CMEC Appendices

Appendix A
2018 Census of Medical Examiner and Coroner Offices Verification Call Script
Good [morning/afternoon/evening], my name is [INTERVIEWER NAME] from RTI
International. I am calling on behalf of the Department of Justice’s Bureau of Justice Statistics
regarding the 2018 Census of Medical Examiner and Coroner Offices.
I am calling [NAME OF MEDICAL EXAMINER OR CORONER] to confirm that I have the
correct contact information so that we can make sure that the upcoming survey is mailed to the
appropriate address.
The purpose of the upcoming survey is to gather information on the structure, operations, and
resources of medical examiner and coroner offices across the country. This information will help
the Bureau of Justice Statistics develop a national picture of the state of medicolegal death
investigation in the United States.
Do you have 5 minutes to answer a few brief questions?
1 YES [GO TO 1.1]
2 NO [SET FOR CALLBACK]
3 NOT AVAILABLE NOW [SET FOR CALLBACK]
4 NOT THE ME/C NAMED IN INTRO [GO TO 1.1a]
1.1

First, I would like to confirm that this phone number is the correct phone number for
[NAME OF MEDICAL EXAMINER OR CORONER].
1 Yes [GO TO 1.2]
2 No [GO TO 1.1a]

1.1a

What is the correct phone number? _____________

1.2

Can you confirm that [Chief Medical Examiner or Coroner’s office name] is the correct
name of this office?
1
2

1.2a

What is the correct name and spelling of the [Medical Examiner or Coroner] office?
______________________________________________________________
1

1.3

YES [GO TO 1.3]
NO [GO TO 1.2a]

NOT AN MEC [GO TO GENERIC THANK YOU SCREEN AND
TERMINATE CALL]

I have the mailing address as [street address, city, state, zip]. Is this information correct?
1 YES [GO TO 1.4]
2 NO [GO TO 1.3a]

1.3a

What is your full street address?
Street Address___________________
City, State
___________________
Zip Code
___________________

1.4

Our records indicate that [TITLE] [FIRST NAME] [LAST NAME] is the Office Head.
Is this information correct?
1
2

1.4a

YES [GO TO 1.5]
NO [GO TO 1.4a]

Who is the Office Head; perhaps this person is the [Chief Medical Examiner or the
Coroner]?
Title

__________________

First Name

__________________

Last Name

__________________

Professional Designation

1.5

Would the [Chief Medical Examiner or the Coroner] be the best point of contact for
sending a survey about office operations, including administrative, budget, and resource
information?
1
2

1.5a

__________________

YES [GO TO 1.6]
NO [GO TO 1.5a]

Please provide us with the name of the best point of contact for sending a survey.
Title

__________________

First Name

__________________

Last Name

__________________

Professional Designation

__________________

1.6

What is the best phone number to contact the [Office Head or Best Point of Contact]?
PHONE NUMBER __________________

1.7

What is the best email address to contact the [Office Head or Best Point of Contact]?
EMAIL ADDRESS __________________@__________________

1.8

Does your office conduct any investigations to determine a cause of death?
1
2

1.9

Does your office sign death certificates?
1
2

1.10

YES
NO

YES
NO

Does your office determine when autopsies should be done, even if your ME/C office
sends the deceased away for autopsies?
1
2

YES [GO TO END]
NO [GO TO END]

GENERIC THANK YOU. Thank you so much for your time.
END. Those are all of the questions that I have. If your office is eligible, RTI International, the
data collection agent for the Bureau of Justice Statistics, will send you the survey using
the contact information provided soon. We thank you for your cooperation. If you have
any questions in the meantime, please call us toll free at 1-XXX-XXXX.

Appendix B
2018 Census of Medical Examiner and Coroner Offices
Cognitive Testing Recruitment Materials

B-1:
B-2:
B-3:
B-4:

Email Invitation to Participate in Cognitive Interviews
Letter Invitation to Participate in Cognitive Interviews
Telephone Script for Recruiting Cognitive Interview Participants
Thank You Letter to Cognitive Interview Participants

Appendix B-1:
Email Invitation to Participate in Cognitive Interviews
Subject: Bureau of Justice Statistics Interview Request
Dear [NAME],
The U.S. Department of Justice’s Bureau of Justice Statistics (BJS) is preparing to conduct the second
Census of Medical Examiner and Coroner Offices (CMEC). This survey was last conducted in 2004 (see
BJS’ 2004 CMEC report). We are aware that the work in your office has likely changed over the past 15
years and we are making updates and improvements to the forthcoming CMEC survey. RTI International,
BJS’s data collection agent for this survey, is working with BJS to modify the questionnaire for gathering
data on current services offered by medical examiner and coroner offices (MECs) and the challenges you
face.
With input from medical examiners and coroners, we have developed a new questionnaire and are asking
for your help to refine the instrument. The perspectives you share will give us the information we need to
refine the CMEC instrument in a way that will reduce burden while producing meaningful, relevant, and
timely statistics to serve the medicolegal death investigation community. To help us ensure that next
year’s data collection is successful in gathering information that is helpful both to BJS and MEC offices
and jurisdictions, we would like you to complete an interview in which you will go through the revised
survey and share your feedback with us.
If you agree to participate, we will schedule a 120-minute telephone interview with you and RTI’s staff
and mail you the survey via overnight delivery so that you can look over the questions before the
interview if you so choose. During the interview, you and the RTI staff member will review the
questionnaire to discuss the clarity, meaning, and your understanding of the questions and answer
categories.
You will not be asked to complete the survey. We are testing to see if the questions and answer categories
make sense, and if it would be possible for your office to answer the questions. We are also asking for
you to estimate the time it would take to complete the survey. The feedback you provide will be carefully
considered by BJS and used to improve the survey.
I have copied [NAME] from RTI on this email. She will be in touch with you in the next week to answer
any of your questions and schedule an interview. We hope you will help us in this effort.
Please feel free to contact me if you have any questions or concerns about this request at
Connor.Brooks@usdoj.gov or 202-514-8633. Thank you for your time and consideration.
Sincerely,

