A series of changes at the Massachusetts medical examiner’s office have shown early signs of success at reducing the agency’s backlog of unfinished death certificates and autopsy reports.
State officials are cautiously optimistic the office is finally making progress toward eliminating its paperwork problems.
“I don’t want to overreact, because it’s early,” said Daniel Bennett, Secretary of the Executive Office of Public Safety and Security, which oversees the office. “I’m tentatively pleased.”
The backlog has delayed the issuance of key documents, putting court cases in limbo and leaving families without closure and unable to collect insurance benefits or close estates. The problem has been so bad it has jeopardized the office’s accreditation.
Late last summer, the agency launched a plan that included hiring a dozen new support staff to do administrative tasks. The plan was fully implemented by late October — and it seems to be working.
As of Dec. 31, the office had 2,146 pending death certificates and 3,471 incomplete autopsy reports dating back as far as 2011, according to an annual report the office sent to the Legislature.
But by Feb. 19, the office had cut its pending death certificates to 2,030 and its incomplete autopsy tally to 3,382 — even as the office took on hundreds of new cases, according to figures provided by the office.
The office also said it has been able to dramatically speed up how quickly it processes cases.
During fiscal year 2015, which ended in July, the office only completed 25 percent of autopsy reports within 90 days. But after Oct. 26, when the new workers joined the office, the office’s 90-day autopsy report completion rate jumped to nearly 80 percent.
The National Association of Medical Examiners, which accredits medical examiner’s offices, requires them to complete 90 percent of autopsy reports within 90 days to receive full accreditation. The Massachusetts office has had only provisional accreditation since December 2012.
State officials have said that the backlog at the office is a paperwork problem, and the office has had no delays in examining and releasing most bodies for burial.
In addition to hiring support staff, officials are moving to hire more medical examiners. A shortage of medical examiners has been a key part of the paperwork problem.
Officials have blamed a nationwide shortage of pathologists, as well as public attention following blunders at the Massachusetts office several years ago.
The office is negotiating with union representatives now to significantly raise medical examiner’s salaries to bring their pay more in line with the national average, which is about $184,000, according to a 2014 report in the Academic Forensic Pathology journal.
The current scale in Massachusetts pays full-time medical examiners between $158,000 and $229,000.
Bennett said the compensation increase is aimed at not only recruiting new pathologists, but retaining ones currently employed by the office. The office also hopes to continue to recruit pathologists through a fellowship program.
State Representative Harold P. Naughton, House chairman of the public safety committee, said that despite some progress at the office, he remains concerned that it still does not have enough resources.
He said, for example, the ongoing opioid crisis could lead to an increase in unattended deaths that require review by the medical examiner’s office.
“There shouldn’t be any backlog,” he said.
New cases are still not being processed quickly enough, he said.
“The goal is to get to an acceptable level of turnaround time,” said Naughton. “I think it’s important that we advocate for that agency and to ensure they have the resources they need.”