Action 11.
Regular Board of Supervisors Meeting
Board of Supervisors
- Meeting Date:
- 05/22/2012
- Title:
- IGA with Pima Cty for Medical Examiner
- Submitted By:
- Kim Lemons, Board of Supervisors
- Department:
- Board of Supervisors
Presentation:
No A/V Presentation
Recommendation:
Approve
Document Signatures:
BOS Signature Required
# of ORIGINALS
Submitted for Signature:
Submitted for Signature:
3
NAME
of PRESENTER:
of PRESENTER:
Mike Ortega
TITLE
of PRESENTER:
of PRESENTER:
County Administrator
Mandated Function?:
Federal or State Mandate
Source of Mandate
or Basis for Support?:
or Basis for Support?:
11-591, 11-592
Docket Number (If applicable):
Information
Agenda Item Text:
Approve an IGA between Pima County and Cochise County for Medical Examiner Services for a five-year term effective May 22, 2012 - May 22, 2017 at an annual rate of $350,000 paid quarterly.
Background:
Dr. Guery Flores provided Cochise County notice that he would not be continuing to provide medical examiner services after June 30, 2012. Staff began exploring options for providing this service after the current contract terminates.
Staff reviewed the potential of recruiting a board certified forensic pathologist that could act as the County Medical Examiner, either as a contractor like Dr. Flores has done, or as a County employee. Upon further discussion, it became obvious recruting a forensic pathologist to come to Cochise County would be difficult and take significant time and certainly beyond the June 30 contract termination date. Since the announcement of the contract termination, staff has been contacted by a semi-retired forensic pathologist that ran the Yavapai and Maricopa County Medical Examiner offices. He has agreed to assist us in the future. The development of this service (potential building and other infrastructure needed to run a Medical Examiner office), is something County staff will continue to explore.
Another option staff explored was establishing an intergovernmental agreement with Pima County to provide these services. Following is a summary of the highlights contained in the IGA:
1. The contract term is for 5 years with a renewal for five one-year periods upon mutual consent of Pima and Cochise.
2. Pima will provide Medical Examiner sevices as outlined in State Statute.
3. Pima County will charge $350,000 to provide Medical Examiner services to be paid in quarterly payments. There other costs that will be billed separately as or if they are incurred by Pima:
a. Non-ME services such as travel, expert testimony and per diem will be billed as per their County reimbursement ordinance.
b. Transportation of decedents to and from the Pima County facility.
The IGA with Pima County is based on the following:
1. There are approximately 300 deaths in Cochise County annually requiring review by the Medical Examiner.
2. Pima will perform autopsies in approximately 60% of all deaths. This is compared to a national average of between 66-67%. Dr. Flores traditionally performed autopsies 22% of the time.
3. Cochise County will be responsible for the transportation of decedents to and from the Pima County facility. Pima will however, work with the transport companies to keep their trips to a minimum (may hold one body a day or two until one of the transport company is in the area). Staff is currently negotiating contracts with mortuaries in Cochise County to provide short-term storage of decedents and transportation. A separate item may be brought to the Board for consideration depending on the amount of the various contracts.
4. Both Pima and Cochise staff agree the estimate of the number of deaths and number of autopsies is based on historic information, but may change on an annual basis. Annually, the staff will review and may recommend adjustments to the cost.
5. Since Pima will be providing full ME services and this is one of the largest contracts they have established, the staff will be reviewing the actual cost associated with providing this service on an annual basis and may recommend adjustments to the cost.
6. Pima is not interested in taking the ME files up to this point. I have assigned Mary Gomez (Health Dept) to develop the file system. There appears to be space available for this purpose and with the exception of shelving and file cabinets, staff does not expect ongoing costs. According the Dr. Flores’ staff, we may be asked to search through old/closed files approximately two times per year.
7. Pima will work closely with the Cochise County Attorney to make sure the information the attorneys need is contained in Pima’s reports. Staff facilitated a meeting between Pima and the Cochise County Attorney where these matters were discussed and the County Attorney was comfortable with the language in the IGA.
8. Pima will work closely with the Cochise County Sheriff and other local law enforcement agencies to make sure there is clarity on expectations with regard to reporting deaths and moving decedents.
Staff will continue to explore obtaining this service through a less expensive method, but for interim, Staff recommends the BOS approve the referenced IGA with Pima County.
