SCHUMER: OPIOID EPIDEMIC IS REACHING A CRITICAL LEVEL IN MONROE COUNTY, AND MORE MEDICAL EXAMINERS ARE DESPERATELY NEEDED TO KEEP UP WITH DOZENS OF OVERDOSE DEATHS; SENATOR CALLS ON U.S. JUSTICE AND HEALTH AND HUMAN SERVICES DEPARTMENTS TO PROVIDE RELIEF FAST
Schumer: A Nationwide Shortage Of Forensic Pathologists Impacting Monroe County; Lack of Specialists To Help Track and Prevent Drug Overdoses and Prosecute Trafficking Crimes Is Reaching Crisis Levels; Rochester And The Finger-Lakes Region Has Experienced An Explosion Of Drug Use Including Fentanyl-Laced Heroin & Meth, As Well As Drug-Related Crime
Senator Pushes U.S. Department of Justice To Support a New Forensic Pathology Fellowship Program at The University of Rochester To Help Alleviate Backlog of Overdoes Cases in Upstate New York and Around the Country & Pushes the Department of Health and Human Services to Make Pathologists Eligible for Medical School Loan Forgiveness Program
Schumer: University Of Rochester Fellowship Program and HHS Loan Forgiveness Could Help Address Shortage Of Forensic Pathologists in Monroe County & Across Upstate New York
U.S. Senate Minority Leader Charles E. Schumer today announced support for a major initiative, with leadership from Monroe County and the University Of Rochester School Of Medicine, to create New York State’s first ever forensic pathologists (FP) fellowship program - outside of New York City. This new fellowship is being created by Monroe County to serve as a national model to help address the nationwide shortage of forensic pathologists. Schumer said with an opioid crisis sweeping through Upstate New York and around the country, more forensic pathologists are desperately needed to fight back.
“The University of Rochester Medical School and Monroe County are stepping into the breach to help curb the tide of the opioid crisis plaguing Upstate New York and the nation. This partnership between U of R, Monroe County Executive Cheryl Dinolfo, and the Monroe County Medical Examiner office, is creating a national model to significantly increase the number of forensic pathologists now, in such short supply. The rise in fatal drug-related overdoses has overwhelmed medical examiner (ME) offices especially in Monroe County. Many of these ME’s are on the front lines of battling the growing caseload of autopsies and toxicology screens fueled by the opioid epidemic. The increasing workload creates a backlog for these hard-working professionals that impacts police investigations and court cases. The federal Departments of Justice and Health and Human Services must do more to help ME offices, which already face obstacles like staff shortages and limited resources.” said Senator Schumer. “By supporting local fellowships, like that between Monroe County and the University of Rochester, and adding would be forensic pathologists to a national loan repayment program, we will encourage a new generation of doctors to complete forensic pathology training, and chip away at the nationwide shortage. I will continue to fight to make sure our communities are equipped with the necessary resources to address this growing problem.”
Schumer explained that right now there are only about half of the number of forensic pathologists needed to keep up with the demands in ME offices across the nation. This shortage has been particularly challenging for the Monroe County Office of the Medical Examiner which provides forensic death investigations and autopsy services to thirteen counties in central and western New York. They are working diligently to attract and recruit full time forensic pathologists to fill three of their four FP positions. In 2015 the Monroe County Medical Examiner’s office received $176,000 from the U.S. Justice Department to help hire contract Forensic Pathologists to work periodically in Monroe County to help shoulder the caseload, however Monroe County, under the leadership of County Executive Cheryl Dinolfo is pursuing new and innovative efforts to recruit and hire new full-time FPs and phase out the contract FPs.
Schumer said, “Monroe County is a prime example of how to combat this shortage. By incentivizing medical professionals to become medical examiners, Monroe is creating a valuable pipeline to fill the gaps in ME offices. In the past, the Monroe County ME office has hired outside help to conduct their autopsies. However, by training and hiring new MEs, the office will be able to save taxpayers money while processing autopsies more efficiently.”
Schumer added, “The forensic pathologist FP shortage is a national issue and requires a national response.”
The Monroe County Office of the Medical Examiner (MCOME) is staffed by Dr. Nadia Granger the Medical Examiner & Chief Forensic Pathologist, as well as a new Associate Forensic Pathologist who begins full time employment this month. The Monroe County ME Office additionally has a commitment from a Forensic Pathologist to start working full time mid-2018. To fill its fourth and last FP vacancy, Monroe County has recently begun negotiations with the University of Rochester School of Medicine and Dentistry to create a new Forensic Pathologist Fellowship program that would place its first FP Fellow to work at the Monroe County ME’s office by 2019.
