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1 Funding for Accreditation of Medicolegal Death Investigation Offices

2 and Certification of Medicolegal Death Investigation Personnel

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4

5 Recommendations

6

7 The National Commission on Forensic Science requests that the Attorney General of the United 

8 States approve policy that recommends:

9

10 1. All Medicolegal Death Investigators be certified within 5 years.

11 2. All offices, facilities or institutions performing medicolegal death investigation activities 

12 will be accredited within 5 years.

13 3. The Department of justice’s Office of Justice Programs will support a grant program or 

14 allow funds within existing programs to be utilized to help defray the costs associated 

15 with certification and accreditation to ensure compliance.

16

17 Background

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19 The National Research Council’s (NRC) report on strengthening the forensic sciences 

20 recommends that all medicolegal death investigation offices be accredited and that personnel be 

21 certified in their area of expertise. In general, accreditation applies to institutions, facilities, and 

22 offices performing a certain task to become accredited, while certification is for the professionals 

23 working within a specific area of expertise. This document discusses the need for mandatory 

24 accreditation and certification, as well as identifies potential funding for the implementation to 

25 accredit all U.S. medicolegal death investigation offices and facilities and to certify all death 

26 investigation professionals. 

27

28 Accreditation of Offices

29

30 Unlike most crime laboratories which are accredited, most medicolegal death investigation 

31 offices, medical examiners and coroner offices, are not accredited. Of the estimated 2,366 

32 medicolegal death investigation offices in the United States (See Table 1), less than 100 are 

33 accredited by either the National Association of Medical Examiners (NAME) or the International 

34 Association of Coroners and Medical Examiners (IAC&ME) which are currently the only two 

35 accrediting bodies in the United States for medicolegal death investigation institutions. 

36 Although NAME and IAC&ME offer accreditation, neither are formally recognized by an 

37 external standards organization which approves entities to offer accreditation, such as the 

38 International Organization for Standards (ISO) or the American National Standards Institute 

39 (ANSI). Formal recognition of NAME or IAC&ME by an existing external standards 

40 organization would likely require significant changes to these organizations current structure to 

41 meet organizational standards. 

42

43 Certification of Staff

44

45 The number of board certified forensic pathologists in the United States is relatively small, in 

46 comparison to the overall number of medicolegal death investigators and non-physician coroners 
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47 currently employed. For the purposes of this proposal, medicolegal death investigator is 

48 considered an investigator employed by a coroner or medical examiner’s jurisdiction and has the 

49 primary function of performing investigations to assist in determining the cause and manner of 

50 death. A study done by the Scientific Working Group on Medicolegal Death Investigation 

51 (SWGMDI), suggested that approximately 9 medicolegal investigators are needed per million 

52 population to operate at needed capacity, therefore the pool of certified investigators needed in 

53 the United States would potentially be approximately 3,000. Additionally, there are also 

54 approximately 2,000 coroners in the United States, so it is likely that the total certifications 

55 required for all such professionals could approach 5,000. The American Board of Medicolegal 

56 Death Investigators (ABMDI) estimates that the number may approach closer to 8,000. At 

57 present, only about 1,500 professionals are certified by the ABMDI. Thus, the pool of persons 

58 needing certification is large. 

59

60 Traditionally physicians seeking board certification bear the cost of certification through well61 established certification bodies such as the American Board of Pathology (ABP). Such is not the 

62 case for thousands of death investigators and non-physician coroners who may wish (or need) to 

63 become certified by ABMDI. In most specialty areas of medicine, physicians have essentially 

64 been required to possess certifications to work in their specialty areas, while the same has not 

65 been true for coroners and death investigators. 

66

67 Accreditation and certification are critical because they show compliance with industry and 

68 professional guidelines, standards, and performance criteria. Unfortunately, many government 

69 bodies which fund death investigations offices do not give priority to death investigation systems 

70 in comparison to other programs that require funding. Thus, budget lines for accreditation and 

71 certification expenses are often non-existent. 

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73 Funding Accreditation

74

75 In the past, some funding was available to pursue accreditation through the use of Paul Coverdell

76 Forensic Science Improvement grant funds. However, there were challenges; accreditation could 

77 not be guaranteed, funding was short term, and there are associated ongoing costs to maintain 

78 accreditation. A potential long term solution might be to reimburse offices and facilities for 

79 expenses incurred to obtain initial accreditation and for maintaining accreditation after such 

80 expenses have been incurred and accreditation has been secured.

