This is an archived article that was published on sltrib.com in 2005, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.
By national standards, you owe the Utah Medical Examiner's Office $2.74.
But you're only paying 81 cents each year to the place, the last doctor's office visit for about 5,000 Utahns a year.
That funding shortage, says Chief Medical Examiner Todd Grey, is making it difficult to analyze fatality data, thus potentially putting public health at risk. The budget issues also are forcing some families to wait longer to collect life insurance on their deceased loved ones.
Grey said funding isn't hampering the office's role in crime investigations, something the office gives priority. Although TV dramas such as "CSI" have glorified medical examiners as white-coated sleuths solving murder mysteries, Grey says Utah pathologists' role in homicide cases are just one, infrequent service they perform.
The medical examiner's larger function is to monitor public health by investigating most sudden or unexplained deaths, documenting their causes and monitoring for contagions or obvious patterns or trends.
The office handled 4,975 cases last year and its workload has been increasing 5 percent annually.
Its budget has not kept up. The state appropriated the medical examiner, a division of the Utah Department of Health, $1.926 million for the current fiscal year - just 5 percent more than the medical examiner got three years ago.
Grey said the appropriation is low compared to other statewide and metropolitan medical examiner offices across the country.
A. Richard Melton, deputy director of the health department, said funding is a matter of priorities.
"It's a terrible way to say it, and I shouldn't say it this way, but he's looking at dead people and many of our programs are looking at live people," Melton said.
Utah is one of a handful of states with a centralized medical examiner system. The office isn't involved in every death in the state. State law requires the medical examiner look only at a relative handful of cases. Some of them are handled by non-pathologists, but the majority are taken to the medical examiner's office at the University of Utah for a more detailed exam.
The office has four full-time pathologists, including Grey. There are two full-time death investigators and the office employs part-time death investigators, usually law-enforcement personnel, stationed in locations around the state. In all, the office employs 13 full-time and 20 part-time workers.
That's not enough, Grey said, and the dearth is keeping the office from performing some of its public-health functions. The medical examiner's office lacks the software and personnel to effectively analyze fatalities and the factors that cause deaths, Grey said.
The pathologist points to the increase in drug-related deaths in Utah, which currently total about 400 a year. Three or four years ago, Grey and some physicians thought they were seeing higher rates of overdose deaths, but had only observations and anecdotal evidence.
With more analytical tools and personnel, Grey says, the office could have more quickly determined what eventually became obvious - drug deaths were on the rise - and alerted health workers to a correctable problem and perhaps saved some lives. Grey said other death trends could be occurring now and his office doesn't know it.
But Grey said it also would help his office if more funds went to another office in the health department - the Utah Public Health Laboratory. The laboratory conducts toxicology tests for the medical examiner, but a lack of personnel and equipment often keeps test results eight to 12 weeks away.
In some of the cases where toxicology tests are required, the lag prevents the medical examiner from issuing a death certificate. Insurance companies often require death certificates before they issue life insurance awards. So slow toxicology results mean families must wait longer for money sometimes needed for burial costs and income losses.
"That's an impact the poor funding has that has the most direct effect on the public," Grey said.
There also is insufficient money to provide ongoing training and meet the industry's salary demands, he said.
Funding complaints are not new at the Utah medical examiner's office. In 1988, State Medical Examiner Edwin S. Sweeney announced he was quitting and joining the private sector because of the long hours, low pay and poor working conditions.
"You could say I've read the tea leaves and saw no immediate improvements in the future," Sweeney told The Salt Lake Tribune at the time. Back then, according to Sweeney, the office investigated 2,000 cases a year.
Grey, with a mix of humor and sincerity, says the good work his office conducts might be one reason for its funding levels. In some medical examiner's offices, changes came after mistakes and catastrophes. Tests were conducted incorrectly or evidence was mishandled and the public and the government realized its medical examiner's office needed fixing.
Sen. Sheldon Killpack, R-Syracuse, co-chair of the Joint Appropriations Committee for Health and Human Services, said his committee relies heavily on the recommendations from the health department, and the medical examiner's office has not been presented to him as a serious priority.
"And certainly, the same argument can be made from every department in the state that they feel underfunded," said Killpack, who nevertheless acknowledged he has never visited the medical examiner's office.
Melton said the health department has worked to provide for the essential needs of the office. In the next fiscal year, the office is receiving a $50,000 budget increase, primarily to pay for the increased costs of transporting bodies.
Melton said he realizes health officials could be missing trends due to a lack of analytical resources in the medical examiner's office. But considering other health department issues, such as Medicaid funding, Melton said, "I'm not sure that's where I would put my first dollar."
Grey said the office is a little better place to work than it was when Sweeney quit in 1988. The office moved into its current building in 1991, and physician salaries there have improved.