each citizen insane patient and was $11.26 more for each alien than for the average (citizen or alien) patient, but that for each citizen patient the net expenditure was $4.66 less than for the average patient. "The foregoing figures of costs for hospital care and for net expenditure for the alien insane for 1912 are very conservative so far as the alien patient is concerned, as they take no account of aliens deported, repatriated or returned from the New York civil hospitals by the Bureau of Deportation during 1912. "The estimate of $2,108,688.05 for the alien insane for 1912 is for net expenditure only. It takes no account of any charge for interest on the investment of New York State in hospitals, lands and personal property estimated in 1912 as of the total value of $33,781,450. "In 1912 the State Hospital Commission estimated the gross cost for that year to the State of each insane patient to be $283.57, as follows: Annual cost of maintenance. Annual cost on account of investment in hospital plants. . Annual cost of general administration.. $203 45 74 78 5 34 $283 57 "The net cost per patient for 1912, therefore, would be $283.57 less the patient per capita average payment to the State in 1912 ($16), or $267.57. "At this rate the 9,241 insane aliens in the civil hospitals on September 30, 1912, would have entailed upon the State of New York for that year a net cost of $2,472,614.37. "If instead of deducting the patient per capita average payment ($16), the alien per capita average payment to the State for 1912 ($4.39) is subtracted from the $283.57 above, the net cost for 1912 for each alien patient is found to be 279.18. On this basis the net cost to New York State for 1912 of its 9,241 alien insane would be increased by $107,288.01, making the total $2,579,902.38. "This estimate does not take into account the hundreds of aliens removed from the State hospitals in 1912. "A census of the foreign-born patients in the State hospitals taken in February, 1912, showed that the average length of hospital residence was 9.85 years. This is probably a fair and low average as most well-informed authorities estimate the average hospital life of the insane patients (whether alien or citizen) in the civil hospitals of New York State at ten years and over. It follows, therefore, that the average net cost of maintaining an alien patient for the time of his average residence in the New York State hospitals, at $279.18 per annum, is $2,749.92, exclusive of interest, and that the total probable net cost to the State of the 9,241 aliens in the State hospitals September 30, 1912, if allowed to complete their average hospital residence, will be $25,412,038.44. It must be borne in mind that there are two hospitals for the criminal insane having a population on September 30, 1912, of 1,272, none of the aliens among whom are included in the figures of this report, and that in 1912, 198 aliens were deported and 172 nonresidents were returned from the psychopathic wards of Bellevue and Kings County hospitals and various other institutions other than State hospitals. Taking the costs of and the expenditure for the average alien patient, as above set forth, the totals would be: Per capita total net cost of entire hospital residence of average alien patient.. Total net cost of maintenance of all the alien. insane for 1912 $2,749 92 1,839,513 46 Total net expenditure for all the alien insane for 1912 .. Total net cost of all the alien insane for 1912.. Total net cost of all the alien insane in civil hospitals in 1912 for average hospital residence... $2,108,688 05 2,579,902 38 25,412,038 44 = "For the year ending September 30, 1912, the expenditures of the Bureau of Deportation were $46,939.24. During the same period 961 aliens were deported or repatriated and 402 nonresidents removed from the civil hospitals of New York, a total of 1,363 aliens and nonresidents taken from the civil hospitals, and in addition to these 12 aliens and 8 nonresidents were sent home in this year from Matteawan and Dannemora, while 198 aliens and 172 nonresidents were removed from hospitals and other institutions, in all 390 additional. The whole number sent from the State in 1912 was 1,753. "As the expenditures of the Bureau of Deportation represented substantially the total expense to New York State in 1912 in removing these alien and nonresident insane from its borders, the per capita net cost of removal of each insane alien or nonresident from all institutions during that year would be $26.77, which is the result reached by dividing $46,939.24, the total expenditure, by 1,753, the total number of aliens and nonresidents sent away. Doubtless $26.77 is more than