BILL ANALYSIS                                                                                                                                                                                                    Ó



          SENATE COMMITTEE ON APPROPRIATIONS
                             Senator Ricardo Lara, Chair
                            2015 - 2016  Regular  Session

          SB 1189 (Pan) - Postmortem examinations or autopsies:  forensic  
          pathologists
          
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          |Version: April 26, 2016         |Policy Vote: HEALTH 6 - 2       |
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          |Urgency: No                     |Mandate: Yes                    |
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          |Hearing Date: May 23, 2016      |Consultant: Brendan McCarthy    |
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          This bill meets the criteria for referral to the Suspense File.

          Bill  
          Summary:  SB 1189 would require a forensic autopsy to be  
          conducted by a licensed physician and require the results of the  
          forensic autopsy and the cause and manner of death to be  
          determined by a licensed physician. The bill would place  
          restrictions on who could be present for an autopsy.


          Fiscal  
          Impact:  Potentially significant state reimbursement costs, due  
          to the requirement in the bill that a licensed physician  
          determine the cause and manner of death (General Fund). 

          By requiring a physician to determine the manner of death in  
          cases where there is a forensic autopsy, the bill may impose  
          additional costs on coroner's offices to have physicians review  
          information developed by investigators and make the final  
          determination of the manner of death. Whether the Commission on  
          state mandates would rule that this requirement imposes a higher  
          level of service (and is therefore reimbursable by the state) is  
          unknown. If the Commission did rule that the bill imposes a  







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          reimbursable mandate, the costs to the state could be  
          considerable. The hourly rate to employ or contract with  
          pathologists is significantly higher than the costs for  
          investigators. The statewide costs to require pathologists to  
          make the determination of the manner of death could be in the  
          millions per year.


          Background:  Under current law, a coroner is required to determine the  
          cause and manner of death under certain circumstances. In a  
          minority of deaths, coroners offices conduct a forensic autopsy  
          to determine the cause of death. Under current practice, most  
          coroner's offices employ or contract with forensic pathologists  
          to conduct autopsies. When there is an autopsy, the pathologist  
          determines the cause of death. The manner of death is determined  
          by the coroner from the autopsy report (if there is one) and  
          from information developed by investigators in the coroner's  
          office. The bill would require a licensed physician to perform  
          the autopsy and to determine both the cause and manner of death.  



          Proposed Law:  
            SB 1189 would require a forensic autopsy to be conducted by a  
          licensed physician and require the results of the forensic  
          autopsy and the cause and manner of death to be determined by a  
          licensed physician. 
          The bill would require that all persons in the autopsy suite  
          have specified training and authorize certain law enforcement  
          personnel to be in the autopsy suite, at the discretion of the  
          pathologist. The bill would prohibit law enforcement personnel  
          directly involved with a death related to law enforcement  
          activity from being involved in a postmortem exam or autopsy.




          Staff  
          Comments:  The bill requires forensic autopsies to be conducted  
          by a physician, whereas current law makes autopsies the  
          responsibility of coroners. In theory, this change in law  
          imposes a new mandate on coroners offices. Under current  
          practice, coroners offices currently use physicians to conduct  
          forensic autopsies, either by employing physicians directly of  








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          contracting for their services. Given that the use of physicians  
          is standard practice, it is unlikely that the Commission on  
          State Mandates would rule that the requirement to use a  
          physician requires a new or higher level of service by coroners  
          offices. Therefore, it is not likely that the state would be  
          required to reimburse local governments for those costs.
          The requirements in the bill regarding who is allowed to be  
          present for an autopsy are not likely to be ruled reimbursable  
          state mandates.The bill generally prohibits people who have not  
          had certain training from being present for an autopsy, rather  
          than requiring all law enforcement personnel to have such  
          training. The Commission is not likely to rule that these  
          requirements require a new or higher level of service from law  
          enforcement agencies or coroners offices. Therefore, it is not  
          likely that the state would be required to reimburse local  
          governments for those costs.




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