Item C16
MONROE COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: March 15-16. 2000
Bulk Item: Yes l No
Division: Public Safety
Department: Medical Examiner
AGENDA ITEM WORDING: Report concerning the Medical Examiner's facilities and approval
to negotiate for additional facilities
ITEM BACKGROUND: See attached Report
PREVIOUS RELEVANT BOCC ACTION: On August 11,1999, Board approved to continue
the existing lease premises with Dean-Lopez Funeral Home for use as Medical Examiner facilities
on a month-to-month basis pending report from staff
STAFF RECOMMENDATION: Approval to negotiate for additional facilities
TOTAL COST: unknown
COST TO COUNTY: unknown
REVENUE PRODUCING: Yes
BUDGETED: Yes
No X
No
N/A
APPROVED BY: County Attorney n/a
DIVISION DIRECTOR APPROVAL:
DOCUMENTATION: Included: X To Follow: _ Not Required:
DISPOSITION: Agenda Item #:
1'(1'"
COUNTY of MONROE
PUBLIC SAFETY DIVISION
James R. "Reggie" Paros, Director ...
490 63rd Street, Suite 140
Marathon, FI. 33050
r---
BOARD OF COUNTY COMMISSIONERS
MAYOR, Shirley Freeman, District 3
Mayor Pro Tem, George Neugent, District 2
Wilhelmina Harvey, District 1
Nora Williams, District 4
Mary Kay Reich, District 5
'\
MEMORANDUM
TO:
Monroe County Board of County Commissioners
Monroe County, Florida
James R. "Reggie" Paros, Director (yJ~
Public Safety Division r;,.
FROM:
SUBJECT:
Report concerning the Medical Examiner's facilities and
approval to negotiate for additional facilities.
DATE:
March 3, 2000
Background
Monroe County formerly leased facilities on Big Pine Key at Memorial Gardens of the
Keys for the Medical Examiner. When those facilities became no longer available, the
Monroe County Board of County Commissioners entered into a lease for facilities for
him with Dean-Lopez Funeral Home on August 19, 1997. The cost was $650 per month,
which was approximately 1/3 the cost of the rent charged previously at the Big Pine
facility. Dean-Lopez provided refrigeration and operating facilities at 418 Simonton St.,
Key West. Additionally, facilities for long-term storage of dead human remains under
refrigeration, and for storage of any other items such as records and equipment used in
conjunction with the medical examiner's responsibilities were at their Florida Keys
Crematory facility located at mile-marker 10.5, Big Coppitt Key. Included at the
facilities and within the monthly costs were utilities, refrigeration, storage space, and
disposal of customary infectious waste. The Board of County Commissioners renewed
the lease with Dean-Lopez on June 10, 1998 for an additional one-year period, at the
same cost as the original lease.
County staff placed an item on the agenda for the August 11, 1999 regular meeting of the
Board of County Commissioners. The item was for approval of an agreement with Dean-
Report: Medical Examiner
Page 2 of4
03/03/00
Lopez Funeral Home to again lease their facilities for the Medical Examiner for a three-
year period at $850. per month, $10,200 per year, with an annual CPI adjustment. The
additional $20.0. per month was requested and justified by Dean-Lopez due to an
upgrading of the refrigeration system. At that meeting, Marilyn Beyer, representing
Beyer Funeral Home, and Bill Langstaff addressed the Board. A motion was made by the
Board and carried to continue the existing leased premises with Dean-Lopez Funeral
Home for use as Medical Examiner facilities on a month to month basis pending report
from Staff.
Over the past several months, there have been written correspondence, meetings and/or
telephone conversations concerning facilities for the Medical Examiner with numerous
individuals, including Jeff Dean, Dean-Lopez Funeral Home, Marilyn Beyer and Bill
Langstaff, Beyer Funeral Home, Tom and Judy Ralph, Martin Vegue Funeral Home, Dr.
Robert J. Nelms, Jr., Medical Examiner, Louis LaTorre, Social Services, Charles Ingram,
Veterans Affairs, Michael Lannon, Superintendent of Schools, Steve Piazza, Construction
Management, James L. Roberts, County Administrator, and County Commissioner Mary
Kay Reich. That process has led to the following findings and conclusions.
