Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Robert J. Foucrault, Coroner
Subject: Forensic Pathology Services Master Service Agreement
RECOMMENDATION:
title
Adopt a resolution authorizing the Coroner, or designee(s), to execute agreements and/or amendments with each contractor listed in Attachment A to provide as-needed forensic pathology services for the three-year term of July 1, 2025 through June 30, 2028 in an aggregate amount not to exceed $2,827,280, and granting a waiver of the competitive bidding process for the provision of the above forensic pathology services pursuant to County Ordinance Code Section 2.83.050(e).
body
BACKGROUND:
The Coroner’s Office is required by statute to investigate and determine the cause and manner of death in all violent, sudden, or unusual deaths in the County of San Mateo. To carry-out this statutory duty, the Coroner’s Office contracts with forensic pathologists certified by the American Board of Forensic Medicine, of which there are currently fewer than 500 practicing full-time in the entire United States.
The need for reliable on-call forensic pathology services is critical, as the recognized industry standard for completion of all autopsies is within 24 hours of the death, a standard that, in certain circumstances, becomes even more pressing, such as in cases of Sudden Infant Death Syndrome, suspected homicides, and where religio-cultural practices require burial in less than 24 hours. Further, since November 2019, the Coroners’ Office has been accredited by the International Association of Coroners and Medical Examiners (IAC&ME), which requires that the Coroner’s Office, in order to maintain its accreditation, complete 80% of all autopsy reports within 90 calendar days of the autopsy having been conducted.
Due to the national shortage of board-certified forensic pathologists, the Coroner’s Office has encountered difficulties in recruiting and retaining board-certified forensic pathologists.
DISCUSSION:
To remedy the persistent difficulties the Coroner’s Office has encountered regarding the provision of reliable forensic pathology services, and to maximize flexibility in the performance of such services, staff recommends that the Board authorize a master services model whereby the Coroner’s Office is authorized to execute agreements and/or amendments with each Board-certified forensic pathology contractor listed in Attachment A, including those over $200,000.00, to provide as-needed forensic pathology services for the three-year term of July 1, 2025 through June 30, 2028 (“Term”) in an aggregate amount not to exceed $2,827,280.
This recommendation is consistent with the model and amount approved by the Board on August 2, 2022 for such services during the three-year period through June 30, 2025. The scope of services for each agreement and/or amendment with the pre-approved contractors listed in Attachment A would be substantially similar to the scope of services provided in Attachment B, and the total not-to-exceed amount would include any agreements and/or amendments entered into on or after August 2, 2022.
Prior to the Coroner, or designee(s), executing agreements and/or amendments with the approved contractors listed in Attachment A, documentation shall be obtained and retained confirming that all such agreements and/or amendments have been reviewed and approved by the County Attorney, Risk Management, and Information Services Department, wherever applicable, and that such agreements and/or amendments comply with applicable County ordinances and are consistent with the terms and conditions approved by the Board.
The Board has previously waived the competitive bidding process for the provision of forensic pathology services pursuant to County Ordinance Code 2.83.050(e) and the Coroner’s Office requests that the Board continue to do so for each agreement entered into with the contractors listed on Attachment A under the master services model, as forensic pathologists are specifically exempt from the competitive bidding process by County Administrative Memorandum B-1, Section IV.B.15, and because the Coroner’s Office is required to use Board-certified forensic pathologists in order to maintain its IAC&ME accreditation and there are fewer than 500 Board-certified forensic pathologies in the entire United States.
The Coroner’s Office requests that it be allowed to add (or remove) qualified forensic pathologists to (or from) Attachment A, as needed, during the Term and subject to the maximum fiscal obligation of $2,827,280, which authority will allow the Coroner’s Office to comply with its statutory duties surrounding timely death investigations without having to return to this Board each time a Board-certified forensic pathologist is added to (or removed from) Attachment A.
Finally, the Coroner’s Office requests that it be authorized to execute additional amendments to each agreement that modify the County’s maximum fiscal obligation by no more than $25,000 for each agreement ($200,000.00 in total), and/or modify the contract term and/or services so long as the modified term or services is/are within the current or revised fiscal provisions.
The County Attorney has reviewed and approved the Resolution as to form.
PERFORMANCE MEASURE:
IAC&ME recommends the completion of 80% of all autopsy reports within 60 calendar days of an autopsy performance as a forensic pathology best practice and requires the completion of 80% of all autopsy reports within 90 calendar days of an autopsy performance. Thus, all agreements with the contractors listed on Attachment A will conform to the following performance measures:
|
Measure |
FY 23-24 Actual |
FY 24-25 Projected |
|
% of autopsy reports completed within 90 days (IAC&ME requirement) |
61% |
80% |
|
Average number of days elapsed from date of autopsy performance to date of autopsy report completion |
81 |
63 |
COMMUNITY IMPACT:
Approval of the master services model for forensic pathology services will help to ensure that all death investigations within San Mateo County are completed in a timely manner, an outcome that recognizes all religio-cultural practices and the Coroner’s commitment to providing equitable, efficient, and courteous services, respecting the needs of families involved in the death of their loved ones.
FISCAL IMPACT:
The total maximum fiscal obligation for all anticipated forensic pathology needs through June 30, 2028 is $2,827,280.00, which amount is partially included in the 2025-2027 Recommended Budget for the Coroner’s Office and the remaining balance will be included in the 2027-2029 Recommended Budget.