As Clark County’s population has continued to climb, so too has the number of deaths and death investigations conducted by the Clark County Medical Examiner’s office.
Community Health Director Andrea Pruett said the increased workload, along with rising expenses and a shortage of forensic pathologists, is straining the department.
On Tuesday, the Clark County Council unanimously approved a new fee structure for medical examiner services, which will go into effect April 1, 2023. To keep up with demand, Pruett said, the department is hiring more staff. Revenue from the fees will help pay the salaries as well as other expenses.
Unnatural deaths rising
The council first reviewed the new fee structure during an Aug. 2 work session. During that meeting, Pruett said the county is seeing a rapid increase in the number of unnatural deaths, with about half attributed to accidental deaths such as falls, drug overdoses and car accidents.
“The increasing death rates are what’s driving the need to increase and stabilize our staffing,” Pruett told the council. “If we keep our death investigator ratios the same, as we experience more unnatural deaths, then we will be ill-equipped and unable to meet the rising demand for services.”
According to Pruett, the county’s population has grown by 18 percent since 2012, while total deaths rose by 59 percent over that same period. In 2021, the county had 4,752 deaths. Of those, 601 were investigated and determined to be under the jurisdiction of the medical examiner. Pruett noted that is an increase of 71.2 percent from 2012.
Under the new fee structure, the medical examiner’s office will charge $70 to process a disposition authorization, which is a legal form detailing what happened to a body after being released by he examiner. The fee will not be charged if the costs of cremation are paid for by the county, such as when a person dies with no known relatives.
Clark County is one of five counties in the state with a medical examiner’s office, along with Pierce, King, Snohomish and Spokane counties, and is the only one of the five not already charging for its services.
“Our primary function is to investigate deaths to determine jurisdiction and determine cause and manner of death for those deaths where we have jurisdictional oversight,” Pruett told The Columbian. “That is embedded in … statute, and it’s strictly unnatural deaths.”
Washington state law assigns jurisdiction to a county’s medical examiner or coroner under specific circumstances. This includes when the circumstances appear unnatural or unlawful, or suspicious; when the death is caused by violence such as a gunshot or stabbing; and in cases of drowning, lightning strike or radiation, among other causes.
Less general fund impact
Pruett said implementing the new fees will also reduce the need for general fund dollars, which currently pays for nearly all the department’s expenses.
“Given our broad position and our projected structural deficit, knowing that the medical examiner’s office is primarily funded with county general funds, we need additional financial capacity to staff the program to keep pace with the population growth, which is directly tied to death rates,” she said in an interview.
Pruett said the county has been searching for an associate medical examiner for over a year but has had difficulty filling the position.
“We’re currently experiencing a sustained national shortage of trained forensic pathologists who are board certified,” she said. “That creates a lot of problems in the discipline. It’s not at all exclusive to Clark County.”
Council Chair Karen Bowerman suggested the office develop a program for low-income individuals or families unable to pay the fees. Pruett said her office would work on finding a solution before the fees go into effect.
“In general, I would prefer not to raise costs or fees on anything if at all possible. However, it’s taking some of the burden off the general public,” Councilor Richard Rylander Jr. said. “The costs associated with performing the work is associated with the end use fees, so it’s much more specific. … This makes sense to me.”
The ordinance and full fee schedule are available at https://bit.ly/3sVuzuM.