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82 Costs associated with reimbursement can be analyzed for several types of offices as shown in 

83 Table 1. There are offices which are full-service facilities (administration, scene investigation, 

84 and autopsy) and others whose services are primarily administrative, investigative-only, or 

85 autopsy only. Regardless of type, costs of accreditation include fees charged for the accreditation 

86 process as well as the purchase of equipment and supplies or hiring of needed personnel to 

87 qualify for accreditation. There is a perception that a lack of motivation and devoted effort are 

88 perhaps the primary reason for failure of offices to become accredited, however the accreditation 

89 fees are a real and significant hurdle for almost all offices. The Commission believes that 

90 reimbursement for accreditation fees will encourage and enable more offices to become 

91 accredited, and that a reimbursement will ensure efficient and appropriate spending of federal 

92 funds. A plan can be developed for gradual implementation over a 5 year period. 
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93 Table 1. Number of potentially accredited offices by state and type. 

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State State ME

Office

Branch State 

ME Offices

Autonomous County Medical 

Examiner Offices 

Coroner Offices Total Potential 

Accreditations

AL 3 1 64 68

AK 1 1

AZ 15 15

AR 1 75 76

CA 4 54 58

CO 1 62 63

CT 1 1

DE 1 1 2

FL 24 (District ME Offices) 24

GA 1 2 5 54 62

HI 1 4 5

ID 44 44

IL 1 101 102

IN 92 92

IA 1 99 100

KS 31 (district coroners) 105 136

KY 1 3 120 124

LA 64 64

ME 1 1

MD 1 1

MA 1 1

MI 83 83

MN 44 43 87

MS 1 82 83

MO 6 109 115

MT 1 1 56 58

NE 93 93

NV 1 16 17

NH 1 1

NJ 1 2 15 18

NM 1 1

NY 24 38 62

NC 1 1 2

ND 1 1 43 45

OH 2 86 88

OK 1 1 2

OR 1 2 3

PA 3 64 67

RI 1 1

SC 46 46

SD 66 66

TN 1 4 5

TX 11 243 (multiple JPs) 254

UT 1 1

VT 1 1

VA 1 3 4

WA 6 33 39

WV 1 1 2

WI 13 59 72

WY 23 23

TOTAL 25 25 390 1939 2379
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95 Potential Accreditation Costs

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97 Fees charged by NAME and IAC&ME vary based on population, number of inspectors required, 

98 whether the inspection is virtual (paper only) or on site, and whether the inspection is conducted 

99 by NAME or IAC&ME. The costs shown in Table 2 are based on average costs and should give 

100 a reasonable ballpark estimate of accreditation costs based upon the various types of offices. 

101

102 It is also important to take note that if NAME and IAC&ME were at some point accredited by 

103 ISO or a similar body which approves entities to be accrediting bodies, the cost of initial 

104 accreditation and ongoing accreditation costs would rise significantly above those depicted in 

105 Table 2. 

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107 ISO or similar approval for NAME and IAC&ME to be accrediting bodies

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109 As it stands now, NAME and IAC&ME would probably have difficulty in obtaining recognition 

110 from ISO accrediting bodies. They lack adequate staff to meet the requirements, the accreditation 

111 processes have to be an entity separate from the organization itself and have their own physical 

112 plant. It is estimated that such approval would cost $40,000 to $60,000 per organization based 

113 on the experience of other groups, and the process could take several years. Partnering with 

114 existing ISO approved entities may make more sense.

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119

120

121

122

123

124

125

126

127

128

129

130

131

132

133

134

135

136

137

138

139

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141 Table 2. Estimated costs for accreditation of each “tier” of office type. 

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Office Type Number Estimated Cost Per Initial Cost Ongoing Yearly 

Cost at $1000/per 

State ME 25 $5,000 125,000 25,000

Branch State 

ME

27 $5,000 135,000 27,000

County ME 

or District 

ME or 

District 

Coroner

375 $5,000 1,875,000 375,000

SUBTOTAL 427 $5,000 2,135,000 427,000

Coroner 

Office (if 

paper only)

1939 $1,000 1,939,000 1,939,000

Coroner 

office (if onsite visit)

1939 $3,500 6,786,500 1,939,000

SUBTOTAL 1939 $2,250 (average) 1,939,000

To

 6,786,500

 1,939,000

TOTAL 2366 4,074,000

To

 8,921,500

 2,366,000

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146 Certification by ABDMI

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148 It is difficult to know exactly how many professionals need to be certified by ABMDI. But

149 foundationally as discussed above and shown in Table 1, there are 1,940 Coroner jurisdictions,