Connor Brooks
CMEC Program Manager
Bureau of Justice Statistics

Appendix B-2:
Letter Invitation to Participate in Cognitive Interviews
NAME
ADDRESS
ADDRESS
CITY, STATE ZIP
Dear [NAME],
The U.S. Department of Justice’s Bureau of Justice Statistics (BJS) is preparing to conduct the second
Census of Medical Examiner and Coroner Offices (CMEC). This survey was last conducted in 2004 (see
https://www.bjs.gov/content/pub/pdf/meco04.pdf). We are aware that the work in your office has likely
changed over the past 15 years and we are making updates and improvements to the forthcoming CMEC
survey. RTI International, BJS’s data collection agent for this survey, is working with BJS to modify the
questionnaire for gathering data on current services offered by medical examiner and coroner offices
(MEC) and the challenges you face.
With input from medical examiners and coroners, we have developed a new questionnaire and are asking
for your help to refine the instrument. The perspectives you share will give us the information we need to
refine the CMEC instrument in a way that will reduce burden while producing meaningful, relevant, and
timely statistics to serve the medicolegal death investigation community. To help us ensure that next
year’s data collection is successful in gathering information that is helpful both to BJS and MEC offices
and jurisdictions, we would like you to complete an interview in which you will go through the revised
survey and share your feedback with us.
If you agree to participate, we will schedule a 120-minute telephone interview with you and RTI’s staff.
RTI will mail you the survey via overnight delivery so you can review the form before the interview if
you so choose. During this interview, you and the RTI staff member will review the questionnaire to
discuss the clarity, meaning, and your understanding of the questions and answer categories.
You will not be asked to complete the survey. We are testing to see if the questions and answer categories
make sense, and if it would be possible for your office to answer the questions. We are also asking for
you to estimate the time it would take to complete the survey. The feedback you provide will be carefully
considered by BJS and used to improve the survey.
[NAME] from RTI will be in touch with you in the next week to answer any of your questions about this
effort and schedule an interview. We hope you will help us in this effort. Please feel free to contact me if
you have any questions or concerns about this request at Connor.Brooks@usdoj.gov or 202-514-8633).
Thank you for your time and consideration. We look forward to hearing from you.
Sincerely,
Connor Brooks
CMEC Program Manager
Bureau of Justice Statistics

Appendix B-3:
Telephone Script for Recruiting Cognitive Interview Participants
Hello. May I please speak with [Cognitive Interviewee]?
REPEAT INTRODUCTION AS NECESSARY FOR NUMEROUS GATEKEEPERS.
My name is [Recruiter Name] and I work for RTI International, an independent nonprofit research
organization.
I am calling you on behalf of the Bureau of Justice Statistics to ask if you’d be willing to participate in an
interview that will inform revisions to the 2018 Census of Medical Examiner and Coroner Offices, also
called CMEC. In the past week, a letter/an email was sent to your office from the Bureau of Justice
Statistics about this survey.
This survey was last conducted in 2004 and we would like to enlist your help to revise the survey. We
have developed a new questionnaire based on input from leaders in the field. We would like you to
participate in an interview with the new version of the survey and share your feedback on it. This will
help us ensure that the data collection is successful in gathering information that is helpful both to BJS
and to your offices and jurisdictions.
If you agree, we will ask you to take part in a two hour interview with me and another colleague. We will
schedule an interview with you to walk through the questionnaire—asking you the survey questions and
then asking for your feedback on those questions—over the phone. You will not be asked to complete the
survey.
The feedback you provide will be carefully considered by BJS and used to improve next year’s survey.
Would you be willing to participate?
IF YES: Great! Thank you! Let’s go ahead and schedule you now for the interview. [SCHEDULING
DISCUSSION BASED ON AVAILABILITY AND TELEPHONE VS IN-PERSON MODE].
IF NO: Thank you so much for your time!
If you have any questions you can contact [ME/INTERVIEWER] at [NUMBER] or [EMAIL], or contact
Connor Brooks (Connor.Brooks@usdoj.gov; 202-514-8633) if you have any questions or concerns about
this request.
Thank you for your time and consideration.

Appendix B-4:
Thank You Letter to Cognitive Interview Participants

DATE
NAME
MEC OFFICE NAME
ADDRESS 1
CITY, STATE ZIP
Dear [NAME]:
On behalf of the Bureau of Justice Statistics (BJS) and RTI International, thank you for participating in
the interviews to test the Bureau of Justice Statistics’ draft instrument for the Census of Medical
Examiner and Coroner Offices (CMEC) on DATE. We know that you are very busy with your important
work and are thus honored that you so generously offered your time and expertise to assist us.
The perspectives you shared along with that of the other 17 coroners and medical examiners we
interviewed have given us the information we need to refine the CMEC instrument in a way that will
reduce burden while producing meaningful, relevant, and timely statistics to serve the medicolegal death
investigation community.
For your invaluable insight, time, and expertise, we extend our deepest appreciation.
Should you have any questions about CMEC or have further thoughts to share, please do not hesitate to
contact us.
Gratefully yours,

Connor Brooks
BJS CMEC Program
Manager
202-514-8633
Connor.Brooks@usdoj.gov

Hope Smiley-McDonald
CMEC Principal
Investigator
919-485-5743
smiley@rti.org

Jeri Ropero-Miller
CMEC Co- Principal
Investigator
919-485-5685
Jerimiller@rti.org

Sarah Cook
CMEC Survey
Methodologist
919-541-1236
scook@rti.org

Appendix C
2018 Census of Medical Examiner and Coroner Offices
Cognitive Testing Informed Consent

C-1:
C-2:

CMEC Informed Consent Form for Participants
CMEC Informed Consent Form for Interviewers

Appendix C-1
CMEC Informed Consent Form for Participants

2018 Census of Medical Examiner and Coroner Offices
Cognitive Testing Informed Consent
What is the purpose of the interview? The interview is part of a research study that is being conducted by the
Bureau of Justice Statistics (BJS). The purpose of the interview is to receive feedback on the 2018 Census of
Medical Examiner and Coroner Offices (CMEC).
What will happen during the testing? The interview will take approximately 120 minutes. You will be asked
to read through the CMEC survey as if you were completing it on your own. During the survey I will stop you and
ask you some questions about the survey and whether the questions make sense and are easy to answer. The
interview will also involve audio recording your comments for later analysis. The audio recording will only be
heard by authorized project staff and your name will never be used. You can choose not to be audio recorded.
Why was I chosen? You were chosen because you are either a medical examiner or coroner. Participants
represent the types of people who will take part in the 2018 CMEC Survey.
Are there risks? There is no expected risk to participating in this study. Any information that is obtained during
this discussion will not be shared with anyone outside the CMEC project staff.
Are there benefits? There are no expected direct benefits to you for participating in this study.
What will I get for participating? By participating you will make an important contribution to the understanding
of the nation’s medicolegal death investigation system.
Do I have to participate? Participation in this interview is entirely voluntary. You can stop the interview at any
time. You can also refuse to answer any question on any form.
Will this be kept private? Participants’ names and other identifying information will not be used in any report
or publication. Everything we learn will be kept private by BJS and RTI to the fullest extent of the law. Only
project team members from RTI and BJS will be allowed access to this information or observe any of the
interviews. You can choose not to be audio recorded or observed.
Whom do I call if I have questions? If you have any questions about the study, you can call the project director,
Hope Smiley-McDonald. Her number is 919-485-5743. If you have any questions about your rights in taking part
in this study, you can call RTI's Office of Research Protection at 1-866-214-2043 (this is a toll-free call).
By participating in this interview, you consent to BJS and RTI using your answers to inform the survey. You are
also acknowledging receipt of this consent form. If there is any part of this form that is not clear to you, be sure to
ask about it before you consent.

