Medical Examiner
Dr. Jeffrey Nine, Medical Examiner
Leslie Horton, CHS Director
1090 Commerce Drive, Prescott, AZ 86305
928-771-3122
Mission Statement
Yavapai County Medical Examiner’s Office serves the citizens of Yavapai County to effectively and efficiently investigate non-natural and unattended mortalities to determine the cause and manner of death. The Medical Examiner also investigates mortalities that are significant to the health andwelfare of the county citizens including emerging infectious diseases, certain patterns of natural death, and situations that may be of epidemiologic importance.
Budget Memorandum
The Medical Examiner’s office was incorporated into YCCHS during FY 17/18. The positive changes implemented in FY 21/22 will continue into the new fiscal year. As we enter this new year, the Medical Examiner's Office has taken on national prominence in the forensic pathology world, as we champion the use of Pathologists' assistants alongside such venerable institutions as Mayo Clinic (Minnesota) and University of Michigan (Detroit Medical Examiner). Dr. Nine has been elected chair for a national working group supported by the National Institute of Justice (NIJ) and National Center for Forensics (NCF) to address workplace shortages in Medical Examiner Offices. Our PA Jena Peters is a member of a national forensic pathology working group in conjunction with the American Association of Forensic Pathologists (AAPA) to promote the use of PAs in forensic pathology offices. Jena also represented the AAPA at the National Association of Medical Examiners (NAME) meeting in the fall. And, not least of all, our legislative proposal to recognize and promote the use of Pathologists' Assistants in the Medical Examiner Office has passed the State Health and Human Services Committee where Dr. Nine testified to the committee members. These initiatives have thrust the Yavapai County Medical Examiner's Office into the national spotlight as a leader in addressing forensic pathology workplace shortages and the promotion of forensic PAs in the field.
Our Medical Examiner and Medicolegal Death Investigators continue to meet with local law enforcement and Judicial leaders to build relationships that help with rapid responses and on scene investigations. Investigator Borg has performed regular training sessions with first responders in our firefighter and paramedic community (CAFMA). Additionally, Investigator Borg, PA Jena, and Dr. Nine have taken on the responsibility of managing the Child Fatality Review (CFR) program for Yavapai County. With our coordination of the regular CFR meetings, we have established outstanding working relationships with state and local partners to effectively and efficiently address the root causes of child fatality in our county.
In relation to overall workload at the office, this calendar year (2021) we handled 1,389 death calls, from which we accepted jurisdiction on 614 cases. This resulted in 251 autopsies with histologic and toxicologic examination, 226 external examinations, and 137 chart reviews. It also includes 775 natural releases (declined jurisdiction) each requiring approximately 45 minutes of staff time to handle considering phone calls, records and report narratives.
As with last year, one of the biggest challenges in 2021 was management of the COVID-19 pandemic, a public health emergency that could have resulted in massive and unmanageable expenditures for the Medical Examiner. This calendar year we handled more natural death calls and COVID-related cases than in 2020. The office again attempted to minimize the financial impact of the pandemic by performing more external examinations while utilizing point-of-care COVID rapid antigen tests combined with extensive investigation into medical history and symptomatology. We also continued to limit our histologic examinations and virology testing procedures to the minimum necessary for establishing the correct diagnosis. This reduced potential laboratory costs to our office. Even so, the COVID-19 pandemic resulted in significant laboratory expenditures, which is expected to continue into the new fiscal year and most likely beyond, as our office investigates more natural deaths and performs more focused testing and histologic examinations. YCCHS has received help in the form of COVID relief grant funds to offset the MEO COVID related testing. Since April 2020, grant funds have offset $21,162 in lab costs and $948 in transport costs. There are still $80,874 available to cover COVID related lab costs through May of 2023.
The current expense budget is at $1,159,282 with projected revenues of $160,000 to offset our transport company costs. We are pleased to be maintaining our budget this fiscal year and feel that we are being fiscally responsible with the funds provided by the County. However, the ME office has five requests for additional funding: a fourth Medicolegal Death Investigator, move the current part-time Administrative Assistant to full time, increase the transport costs, increase the amount for purchase of body bags and provide for moving expenses for the new Medical Director. As we move into a new era of post-pandemic death investigation, the amount of time spent on natural deaths is rising. This results in longer and more detailed death investigations, gathering of medical records, and interviews with family members and hospital
personnel. The current team of three Medicolegal Death Investigators is juggling a demanding on-call schedule and a high volume of cases. A fourth Medicolegal Death Investigator would assist in more evenly dividing the case investigation as well as allowing one of the investigators to assist with maintaining the autopsy suite. The increase in administrative tasks for the Investigators have resulted in significant time investment on the part of the Investigators. For this reason, we are asking for funding to increase the current part time administrative assistant to full-time. This position would manage many of the administrative tasks that the investigators can no longer negotiate with their demanding on-call schedules, which would free them to spend time on their most important tasks of death investigation while covering a 24/7 on-call schedule.
Additionally costs have increased for the Medical Examiner’s office for transport costs. The Medical Examiner’s office took on the task of bringing the Public Fiduciary cases to the office rather than directing them to the funeral homes, the ME office significantly increased the number of cases that are transported. We are asking to increase this line item by $15,000 and bring it to a total amount of $120,000. Community Health Services has been able to assist the Medical Examiner’s office by purchasing body bags with grant funds over the last two years. However, the grant funds are no longer available and the Medical Examiner’s office will need to make this purchase in FY 22/23. Costs have significantly increased for this purchase and we are asking for an increase of $12,000 to the Medical Supplies budget line item to cover the additional cost of the necessary item. Historically, the Medical Examiner’s office has assisted with moving costs for a new Medical Examiner and we are requesting to add the $5,000 cost into the budget for FY 22/23 for when a new Medical Examiner is hired.
To view the 2021 Annual Report for the Medical Examiner's Office, please use this link: