County Board Will Decide: Coroner/Medical Examiner
When Marinette County Board meets on Tuesday, Jan. 28, supervisors will be asked to decide if the county should stay with an elected County /coroner for the next four years, or switch to a medical examiner model under the supervision of the County Administrator. After discussing the issue at length on Thursday, Jan. 16, members of the Executive Committee voted unanimously to forward the information to the full county board without a recommendation.
Members present, all committee chairs or board officers, were Supervisors Russ Bauer, Alice Baumgarten, Mike Behnke, Ken Casper, Kathy Just, Ken Keller, Ted Sauve, Vilas Schroeder, Connie Seefeldt, and Bill Walker. Supervisors Russ Bousley and Melissa Christiansen were absent. Among others on hand were County Clerk Kathy Brandt, Corporation Counsel Gale Mattison, County Administrator Ellen Sorensen, Coroner George Smith, and Elderly Services Director Pam Mueller-Johnson.
Also on the agenda for discussion only was information on a $9.435 million bond issue County Board will be asked to approve on Tuesday, as well as additional bond issues to finance capital improvements projected for the next five years.
The Executive Committee meeting started on a discordant note when Mueller-Johnson, during time for public comment, chastised the committee for failing to properly notify her that a county contract with her agency was on the agenda for action. She said the information came to her indirectly, by way of a generic e-mail, in the midst of a hard week dealing with frigid weather, Elderly Transport busses in a ditch, and Meals on Wheels deliveries hampered by snow and cold.
Transparency - you want transparency, we want transparency...This is not the way a government should be run! She said she would gladly present whatever reports the county wants to show how the money they allocate to her agency is used. She said they get about $150,000 a year from the county, and provide 48,000 home delivered meals plus at least 8,000 one-way trips for elderly and disabled people for shopping and medical appointments.
However, when all was said and done, the committee agreed that money going from county coffers should be done by way of contracts. A motion directing pursuit of a contract or purchase of service agreement with Elderly Services related to funding provided by the county was approved without dissent. During discussion, Just, who chairs the Health and Human Services Committee, noted all their agreements with service providers are backed by contracts.
Smith, also speaking under time for public comment, thanked the group for inviting him, and for providing the paper work I generally dont get.
The paper work included Sorensens analysis of pros and cons of the medical examiner versus coroner models of death investigation responsibilities, and budgets she had projected for each.
Smith took exception to the budget projections, terming them not even close, and predicted they will be at least $50,000 more than shown on the sheet Sorensen had prepared.
Smith thanked Sorensen for assuring him there was nothing personal in the coroner/medical examiner presentation.
Smith felt Marinette County probably would not be involved with other counties except perhaps Brown County if they go to a medical examiner. He commented Brown County, though too far away, is certainly better than Fond du lac County. As for liability issues, Smith declared, There is always liability for everyone in this room!
Sorensen had said previously she had assembled the coroner/medical examiner information in response to requests that had been made by several supervisors when she was first hired for the County Administrator position.
Smith, who has been Marinette County Coroner for many years, has said he expects to run again in the November elections, but added there is never certainty what might happen months down the road.
County Board must set pay for elected positions to be filled in November before candidates begin circulating nomination papers on June 1.
In her report for the Executive Committee and County Board, Sorensen said in Wisconsin each county individually chooses between one of two death investigation systems, either a coroner system or a medical examiner system.
In general, a medical examiner system is one in which the office is supervised by a medical examiner who is an appointed county official and a coroner system is one in which the office is supervised by a coroner who is an elected official. Neither is required to be a forensic pathologist or physician in Wisconsin, and both systems have the same authority under Wisconsin statutes, the report states.
The cost to Marinette County currently remains relatively the same under each system, according to Sorensens tentative analysis. There are potential financial advantages of a medical examiner system which are currently undeterminably. Two main advantages are the ability to enter into an arrangement with other counties to develop a regional medical examiner system and the ability to control/mitigate liability to Marinette County, her report stated.
She suggested if the county entered a long term agreement with Brown, Oconto and Door counties for a regional medical examiner Sturm, the office would most likely be housed in Brown County with death investigators trained and accredited to do on-scene investigations. Autopsies would be done in Green Bay. Marinette County could decide whether or not the medical examiner would have to be a licensed physician or a board certified forensic pathologist. She suggested Marinette County would be better served by being a partner when a system is being designed than by purchasing services after the fact. Her report said because of standardization of training, response and investigation creates continuity of service.
On the pro side for the elected coroner she listed only: It is how it has always been. On the con side are listed lack of county standards with regard to financial, personnel and operational or standardized training.
As medical examiner pros she listed ability to enter into an agreement with other counties to develop a regional system, professionalize the operation, standardize expectations, train and certify death investigators, and mitigate liability for the county. She listed no arguments against the medical examiner system, but as a neutral she said the county would have to transition from a traditional elected position to a supervised position.
The coroner investigates all deaths in which there are unexplained, unusual or suspicious circumstances; all homicides; all suicides; all deaths following an abortion; all deaths due to poisoning or toxicity, whether homicidal, suicidal or accidental; certain religious denominations which rely on prayer or spiritual means for healing; if a physician refuses to sign a death certificate,and when, after reasonable efforts, a physician cannot be found to sign the death certificate.
A comparison of the positions submitted by the coroner in 2013 included, on the coroner side that it is an elected position in which the person serves for four years at a pre-set salary. There are no requirements for education, training or experience, the person elected could be anyone, with no statutory limitations.