Appendix C-2
CMEC Informed Consent form for Interviewers

2018 Census of Medical Examiner and Coroner Offices
Cognitive Testing Informed Consent
What is the purpose of the interview? The interview is part of a research study that is being conducted by the
Bureau of Justice Statistics (BJS). The purpose of the interview is to receive feedback on the 2018 Census of
Medical Examiner and Coroner Offices (CMEC).
What will happen during the testing? The interview will take approximately 120 minutes. You will be asked
to read through the CMEC survey as if you were completing it on your own. During the survey I will stop you and
ask you some questions about the survey and whether the questions make sense and are easy to answer. The
interview will also involve audio recording your comments for later analysis. The audio recording will only be
heard by authorized project staff and your name will never be used. You can choose not to be audio recorded.
Why was I chosen? You were chosen because you are either a medical examiner or coroner. Participants
represent the types of people who will take part in the 2018 CMEC Survey.
Are there risks? There is no expected risk to participating in this study. Any information that is obtained during
this discussion will not be shared with anyone outside the CMEC project staff.
Are there benefits? There are no expected direct benefits to you for participating in this study.
What will I get for participating? By participating you will make an important contribution to the understanding
of the nation’s medicolegal death investigation system.
Do I have to participate? Participation in this interview is entirely voluntary. You can stop the interview at any
time. You can also refuse to answer any question on any form.
Will this be kept private? Participants’ names and other identifying information will not be used in any report
or publication. Everything we learn will be kept private by BJS and RTI to the fullest extent of the law. Only
project team members from RTI and BJS will be allowed access to this information or observe any of the
interviews. You can choose not to be audio recorded or observed.
Whom do I call if I have questions? If you have any questions about the study, you can call the project director,
Hope Smiley-McDonald. Her number is 919-485-5743. If you have any questions about your rights in taking part
in this study, you can call RTI's Office of Research Protection at 1-866-214-2043 (this is a toll-free call).
By participating in this interview, you consent to BJS and RTI using your answers to inform the survey. You are
also acknowledging receipt of this consent form. If there is any part of this form that is not clear to you, be sure to
ask about it before you consent.
Do you have any questions?
Do we have permission to continue with the interview?
 Yes
 No
Do we have your permission to audio record this discussion?
 Yes
 No

IF OBSERVER: Do you agree to have an observer sit in on this interview?
 Yes
 No

I certify that the nature, purpose, and privacy policy associated with participating in this research have been
explained to the participant and the participant has given their consent to participate in this cognitive interview.
Decisions whether or not to record or allow observers were the decisions of the participant.

Signature of Interviewer

Date

Appendix D
2018 Census of Medical Examiner and Coroner Offices
Instrument

1

2018 Census of Medical Examiner and
Coroner Offices

2

SECTION A

ADMINISTRATIVE

A1. What is the title of the chief position in your medical examiner or coroner office (e.g.,
Chief Medical Examiner, Coroner) and who holds that title?
Title:

__________________________________

Name: __________________________________
A2. Which of the following best describes your death investigation office?

O
O
O
O
O

Coroner office
Medical examiner office
Justice of the peace GO TO END OF SURVEY
My office does not investigate deaths  GO TO END OF SURVEY
Other medicolegal death investigation office (please specify)
__________________________________

A3. What level of government best describes your office?

O
O
O
O

City office
County office
District/regional office
State office

A4. Which of the following best describes the agency your office reports to?

O
O
O
O
O
O

Public health agency (e.g., department or division of public health)
Law enforcement agency (e.g., department or division of public safety)
Government attorney’s office (e.g., district attorney)
Department or division of forensic science
My office is a stand-alone agency that is not under the umbrella of another agency
Other (please specify) __________________________________

A5. What jurisdictions does your office serve (e.g. Illinois State, Los Angeles County, New
York City, First Judicial District)?

3

A6. Is your office accredited by the International Association of Coroners & Medical
Examiners (IAC&ME)?

O Yes
O No
O I expect that my office will be accredited by IAC&ME by December 31, 2019.

A7. Is your office accredited by the National Association of Medical Examiners (NAME)?

O Yes
O No
O I expect that my office will be accredited by NAME by December 31, 2019.

4

A8. On June 30, 2018, how many full-time employees, part-time employees, consultants
or contractors, and unpaid volunteers did your agency have on staff?
Count each employee only once.
Enter zero (0) if you do not have any staff in a category so no entry is left blank.
•
•

Full-time employees are those regularly scheduled for 35 or more hours per week.
Part-time employees are those regularly scheduled for 34 or less hours per week.

Role

Full-Time
Employees
on June 30,
2018

Part-time
Employees
on June 30,
2018

Consultants/
Contractors
on June 30,
2018

Unpaid
Volunteers
on June 30,
2018

a. Autopsy pathologists









b. Coroners/non-physicians









c. Death investigators (or
coroner investigators)









d. Forensic Toxicologists









e. Other scientific investigative
support staff (e.g.,
anthropologists, histologists)









f. Administrative staff (e.g.,
secretary, accountant)









g. Ancillary staff (e.g., drivers,
photographers)









5

If you do not have any coroners or death investigators, SKIP to box above A10.

A9. How many of your coroners or death investigators are certified by the
American Board of Medicolegal Death Investigators (ABMDI)?

O All death investigators are ABMDI certified
O Some death investigators are ABMDI certified
O No death investigators are ABMDI certified

If you do not have any autopsy pathologists, SKIP to box above A11.

A10. How many of your autopsy pathologists (i.e., medical examiners) are certified
by the American Medical Association (AMA)?

O All autopsy pathologists are AMA certified
O Some autopsy pathologists are AMA certified
O No autopsy pathologists are AMA certified

If you do not have any forensic toxicologists, SKIP to B1.
A11. How many of your forensic toxicologists are certified by the American Board
of Forensic Toxicology (ABFT)?

O All forensic toxicologists are ABFT certified
O Some forensic toxicologists are ABFT certified
O No forensic toxicologists are ABFT certified

6

SECTION B

BUDGET AND CAPITAL RESOURCES

B1. In the fiscal year that included June 30, 2018, what was your total budget?

$,,,.00

If estimate, check here: 

B2. Does your office have a specific personnel budget for items such as wages, salaries
and benefits?

O Yes
O No

If your office does not have a specific personnel budget, SKIP to B4.
B3. How much of the total budget was allocated for personnel costs?

$,,.00 If estimate, check here: 

B4. In the fiscal year that included June 30, 2018, did you or staff spend any of their own
money to perform their job, including but not limited to, office supplies, travel
costs, certification, and training?

O Yes
O No

7

B5. Does your office receive money from any of the following?
Revenue Source

Yes

No

Don’t Know

a. Consultant fees

O

O

O

b. Cremation waiver or permit fees

O

O

O

c.

O

O

O

d. Report fees

O

O

O

e. Testimony fees

O

O

O

f.