the average cost of removing an insane nonresident from this State and less than the average cost of repatriating an insane alien, but the exact difference has not been computed. No statistics are available from which the exact cost of removing each class can be determined. "In 1912 the total net cost to New York State for the average alien patient in the civil hospitals was $279.18. If from this is deducted $26.77, the estimated average per capita net cost of removing alien insane from the State in the same year, the result is $252.41, which indicates the rate of saving to the State in total net cost for the first year on every alien deported or repatriated in 1912. "On this basis the State saved for the first year in total net cost $295,572.11 on the 1,171 aliens removed from the State in 1912. Figured on the same basis the saving to the State for the first year in net cost on the 582 nonresidents returned from the State in 1912 would be $146,902.62, making a total saving for the first year on the 1,753 aliens and nonresidents removed in 1912 of $442,474.73. Assuming that each of these 1,171 aliens lived out his average hospital residence in the civil hospitals of 9.85 years, the total saving would be the present worth of the State's yearly contributions for the support of these patients for such period less the cost of removal. On a 4 per cent basis the present worth of $1 paid each year for 9.85 years, according to standard momentary tables, is $8.00956. Accordingly the present worth of $279.18, the yearly net cost to the State of the average insane alien, paid annually for 9.85 years would amount to $2,236.11. Deducting from this amount $26.77, the average cost of removing an insane alien, the remainder is $2,209.34, which is the net saving to the State resulting from the removal of each insane alien in 1912. If this $2,209.34 is multiplied by 1,171, the number of insane aliens removed from the State in 1912, the product would be $2,587,137.14, the total saving in net cost to the State from the removal of such insane aliens. On the same basis the total saving in net cost of the 582 nonresidents returned in 1912 would be $1,285,835.02, making a grand total of $3,872,973.02. "As the per capita expenditure increases from year to year these rates of saving will increase correspondingly. According to the foregoing computations, for each $1 expended by New York State in 1912 in removing alien and nonresident insane from its borders, the total savings in net cost for the first year was $9.43 and for the patient average hospital residence (9.85 years) amounted to $82:51. "The following is a summary of the foregoing: SUMMARY OF SAVING TO NEW YORK STATE FROM REMOVAL OF ALIEN AND NONRESIDENT INSANE IN 1912 Average per capita cost of removal of an alien or nonresident insane patient in 1912. . . . . . Per capita rate of saving per annum in net cost for each alien or nonresident removed in 1912. $26 77 252 41 Total saving for the first year in net cost from removal of 582 nonresident insane in 1912.. Total saving for the first year in net cost from removal of 1,171 alien insane in 1912. . . . . . Total saving for the first year in net cost from removal of 1,753 alien and nonresident insane in 1912 Total saving in net cost resulting from removal of 582 nonresident insane in 1912, based on average hospital residence of 9.85 years.... Total saving in net cost resulting from removal of 1,171 alien insane in 1912, based on average hospital residence of 9.85 years.. Total saving in net cost resulting from removal of 1,753 alien and nonresident insane in 1912, based on average hospital residence of 9.85 years Total saving in net cost for the first year for each $1 expended by New York State in 1912 in removing alien and nonresident insane.... Total saving in net cost for average hospital residence of 9.85 years for each $1 expended by New York State in 1912 in removing alien and nonresident insane $146,902 62 295,572 11 442,474 73 1,285,835 02 2,587,137 14 3,872,973 02 9 43 82 51 "The total number of alien and nonresident insane removed from the State in 1913 by the Bureau of Deportation was 1,352 on a total expenditure of $59,184.14, as against 1,753 in 1912 for a total expenditure of $46,939.24, making the per capita cost of removal $43.78 in 1913 as against $26.77 in 1912, a per capita increase in the cost of removal of $17.01, or 63.54 per cent. "It is obvious that as the per capita cost of removal increases the saving resulting from the removal of the alien and nonresident insane decreases and vice versa. "The total estimated capacity of the fourteen civil State hospitals for the insane on September 30, 1912, as certified by the |