Schumer is pushing the U.S. Department of Justice to act on recommendations stemming from the DOJ’s National Commission on Forensic Science to establish a new grant program to help create and operate new Forensic Pathologist Fellowship. Communities like Monroe that are planning to establish Fellowship programs will require financial support to help fund activities such as the Fellows’ salaries, training costs, and training materials. The Fellows would be University of Rochester Forensic Pathology students in the 3rd year of their residency. In his letter to the Department of Justice, Schumer noted that this new Fellowship program would be only the second of its kind in New York and is representative of exactly the type of new Fellowship program envisioned and recommended by the National Commission on Forensic Science for national support from the Department of Justice to address the Forensic Pathologist shortage. Costs associated with the training and support of the FP Fellows during their time working in an ME office could be supported by new DOJ grant programs while ME offices would receive the benefit of a new pipeline of trained forensic pathologists. Moreover, Schumer noted now is a key time for the DOJ to act in light of its April announcement to finalize a strategic plan aimed to increase the capacity of forensic science providers, including conducting a needs assessment of forensic science laboratories that examines workload, backlog, personnel and equipment needs.
Secondly, Schumer urged the DOJ to act on the DOJ’s National Commission on Forensic Science (NCFS) recommendation to work with university medical schools to add forensic pathology in the medical school curriculum within the first 2 years of study since this is a prime time to attract future FPs. The Commission also recommends adding elective rotations in forensic pathology in later years. Currently all University of Rochester medical students are required to spend 2 hours in the Autopsy suite examining organs and generating Cause of Death differentials and the school offers students a one month elective in Forensic Pathology while the Pathology Interest Group coordinates a 1 hour session with a forensic pathologist on forensic pathology.
Lastly, under his plan announced today, Schumer is also calling on the Department of Health and Human Services to include Forensic Pathologists alongside a select group of other medical specialties that are eligible to receive loan forgiveness through the National Health Service Corps Loan Repayment Program in return for practicing medicine in under-served communities. In its 2015 report the U.S. Department of Justice’s National Commission on Forensic Science concluded that while there are only an estimated 500 Forensic Pathologist in the nation now working full time, the workload requires that there actually be between 1,100 and 1,200 full time forensic pathologist to meet present day needs. Therefore, to meet this need and address the national backlog for FP services, the nation needs to more than double its current FP workforce. Moreover, the increase in drug-related deaths is exacerbating directly reflects the need for forensic pathologists. By allowing these providers to be eligible for the NHSC Loan Repayment Program, states and localities will be able to ease the growing number of cases forensic pathologists undertake. A recent study commissioned by AAMC and cited in the NCFS’ 2015 report found that 86% of medical school graduates report having debt, and in 2012, the median debt of graduating physicians was $170,000. Enabling medical students to receive loan repayment in return for becoming forensic pathologists and work in underserved states and localities, the Department of Health and Human Services can help incentivize more FPs to enter the workforce and thereby help reduce the national shortage of full time practicing forensic pathologists.
Schumer was joined by Monroe County Executive Cheryl Dinolfo, Monroe County Medical Examiner Nadia Granger, M.D., Office of the Medical Examiner Chief Investigator Robert Zerby, Jr., and Bruce Smoller, M.D., Professor and Chair for the Department of Pathology and Laboratory Services and Professor of Dermatology at the University of Rochester School of Medicine and Dentistry, Monroe County Police Chiefs Association President and Gates Police Chief James VanBrederode, Monroe County Sheriff Patrick O’Flynn, and Monroe County District Attorney Sandra Doorley
Monroe County Executive Cheryl Dinolfo said, “As our nation continues to grapple with a shortage of forensic pathologists, it’s essential that we seek proactive and meaningful solutions. Today, I’m proud to announce we are taking an important step forward and addressing this critical need by working closely with the University of Rochester Department of Pathology and Laboratory Services to establish a Fellowship Program. I know that this program will have a tremendous impact on the Office of the Medical Examiner in both the short-term and the long-term, and I want to thank Senator Schumer for his assistance in highlighting our program as a national model. Moving forward, I know our community can continue to rely on the professionalism of Dr. Nadia Granger and her staff and I look forward to the Fellowship Program beginning in 2019.”
Schumer has long advocated for policies to help combat the opioid crisis and the medical examiner shortage. Schumer co-sponsored the INDERDICT Act which ensures that Customs and Border Protection receive resources needed to improve detection capabilities and increase the seizure of illicit fentanyl shipped to U.S. from abroad through mail and express consignment carriers. Fentanyl even in small amounts is deadly and is suspected to be a contributing factor in the nation’s rising overdose deaths.
Copies of Schumer’s letters appears below:
Dear Attorney General Sessions:
As the Department of Justice's Task Force on Crime Reduction and Public Safety develops a strategy to advance national forensic science standards and operations, I encourage you to give particular consideration to the forensic pathologist shortage facing communities nationwide. In doing so, I request that you take steps that could immediately close the gap and incentivize more interest in this critical field. Specifically, I urge you to enact a number of recommendations previously published by the National Commission on Forensic Science.
