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Kentucky Seeks Relief As Autopsy Requests Surge

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As the opioid epidemic rages across Appalachia, one grim consequence has played out in Kentucky's medical examiner's office: A staggering increase in autopsy requests.

Autopsy requests for overdose deaths have jumped more than 26 percent since 2013, part of an overall 18 percent increase of autopsy requests statewide. The increase has coincided with a 39 percent increase in drug overdose deaths during that same time.

The increase has overwhelmed the State Medical Examiner's Office, which consists of nine doctors for the entire state. And it comes amid a national shortage of forensic pathologists that makes it difficult to hire and retain qualified people.

Monday, Gov. Matt Bevin's administration announced a partnership with the state's largest public universities to offer some relief. The state hopes to move all of its forensic pathologists to the payrolls of the University of Kentucky and the University of Louisville.

The doctors would still perform autopsies and the Justice and Public Safety Cabinet would still pay their salaries of between $132,000 and $157,000 a year. But the universities would add in pay raises of as much as 17 percent to cover additional duties of teaching and research.

If the doctors agree to go, they would exit the state's troubled pension system. Justice and Public Safety Cabinet Secretary John Tilley said the state would take the savings from that and use it to hire more doctors.

He said he hopes the prestige of working for a university medical school instead of state government will help the state recruit and retain doctors. And he said the university would help the state apply for federal grant money, which is more readily available now for fighting the opioid epidemic.

"A continuous string of autopsies is always in front of them. The work never slows," Tilley said. "I don't really see it slowing much in the near future."

Dr. William Ralston, Kentucky's chief medical examiner, was not available for comment Monday. Jimmy Cornelison, president of the Kentucky Coroners Association, did not return a call seeking comment.

The Medical Examiner's Office handles autopsy requests from the state's county coroners. Those autopsies are often crucial in criminal prosecutions. But as opioid addiction has swept across the region, the autopsies have also proved valuable in identifying the types of drugs tormenting communities.

In 2015, data from thousands of autopsies confirmed that fentanyl — a stronger, synthetic form of heroin — was a growing cause of death. Lawmakers responded by passing a law last year defining fentanyl and increasing penalties for people who sell it.

"Without this office, we wouldn't know," Tilley said.

The surge of autopsy requests is a problem not just in Kentucky, but nationwide as the country continues to struggle with the opioid problem. Tilley said the country has just 500 forensic pathologists working in the country, making it difficult to hire them.

That's one reason he wanted to partner with the state's medical schools. Dr. Darrell Jennings, chair of the University of Kentucky Department of Pathology and Laboratory medicine, said in a news release the arrangement will provide medical students in Lexington, Bowling Green and northern Kentucky "with unparalleled training on the front lines."

Jonese Franklin

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