna Laney receives treatment, said it charges because it's a hospital, not a prison.

"Our role is to take care of you. ... That's the reason why we're able to charge, just like a real hospital," she said. "Whether or not that's right or wrong is a legal issue, it's a legislative thing."

Charging some patients was written into Texas law years ago to enable the state to provide care for poor patients, said Don Rogers, a spokesman for the Department of Mental Health and Mental Retardation.

"This is an opportunity to bring in funds so that we can provide services for more people," Rogers said.

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On the Net:

Texas Mental Health and Mental Retardation: http://www.mhmr.state.tx.us/