Gov. Pat McCrory’s new budget proposal seeks nearly $4 million in new funds to fix North Carolina’s troubled medical examiner system.
Under the proposal, rolled out last week, the state’s 350 medical examiners would get training and higher pay for each case they handle, and the state would hire more than a dozen professional investigators over the next two years.
The plan helps McCrory keep promises made after an Observer series last year revealed that medical examiners have conducted thousands of flawed investigations into homicides, suicides and other suspicious deaths.
After the series, McCrory and other lawmakers vowed to overhaul the medical examiner’s system, which he said had been “ignored for far too long.”
McCrory’s plan would raise spending for the office even as many state agencies were asked to trim their budgets by up to 2 percent. The administration said the proposal would lift the examiner’s office’s state funding from $6.3 million last year to $10 million, a 17 percent jump.
But the proposal doesn’t come close to addressing all the problems that N.C. Department of Health and Human Services Secretary Aldona Wos and other state officials laid out less than six months ago. The governor’s budget, for example, doesn’t offer any construction money to replace outdated buildings where autopsies are performed. No money is earmarked to address a statewide shortage of experienced forensic pathologists, who perform the autopsies.
McCrory’s budget represents his recommendations for state spending. It goes to lawmakers, who will offer their own plans during a process expected to last through June.
State Sen. Jeff Tarte, a Cornelius Republican, said he will introduce a medical examiner bill that would replace volunteers, who are now paid $100 per case, with full-time trained investigators. The legislation would also require medical examiners to go to death scenes in more cases, he said. Unlike states and counties with top-notch medical examiner systems, North Carolina investigators rarely visit scenes to look for clues.
Tarte said McCrory’s proposal is a positive step, but falls short of what’s needed to repair a system that has become “an embarrassment around the country.”
“We need more than incremental improvements,” Tarte said. “We need to transform it.”
A failed system
Medical examiners – usually doctors and nurses who look into deaths in their spare time – are supposed to determine the cause of suspicious and violent deaths, such as shootings, suicides, auto wrecks and drownings. Their findings are used to help solve crimes, identify public health trends and settle life insurance payouts.
But North Carolina’s system is one of the worst-funded in the nation and recent events have highlighted the consequences. When an elderly couple died the same night in 2013 inside a Boone hotel room, the local medical examiner did not go to the scene or alert the state toxicology lab in Raleigh about the unusual circumstances.
It took the state nearly six weeks to determine that carbon monoxide killed the couple. After the medical examiner’s office failed to warn the public about the findings, the poisonous gas leaked into the hotel room again and killed 11-year-old Jeffrey Williams.
In a separate case, the N.C. Industrial Commission last month awarded a widow more than $63,000 in damages because a state medical examiner did not take basic steps to find out how her husband died. The incorrect ruling after a fatal auto wreck prevented the woman from collecting life insurance payouts she deserved.
It marked the second time in less than a year the commission ordered the state to pay survivors. The state reached a settlement in January in another case involving a living man incorrectly declared dead, zipped in a body bag and sent to a morgue.
McCrory’s budget proposal would provide money for ideas recommended more than a decade ago after a previous Observer investigative series.
Among the plans:
▪ Raise the pay for medical examiners to $250 per case. Experts said paying $100 per case gives examiners almost no incentive to drive to death scenes or ensure thorough investigations.
▪ Hire 14 professional investigators based at the Office of the Chief Medical Examiner in Raleigh. Using state employees, experts said, increases accountability.
▪ Provide an unspecified amount of money to conduct training and seek accreditation from the National Association of Medical Examiners.
In September, officials from the N.C. Department of Health and Human Services presented a legislative committee with a lengthy list of needs. It would cost the state about $6 million more per year.
Among suggestions were mandatory training for medical examiners and spending money to replace aging autopsy centers in Winston-Salem and Greenville and upgrades in technology.
Officials also called for the state to help pay for renovating Mecklenburg County’s medical examiner’s office, which opened in 2008, and constructing two new autopsy centers.
The legislative committee endorsed the ideas but warned that the state’s finances could prevent them from providing immediate funding.
North Carolina spends only about 93 cents per capita on its system – much less than systems with accreditation. Leading state and counties typically spend about $3 per capita in death investigations, according to a study.
Tarte said it will likely take at least five years to come up with the $35 million to $40 million needed to reform the system.
Dr. Patrick Lantz, a Winston-Salem forensic pathologist who performs autopsies for the state, said the governor’s budget proposal was disappointing. He hopes legislators will allocate more money.
“It’s been so underfunded for so long, it hurts to catch up,” he said.