II 118th CONGRESS 2d Session S. 4159 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. Short title This Act may be cited as the Strengthening the Medical Examiner and Coroner System Act of 2024 . 2. Forensic medical needs Part E of title VII of the Public Health Service Act ( 42 U.S.C. 294n et seq. ) is amended by adding at the end the following: 4 Forensic pathology workforce 779. Grants to address the forensic medicine service provider shortage (a) Definitions In this section: (1) Forensic medicine service provider The term forensic medicine service provider has the meaning given the term in section 6 of Billy's Law ( 34 U.S.C. 40506 note; Public Law 117–327 ). (2) Medicolegal death investigator The term medicolegal death investigator means an individual who performs formal inquiry into the circumstances surrounding the death of a human being to assist in the determination of the cause and manner of death. (3) Secretary The term Secretary means the Secretary, acting through the Collaborating Office of Medical Examiners and Coroners of the Centers for Disease Control and Prevention. (b) Purposes The purposes of this section are— (1) to encourage and incentivize qualified medical school graduates to enter the practice of forensic pathology by supporting forensic pathology fellowships; (2) to encourage and incentivize qualified individuals to enter the field of medicolegal death investigation to conduct death investigations in support of forensic medicine service providers; and (3) to support qualified individuals who enter the field of forensic toxicology through employment in forensic toxicology laboratories in the acquisition of skills in pharmacology, advanced and emerging toxicological methods, and instrumentation needed to assist with the interpretation of toxicological findings. (c) Grants The Secretary shall award grants to eligible entities described in subsection (d) to assist such entities in addressing their shortages by offering the training and fellowships described in subsection (e)(1). (d) Eligibility To be eligible to receive a grant under this section, an entity shall be— (1) a graduate medical education program— (A) accredited by the Accreditation Council for Graduate Medical Education that offers a forensic pathology fellowship that is so accredited; or (B) that is seeking such accreditation for a forensic pathology fellowship; (2) a publicly funded medical examiner or coroner office that is accredited or seeking accreditation; or (3) a publicly funded forensic toxicology laboratory that supports medical examiner and coroner offices and that is accredited or seeking accreditation. (e) Use of grant funds (1) In general An eligible entity that receives a grant under this section shall use the grant funds— (A) to provide payment to individuals selected by such entity for a forensic pathology fellowship for salary, fringe benefits, related supply expenses, and other educational expenses of such individuals; (B) provide training for medicolegal death investigators, including paying for the costs of continuing education for medicolegal death investigators for purposes of such individuals— (i) becoming certified by the American Board of Medicolegal Death Investigation (or another accredited certifying organization); and (ii) maintaining such certification; or (C) to assist eligible entities— (i) in providing the education and training to individuals employed by such entities necessary— (I) to gain initial competency, additional training, and continuing education in pharmacology and advanced and emerging toxicological methods and instrumentation needed to assist with the interpretation of toxicological findings; (II) to become certified by the American Board of Forensic Toxicology, the American Association of Clinical Chemistry, or another accredited certifying organization; or (III) to maintain such certification or to obtain recertification by such a certifying organization; or (ii) in obtaining accreditation by the Accreditation Council for Graduate Medical Education for forensic pathology fellowships. (2) Administrative costs An eligible entity that receives a grant under this section may use not more than 15 percent of the total amount of the grant for administrative expenses, including grant management services. (f) Recipient requirements To be eligible to receive a fellowship funded by a grant under this section, an individual shall— (1) (A) be enrolled in, or shall have completed, an anatomical pathology or anatomical and clinical pathology residency program accredited by the Accreditation Council for Graduate Medical Education; and (B) not be, and shall never have been, in default on any public or private student loan; (2) (A) be an individual who has completed a program of baccalaureate or postbaccalaureate education and earned a degree, or completed a concentration, in forensic science, natural science, anthropology, nursing, or other medical and forensic-related fields; and (B) be a coroner or medicolegal death investigator working full-time at, or in a contractual relationship with, a publicly funded medical examiner or coroner office who— (i) has not achieved, and is seeking, certification by an accredited certification organization described in subsection (e)(1)(B)(i); or (ii) who is seeking continuing education for purposes of maintaining such certification; (3) (A) have completed a program of baccalaureate or postbaccalaureate education and earned a degree, or completed a concentration, in forensic science or physical or natural sciences, with a chemistry, toxicology, or other closely related scientific or forensic component; and (B) be employed by the eligible entity as a toxicologist or pharmacologist. (g) Tax waiver The payment amounts to an individual under this section or any other benefit received by the individual from the grant recipient shall not be taxable to the individual. (h) Geographic distribution In awarding grants under this section, the Secretary shall take into consideration— (1) the geographic distribution of grant funding among the States; (2) the relative proportion of grant funding between rural and urban areas; and (3) the unique needs of rural communities, including— (A) communities with an incidence of individuals with opioid use disorder that is above the national average; and (B) communities with a shortage of forensic medicine service providers. (i) Authorization of appropriations (1) In general There is authorized to be appropriated to the Secretary to carry out this section $13,000,000 for each of fiscal years 2025 through 2029. (2) Allocations Of the amounts made available each fiscal year under paragraph (1), the Secretary shall allocate— (A) subject to paragraph (3), not less than $7,000,000 for grants to eligible entities carrying out the purpose described in subsection (e)(1)(A); (B) not less than $3,000,000 for grants to eligible entities carrying out the purpose described in subsection (e)(1)(B); and (C) not less than $3,000,000 for grants to eligible entities carrying out the purpose described in subsection (e)(1)(C). (3) Fellowship minimum In allocating amounts for grants to eligible entities carrying out the purpose described in subsection (e)(1)(A), the Secretary shall award sufficient grant funding to such entities to ensure that not fewer than 40 forensic pathology fellowships are funded. .