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Reform Pending for New Jersey’s Medical Examiner System

Overworked, underfunded agency will be transferred to Department of Health, in line for cash infusion, new chain of command

Valerie Vainieri Huttle
Assemblywoman Valerie Vainieri Huttle (D-Bergen) has been a longtime champion of the reform.

Gov. Phil Murphy recommitted to reforming New Jersey’s beleaguered medical examiner system and is now reviewing bipartisan-backed legislation to create a more accountable, comprehensive, and professional process for investigating mysterious and suspicious deaths.

The state Assembly voted unanimously last week to approve a plan to transfer oversight of the medical examiner system to the Department of Health, establish uniform protocols and standards for investigations, and require equipment and training upgrades, among other things. If signed by Murphy, the bill, which cleared the Senate in March, would take effect in a month.

The Democratic governor called for “wholesale reform” of the system in December, a month before he took office, following an NJ.com investigation into the state’s medical examiner program, which Murphy called “shocking and appalling,” according to the news organization. The stories documented longstanding problems and suggested New Jersey’s system has failed to keep par with death investigations in other states.

‘Historically underfunded’

As an initial investment, Murphy included $500,000 in additional funding for the program in his proposed budget for next year, flagging it as a “historically underfunded” office. Overall, the system would get nearly $12 million in state funds under Murphy’s funding plan, which requires legislative approval before it can take effect in July.

“Governor Murphy has closely followed the Legislature's deliberations on much-needed changes to the medical examiner system, and he looks forward to working with all relevant parties to reform it,” spokesman Dan Bryan said Wednesday, noting that Murphy is reviewing this bill and others sent to him by lawmakers.

Forensic pathologists joined family members of crime victims and current and former staff of the state’s medical examiner system at a packed legislative hearing in January to share concerns about the program. Witnesses noted that examiners are underpaid, more doctors are needed, facilities are subpar and underheated, and autopsy delays are common, sparking frustration for family members and law enforcement officials waiting on the findings for use at trial.

New Jersey’s system now involves 10 regional offices — a mix of county, multicounty, and private-contractor facilities — but the state medical examiner has direct control over just two of these. It falls under the jurisdiction of the attorney general’s office, which oversees all law enforcement, a situation that critics said makes it hard for medical examiners to maintain their independence when conducting autopsies.

Last year, these offices reviewed 21,000 deaths statewide and conducted some 5,000 autopsies, officials said. The problem is exacerbated by the growing toll of the opioid epidemic, which killed nearly 2,000 people last year, and results in complex and highly emotional cases for investigators.

To address these concerns, the bill (A-1709/S-976) would create a new, more powerful Office of the Chief State Medical Examiner within the health department, and empower its leader with “significant statutory authority and operational oversight to ensure the effective and efficient operation of the entire medical examiner system in New Jersey.”

New chain of command

“By putting oversight of forensic pathologists under the Department of Health instead of the state’s top prosecutor, we are creating a more unified system and removing any perception of prosecutorial influence,” said Assemblyman Raj Mukherji (D-Hudson), a lead sponsor. “I applaud Attorney General Grewal for supporting this rationale,” Mukherji added; according to NJ.com, Grewal issued a memo indicating his support for this shift.

The chief medical examiner — to be appointed by the governor, with Senate approval — would establish clear autopsy protocols and performance standards, ensure the system is properly staffed and funded, and intervene in local office proceedings, if needed. These regulations must clearly spell out when an autopsy is required; currently there are many factors, including caseload, that influence when an investigator conducts an external death review versus a full autopsy, in which the body is dissected and organs are analyzed.

Each county or multicounty office would be required to meet those metrics and hire a qualified local leader to report to the state chief, under the proposal. It also calls for a fellowship program to boost interest and professional capacity and allows for the chief to contract with state colleges, hospitals, and other facilities if the system needs additional storage space.

"This bill will provide much needed reformation to the medical examiner system," said Assemblywoman Valerie Vainieri Huttle (D-Bergen), a longtime champion for reform. "A well-equipped staff as well as oversight of county and intercounty medical examiner offices will provide more efficient assistance to mourning families in our state. It’s long overdue, and our forensic investigatory apparatus would have the much needed independence from the judicial system it deserves."

Other key sponsors include Sen. Joseph Vitale (D-Middlesex), the health committee chairman and a longtime advocate for reform, Sen. Christopher “Kip” Bateman (R-Hunterdon), and former Assemblyman Joseph Lagana (D-Bergen), who was recently sworn in to replace former Sen. Robert Gordon (D-Bergen), who was appointed to a post on the state Board of Public Utilities.

"These reforms are long overdue and are desperately needed for a system that is fragmented, mismanaged, underresourced and overworked," Vitale said. "For too long, the medical examiner's office hands have been tied making it an ineffective manager of a fragmented system with no central oversight, inadequate staffing, meager funding, bad standards, and poor quality control."

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