As you know, the widespread uptick of illicit opioid and prescription drug abuse has presented grave new challenges to local communities. The rise in fatal drug-related overdoses has overwhelmed medical examiner (ME) offices across the country, many of whom are on the front lines of battling the growing caseload of autopsies fueled by the opioid epidemic. Some estimates report that the nation has less than half the number of forensic pathologists it needs. Furthermore, only 30 to 40 doctors complete forensic pathology training annually. Of those, few go into full-time forensic pathology practice.
As workloads increase, ME offices across the country face limitations that raise their costs while threatening their accreditations. According to the national accrediting association, MEs are recommended to performing no more than 250 autopsies a year in order to minimize risk of error. As a result, ME offices that are close to surpassing the limit are forced to contract outside pathologists in order to keep caseloads within the guidelines and maintain accreditation. This shortage has been particularly damaging to Monroe County in Upstate New York, where the Monroe County Office of the Medical Examiner which provides forensic death investigations and autopsy services to thirteen counties in central and western New York is working diligently to attract and recruit full time forensic pathologists to fill three of their four FP positions. While Monroe County is working diligently to use all the resources at its disposal recruit full time forensic pathologists, including adding one new hire beginning this month, the FP shortage is a national issue and requires a national response.
With the rate of opioid overdose deaths expected to grow, the need for adequate MEs is more important now than ever. The National Commission on Forensic Science recently considered this issue and offered a number of fruitful recommendations that could help to combat this growing shortage. First, the Commission recommended the creation of a new grant to support a fellowship program between universities and local MEs, a step that could encourage interest in the field and a new pipeline of FPs to help shoulder the increasing workload of understaffed ME offices. Secondly, the Commission recommended that university medical schools add forensic pathology in the medical school curriculum within the first 2 years as this is a prime time to attract future FPs, followed by elective rotations in forensic pathology in later years. Put together, these recommendations could have a worthwhile impact to reverse the nationwide shortage, and I strongly urge you to implement them as part of your mission to update national forensic science initiatives. In doing so, I also ask you to help support a new innovative Forensic Pathology Fellowship program that Monroe County has now begun to develop with the University of Rochester School of Medicine and Dentistry. This new Fellowship program would be only the second of its kind in New York and is representative of exactly the type of new Fellowship program envisioned and recommended by the National Commission on Forensic Science for national support from the Department of Justice. Costs associated with the training and support of the FP Fellows during their time working in an ME office could be supported by new DOJ grant programs while ME offices would receive the benefit of a new pipeline of trained forensic pathologists.
It is essential that our local counties have the tools necessary to perform toxicology testing, determine causes of death, and issue timely reports. These reports are often integral to determining unknown causes of deaths, facilitating police investigations, and providing the information necessary to properly diagnose this raging epidemic. If the federal government fails to provide the targeted investments needed to address the growing shortage of forensic pathologists, communities will be left without the vital resources that are necessary to confront this growing crisis.
Thank you for taking the time to consider this request. I look forward to hearing from you.
Sincerely,
Charles E. Schumer
United States Senator
Secretary Price:
I write today with great concern for the increase in deaths drug-related overdose across the country. As we work to combat the epidemic of opioid abuse, it is critical that the entirety of the medical community providing preventive and recovery services receive support. That is why I ask you to strongly consider adding forensic pathologists as eligible providers in the National Health Service Corps Loan Repayment Program.
As you know, the death rate related to drug overdose has risen exponentially in the past few years. According to the National Center for Health Statistics, since 2015, over 50,000 people across the country have died from drug-related overdoses annually. With this unfortunate increase in access to opioids, resources for providers have become more strained and forensic pathologist offices are no exception. A thorough forensic examination of a drug-related death can take months to allow the necessary procedures and testing to be completed. According to the National Association of Medical Examiners, individual providers average 250 autopsies per year and any more than this threatens the quality and thoroughness an examiner may be able to provide. In its 2015 report the U.S. Department of Justice’s National Commission on Forensic Science (NCFS) concluded that while there are only an estimated 500 Forensic Pathologist in the nation now working full time, the workload requires that there actually be between 1,100 and 1,200 full time forensic pathologist to meet present day needs. Therefore, to meet this need and address the national backlog for FP services, the nation needs to more than double its current FP workforce. Moreover, the increase in drug-related deaths is exacerbating the need for forensic pathologists.
By allowing these providers to be eligible for the NHSC Loan Repayment Program, states and localities will be able to ease the growing number of cases forensic pathologists undertake. A recent study commissioned by AAMC and cited in the NCFS’ 2015 report found that 86% of medical school graduates report having debt, and in 2012, the median debt of graduating physicians was $170,000. By allowing medical students to receive loan repayment in return for becoming forensic pathologists and work in underserved states and localities, the Department of Health and Human Services can help incentivize more FPs to enter the workforce and thereby help reduce the national shortage of full time practicing forensic pathologists.
Forensic pathologists provide a crucial service that allows doctors and researchers to better understand the pathology of harmful drugs in the human body, while facilitating police investigations, and providing the information necessary to properly diagnose this raging opioid epidemic.
Thank you for your attention to this request.
Sincerely,
Charles E. Schumer
United States Senator
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