MMR - FY20 - Office of Chief Medical Examiner

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    • DEPARTMENT OF HEALTH AND MENTAL HYGIENE
    • OFFICE OF CHIEF MEDICAL EXAMINER
    • Dr. Barbara Sampson, Chief Medical Examiner
    • OFFICE OF CHIEF MEDICAL EXAMINER | Page 163
    • WHAT WE DO
    • The Office of Chief Medical
    • Examiner (OCME) serves public
    • health and the criminal justice
    • system through forensic science.
    • OCME’s independent investigations
    • of deaths and analysis of evidence
    • provide answers to families and
    • communities during times of
    • profound need. OCME is responsible
    • for investigating deaths resulting
    • from criminal violence, accident or
    • suicide; that occur suddenly and
    • when in apparent good health;
    • when unattended by a physician; in
    • a correctional facility or in custody
    • of any criminal justice entity; or
    • occurring in any suspicious or unusual
    • manner or threat to public health.
    • These types of cases are referred to
    • as being under “Medical Examiner
    • jurisdiction.” The Office also reviews
    • all applications for permits to
    • cremate the body of a person who
    • dies in New York City. The Office
    • provides additional forensic services,
    • including DNA testing, to support
    • investigations. OCME also manages
    • all functions of the City mortuary,
    • including the retrieval and processing
    • of unclaimed deceased bodies, and
    • facilitates final disposition. Finally,
    • OCME maintains a specialized mass
    • fatality management team ready to
    • support the City in responding to
    • mass fatalities and other disasters.
    • FOCUS ON EQUITY
    • To best serve all New Yorkers—regardless of economic ability—OCME operates
    • Family Services Centers in all five boroughs so that all communities have equal
    • service access. At these centers, staff interact with family members, medical
    • practitioners, and other advisors to receive and verify information that will assist
    • in determining the identity of deceased persons and aid in final disposition. For
    • families who may need or choose interment of their loved ones in the City Cemetery,
    • OCME provides an opportunity for a final viewing before burial. In addition, OCME
    • also serves as the independent pathologist for families by performing its own
    • impartial death investigations and autopsies, free from undue influence by legal
    • or medical communities or law enforcement. OCME develops and maintains a
    • workplace culture in which employment and advancement decisions are made
    • fairly and employees are treated equitably, regardless of race/ethnicity, age, gender,
    • religion/creed, national origin, disability, or sexual orientation. This is accomplished
    • through agency wide training and continual engagement with managers to
    • ensure familiarity with the city’s EEO, diversity and inclusion policies, and through
    • incorporating these policies into recruitment, selection, promotion, and workplace
    • activities so that all employees feel welcome and inspired to succeed.
    • OUR SERVICES AND GOALS
    • SERVICE 1 Perform the processes necessary to certify deaths falling
    • within the agency’s jurisdiction.
    • Goal 1a Respond promptly to scenes of reportable fatalities and conduct
    • related investigations.
    • Goal 1b Complete autopsy reports in a timely manner to best serve families,
    • the criminal justice system and other stakeholders.
    • Goal 1c Provide diligent investigation for all cremation requests.
    • Goal 1d Certify death certificates in a timely manner.
    • SERVICE 2 Provide mortuary services to the City.
    • Goal 2a Recover and transport decedents to City mortuary facilities in a
    • timely manner.
    • SERVICE 3 Respond to disasters and emergencies when fatalities are
    • involved.
    • Goal 3a Provide rapid response and safe fatality management services to
    • the City.
    • Goal 3b Identify victims of disasters and return their remains to families in
    • a timely manner.
    • SERVICE 4 Provide services to the City for forensic purposes.
    • Goal 4a Provide timely and accurate laboratory services for criminal justice
    • purposes.
    • Page 164 | MAYOR’S MANAGEMENT REPORT
    • HOW WE PERFORMED IN FISCAL 2020
    • SERVICE 1 Perform the processes necessary to certify deaths falling within the agency’s jurisdiction.
