Commissioners discuss building county medical examiner's office

With more than 250 autopsies requested each year, Williamson County officials are considering service alternatives as the county's go-to medical examiner's office in Travis County outgrows its current location.

Because of growth in the 42 counties the Austin-based Travis County Medical Examiner's Office serves, the facility is operating at its limit. Operations must move to a larger location to maintain the office's National Association of Medical Examiners accreditation, according to a presentation TCMEO representatives shared with Williamson County commissioners at a May 29 workshop.

Statute 49.25 of the state Code of Criminal Procedure requires a medical examiner to investigate unattended deaths, deaths that occur within 24 hours of admission to a hospital and deaths with unknown or unnatural causes.

Of the autopsies performed by the Travis County office, 14 percent come from Williamson County, according to the TCMEO 2012 annual report. The only county with a higher percent of use is Travis County itself.

TCMEO officials asked if Williamson County officials would help offset the costs of a new medical examiner's facility at the May 29

discussion.

"We were really looking for a partnership with Williamson County," said Sarah Scott, chief administrative officer for TCMEO. "It doesn't make sense for us to go to smaller counties that have less resources and for whom it would be even more burdensome."

But Williamson County has other ideas.

Future medical examiner's office

Williamson County Judge Dan Gattis said based on discussions he has had with other county officials, Williamson County will most likely not partner with Travis County to build a new medical examiner's facility.

"The direction I feel, with no votes or action taken, is that elected officials would like us to have our own [medical examiner's] office in the future," Gattis said.

At a workshop held July 30, Gattis, county commissioners, justices of the peace and other county officials discussed the viability of building a Williamson County medical examiner's office and sending more cases to the medical examiner's office in Tarrant County while Travis County figures out its facility funding dilemmas.

Gattis said he has been speaking with officials in other counties with medical examiner's offices, such as Tarrant County, which includes Fort Worth, to find out how and when they approached adding the service.

"I've had visits with the county judge [in Tarrant County]," Gattis said. "They started [a medical examiner's officer] at [a population of] 500,000."

Williamson County had an estimated population of 456,000 in 2012, according to the U.S. Census Bureau.

Dain Johnson, Williamson County Precinct 1 justice of the peace, said he believes a Williamson County Medical Examiner's office is in the future, but distantly so.

"Inevitably, I would think the county is going to need a facility," he said. "But it doesn't make sense at this point to build a medical examiner's office until the cost of outsourcing is equal to having your own."

Statute 49.25 of the state's Code of Criminal Procedure also states the commissioners court of any county that has more than 1 million residents and does not have a reputable medical school may establish and maintain a medical examiner's office.

Gattis said he has been speaking with officials at Texas A&M Health Science Center in Round Rock, a medical school which has shown an interest in partnering with the county on providing space in exchange for educational opportunities for students. However, Gattis said he is aware the county is still not large enough to support a medical examiner's department at this point.

"I'm not expecting a call from A&M tomorrow saying they're going to hire a [medical examiner] and build us an office," he said.

But Gattis said bringing the topic to light now, before the need for a medical examiner's office becomes pressing, has resonated with justices of the peace in the county.

"I think that down the line, it's inevitable [that Williamson County will need a medical examiners office]," said Judy Hobbs, Precinct 4 justice of the peace. "I'm very glad [Gattis is] working up front and not waiting until the last minute, when we have to do it."

Travis County vs. Tarrant County

The Travis County MEO charges $2,600 per autopsy. Examinations are completed in about a day, and Johnson said he receives preliminary reports from TCMEO after one to two days and full reports in eight to 14 weeks.

The Tarrant County MEO charges between $1,375 and $2,400 per autopsy, depending on the number of tests and amount of investigation required, according to its fee schedule. Preliminary reports are available one or two days following an exam, and full reports are available in four to eight weeks, depending on tests required, said Linda Anderson, public information officer for the Tarrant County office. Only four counties are listed as users of the Tarrant County office in its 2012 annual report.

Use of Tarrant County

Gattis said there is not a set rule for which examiner's office Williamson County justices of the peace may use. The decision comes down to personal preference; some judges, such as Johnson, said they prefer to use Travis County simply because it is closer.

Hobbs, however, said she prefers sending her autopsy cases to Tarrant County, despite the farther distance, because she likes the facility, doctors and investigators she works with in that office.

"The reports come back from up there quicker, in my opinion," Hobbs said. "The autopsies are cheaper And the service and the doctors make it very worthwhile as far as I'm concerned."

Tarrant County is being looked at as a model for developing medical examiner services by Williamson County officials, such as Bill Gravell Jr., Precinct 3 justice of the peace.

The Tarrant County office has slowly expanded its medical examiner's facility since opening it in 1965, adding services such as forensic dentistry in 1982, a crime lab in 1989 and a human identity section in 2007, according to the office's 2012 annual report. The office completed an expansion in 2011.

"[We can] develop a model that expands as we do," Gravell said. "It works superbly [in Tarrant County]."