Findings and Conclusions
· The Medical Examiner presently uses facilities at Dean-Lopez, Beyer, and Martin
Vegue Funeral Homes to some extent for autopsies and post mortem (external)
examinations.
· Removal services and transportation of dead human remains are provided for the
Medical Examiner by his own staff and Dean-Lopez, Beyer, and Martin Vegue
Funeral Homes.
· Most of the Medical Examiner's paper records, photographic slides and specimens are
kept at the Dean-Lopez facilities.
· Only Dean-Lopez is being compensated on a regularly recurring basis for the Medical
Examiner's use of their facilities.
· Beyer and Martin Vegue Funeral Homes are incurring certain expenses even though
they are not receiving any compensation from the County as a result of the Medical
Examiner's use of their facilities and their providing of removals and transportation
servIces.
· Concerns have been voiced about vehicles with private company markings being used
for removals and transportation of medical examiner cases, and about the
unauthorized and/or inappropriate use by the Medical Examiner's staff of some
funeral home-owned supplies and equipment.
· A suggestion was made that the old Mariner's Hospital should be considered for use
as a Medical Examiner's facility.
· The Medical Examiner needs specific equipment at all locations at which he performs
autopsies. This is equipment other than what is normally available at funeral homes.
Report: Medical Examiner
Page 3 of4
03/03/00
· The Medical Examiner has some problems presently when handling other than
normal cases due to not having an appropriate facility, e.g., cases involving: special
techniques and procedures, facial re-constructions, full body x-rays (presently
requires transporting a portable x-ray machine to the autopsy site and then taking 18 -
20 exposures).
· The Medical Examiner needs secure, centralized storage for paper records, ,
photographic slides, skeletons and formalin specimens (3-years). Additionally
needed are short and long-term refrigeration for dead human remains pending final
disposition, and blood and urine toxicology specimens (3-years); freezer facilities for
DNA specimens; climate controlled space for paraffin block specimens; and x-ray
developing capabilities. Specimens should be located at or in close proximity to the
Medical Examiner's laboratory facilities.
· The Medical Examiner should have trained investigators at every scene and
photographs taken.
· The Medical Examiner should have somebody on his staff available at the facility
when family members or others come to make identification. Accordingly, having
the facility located in an area near airport access would make it more convenient.
· A Medical Examiner's facility that is geographically centrally located within the
County and appropriately staffed should enhance overall effectiveness. It could
provide: secure storage of all records and specimens; timely response to and
investigation of scenes; timely removal and transportation of dead human remains;
properly designed and equipped operating room(s) and other features.
· County Social Services and Veterans Affairs departments sometimes utilize the
funeral homes' refrigeration facilities while attempting to locate a deceased's next of
kin.
Medical Examiner's Autopsies and Post Mortem Exams (external)
Period of Report: November 1998 - September 1999*
*Note: Dr. Nelms gathered information from the reports and logs he had available in his
office. Therefore, autopsies and post mortem exams cover an II-month period only.
Service Performed
Location
Key West
Marathon
Key Largo
Autopsies
55 (53%)
29 (28%)
20 (19%)
Post Mortem Exams
18 (49%)
7 (19%)
12 (32%)
Total:
73(51%)
36 (26%)
32 (23%)
Report: Medical Examiner
Page 4 of4
03/03/00
Period of Report: October 1, 1999 - February 29, 2000
Service Performed Location
Key West Marathon Key Largo
Autopsies 43 (65%) 9 (14%) 14 (21 %)
Post Mortem Exams 6 (60%) 3 (30%) 1 (10%)
Total: 49 (63%) 12 (15%) 15 (19%)
Recommendations
Short-term:
· Approval of an agreement with Dean-Lopez Funeral Home to lease their
facilities for the Medical Examiner for a three-year period at $850 per month,
$10,200 per year, with an annual CPI adjustment.
· Authorize staff to negotiate agreements with both Martin Vegue and Beyer
Funeral Homes for the use of their facilities by the Medical Examiner.
· Acquire temporary vehicle signs (magnetic) with the wording: "MEDICAL
EXAMINER" and distribute to each of the businesses that do removals and
transportation services for him for display on their respective vehicles when
they are performing services on his behalf.
Long-term:
· Identify, acquire, design, construct, and/or reconstruct a facility
geographically centrally located within the County, and properly equip it for
use by the Medical Examiner.
Cc: County Administrator
County Attorney
County Clerk