    • Goal 1a Respond promptly to scenes of reportable fatalities and conduct related investigations.
    • In Fiscal 2020, OCME took jurisdiction in 7,547 cases, approximately the same as in the previous year. OCME death scene
    • investigators, called medicolegal investigators (MLIs), respond to the scene of reported deaths that fall within Medical
    • Examiner jurisdiction. The median time for scene arrivals by investigators (MLIs) remained steady at 1.8 hours. The number
    • of deaths reported to OCME increased, corresponding to the surge in NYC deaths during the pandemic. Not all decedents
    • reported were transported or handled by OCME. The majority of the decedents who passed away in health care facilities
    • were claimed by funeral directors.
    • Performance Indicators
    • Actual Target Trend
    • FY16 FY17 FY18 FY19 FY20 FY20 FY21 5-Year
    • Desired
    • Direction
    • Median time for scene arrivals by medicolegal investigators (MLIs)
    • (hours) 2.4 1.9 1.8 1.9 1.8 * * Down Down
    • Deaths reported 27,674 28,940 30,213 30,964 65,712 * * Up *
    • « Cases where Chief Medical Examiner takes jurisdiction 7,375 7,704 7,632 7,554 7,547 * * Neutral *
    • « Critical Indicator “NA” Not Available ñò Directional Target * None
    • Goal 1b Complete autopsy reports in a timely manner to best serve families, the criminal justice system and other
    • stakeholders.
    • OCME forensic pathologists examined 7,568 decedents in Fiscal
    • 2020, up from 7,325 in Fiscal 2019. OCME performed 4,854
    • autopsies in Fiscal 2020, down from the 5,399 autopsies in Fiscal
    • 2019. The median time to complete OCME autopsy reports in
    • Fiscal 2020 was 67 days, an 11-day increase from the previous
    • year while well within the 90-day target. In the midst of the
    • pandemic, the OCME laboratories were essentially closed but for
    • some high-priority cases and the majority of laboratory staff were
    • temporarily reassigned to assist in the mortuary to keep up with
    • the surge in deaths. This contributed to a delay in reports that
    • are relied upon by Medical Examiners to help complete autopsy
    • reports.
    • Performance Indicators
    • Actual Target Trend
    • FY16 FY17 FY18 FY19 FY20 FY20 FY21 5-Year
    • Desired
    • Direction
    • « Median time to complete autopsy reports (days) 69.0 57.0 45.0 56.0 67.0 90.0 90.0 Neutral Down
    • « Critical Indicator “NA” Not Available ñò Directional Target * None
    • Goal 1c Provide diligent investigation for all cremation requests.
    • OCME reviews all applications for a permit to cremate the body of any person who dies in the City. When OCME’s review
    • of the cremation application reveals a cause or manner of death that falls within the Medical Examiner jurisdiction, the
    • application will be rejected and OCME will investigate accordingly. However, once the investigation is complete, family
    • members will have the opportunity to have the remains of their loved ones cremated if they wish.
      • Autopsy Reports Toxicology Cases
    • FY 16 FY 17 FY 18 FY 19 FY 20
    • Autopsy Report and Toxicology Results Completion
    • (median days)
    • 45.0
    • 29.0
    • 57.0
    • 20.0
    • 56.0 56.0
    • 22.0
    • 69.0
    • 47.0
    • 67.0
    • OFFICE OF CHIEF MEDICAL EXAMINER | Page 165
    • In Fiscal 2020, OCME responded to 27,863 cremation requests, up from 17,148 last year. This increase came about during
    • the months of March through June where OCME received 16,115 requests, a number that approached the entire Fiscal
    • 2019 total. This increase corresponds to the surge in deaths NYC experienced during the pandemic to date. OCME rejected
    • 159 cremation requests after investigation and converted them over to the Medical Examiner jurisdiction.