Staff reviewed the potential of recruiting a board certified forensic pathologist that could act as the County Medical Examiner, either as a contractor like Dr. Flores has done, or as a County employee. Upon further discussion, it became obvious recruting a forensic pathologist to come to Cochise County would be difficult and take significant time and certainly beyond the June 30 contract termination date. Since the announcement of the contract termination, staff has been contacted by a semi-retired forensic pathologist that ran the Yavapai and Maricopa County Medical Examiner offices. He has agreed to assist us in the future. The development of this service (potential building and other infrastructure needed to run a Medical Examiner office), is something County staff will continue to explore.
Another option staff explored was establishing an intergovernmental agreement with Pima County to provide these services. Following is a summary of the highlights contained in the IGA:
1. The contract term is for 5 years with a renewal for five one-year periods upon mutual consent of Pima and Cochise.
2. Pima will provide Medical Examiner sevices as outlined in State Statute.
3. Pima County will charge $350,000 to provide Medical Examiner services to be paid in quarterly payments. There other costs that will be billed separately as or if they are incurred by Pima:
a. Non-ME services such as travel, expert testimony and per diem will be billed as per their County reimbursement ordinance.
b. Transportation of decedents to and from the Pima County facility.
The IGA with Pima County is based on the following:
1. There are approximately 300 deaths in Cochise County annually requiring review by the Medical Examiner.
2. Pima will perform autopsies in approximately 60% of all deaths. This is compared to a national average of between 66-67%. Dr. Flores traditionally performed autopsies 22% of the time.
3. Cochise County will be responsible for the transportation of decedents to and from the Pima County facility. Pima will however, work with the transport companies to keep their trips to a minimum (may hold one body a day or two until one of the transport company is in the area). Staff is currently negotiating contracts with mortuaries in Cochise County to provide short-term storage of decedents and transportation. A separate item may be brought to the Board for consideration depending on the amount of the various contracts.
4. Both Pima and Cochise staff agree the estimate of the number of deaths and number of autopsies is based on historic information, but may change on an annual basis. Annually, the staff will review and may recommend adjustments to the cost.
5. Since Pima will be providing full ME services and this is one of the largest contracts they have established, the staff will be reviewing the actual cost associated with providing this service on an annual basis and may recommend adjustments to the cost.
6. Pima is not interested in taking the ME files up to this point. I have assigned Mary Gomez (Health Dept) to develop the file system. There appears to be space available for this purpose and with the exception of shelving and file cabinets, staff does not expect ongoing costs. According the Dr. Flores’ staff, we may be asked to search through old/closed files approximately two times per year.
7. Pima will work closely with the Cochise County Attorney to make sure the information the attorneys need is contained in Pima’s reports. Staff facilitated a meeting between Pima and the Cochise County Attorney where these matters were discussed and the County Attorney was comfortable with the language in the IGA.
8. Pima will work closely with the Cochise County Sheriff and other local law enforcement agencies to make sure there is clarity on expectations with regard to reporting deaths and moving decedents.
Staff will continue to explore obtaining this service through a less expensive method, but for interim, Staff recommends the BOS approve the referenced IGA with Pima County.
Department's Next Steps (if approved):
If approved, staff will notify Pima County and prepare to start transporting decedents July 1, 2012.
Impact of NOT Approving/Alternatives:
Cochise County would be out of compliance with State statutes and not be able to provide Medical Examiner services.
To BOS Staff: Document Disposition/Follow-Up:
Return copy of signed IGA to Pima County.
Fiscal Impact
- Fiscal Year:
- 2012/2013
- One-time Fixed Costs? ($$$):
- Ongoing Costs? ($$$):
- $350,000
- County Match Required? ($$$):
- A-87 Overhead Amt? (Co. Cost Allocation $$$):
- Source of Funding?:
- General Fund
Fiscal Impact & Funding Sources (if known):
Five year contract with Pima County at $350,000 per year to cover medical examiner services. Funds will be budgeted in 100-3500-421.500.
The fiscal impact associated with the IGA is estimated to be approximately $360k; $350k for the provisions of the IGA and $10k for other expenses. In addition, staff is budgeting an additional $40k for transportation costs.
Total cost of contracting the Medical Examiner services is budgeted at $400k to be paid from the General Fund. Please note the current amount budgeted for these services is $180k.
The fiscal impact associated with the IGA is estimated to be approximately $360k; $350k for the provisions of the IGA and $10k for other expenses. In addition, staff is budgeting an additional $40k for transportation costs.
Total cost of contracting the Medical Examiner services is budgeted at $400k to be paid from the General Fund. Please note the current amount budgeted for these services is $180k.