Fee hike could force other counties to break with Travis ME’s office

A move by the Travis County Commissioners Court to raise the fee it charges to other jurisdictions for post-mortem examinations may also drive down external use of the county morgue. Though Executive Manager of Emergency Services Danny Hobby insists that county officials do not use pricing to achieve a reduction in the number of autopsies each county medical examiner performs, a decrease in autopsies from other counties would have that added effect.

 

In addition to pure workload concerns, a decrease in autopsies per examiner – one of the metrics used by the licensing agency that awards the facility its accreditation – would also increase the chances that the Travis County Morgue will retain its certification. Still, Hobby told County Commissioners that the decrease in the number of external cases the medical examiner handles is not easy to predict. “It’s unpredictable based upon the economy, based upon all the circumstances that are now going within other counties,” he said.

 

Commissioners approved the new fees by a unanimous vote. The new structure raises out-of-county prices for autopsies from $2,300 a body to $2,600. It also brings court appearance fees for the pathologists up from $100 an hour to $121 an hour and the cost of an external exam from $800 to $900.

 

All told, county officials expect to make $39,000 in additional revenue for the remainder of FY2012. That figure is expected to jump to $220,000 for FY2013.

 

In addition to jurisdictions around Travis County, the Travis County Medical Examiners Office serves 42 other counties. These include areas as far south as Refugio County, as far north as Brown County, and as far west as Ward County.  

 

The department initially received its accreditation from the National Association of Medical Examiners, or Name, in 2009. It has since teetered on the edge of losing that certificate thanks to cramped quarters, which have, in turn, lead to a lack of pathologists (See In Fact Daily, Nov. 9, 2011). In order to keep NAME’s approval, each pathologist must perform less than 325 autopsies a year. In November, Travis County Medical Examiner David Dolinak predicted that doctors at the facility would hit that number at the end of 2011.

 

The Travis County Medical Examiners office is a 14,000 square foot facility. Dolinak has pushed the court for a new office that might better handle his team’s workload. Consultants have recommended that the county construct a facility that is as big as 31,000 square feet.

 

Hobby noted that a fee hike could help to increase staff or other operational income. “Fees are in relationship to cost and expenditures of the office,” he said. “If we were to add another doc, if we were to add additional staff…We’re going to probably be looking at this again, once we have increases in expenditures and operational costs.”

 

Commissioners also gave their approval to a letter that will go out to county Medical Examiner clients explaining the fee adjustment. County officials are required by contract to give 60 days notice for the change.