The Office of the County Auditor conducted a performance review of The Office of Medical Examiner and Trauma Services (OMETS). Our review objective is to analyze OMETS’ effectiveness and efficiency in several key performance areas. An additional objective is to determine the adequacy of expert witness and toxicology revenue collection practices.
We conclude that the office operates within established parameters for Florida medical examiners and generally provides services in an efficient and effective manner when compared to established standards and/or peers. Revenue collection practices are not adequate.
We commend the Medical Examiner’s Office for their pursuit of accreditation and certifications of staff. The Medical Examiner’s Office received full accreditation status through the National Association of Medical Examiners in November 2016. All investigators are certified by the American Board of Medicolegal Death Investigators. All Forensic Pathologists are certified by the American Board of Pathology.
The Medical Examiner’s Office compares favorably to local peers and industry best practices. The cost per resident for the Broward Medical Examiner’s Office is $2.94 while the average cost per resident, excluding Broward, is $3.20 for other Medical Examiners (Fiscal Year 2016). Also, one professional organization recommends a minimum annual funding of $3.87 per resident (adjusted to Fiscal Year 2016). From Fiscal Year 2013-Fiscal Year 2016, we noted that the Medical Examiner’s Office completed 97% of their autopsies within 24 hours. This exceeds the accreditation standard of 90% of autopsies within 48 hours.
Approximately $1.67 million in receivables are due to the County for services provided by the Medical Examiner’s Office and remains unpaid. Nearly $1 million of this amount is from the State Attorney’s Office, which has continued to accrue over several years without payment. Without reimbursement, County taxpayers are subsidizing the cost of services provided to the state of Florida.
A staffing level assessment should be conducted to determine appropriate staffing needs. Workloads for all operational areas (Investigations, Pathology and Toxicology) increased in 2016.
We also noted opportunities for improvement related to the accounting and management information systems and the accuracy of reported performance metrics.
We recommend to Management the following for improvement:
- Develop and implement practices to ensure amounts invoiced for services are collected on a timely basis;
- Develop procedures to ensure charges for services are appropriately entered into PeopleSoft;
- Continue to work with the LabLynx vendor on correcting issues and improving system functionality;
- Develop methods to ensure consistent and accurate reporting to OMB. This may include developing meaningful measures and improved methodologies for tracking and calculating certain measures; and
- Conduct a staffing level assessment to determine the appropriate staffing levels and propose budgetary resources needed to achieve necessary levels.
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