II 

118TH CONGRESS 

2D SESSION S. 4159 

To amend the Public Health Service Act to encourage qualified individuals 

to enter the forensic pathology workforce, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

APRIL 18, 2024 

Mr. CORNYN (for himself and Mr. MURPHY) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend the Public Health Service Act to encourage qualified individuals to enter the forensic pathology workforce, 

and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Strengthening the 

5 Medical Examiner and Coroner System Act of 2024’’. 

6 SEC. 2. FORENSIC MEDICAL NEEDS. 

7 Part E of title VII of the Public Health Service Act 

8 (42 U.S.C. 294n et seq.) is amended by adding at the end 

9 the following: 


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1 ‘‘Subpart 4—Forensic Pathology Workforce 

2 ‘‘SEC. 779. GRANTS TO ADDRESS THE FORENSIC MEDICINE 

3 SERVICE PROVIDER SHORTAGE. 

4 ‘‘(a) DEFINITIONS.—In this section: 

5 ‘‘(1) FORENSIC MEDICINE SERVICE PRO6 VIDER.—The term ‘forensic medicine service pro7 vider’ has the meaning given the term in section 6 

8 of Billy’s Law (34 U.S.C. 40506 note; Public Law 

9 117–327). 

10 ‘‘(2) MEDICOLEGAL DEATH INVESTIGATOR.— 

11 The term ‘medicolegal death investigator’ means an 

12 individual who performs formal inquiry into the cir13 cumstances surrounding the death of a human being 

14 to assist in the determination of the cause and man15 ner of death. 

16 ‘‘(3) SECRETARY.—The term ‘Secretary’ means 

17 the Secretary, acting through the Collaborating Of18 fice of Medical Examiners and Coroners of the Cen19 ters for Disease Control and Prevention. 

20 ‘‘(b) PURPOSES.—The purposes of this section are— 

21 ‘‘(1) to encourage and incentivize qualified med22 ical school graduates to enter the practice of forensic 

23 pathology by supporting forensic pathology fellow24 ships; 

25 ‘‘(2) to encourage and incentivize qualified indi26 viduals to enter the field of medicolegal death invesVerDate Sep 11 2014 22:16 May 02, 2024 Jkt 049200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S4159.IS S4159

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1 tigation to conduct death investigations in support 

2 of forensic medicine service providers; and 

3 ‘‘(3) to support qualified individuals who enter 

4 the field of forensic toxicology through employment 

5 in forensic toxicology laboratories in the acquisition 

6 of skills in pharmacology, advanced and emerging 

7 toxicological methods, and instrumentation needed to 

8 assist with the interpretation of toxicological find9 ings. 

10 ‘‘(c) GRANTS.—The Secretary shall award grants to 

11 eligible entities described in subsection (d) to assist such 

12 entities in addressing their shortages by offering the train13 ing and fellowships described in subsection (e)(1). 

14 ‘‘(d) ELIGIBILITY.—To be eligible to receive a grant 

15 under this section, an entity shall be— 

16 ‘‘(1) a graduate medical education program— 

17 ‘‘(A) accredited by the Accreditation Coun18 cil for Graduate Medical Education that offers 

19 a forensic pathology fellowship that is so ac20 credited; or 

21 ‘‘(B) that is seeking such accreditation for 

22 a forensic pathology fellowship; 

23 ‘‘(2) a publicly funded medical examiner or cor24 oner office that is accredited or seeking accredita25 tion; or 


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1 ‘‘(3) a publicly funded forensic toxicology lab2 oratory that supports medical examiner and coroner 

3 offices and that is accredited or seeking accredita4 tion. 

5 ‘‘(e) USE OF GRANT FUNDS.— 

6 ‘‘(1) IN GENERAL.—An eligible entity that re7 ceives a grant under this section shall use the grant 

8 funds— 

9 ‘‘(A) to provide payment to individuals se10 lected by such entity for a forensic pathology 

11 fellowship for salary, fringe benefits, related 

12 supply expenses, and other educational expenses 

13 of such individuals; 

14 ‘‘(B) provide training for medicolegal death 

15 investigators, including paying for the costs of 

16 continuing education for medicolegal death in17 vestigators for purposes of such individuals— 

18 ‘‘(i) becoming certified by the Amer19 ican Board of Medicolegal Death Investiga20 tion (or another accredited certifying orga21 nization); and 

22 ‘‘(ii) maintaining such certification; or 

23 ‘‘(C) to assist eligible entities— 


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1 ‘‘(i) in providing the education and 

