Monroe County Clerk Releases Audit of Medical Examiner’s Office; Monroe County will Follow Recommendations to Improve Operations

KEY WEST – Monroe County Administrator Roman Gastesi sent a letter dated April 24, 2015 to the Monroe County Clerk of the Circuit Court & Comptroller’s Office requesting an operation and finance audit of the Medical Examiner’s Office. That office services the 16th District and is funded by the Monroe County Board of County Commissioners.

The 13-month audit was recently completed and the final report was made public today.

The final report has 16 findings regarding policies, procedures and practices of the Medical Examiner and BOCC management that could be improved, primarily recommendations that include changes to the existing and future contracts with the Medical Examiner that create more operational and financial accountability.

“This is why we have audits,” Gastesi said. “They help us improve our operations to ensure that taxpayers’ money is being used wisely and efficiently for the intended public purposes.”

In Monroe County, as well as many other counties in Florida, the Medical Examiner is an independent contractor and not a County employee.

Monroe County’s current contract with the Medical Examiner, Thomas Beaver, M.D., is similar to other medical examiner contracts around the state. His contract also is nearly identical to contracts used for the past 20 years with previous medical examiners in Monroe County.

“We researched other medical examiner contracts around Florida and found that ours was as detailed if not more detailed than the others,” Monroe County Assistant County Attorney Cynthia L. Hall said.

While the audit’s contract-related recommendations are extremely unusual in these type of contracts with medical examiners, Monroe County agrees with them.

The County has been working the past few years to upgrade most of its other contracts. The County also has already begun taking steps to include more accountability in future contracts with the Medical Examiner. The County also will work with Dr. Beaver to incorporate them into his existing contract.

“Monroe County hopes to be a model in the State of Florida for clear and detailed contracts with medical examiners,” Gastesi said. “The changes will be consistent with our trend over the past several years of writing more accountability into all our contracts.”

On June 11, 2014, Dr. Beaver entered into an agreement with Monroe County to become its interim Medical Examiner, replacing Dr. Hunt Scheuerman, who resigned to teach. Dr. Beaver was nominated by a committee and appointed on an interim basis. The state Medical Examiners Commission recommended him to Gov. Rick Scott, who officially appointed Dr. Beaver on Feb. 25, 2015.

Monroe County has no authority over the Medical Examiner’s appointment or removal. Monroe County’s authority and responsibility, under F.S. 406.06(3), is to establish reasonable salary, fees and other costs that are necessary for the operation of the Medical Examiner’s Office. The office performs examinations, investigations and autopsies to determine cause of death, as well as issue cremation approvals and fill out death certificates.

Less than a year into Dr. Beaver’s contract, concerns were presented to the Monroe County Board of County Commissioners regarding the operation of the Medical Examiner’s Office. Prior to that meeting in May 2015, Gastesi and the individual commissioners already had learned of some of the concerns, prompting Gastesi to request the audit.

During the 13-month period of the audit (from the start of Dr. Beaver’s contract in June 2014 through June 2015) Monroe County paid the Medical Examiner $662,401, dispersed in monthly lump sum payments. The Medical Examiner also received another $8,273 in collected fees from other sources.

During this period, 240 total death cases were referred to the Medical Examiner’s Office. He accepted 211 of them, and also approved 491 cremations.

The audit did not deal with the medical operations of the Medical Examiner’s Office. It dealt with the financial operations and found that the Medical Examiner spent County funds for personal use, including $25,965 to rent, furnish and maintain an apartment in Marathon for his personal residence.

In the audit report, the Medical Examiner stated through his bookkeeper and attorney that the funds the BOCC paid to him and revenues generated from other sources cease to remain public funds once received by his office.

The audit found that the contract agreement between the County and the Medical Examiner did not establish and allocate the Medical Examiner’s operating funds in a manner that provides accountability for those funds.

The audit recommends that BOCC management allocate the annual funds for the current Medical Examiner’s remaining term, which expires May 31, 2017, “in a manner that clearly identifies the Medical Examiner’s compensation, other personnel, operating and capital costs.”

While Dr. Beaver’s past budget requests were similar to those of past Medical Examiners, Monroe County will more carefully scrutinize future budget requests to ensure the Office receives the appropriate amount of funding necessary to complete its mission. Dr. Beaver already has submitted a considerably more detailed budget request for the upcoming fiscal year.  In addition, the County also will be asking Dr. Beaver to amend his contract to include the level of detail recommended by the audit.

The audit also recommends reducing future payments to the Medical Examiner for the personal expenditures identified in the audit. Monroe County will review Dr. Beaver’s response before taking any action on this type of recommendation.

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