    • Performance Indicators
    • Actual Target Trend
    • FY16 FY17 FY18 FY19 FY20 FY20 FY21 5-Year
    • Desired
    • Direction
    • Total cremation requests received and investigated as requirement of processing 15,719 16,525 17,252 17,148 27,863 * * Up *
    • « Cremation requests rejected after investigation and turned
    • over to Medical Examiner jurisdiction 63 84 91 140 159 * * Up *
    • « Critical Indicator “NA” Not Available ñò Directional Target * None
    • Goal 1d Certify death certificates in a timely manner.
    • In Fiscal 2020, the median time for OCME to certify the cause and manner of death for all death certificates was 15.6 hours
    • after initial receipt of decedents’ remains, well within the 72-hour target.
    • Performance Indicators
    • Actual Target Trend
    • FY16 FY17 FY18 FY19 FY20 FY20 FY21 5-Year
    • Desired
    • Direction
    • « Median time to certify death certificates after initial receipt
    • of decedents’ remains (hours) 19.7 15.8 16.6 16.3 15.6 72.0 72.0 Down Down
    • « Critical Indicator “NA” Not Available ñò Directional Target * None
    • SERVICE 2 Provide mortuary services to the City.
    • Goal 2a Recover and transport decedents to City mortuary facilities in a timely manner.
    • In addition to those cases falling under Medical Examiner jurisdiction, the Office provides mortuary services for the City,
    • including the retrieval and processing of unclaimed deceased bodies. In Fiscal 2020, the median time from OCME receipt
    • of decedents’ remains to “Ready to Release” was well under an hour. This is because during the months of March through
    • June, the vast majority of deceased that arrived at OCME constituted non-forensic cases. Because these decedents arrive
    • at OCME having been already identified, generally having come from health care facilities, they are typically ready to
    • release almost as soon as they arrive. The large number of these cases resulted in a median time under one hour. The
    • median time to clear and release to funeral directors per case was 37 minutes, as OCME brought in additional staff to
    • assist mortuary operations, including the federal resources, private contractors and OCME laboratory staff who were
    • reassigned to mortuary duties.
    • Performance Indicators
    • Actual Target Trend
    • FY16 FY17 FY18 FY19 FY20 FY20 FY21 5-Year
    • Desired
    • Direction
    • Decedents’ remains transported and stored by OCME 10,108 10,330 11,255 11,281 17,606 * * Up *
    • « Median time from OCME receipt of decedents’ remains to
    • “Ready to Release” status (hours) 14.38 12.91 11.82 11.59 0.10 ò ò Down Down
    • Median time to clear and release to third party for final disposition, per case (minutes) 33.0 34.0 35.0 35.0 37.0 * * Up Down
    • « Critical Indicator “NA” Not Available ñò Directional Target * None
    • Page 166 | MAYOR’S MANAGEMENT REPORT
    • SERVICE 3 Respond to disasters and emergencies when fatalities are involved.
    • Goal 3a Provide rapid response and safe fatality management services to the City.
    • OCME recovered no new remains of the 9/11 World Trade Center attacks in Fiscal 2020.
    • Performance Indicators
    • Actual Target Trend
    • FY16 FY17 FY18 FY19 FY20 FY20 FY21 5-Year
    • Desired
    • Direction
    • Remains recovered following the September 11, 2001 attacks
    • (cumulative) 21,905 21,905 21,905 21,905 21,905 * * Neutral *
    • « Critical Indicator “NA” Not Available ñò Directional Target * None
    • Goal 3b Identify victims of disasters and return their remains to families in a timely manner.
    • OCME continues to identify remains of the victims of the 9/11 World Trade Center attacks. In Fiscal 2020, an additional
    • 93 remains were identified.
