CT Chief Medical Examiner asks for higher budget from government to help regain national accreditation

James Gill (Photo: CT.gov)

(WTNH) — The Chief Medical Examiner for the State of Connecticut Dr. James Gill testified for a higher budget at the Appropriations Committee Meeting for the Governor’s 2018-2019 Budget on Thursday.

“The Office of the Chief Medical Examiner is the only state agency that performs medical death investigations. We provide an essential core service and are bound by statute to investigate all deaths that are unexpected, suspicious or unnatural,” Gill stated.

According to Gill, for the past 10 years, their office had been accredited by the National Association of Medical Examiners, also known by the acronym, NAME. Accreditation from NAME meant that the office was conducting appropriate investigations with high accuracy, thorough documentation and timely outcomes. Gill says the Connecticut Chief Medical Examiner’s office was notified in February that they had lost full NAME accreditation.

During the past three years, Gill says they have been faced with record high numbers of deaths requiring investigation coupled with record low staffing levels. He says this has resulted in the delay in the backlogs in completing final death certificates and autopsy reports and an overworked staff. Gill says the OCME has been downgraded to provisional accreditation status and has until September of 2017 to correct the deficiencies to be eligible for full NAME re-accreditation. If these deficiencies are not corrected by that time, the office will lose full NAME accreditation.

According to Gill, NAME accreditation is important because it instills confidence in the people they serve, the families, police departments, attorneys and insurance companies. He says it signifies to those parties that their office meets or exceeds standards for death investigation. Massachusetts, Vermont, New Hampshire and Rhode Island are either fully or provisionally accredited, as are over 80 other states and cities across the country. Loss of accreditation is a red flag to the government that the OCME office is having a problem. Gill says it means that they are not meeting minimal standards. The NAME report tells people what the problems are and what needs to be done to fix them. The OCME is asking for the government’s help in fixing those problems.

Since the accreditation status has been changed, Gill says it now means that family members will have to wait additional days for the remains of their loved ones before they can be released to a funeral home, which also delays funeral arrangements. It also means that family members will have to wait additional months to get a final death certificate or an autopsy report. According to Gill, many life insurance companies will not release benefits until they get a copy of the death certificate so families and funeral homes will have to wait additional months for those financial benefits.

Loss of accreditation also affects the criminal justice system. It means that the OCME’s opinions on causes of death are more likely to be challenged or doubted in court. On average, according to Gill, one of their medical examiners will testify once or twice a week in a homicide trial.

According to Gill, OCME lost full accreditation because of four major deficiencies. Three of those things relate to inadequate staffing, medical examiners, investigators and medical records staff and one due to inadequate refrigerated body storage space. The OCME has been working with various other organizations to correct the staffing deficiencies. The technical and non-technical staff vacancies have been largely refilled and they are working on a refrigerated storage space that will be put out to bid in March. Gill says the current progress in the office should satisfy those four major deficiencies. He says the only remaining deficiency that would prevent the office from regaining full accreditation would be the medical examiner staffing shortage. Gill says the current medical examiner staff is simply an insufficient size to the number of deaths they investigate.

“Since our autopsy numbers have increased 60%, approximately 900 additional autopsies over the past three years, we either need more medical examiners or need to do fewer autopsies.” Gill said about the office. Fewer autopsies is not a valid option, Gill goes on to say. He believes doing fewer autopsies would compromise the death investigations and would worsen this public health problem. Even if drug deaths start to decrease, he says autopsy numbers are unlikely to fall dramatically.

917 people in Connecticut died from accidental drug intoxications in 2016. That’s a 25% increase from the 729 that died in 2015. Deaths involving fentanyl (479) increased by 155% and nearly surpassed the number of deaths involving heroin (504),” Gill said on drug deaths for this year.

NAME has recommended the addition of three new medical examiner positions to correct the autopsy and medical examiner deficiency. Gill says in order to correct only that major deficiency to regain full accreditation, hiring only two new medical examiners would do the trick. The OCME is asking to include two new medical examiners in the fiscal year 2018-2019 budget. If they fill the two new medical examiner positions, the CT OCME will have 48 staff members total.