A medical examiner would be appointed, with salary, training and education requirements set by county board, and would serve at the pleasure of the appointing authority.
Smith said under the medical examiner model the position would most likely be most directly controlled by the Corporation Counsel.
Sorensen said she considered the possibility of partnering with Menominee County but was advised by Corporation Counsel Gale Mattison that there would be legal issues because two states would be involved. She felt Brown County would be most likely,but she also met with Dane County as a possibility.
Why would you pick Dane County to talk to? Sorensen wanted to know.
Sorensen said Lock and Load is looking into getting a refrigerated truck to transport bodies and Dane County is expanding their Medical Examiners office. I was asked to look into this, and Ive done a lot of research, she declared.
Vilas Schroeder, Marinette County Board chair, asked if there are some hidden costs in the medical examiners scenario, for example more mileage. She noted there is mileage in the current budget scenarios, but agreed there might be more with a shared medical examiner.
Schroeder suggested there are also training expenses not included in the budget projections, particularly if they aim for certified death investigators. Currently, he said, they could have exactly the same death investigators who work for the county now.
Behnke moved to postpone the decision until the next time to circulate nomination papers, which would be June of 2018. That motion was seconded by Baumgarten. Casper said they would need to decide sooner, to get the costs put into the budget.
Keller was opposed to postponement. If were going to do it, do it. Otherwise, vote it down, he urged. He said if you look at whats beneficial in the long run for law enforcement, a medical examiner might be the way to go, because there could be standardization and educational requirements. On the other hand, he added, Our coroner has done an excellent job. He repeated, If you want to vote it down, do it now.
Behnke commented more counties have coroners than medical examiners, and he expressed dissatisfaction with the projected medical examiner costs, and with the services that might be offered.
Mattison halted that part of the discussion by saying right now they should just be discussing whether or not the decision should be postponed.
Just suggested taking the decision to the full board without a recommendation.
Sauve agreed with Behnke that the medical examiner figures did not appear complete.
Schroeder also attempted to cut off discussion of costs and desire for more information.
Motion to postpone the decision was defeated, with Keller, Schroeder, Seefeldt, Walker and Casper opposed, and Baumgarten, Behnke, Bauer and Just in favor.
Seefeldt then moved to forward the entire issue to County Board without a recommendation, and that passed by unanimous vote.
Sorensen presented a packet of proposals she will explain more in future about ways the county can either cut costs or increase income to cut the existing $800,000 structural deficit in the 2014 budget. She said that had been 10 years in the making and was $1.7 million when she was hired. But she added,Ive pretty much picked the low hanging fruit. She said future cuts will be more difficult, and added, I want you to tell me where you want me to go. She noted the state and federal governments mandate them to do many things, but for example the county is not required to have an administrator... In at least one county, the County Clerk does it. She said non-mandated services can either be eliminated or assigned to other departments.
One area of savings was the telephone audit, which currently is saving the county $44,000 a year in unnecessary expenses. Health insurance is down $400,000 for 2014. There is some sick pay abuse that can be eliminated.
She hopes successful implementation of the TAD programs and Drug Court will cut jail population to the point where new pod will not be needed in 2019, because that entails not only capital expenditure but also more personnel.
After a bit of discussion the committee agreed to allocate money for overlap, in order to have a new employee trained by the person leaving the position, and to allocate authority for that decision to the County Administrator.
A proposal to allow purchase of budgeted items at the committee level without bringing them for county board approval was discussed and then rejected, so the policy remains that anything costing more than $5,000 needs to be approved by the full board. Conclusion was that just because the money is there does not mean it should be spent. Keller recalled the same idea was discussed and rejected some years back. Baumgarten felt requiring board approval would keep committees and department heads honest.
Keller had seconded a motion by Just to eliminate the requirement for board approval, and then withdrew it. He felt preserving that requirement would allow someone to vote against a purchase if they wanted to. Seefeldt noted it if is an easy decision it only takes a minute or two on the board floor in any case. Motion to make the change failed by six to four vote, with Bauer, Seefeldt, Baumgarten, Casper, Keller and Walker opposed, and Behnke, Schroeder, Just and Sauve in favor.
Schroeder announced Sorensen had been nominated to attend a national event, The U.S. War College in Pennsylvania, this year to discuss national security. He asked for a motion to pay the cost of getting there and back. The War College itself covers all other expenses. This is kind of an honor, Sorensen told the committee. She was nominated by Susan Finco of Green Bay, partly because of her background in government and emergency response.
Sauve felt this should be the role of the Emergency Government director.
Sorensen explained 160 people from across the country are invited to the symposium to discuss national security threats. Sauve continued to suggest that should be the role of the Emergency Government Director.
If she was nominated for this prestigious meeting, I feel we should endorse it, Keller argued. Eventually the motion to pay transportation expenses passed, with only Sauve voting against it.
Before voting on the requirement for a purchase of services agreement or contract with Elderly Services, Behnke declared, Were not trying to take any money away from Elderly Services...I would never allow that to happen. However, Mattison had recommended a contract or agreement to be formally approved by County Board.
We have a right to know how taxpayer money is being spent. Nobody should be offended by this, Just declared.
Its not a right...Its an obligation, Behnke reiterated.
Walker too called Elderly Services an excellent program, but favored the contract idea to have things spelled out. Everyone voted in favor. Mattison said she will draw up an agreement and bring it to the full board for approval.
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