    • Performance Indicators
    • Actual Target Trend
    • FY16 FY17 FY18 FY19 FY20 FY20 FY21 5-Year
    • Desired
    • Direction
    • Remains identified following the September 11, 2001 attacks
    • (cumulative) 14,308 14,348 14,467 14,608 14,701 * * Neutral Up
    • « Critical Indicator “NA” Not Available ñò Directional Target * None
    • SERVICE 4 Provide services to the City for forensic purposes.
    • Goal 4a Provide timely and accurate laboratory services for criminal justice purposes.
    • The Forensic Biology Department’s Fiscal 2020 median times for DNA case completions in each case type are shown below.
    • The median times to complete DNA cases all decreased in Fiscal 2020 compared to Fiscal 2019. These improved case
    • turnaround times (TAT) were attributable to progress at the beginning of Fiscal 2020 when Lean Six Sigma improvement
    • programs were reaping benefits and several new staff hired in previous years were fully trained and processing cases.
    • Subsequently, because of the pandemic, the Forensic Biology lab closed for three months and a limited number of staff were
    • processing a very small number of priority cases. As a result, turnaround times rose towards the end of the year, though
    • the overall annual median DNA case turnaround times remained within their targets due to the lower numbers earlier in
    • the year. The number of DNA matches with profiles in the database decreased from 11,042 in Fiscal 2019 to 5,988 in Fiscal
    • 2020. This was due to the lab closure and a reduced number of staff working on only a small number of priority cases.
    • Median turnaround times for the Forensic Toxicology Department were 30 days or less for all case types (postmortem,
    • DUI, sexual assault) at the start of Fiscal 2020. By the end of the first half of Fiscal 2020, the median turnaround times
    • had increased to between 34 to 38 days due to preparations for the new speedy trial and pre-trial discovery reforms that
    • went into effect January 1, 2020. These changes are attributable to Article 245 of the New York State Criminal Procedure
    • Law (CPL), which requires OCME laboratories to supply City prosecutors with comprehensive information on thousands of
    • preexisting cases and all new cases going forward, and to deliver this information as soon as possible and no later than 60
    • days before trial. CPL Article 245 has thus created a significant workload impact for OCME
    • At the end of the third quarter the median Forensic Toxicology TATs had increased to between 42 and 46 days. Prior to
    • COVID-19, the Forensic Toxicology Department was already feeling the full force of the new discovery law and had only
    • just welcomed new recruits brought in to assist with that workload. The pandemic caused the temporary closure of the
    • Forensic Toxicology laboratories for over three months and resulted in a median turnaround time for postmortem cases of
    • 153 days for the month of June alone.
    • OFFICE OF CHIEF MEDICAL EXAMINER | Page 167
    • At the end of Fiscal 2020, there were more than 1,370 cases pending tests, of which 75 percent were aged to over 90
    • days. Furthermore, there were over 1,300 new cases collected during the laboratory closure and placed in storage by the
    • OCME Evidence Unit awaiting the reopening of the Forensic Toxicology Laboratory. OCME will accession these cases and
    • begin testing on them in early Fiscal 2021. Accordingly, the backlog initially attributed to the new discovery law was then
    • compounded by the closure of the laboratories caused by COVID-19, resulting in increased turnaround times for the Forensic
    • Biology and Toxicology Departments in Fiscal 2020 and, OCME anticipates, into Fiscal 2021.