O

O

O

g. Grants

O

O

O

h. Other (please specify)
_______________________________

O

O

O

Private autopsy fees

Transportation fees

B6. In the fiscal year that included June 30, 2018, what was your average cost for
conducting a full autopsy?

$,.00 If estimate, check here: 

B7. In the fiscal year that included June 30, 2018, what was your average cost for
conducting forensic toxicology testing per case?

$,.00 If estimate, check here: 

8

SECTION C

WORKLOAD (DEATH INVESTIGATIONS)

C1. In the fiscal year that included June 30, 2018, did your office receive any referred
cases?

O Yes
O No

If your office did not receive any referred cases, SKIP to C11.

C2. In the fiscal year that included June 30, 2018, what was the total number of
cases referred to your office, including all cases in which your office
conducted an investigation or documented referral of the case to your
office?
 We did not track referred cases

, Total cases referred

If estimate, check here: 

C3. “Accepted cases” are cases for which the office completes the death certificate or
otherwise determines the cause and manner of death. For the fiscal year including
June 30, 2018, did you have any accepted cases? Do not include cremation approval
cases or cases in which jurisdiction was declined.

O Yes
O No

If your office did not have any accepted cases, SKIP to C5.

9

C4. In the fiscal year that included June 30, 2018, what was the total number of
cases accepted by your office? Do not include cremation approval cases or
cases in which jurisdiction was declined.
 We did not track accepted cases

, Total cases accepted

If estimate, check here: 

Please Check Your Numbers! The number of your “accepted cases” in C4 should be LESS
THAN or EQUAL TO the number of “referred cases” in C2.

C5. In the fiscal year that included June 30, 2018, did your office receive any referred
cases from tribal lands? The term ‘tribal lands’ includes areas labeled Indian Country,
federal or state recognized reservations, trust lands, Alaska Native villages, and tribal
communities.

O Yes
O No

If your office did not receive referred cases from tribal lands, SKIP to C11.

C6. In the fiscal year that included June 30, 2018, how many of the total cases
referred to your office were from tribal land(s)?
 We did not track referred cases from tribal lands

, Referred from tribal lands

If estimate, check here: 

C7. Did you include cases referred from tribal lands (C6) in the total number of
referred cases (C2) you reported?

O Yes
O No

10

C8. In the fiscal year that included June 30, 2018, did your office accept any cases from
tribal lands?

O Yes
O No

If your office did not accept any cases from tribal lands, SKIP to C11.

C9. In the fiscal year that included June 30, 2018, how many of the total cases
accepted by your office were from tribal land(s)?
 We did not track accepted cases from tribal lands separately

, Accepted from tribal lands

If estimate, check here: 

Please Check Your Numbers! The number of your “accepted cases” from tribal lands in C9
should be LESS THAN or EQUAL TO the number of “referred cases” from tribal lands in
C6.

C10. Did you include cases accepted from tribal lands (C9) in the total number of
accepted cases (C4) you reported?

O Yes
O No

C11. In the fiscal year that included June 30, 2018, how many full autopsies did your
office conduct?

, Full autopsies

If estimate, check here: 

11

C12. Some functions of a medical examiner or coroner’s office are done within one’s
own office (internally). Other functions may be done by using an outside
organization or independent facility, such as a health department or commercial
laboratory (externally).
Below, please indicate if most of the time your office provides these functions
internally, externally, if the function or service is not available to your office, or if
the function or service is not necessary for your office. Please mark one response
for each row.
My Office
Provides
this
Function
Internally

My Office
Provides
this
Function
Externally

Function or
Service Is
Not
Available

Function or
Service is
Not
Necessary

a. Death scene investigation

O

O

O

O

b. Medical record review

O

O

O

O

c. External examinations

O

O

O

O

d. Partial autopsy
(Minimal dissection, less than a
complete autopsy)

O

O

O

O

e. Complete autopsy
(Remove and examine the brain,
thoracic, and abdominal organs)

O

O

O

O

O

O

O

O

g. Autopsy photography

O

O

O

O

h. Forensic toxicology testing

O

O

O

O

i.

Radiology (X-rays)

O

O

O

O

j.

Metabolic screen

O

O

O

O

k. Ancillary scientific investigative
functions
(e.g., microbiology, anthropology,
histology, neuropathology, cardiac
pathology)

O

O

O

O

l.

O

O

O

O

O

O

O

O

Function

f.

Characterization of skeletal
remains

Cremation waivers

m. Certified death certificates

12

C13. For those functions that are conducted internally at your office, who are the people
that perform those duties? Please mark all that apply.
Not
Performed
by My
Office

Autopsy
Pathologists

Coroner/NonPhysician

Death
Investigators

Other
Internal
Staff

a. Death scene
investigations











b. Determination of
which cases are
accepted/ declined











c.

External
examinations











d. Determination of
which cases are
autopsied











e. Determination of
which cases
receive forensic
toxicology testing











Duty

C14. In your office, who is responsible for notifying the next of kin? Check all that apply.






Medical examiner/coroner personnel
Family services personnel (either internal or external)
Law enforcement personnel
Someone else (please specify) __________________________________

C15. In your office, who is responsible for follow-up communication with the next of kin,
such as cultural preferences, returning belongings, and other policies and
procedures? Check all that apply.






Medical examiner/coroner personnel
Family services personnel (either internal or external)
Law enforcement personnel
Someone else (please specify) __________________________________

13

SECTION D

SPECIALIZED DEATH INVESTIGATIONS

D1. Does your office have a written policy for final disposition (e.g., burial, cremation,
long-term storage) of unidentified remains after a specified period?

O Yes
O No
O Don’t know
D2. In the fiscal year that included June 30, 2018, did your office have any unidentified
remains on record?

O Yes
O No

If your office did not have any unidentified remains on record, SKIP to D6.

D3. In your office, how many total cases of unidentified remains …
a. Were on record as of June 30, 2018?

, Unidentified remains on record

If estimate, check here: 

 Don’
t know

b. Were on record as of June 30, 2018 and have had DNA evidence collected from
them?

, Have had DNA evidence collected

If estimate, check here: 

 Don’
t know

Please Check Your Numbers! Make sure the number of unidentified remains that have had
DNA evidence collected in D3b is LESS THAN or EQUAL TO those presently on record in
D3a.

14

D4. What is the year of your oldest case of unidentified remains currently on
record?

 If estimate, check here: 
 Don’
t know
D5. In the fiscal year that included June 30, 2018, how many unidentified remains
were classified as unidentified in their final disposition?

, Unidentified in final disposition

If estimate, check here: 

 Don’
t know
D6. Does your office use the Sudden Infant Death Syndrome, or SIDS, diagnosis?

O Yes
O No

D7. Does your office use the Sudden Unexplained Infant Death, or SUID, diagnosis?

O Yes
O No

D8. Are the following procedures standard parts of your office’s death investigations for
sudden, unexpected infant deaths?

Procedure

Yes

No

Don’t Know

a.

Scene investigation

O

O

O

b.

