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Covering the cost of autopsies

Robert Houk • May 20, 2018 at 12:00 AM

Tennessee's opioid crisis and a 2013 state law requiring autopsies to be performed in suspected drug-related deaths have combined to create a new budget headache for counties in Northeast Tennessee. As a result, area county mayors are scrambling to find a funding solution to a problem they say isn't going away anytime soon.

Washington County Mayor Dan Eldridge told members of the Washington County Commission's Budget Committee last week an increase in opioid-related deaths has helped to spike the forensic costs for members of the First Tennessee Development District. Eldridge said he and the mayors of Sullivan, Greene, Carter, Unicoi, Hawkins, Johnson and Hancock counties have been meeting with officials at East Tennessee State University to get a handle on the problem.

Paying The Costs

The eight counties contract with ETSU's William L. Jenkins Forensic Center, which is located on the campus of the Mountain Home Veterans Affairs Medical Center, to perform autopsies. Each county pays a fee of $1.91 per capita for those forensic services.

Washington County budgeted $267,000 for autopsies in the current fiscal year for forensic services that are provided as part of a three-year contract

Sullivan County, with the largest population in the area, pays the bulk of the cost for forensics, followed by Washington and Greene counties. Eldridge said it is the five smaller counties of the region that are facing the most difficulty in meeting the budgetary demands of the program.

Eldridge said state law requires counties to perform autopsies in specific cases. He said it also should be noted that ETSU is under no legal obligations to provide forensic services. And the cost for such services are much higher elsewhere.

"They are paying $7 per capita in Knox County," he said

New Resources

ETSU officials say the forensic center has seen its workload nearly double in recent years. The forensic center handled 455 cases in 2015. By 2016, that number had risen to 674 autopsies in the eight-county region.

"About half of those were drug-related cases," Eldridge said. "We are conducting a lot more autopsies because of the 2013 law."

As a result, officials at the forensic center say they need more resources to handle the demand. Eldridge said ETSU is asking for an additional forensic pathologist and an additional autopsy technician, as well as making a part-time secretary a full-time position and purchasing a vehicle for the staff to do field work.

Eldridge said ETSU and FTDD members have discussed a number of different scenarios that could put the contract costs between $300,000 and $500,000.

"There has got be a place we can get to where we all agree," he said.

One such place, Eldridge said, might be for the eight counties to pick up the costs to bring employees of the forensic center up to the same salary and benefits level of other ETSU employees.

A Valued Service

Rising costs aside, Eldridge said he and other county mayors have few complaints about the services they receive from the forensic center. He said the backlog of autopsies that had once plagued local law enforcement officials no longer exists. He said the ETSU center has a reputation for professionalism that has made it the talk of the state.

And he said the turn-around time for an autopsy at the forensic center "is the lowest they have ever been." He said an autopsy can be performed at the center within one-and-a-half days.

"That's very important to the families of the deceased," Eldridge said.

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