    • Performance Indicators
    • Actual Target Trend
    • FY16 FY17 FY18 FY19 FY20 FY20 FY21 5-Year
    • Desired
    • Direction
    • Median time to complete analysis of a DNA case (days) 45.0 53.0 69.0 59.0 51.0 60.0 60.0 Up Down
    • « Median time to complete DNA homicide cases, from evidence
    • submission to report (days) 39.0 44.0 38.0 47.0 39.0 45.0 45.0 Neutral Down
    • « Median time to complete DNA sexual assault cases, from
    • evidence submission to report (days) 36.0 36.0 40.0 32.0 31.0 45.0 45.0 Down Down
    • « Median time to complete DNA property crime cases, from
    • evidence submission to report (days) 57.0 63.0 172.0 149.0 50.0 120.0 120.0 Up Down
    • DNA matches with profiles in database 7,758 8,719 8,766 11,042 5,988 * * Neutral *
    • « Median time to complete toxicology cases (days) 56.0 22.0 20.0 29.0 47.0 30.0 30.0 Down Down
    • Median time to complete toxicology DUI (driving under the influence) cases (days) 43.0 17.0 14.0 23.0 42.0 30.0 30.0 Neutral Down
    • Median time to complete toxicology sexual assault cases (days) 84.0 23.0 18.0 28.0 43.0 30.0 30.0 Down Down
    • « Critical Indicator “NA” Not Available ñò Directional Target * None
    • AGENCY CUSTOMER SERVICE
    • Performance Indicators Actual Target Trend
    • Customer Experience FY16 FY17 FY18 FY19 FY20 FY20 FY21 5-Year
    • Desired
    • Direction
    • Completed customer requests for interpretation 664 1,091 1,318 1,525 1,161 * * Up *
    • Letters responded to in 14 days (%) 100% 100% 100% 100% 100% * * Neutral Up
    • E-mails responded to in 14 days (%) 100% 100% 98% 95% 92% * * Neutral Up
    • « Critical Indicator “NA” Not Available ñò Directional Target * None
    • AGENCY RESOURCES
    • Resource Indicators Actual¹ Plan²
    • FY16 FY17 FY18 FY19 FY20 FY20 FY21 5yr Trend
    • Expenditures ($000,000)³ $68.6 $71.9 $76.6 $84.7 $150.4 $95.6 $90.4 Up
    • Revenues ($000) $36 $76 $8 $2 $2 $50 $50 Down
    • Personnel 566 591 639 672 716 791 769 Up
    • Overtime paid ($000,000) $5.1 $5.5 $5.8 $6.7 $2.6 $2.6 $2.5 Down
    • ¹Actual financial amounts for the current fiscal year are not yet final. Final fiscal year actuals, from the Comptroller’s Comprehensive Annual Financial Report, will be reported
    • in the next PMMR. Refer to the “Indicator Definitions” at nyc.gov/mmr for details. ²Authorized Budget Level ³Expenditures include all funds “NA” - Not Available * None
    • Page 168 | MAYOR’S MANAGEMENT REPORT
    • SPENDING AND BUDGET INFORMATION
    • Where possible, the relationship between an agency’s goals and its expenditures and planned resources, by budgetary unit
    • of appropriation (UA), is shown in the ‘Applicable MMR Goals’ column. Each relationship is not necessarily exhaustive or
    • exclusive. Any one goal may be connected to multiple UAs, and any UA may be connected to multiple goals.
    • Unit of Appropriation
    • Expenditures
    • FY192
    • ($000,000)
    • Modified Budget
    • FY202
    • ($000,000) Applicable MMR Goals4
    • 106 - Office of Chief Medical Examiner (Personal
    • Services) $63.1 $68.7 All
    • 116 - Office of Chief Medical Examiner (Other Than
    • Personal Services) $21.6 $81.7 All
    • Agency Total1 $84.7 $150.4
    • 1
    • OCME is contained within the Department of Health and Mental Hygiene and appropriations are made through that agency. 2
    • Comprehensive Annual Financial Report (CAFR)
    • for the Fiscal Year ended June 30, 2019. Includes all funds. 3
    • City of New York Adopted Budget for Fiscal 2020, as of June 2020. Includes all funds. 4Refer to agency goals
    • listed at front of chapter. “NA” Not Available * None
    • NOTEWORTHY CHANGES, ADDITIONS OR DELETIONS !
    • None.
    • ADDITIONAL RESOURCES
    • For more information on the agency, please visit: www.nyc.gov/ocme.