Scene re-enactment

O

O

O

c.

Comprehensive forensic toxicology
(e.g., multiple toxin screens)

O

O

O

d.

Complete autopsy

O

O

O

e.

Child or infant death review

O

O

O

15

D9. Has the increase in novel psychoactive substances and the opioid epidemic changed
your strategy for forensic toxicology testing?

O Yes
O No

D10. Does your office perform presumptive toxicology testing, either on scene or at
autopsy, before sending specimens to a toxicology laboratory?

O Yes
O No

16

SECTION E

RECORDS AND EVIDENCE RETENTION

E1. Does your office have a computerized system used to manage, compile, or track
cases or evidence? Such a system is also known as a computerized information
management system or CMS. This does not include the use of Excel or other
spreadsheet software to manage case information.

O Yes
O No

If you do not have a computerized system, or CMS, SKIP to E3.

E2. Is your computerized information management system or CMS networked so
that information on all cases is available to all authorized users?

O Yes
O No

E3. Does your office have a written retention schedule for the following sources?
Source

Yes

No

Don’t Know

a. Case records

O

O

O

b. Forensic toxicology specimens

O

O

O

c.

O

O

O

O

O

O

Physical evidence

d. Unidentified remains (including x-rays,
fingerprints, DNA)

E4. Are case records maintained for storage as hard copies, electronically, or both?

O Hard copies
O Electronically
O Both

17

E5. Does your office archive hard copies of your official investigative records and
reports?

O Yes
O No

If your office does not archive hard copies, SKIP to F1.
E6. Are hard copies of your official investigative records and reports archived at
any of the following places? Please mark one response for each row.
Location

Yes

No

a. On site

O

O

b. A government-owned or government-paid storage
facility

O

O

c.

O

O

Some other location

If your office does not archive hard copies at some other location (you answered ‘No’ to
E6C), SKIP to F1.

E7. At what other location do you archive hard copies of your official investigative
records and reports?
______________________________________________________________________
______________________________________________________________________

18

SECTION F

RESOURCES AND OPERATIONS

F1. Does your office have access to the Internet separate from a personal device?

O Yes
O No

F2. Does your office have access to the following resources?

Resource

Yes

No

a. Criminal history databases

O

O

b.

Fingerprint databases

O

O

c.

Prescription drug monitoring programs

O

O

F3. Does your office currently have access to the following trainings or resources, either
externally or internally?
Training or Resource
a. Mass Fatality Investigation

Yes

No

O

O

b.

Disaster planning (e.g., National Incident
Management System [NIMS])

O

O

c.

Bloodborne pathogens

O

O

d.

Proper lifting procedures

O

O

e.

Stress management

O

O

F4. Does your office participate in county/statewide emergency response drills?

O Yes
O No

19

F5. Does your office have access to the following investigative technologies, either
internally or externally?

Technology

Yes

No

a. Computerized axial tomography (CAT) scan

O

O

b. Magnetic resonance imaging (MRI)

O

O

c.

O

O

Non-targeted forensic toxicology analysis

F6. What other investigative technologies not listed here does your office have access
to?
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

F7. Does your office have access to the following specialized investigative teams, either
externally or internally?

Specialty Area

Yes

No

a. Child fatality

O

O

b. Drug case review/surveillance

O

O

c.

O

O

Vulnerable adult fatality review

20

F8. To what extent are the following resources needed to improve your ability to
complete cases?

Not at all

To some
extent

To a
moderate
extent

To a great
extent

a. Death investigation staff (e.g., medical
examiners, coroners, death
investigators, anthropologists,
histologists, forensic toxicologists)

O

O

O

O

b. Administrative and ancillary staff (e.g.,
technicians, autopsy technicians,
photographers, administrative
assistants, accountants, drivers)

O

O

O

O

c.

O

O

O

O

d. Laboratory/facility space

O

O

O

O

e. Administrative and evidence storage
facilities

O

O

O

O

O

O

O

O

g. Analytical instrumentation and
laboratory supplies

O

O

O

O

h. Access to literature resources (e.g.,
books, journals, electronic mailing lists,
databases)

O

O

O

O

O

O

O

O

Resources

f.

i.

Training

Office equipment (e.g., computers,
software)

Other (please specify)
_______________________________

21

F9. Does your office currently participate in any of these data collection efforts?

Data Collection

Yes

No

Don’t
know

a.

Combined DNA Index System (CODIS)
Sponsor: Federal Bureau of Investigation (FBI)

O

O

O

b.

Fatality Analysis Reporting System (FARS)
Sponsor: National Highway Traffic Safety Administration
(NHTSA)

O

O

O

c.

National Crime Information Center (NCIC)
Sponsor: Federal Bureau of Investigation (FBI)

O

O

O

d.

National Forensic Laboratory Information System (NFLIS)
Sponsor: Drug Enforcement Agency (DEA)

O

O

O

e.

National Missing and Unidentified Persons System (NamUs)
Sponsor: Department of Justice (DOJ)

O

O

O

f.

National Violent Death Reporting System (NVDRS)
Sponsor: Centers for Disease Control and Prevention (CDC)

O

O

O

g.

State or local data collections

O

O

O

h.

Other data collection

O

O

O

F10. Does your office have access to the following support services, either externally or
internally?
Support Service

Yes

No

a. Advocates for families of victims

O

O

b. Grief and bereavement services for survivors
(e.g. counseling or therapy, homicide survivor
groups)

O

O

O

O

O

O

c.

On-scene support or advocacy for bystanders or
other family and friends of the deceased

d. Other (please specify)
_______________________________

22

F11. Is your office located within another business, such as a funeral home?

O Yes
O No

F12. Does your office have a Department Originating Agency Identifier Number or, ORI
number?

O Yes
O No
O Don’t know
If you do not have a Department Originating Agency Identifier Number (ORI), SKIP to END.

F13. What is your Department Originating Agency Identifier Number or ORI
number?



END. Thank you for your participation in the 2018 Census of Medical Examiner and
Coroner Offices (CMEC). Your feedback is very important to us!