2 training to individuals employed by such 

3 entities necessary— 

4 ‘‘(I) to gain initial competency, 

5 additional training, and continuing 

6 education in pharmacology and ad7 vanced and emerging toxicological 

8 methods and instrumentation needed 

9 to assist with the interpretation of 

10 toxicological findings; 

11 ‘‘(II) to become certified by the 

12 American Board of Forensic Toxi13 cology, the American Association of 

14 Clinical Chemistry, or another accred15 ited certifying organization; or 

16 ‘‘(III) to maintain such certifi17 cation or to obtain recertification by 

18 such a certifying organization; or 

19 ‘‘(ii) in obtaining accreditation by the 

20 Accreditation Council for Graduate Med21 ical Education for forensic pathology fel22 lowships. 

23 ‘‘(2) ADMINISTRATIVE COSTS.—An eligible enti24 ty that receives a grant under this section may use 

25 not more than 15 percent of the total amount of the 


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1 grant for administrative expenses, including grant 

2 management services. 

3 ‘‘(f) RECIPIENT REQUIREMENTS.—To be eligible to 

4 receive a fellowship funded by a grant under this section, 

5 an individual shall— 

6 ‘‘(1)(A) be enrolled in, or shall have completed, 

7 an anatomical pathology or anatomical and clinical 

8 pathology residency program accredited by the Ac9 creditation Council for Graduate Medical Education; 

10 and 

11 ‘‘(B) not be, and shall never have been, in de12 fault on any public or private student loan; 

13 ‘‘(2)(A) be an individual who has completed a 

14 program of baccalaureate or postbaccalaureate edu15 cation and earned a degree, or completed a con16 centration, in forensic science, natural science, an17 thropology, nursing, or other medical and forensic18 related fields; and 

19 ‘‘(B) be a coroner or medicolegal death investi20 gator working full-time at, or in a contractual rela21 tionship with, a publicly funded medical examiner or 

22 coroner office who— 

23 ‘‘(i) has not achieved, and is seeking, cer24 tification by an accredited certification organi25 zation described in subsection (e)(1)(B)(i); or 


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1 ‘‘(ii) who is seeking continuing education 

2 for purposes of maintaining such certification; 

3 ‘‘(3)(A) have completed a program of bacca4 laureate or postbaccalaureate education and earned 

5 a degree, or completed a concentration, in forensic 

6 science or physical or natural sciences, with a chem7 istry, toxicology, or other closely related scientific or 

8 forensic component; and 

9 ‘‘(B) be employed by the eligible entity as a tox10 icologist or pharmacologist. 

11 ‘‘(g) TAX WAIVER.—The payment amounts to an in12 dividual under this section or any other benefit received 

13 by the individual from the grant recipient shall not be tax14 able to the individual. 

15 ‘‘(h) GEOGRAPHIC DISTRIBUTION.—In awarding 

16 grants under this section, the Secretary shall take into 

17 consideration— 

18 ‘‘(1) the geographic distribution of grant fund19 ing among the States; 

20 ‘‘(2) the relative proportion of grant funding 

21 between rural and urban areas; and 

22 ‘‘(3) the unique needs of rural communities, in23 cluding— 


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1 ‘‘(A) communities with an incidence of in2 dividuals with opioid use disorder that is above 

3 the national average; and 

4 ‘‘(B) communities with a shortage of fo5 rensic medicine service providers. 

6 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.— 

7 ‘‘(1) IN GENERAL.—There is authorized to be 

8 appropriated to the Secretary to carry out this sec9 tion $13,000,000 for each of fiscal years 2025 

10 through 2029. 

11 ‘‘(2) ALLOCATIONS.—Of the amounts made 

12 available each fiscal year under paragraph (1), the 

13 Secretary shall allocate— 

14 ‘‘(A) subject to paragraph (3), not less 

15 than $7,000,000 for grants to eligible entities 

16 carrying out the purpose described in sub17 section (e)(1)(A); 

18 ‘‘(B) not less than $3,000,000 for grants 

19 to eligible entities carrying out the purpose de20 scribed in subsection (e)(1)(B); and 

21 ‘‘(C) not less than $3,000,000 for grants 

22 to eligible entities carrying out the purpose de23 scribed in subsection (e)(1)(C). 

24 ‘‘(3) FELLOWSHIP MINIMUM.—In allocating 

25 amounts for grants to eligible entities carrying out 


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1 the purpose described in subsection (e)(1)(A), the 

2 Secretary shall award sufficient grant funding to 

3 such entities to ensure that not fewer than 40 foren4 sic pathology fellowships are funded.’’. 

Æ 


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