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Medical Examiner tells commissioners his office “bursting at the seams”

Wednesday, November 9, 2011 by Michael Kanin

Travis County Medical Examiner David Dolinak told the Travis County Commissioners’ Court Tuesday that his department is close to a workload statistic that could cause a loss of accreditation. “In terms of the autopsy workload and…accreditation standards, currently, we’re toeing the line,” he said. “We’re very close to doing more work than (the National Association of Medical Examiners) would suggest is their requirement.”


That news came as court members got their first peek at what it might cost to construct a new office for Dolinak and his team. According to consultants hired by the county to analyze the examiner’s needs through 2045, that price tag could run as high as $27.1 million.


That figure is the bottom line of one of four scenarios offered by the consultant, Michigan-based Crime Lab Design. Of the four, it is the only one that leaves the medical examiner’s range of service at its current 42-county level.


The Travis County Medical Examiner’s office has taken a fair amount of heat in the past few years. As far back as 2006, a detailed report in the Austin Chronicle suggested that the office was too cramped to handle its workload.


On Tuesday, Dolinak and the consultants continued to illustrate that point. “We’ve been making accommodations in the past few years with our existing facility, including a major renovation…to manage an increased workload and all of the other services and aspects that go with that,” Dolinak told the court. “There’s going to be a time when we can no longer afford to make more accommodations…We’re bulging at the seams as it is. At some point, something is going to give.”


The National Association of Medical Examiners bases a portion of its accreditation formula on a workload ratio. According to Dolinak, 250 or fewer cases per examiner per year are ideal. Anything more than 325 could trigger a loss of accreditation. Dolinak told the court that his office believes that it will be at 325 by the end of 2011.


The new office and additional pathologists to use it could take care of that concern. At its smallest, the new facility would be a full 10,000 square feet larger than the medical examiner’s current digs. If the court opts for the largest version of the facility, space would increase from a current measure of 14,410 square feet to 31,029.


The consultants based their variations on the medical examiner’s service area. The most ambitious of these options keeps Travis County serving its entire current span, including the autopsy needs of smaller municipalities as far west as Ward County. The most restricted option limits the county to serving only medical examiner needs within its own borders.


Travis’ county executive in charge of Emergency Services Danny Hobby suggested that the county has an obligation to smaller municipalities. “The way the State of Texas is set up, those smaller entities actually look toward us…because they can’t afford to build their own (facilities),” he said. “There is a need for us to make sure that we don’t neglect, or just throw away folks that really need our help.”


Principal Crime Lab Design Engineer Lou Hartman recommended that the court continue the medical examiners’ full range of service. As part of his argument, Hartman suggested that the revenues collected for autopsies performed for other municipalities could do much to offset the cost of the new facility’s construction.


County Judge Sam Biscoe wondered if forward movement on a larger facility might forestall a loss of accreditation. Crime Lab’s Susan Halla said that it might. “We’ve had other people that have been in this same behind-the-8-ball scenario before and if they can say to the accrediting body, ‘this is our plan…’ then the accrediting body has been pretty good about allowing that to go forward…provisionally,” she said.


Still, Hobby suggested that it might be April before his office decides on a recommendation.

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