23

Appendix E
2018 Census of Medical Examiner and Coroner Offices
Cognitive Interview Protocol

1

Cognitive Interview Protocol
Participant#________
Date of Interview__________________
READ (OR PARAPHRASE) THE FOLLOWING TO THE SUBJECT AFTER THE INFORMED CONSENT IS SIGNED:
On behalf of the Bureau of Justice Statistics and the project team at RTI, thank you for participating in
the testing of the 2018 Census of Medical Examiners and Coroners. We’re talking today because we
want to see how well people understand these questions and how they might answer them. BJS’s goals
for the 2018 survey are listed on the reference card you received with the survey.
During this process, you and I will go through the survey items together while you answer the questions
you can without doing additional research. For those questions for which you would need to do
additional research, please tell me whether you would be able to answer the question and, if so, how
long it would take to get the answer. In the same spirit, you do not need to provide exact numbers; you
can just estimate. However, please let me know if you would not be able to provide exact numbers
when we are actually collecting these data next year.
After some questions, I may stop you and ask how you came up with your answer, or what specifically
you were thinking about. These questions will help me understand your thought process when
answering the questions. In order for me to know where you are in the survey, I ask that you read
aloud anything your read on the paper whether it’s instructions, questions or response options.
There are no right or wrong answers to the questions I ask. Our goal is to make sure that the questions
make sense and that people like yourself can answer them and follow the questionnaire instructions
easily. You can help us by pointing out anything you find confusing or unclear. If something doesn't
make sense, please tell me that and why that phrase or item is unclear. Or, if you're not sure about your
response, please tell me that too.
Do you have any questions? [ANSWER ANY QUESTIONS]

Ok, let’s begin.
First, I have a few general questions about you.
Probe1. What is your job title?
Probe2. How long have you been in this position?
Probe3. (If needed) How long have you been at your agency?

2

SECTION A

ADMINISTRATIVE

A1. What is the title of the chief position in your medical examiner or coroner office (e.g.,
Chief Medical Examiner, Coroner) and who holds that title?
Title:

__________________________________

Name: __________________________________
A2. Which of the following best describes your death investigation office?

O
O
O
O
O

Coroner office
Medical examiner office
Justice of the peace GO TO END OF SURVEY
My office does not investigate deaths  GO TO END OF SURVEY
Other medicolegal death investigation office (please specify)
__________________________________

Probe1. Is anything missing from the list of responses?

Probe2. Do you believe that justices of the peace should be included in the scope of this survey
given BJS’s goals for this effort?

A3. What level of government best describes your office?

O
O
O
O

City office
County office
District/regional office
State office

A4. Which of the following best describes the agency your office reports to?

O
O
O
O
O
O

Public health agency (e.g., department or division of public health)
Law enforcement agency (e.g., department or division of public safety)
Government attorney’s office (e.g., district attorney)
Department or division of forensic science
My office is a stand-alone agency that is not under the umbrella of another agency
Other (please specify) __________________________________

Probe1. What does a “department or division of forensic science” mean to you?

3

Probe2. Is anything missing from the list of response options?

A5. What jurisdictions does your office serve (e.g. Illinois State, Los Angeles County, New
York City, First Judicial District)?

A6. Is your office accredited by the International Association of Coroners & Medical
Examiners (IAC&ME)?

O Yes
O No
O I expect that my office will be accredited by IAC&ME by December 31, 2019.

A7. Is your office accredited by the National Association of Medical Examiners (NAME)?

O Yes
O No
O I expect that my office will be accredited by NAME by December 31, 2019.

4

A8. On June 30, 2018, how many full-time employees, part-time employees, consultants
or contractors, and unpaid volunteers did your agency have on staff?
Count each employee only once.
Enter zero (0) if you do not have any staff in a category so no entry is left blank.
•
•

Full-time employees are those regularly scheduled for 35 or more hours per week.
Part-time employees are those regularly scheduled for 34 or less hours per week.

Role

Full-Time
Employees
on June 30,
2018

Part-time
Employees
on June 30,
2018

Consultants/
Contractors
on June 30,
2018

Unpaid
Volunteers
on June 30,
2018

a. Autopsy pathologists









b. Coroners/non-physicians









c. Death investigators (or
coroner investigators)









d. Forensic Toxicologists









e. Other scientific investigative
support staff (e.g.,
anthropologists, histologists)









f. Administrative staff (e.g.,
secretary, accountant)









g. Ancillary staff (e.g., drivers,
photographers)









Probe1. What would be involved in obtaining these numbers for your office?

5

Probe2. How long do you think it would take to get these numbers?

Probe3. Are there any roles for which you would have trouble providing staff numbers?

Probe4. Are there any scenarios here where you would not know where to put an employee (i.e.,
fits in multiple categories, missing category)?

If you do not have any coroners or death investigators, SKIP to box above A10.

A9. How many of your coroners or death investigators are certified by the
American Board of Medicolegal Death Investigators (ABMDI)?

O All death investigators are ABMDI certified
O Some death investigators are ABMDI certified
O No death investigators are ABMDI certified
Probe1. What does the response option “No death investigators” mean to you?

If you do not have any autopsy pathologists, SKIP to box above A11.

A10. How many of your autopsy pathologists (i.e., medical examiners) are certified
by the American Medical Association (AMA)?

O All autopsy pathologists are AMA certified
O Some autopsy pathologists are AMA certified
O No autopsy pathologists are AMA certified

6

If you do not have any forensic toxicologists, SKIP to B1.
A11. How many of your forensic toxicologists are certified by the American Board
of Forensic Toxicology (ABFT)?

O All forensic toxicologists are ABFT certified
O Some forensic toxicologists are ABFT certified
O No forensic toxicologists are ABFT certified

7

SECTION B

BUDGET AND CAPITAL RESOURCES

B1. In the fiscal year that included June 30, 2018, what was your total budget?

$,,,.00

If estimate, check here: 

Probe1. What time frame are you thinking about when answering this question?

Probe2. When does your fiscal year begin and end?

Probe3. How easy or difficult will it be for you to come up with this number?

B2. Does your office have a specific personnel budget for items such as wages, salaries
and benefits?

O Yes
O No
Probe1. What do you consider a “personnel budget”?

If your office does not have a specific personnel budget, SKIP to B4.
B3. How much of the total budget was allocated for personnel costs?

$,,.00 If estimate, check here: 
Probe1. How easy or difficult will it be for you to come up with this number?

8

B4. In the fiscal year that included June 30, 2018, did you or staff spend any of their own
money to perform their job, including but not limited to, office supplies, travel
costs, certification, and training?

O Yes
O No
Probe1. What do you think this question is asking?

Probe2. Can you give me an example of a situation that should be counted in this question?

Probe3. Is this question important?

Probe4. Is there a better way of asking this question?

B5. Does your office receive money from any of the following?
Revenue Source

Yes

No

Don’t Know

a. Consultant fees

O

O

O

b. Cremation waiver or permit fees

O

O

O

c.

O

O

O

d. Report fees

O

O

O

e. Testimony fees

O

O

O

f.

O

O

O

g. Grants

O

O

O

h. Other (please specify)
_______________________________

O

O

O

Private autopsy fees

Transportation fees

9

Probe1. What do you think we mean by “receive money”?

Probe2. What do “cremation waiver or permit fees” mean to you? Is there a better way of
describing this type of fee?

Probe3. Can you think of anything missing from this list?

B6. In the fiscal year that included June 30, 2018, what was your average cost for
conducting a full autopsy?

$,.00 If estimate, check here: 
Probe1. How would you come up with your answer to this question?

B7. In the fiscal year that included June 30, 2018, what was your average cost for
conducting forensic toxicology testing per case?

$,.00 If estimate, check here: 
Probe1. How would you come up with your answer to this question?