150 plus the additional Deputy Coroners, Coroner Investigators, and Medical Examiner Investigators

151 who would need to be accounted for as they require certification as well. Historically, some 

152 jurisdictions rely on police for conducting medicolegal death investigations, but this is generally 

153 because these offices have not traditionally had the resources to have their own dedicated 

154 professional medicolegal death investigators who would work closely with the forensic 

155 pathologists investigating cases from a medical perspective and support them in their 

156 determination of cause and manner of death. As previously outlined, based upon population, the

157 estimated number of medicolegal death investigators needed nationally is approximately 3,000,

158 however when accounting for all medicolegal professionals that would require ABMDI 

159 certification, the number approaches a total of 8,000, if all potentially eligible persons are 

160 included. 

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162 ABDMI certification costs $450 and annual maintenance fees are $50. Thus, estimated costs can 

163 be calculated as shown in Table 3.

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165 Table 3. Estimated cost of ABMDI certification

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Group Number Already 

ABDMI 

Certified or 

Registered 

(Estimated)

Need 

Certification

Initial Cost at 

$450

Ongoing 

Maintenance 

Cost at $50 

per year

Investigators 6061 1200 4,861 2,187,450 303,050

Coroners 1939 300 1,639 737,550 96,950

Total 8000 1500 6,500 2,925,000 400,000

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168 In addition to the initial costs for certification, ABMDI requires 45 hours of continuing education 

169 credit every 5 years to maintain ABMDI certification. Some of this credit can be obtained via on170 line continuing education programs, but it is recommended that funding be provided for the 

171 registration fee for two, one week CE-approved courses during the five year period for each 

172 eligible person. Thus, assuming an estimated $600 registration fee for such courses, and that

173 potentially 8,000 people would need to attend two courses during a five year period, the 

174 estimated costs to fund such training annually would be approximately $1,920,000.

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176 Funding Strategy 

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178 Federal funding to help defray costs associated with accreditation or certification could be 

179 dispersed via existing or new grant programs through Department of Justice agencies or offices 

180 such as the Office of Justice Program’s (OJP) National Institute of Justice (NIJ), or other federal 

181 entities such as the National Institute of Health (NIH). Agency reimbursement would occur 

182 when an entity or person produces proof of accreditation or certification, respectively. 

183

184 The estimated costs of such an endeavor, based on the assumption that a maximum expense 

185 approach is taken to ensure accreditation and certification of all eligible entities and

186 professionals is as follows:

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Initial accreditation of all offices $8,921,500

Initial certification of all personnel $2,925,000

Total initial cost $11,846,500

Annual maintenance cost for accreditations $2,366,000

Annual maintenance cost for certifications $400,000

Annual cost of course registration fees $1,920,000

Total annual maintenance costs $4,686,000

ISO approval of NAME and IAC&ME $100,000 (plus staff and facility costs)

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189 The chart below shows an estimated need of federal funding to support reaching a 50% 

190 certification rate goal and a 75% accreditation rate goal over the next five years. 

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Certification 

Rate

Certification Costs Accreditation 

Rate

Accreditation Costs

10%

Year 1

Initial $292,500

Maintenance 40,000 

Total $332,000 

15% Initial $1,338,225

Maintenance 354,900

Total $1,693,125 

10%

Year 2

Initial $292,500

Maintenance 80,000

Total $372,000

15% Initial $1338,225 

Maintenance 709,800 

Total $2,048,025

10%

Year 3

Initial $292,500

Maintenance 120,000

Total $412,000

15% Initial $1,338,225 

Maintenance 1,064,700

Total $2,402,925 

10%

Year 4

Initial $292,500

Maintenance 160,000

Total $452,000

15% Initial $1,338,225 

Maintenance 1,419,600

Total $2,757,825

10%

Year 5

Initial $292,500

Maintenance 200,000

Total $492,000 

15% Initial $1,338,225 

Maintenance 1,774,500

Total $3,112,725

50% of eligible 

persons certified 

within 5 years

Total $2,060,000 75% of all 

eligible offices 

accredited within 

5 years

Total $12,014,625

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193 As shown, the total cost for certification and accreditation would increase annually from a first 

194 year total of $2,025,125 in year one to a total of $3,604,725 by year five, with a total cost of 

195 $14,074,625 over the five year period. This plan would enable certification of 50% of personnel 

196 and accreditation of 75% of offices. Added to this would be an approximate $192,000 per year 

197 for continuing education course registration fees. 

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