10

SECTION C

WORKLOAD (DEATH INVESTIGATIONS)

C1. In the fiscal year that included June 30, 2018, did your office receive any referred
cases?

O Yes
O No
Probe1. What do you consider to be a “referred case”?

If your office did not receive any referred cases, SKIP to C11.

C2. In the fiscal year that included June 30, 2018, what was the total number of
cases referred to your office, including all cases in which your office
conducted an investigation or documented referral of the case to your
office?
 We did not track referred cases

, Total cases referred

If estimate, check here: 

Probe1. Would you be able to access this number easily?

Probe2. IF NEEDED, What would you have to do to come up with this number?

Probe3. What do you think of the checkboxes provided here? How would you use them?

C3. “Accepted cases” are cases for which the office completes the death certificate or
otherwise determines the cause and manner of death. For the fiscal year including
June 30, 2018, did you have any accepted cases? Do not include cremation approval
cases or cases in which jurisdiction was declined.

O Yes
O No
11

Probe1. Would you be able to access this number easily?

Probe2. What did you think of the definition of “accepted cases” that we provided?

If your office did not have any accepted cases, SKIP to C5.

C4. In the fiscal year that included June 30, 2018, what was the total number of
cases accepted by your office? Do not include cremation approval cases or
cases in which jurisdiction was declined.
 We did not track accepted cases

, Total cases accepted

If estimate, check here: 

Please Check Your Numbers! The number of your “accepted cases” in C4 should be LESS
THAN or EQUAL TO the number of “referred cases” in C2.

Probe1. How would you come up with the total number of accepted cases?

Probe2. What are your thoughts on the “Check Your Numbers!” box?

Probe3. IF NEEDED, Did you read the information on what cases not to include?

12

C5. In the fiscal year that included June 30, 2018, did your office receive any referred
cases from tribal lands? The term ‘tribal lands’ includes areas labeled Indian Country,
federal or state recognized reservations, trust lands, Alaska Native villages, and tribal
communities.

O Yes
O No
Probe1. Do you have any tribal lands in the jurisdiction you serve?

Probe2. IF NO, Do you think we should have a way for you to indicate that your jurisdiction does
not serve tribal lands?

Probe3. IF NEEDED, Did you read the description of what should be considered “tribal lands”?

If your office did not receive referred cases from tribal lands, SKIP to C11.

C6. In the fiscal year that included June 30, 2018, how many of the total cases
referred to your office were from tribal land(s)?
 We did not track referred cases from tribal lands

, Referred from tribal lands

If estimate, check here: 

C7. Did you include cases referred from tribal lands (C6) in the total number of
referred cases (C2) you reported?

O Yes
O No
Probe1. In your own words, what do you think this question is asking?

13

C8. In the fiscal year that included June 30, 2018, did your office accept any cases from
tribal lands?

O Yes
O No
Probe1. Do you think we need to provide the definition of “tribal lands” again on this question?

If your office did not accept any cases from tribal lands, SKIP to C11.

C9. In the fiscal year that included June 30, 2018, how many of the total cases
accepted by your office were from tribal land(s)?
 We did not track accepted cases from tribal lands separately

, Accepted from tribal lands

If estimate, check here: 

Please Check Your Numbers! The number of your “accepted cases” from tribal lands in C9
should be LESS THAN or EQUAL TO the number of “referred cases” from tribal lands in
C6.

C10. Did you include cases accepted from tribal lands (C9) in the total number of
accepted cases (C4) you reported?

O Yes
O No
Probe1. In your own words, what do you think this question is asking?

C11. In the fiscal year that included June 30, 2018, how many full autopsies did your
office conduct?

, Full autopsies

If estimate, check here: 

Probe1. What do you think we mean by “full autopsies”?

14

Probe2. Is it possible for a jurisdiction to have zero referred cases but still have autopsies to
report? What about accepted cases?

Probe3. How does your office track the number of autopsies completed?

C12. Some functions of a medical examiner or coroner’s office are done within one’s
own office (internally). Other functions may be done by using an outside
organization or independent facility, such as a health department or commercial
laboratory (externally).
Below, please indicate if most of the time your office provides these functions
internally, externally, if the function or service is not available to your office, or if
the function or service is not necessary for your office. Please mark one response
for each row.
My Office
Provides
this
Function
Internally

My Office
Provides
this
Function
Externally

Function or
Service Is
Not
Available

Function or
Service is
Not
Necessary

a. Death scene investigation

O

O

O

O

b. Medical record review

O

O

O

O

c. External examinations

O

O

O

O

d. Partial autopsy
(Minimal dissection, less than a
complete autopsy)

O

O

O

O

e. Complete autopsy
(Remove and examine the brain,
thoracic, and abdominal organs)

O

O

O

O

O

O

O

O

g. Autopsy photography

O

O

O

O

h. Forensic toxicology testing

O

O

O

O

i.

Radiology (X-rays)

O

O

O

O

j.

Metabolic screen

O

O

O

O

Function

f.

Characterization of skeletal
remains

15

k. Ancillary scientific investigative
functions
(e.g., microbiology, anthropology,
histology, neuropathology, cardiac
pathology)

O

O

O

O

l.

O

O

O

O

O

O

O

O

Cremation waivers

m. Certified death certificates

Probe1. How easy or difficult was it to complete this table?

Probe2. IF NEEDED, How did you decide whether a function was “not necessary”? GO BACK
THROUGH TABLE IF NEEDED.

Probe3. IF NEEDED, How did you decide what functions were provided internally vs. externally?
GO BACK THROUGH TABLE IF NEEDED.

Probe4. Were there any function descriptions in the first column that you were not sure what they
meant, or that you would change?

Probe5. Are there any functions you think are missing?

16

C13. For those functions that are conducted internally at your office, who are the people
that perform those duties? Please mark all that apply.
Not
Performed
by My
Office

Autopsy
Pathologists

Coroner/NonPhysician

Death
Investigators

Other
Internal
Staff

a. Death scene
investigations











b. Determination of
which cases are
accepted/ declined











c.

External
examinations











d. Determination of
which cases are
autopsied











e. Determination of
which cases
receive forensic
toxicology testing











Duty

Probe1. How easy or difficult was it to understand how to complete this table?

Probe2. Where there any items here you weren’t sure how to answer?

Probe3. How would you answer if you outsourced any of these duties?

Probe4. IF ANSWERED OTHER: What other internal staff were you thinking of?

17

Probe5. IF ONLY MARKED ONE ANSWER EACH, Was it clear that you could pick more than one
answer per row?

C14. In your office, who is responsible for notifying the next of kin? Check all that apply.






Medical examiner/coroner personnel
Family services personnel (either internal or external)
Law enforcement personnel
Someone else (please specify) __________________________________

C15. In your office, who is responsible for follow-up communication with the next of kin,
such as cultural preferences, returning belongings, and other policies and
procedures? Check all that apply.






Medical examiner/coroner personnel
Family services personnel (either internal or external)
Law enforcement personnel
Someone else (please specify) __________________________________

Probe1. Did you notice that you could check more than one option?

Probe2. Was there anything confusing about these questions?

Probe3. Is anything missing from the list of responses?

18

SECTION D

SPECIALIZED DEATH INVESTIGATIONS

D1. Does your office have a written policy for final disposition (e.g., burial, cremation,
long-term storage) of unidentified remains after a specified period?

O Yes
O No
O Don’t know
Probe1. What do you think we mean by a “written policy”?

Probe2. Is the phrase “final disposition” familiar to you?

Probe3. What do you think of the examples listed?

D2. In the fiscal year that included June 30, 2018, did your office have any unidentified
remains on record?

O Yes
O No
Probe1. What does having “unidentified remains on record” mean to you? Can you give an
example?

Probe2. Does your office use the term “unidentified remains” or do you call them something else?

If your office did not have any unidentified remains on record, SKIP to D6.

D3. In your office, how many total cases of unidentified remains …
a. Were on record as of June 30, 2018?

, Unidentified remains on record If estimate, check here: 
 Don’
t know

19

b. Were on record as of June 30, 2018 and have had DNA evidence collected from
them?

, Have had DNA evidence collected If estimate, check here: 
 Don’
t know
Probe1. How easy or difficult is it for you to come up with these numbers?

Please Check Your Numbers! Make sure the number of unidentified remains that have had
DNA evidence collected in D3b is LESS THAN or EQUAL TO those presently on record in
D3a.

D4. What is the year of your oldest case of unidentified remains currently on
record?

 If estimate, check here: 
 Don’
t know
Probe1. Describe how you would determine what the “oldest case of unidentified remains
currently on record” was.

Probe2. What year do you think we are asking for when we ask for the year of your oldest case of
unidentified human remains? (e.g., year they were found, expected year of death, etc.)?

D5. In the fiscal year that included June 30, 2018, how many unidentified remains
were classified as unidentified in their final disposition?

, Unidentified in final disposition If estimate, check here: 
 Don’
t know
Probe1. What does “unidentified in their final disposition” mean to you?

20

D6. Does your office use the Sudden Infant Death Syndrome, or SIDS, diagnosis?

O Yes
O No

D7. Does your office use the Sudden Unexplained Infant Death, or SUID, diagnosis?

O Yes
O No
Probe1. On these last two questions, would it effect either answer if we asked if the “certifying
pathologist” used these diagnosis, as opposed to “your office”?

D8. Are the following procedures standard parts of your office’s death investigations for
sudden, unexpected infant deaths?

Procedure

Yes

No

Don’t Know

a.

Scene investigation

O

O

O

b.

Scene re-enactment

O

O

O

c.

Comprehensive forensic toxicology
(e.g., multiple toxin screens)

O

O

O

d.

Complete autopsy

O

O

O

e.

Child or infant death review

O

O

O

Probe1. Are you unfamiliar with any procedures listed here?

Probe2. Is anything missing from the list of responses?

D9. Has the increase in novel psychoactive substances and the opioid epidemic changed
your strategy for forensic toxicology testing?

O Yes
O No

21

Probe1. What drugs come to mind when you see the phrase “novel psychoactive substances”?

Probe2. Do you think your strategy for toxicology testing will change any time soon?

Probe3. IF YES, What changes have been made to your strategy for forensic toxicology testing?

D10. Does your office perform presumptive toxicology testing, either on scene or at
autopsy, before sending specimens to a toxicology laboratory?

O Yes
O No
Probe1. What does the phrase “presumptive toxicology testing” mean to you?

22

SECTION E

RECORDS AND EVIDENCE RETENTION

E1. Does your office have a computerized system used to manage, compile, or track
cases or evidence? Such a system is also known as a computerized information
management system or CMS. This does not include the use of Excel or other
spreadsheet software to manage case information.

O Yes
O No
Probe1. How does your office keep track of cases and/or evidence?

Probe2. What time frame are you thinking about when answering this question? Currently? The
fiscal year including June 30, 2018?

If you do not have a computerized system, or CMS, SKIP to E3.

E2. Is your computerized information management system or CMS networked so
that information on all cases is available to all authorized users?

O Yes
O No
Probe1. What do you think we are asking about in this question?

E3. Does your office have a written retention schedule for the following sources?
Source

Yes

No

Don’t Know

a. Case records

O

O

O

b. Forensic toxicology specimens

O

O

O

c.

O

O

O

O

O

O

Physical evidence

d. Unidentified remains (including x-rays,
fingerprints, DNA)

23

Probe1. In your own words, what is a written retention schedule?

Probe2. Does it make sense to use the word “source” to describe the items in the table? Any
suggestions for other terminology?

E4. Are case records maintained for storage as hard copies, electronically, or both?

O Hard copies
O Electronically
O Both
Probe1. When answering this question, were you thinking of only new cases or all cases?

E5. Does your office archive hard copies of your official investigative records and
reports?

O Yes
O No
Probe1. IF YES, Does your office archive hard copies of both investigative records and reports?

Probe2. IF NO, Does your office archive hard copies of neither investigative records nor reports?

If your office does not archive hard copies, SKIP to F1.
E6. Are hard copies of your official investigative records and reports archived at
any of the following places? Please mark one response for each row.
Location

Yes

No

a. On site

O

O

b. A government-owned or government-paid storage
facility

O

O

c.

O

O

Some other location

24

Probe1. How do you know where hard copies of archived records and reports are stored?

Probe2. Have you seen or heard of hard copy archives being stored at personal or non-official
locations, such as at someone’s house?

Probe3. IF NOT SOME OTHER LOCATION, What other locations can you think of where hard
copies may be stored?

If your office does not archive hard copies at some other location (you answered ‘No’ to
E6C), SKIP to F1.

E7. At what other location do you archive hard copies of your official investigative
records and reports?
______________________________________________________________________
______________________________________________________________________

25

SECTION F

RESOURCES AND OPERATIONS

F1. Does your office have access to the Internet separate from a personal device?

O Yes
O No
Probe1. What do you think we are asking for in this question?

Probe2. Do you think this question is important to ask?

F2. Does your office have access to the following resources?

Resource

Yes

No

a. Criminal history databases

O

O

b.

Fingerprint databases

O

O

c.

Prescription drug monitoring programs

O

O

Probe1. What does “access” to these resources mean to you?

F3. Does your office currently have access to the following trainings or resources, either
externally or internally?
Training or Resource
a. Mass Fatality Investigation

Yes

No

O

O

b.

Disaster planning (e.g., National Incident
Management System [NIMS])

O

O

c.

Bloodborne pathogens

O

O

d.

Proper lifting procedures

O

O

e.

Stress management

O

O

Probe1. Is anything missing from the list of responses?

26

Probe2. What does access to trainings mean to you?

F4. Does your office participate in county/statewide emergency response drills?

O Yes
O No
Probe1. Would it be better to ask offices if they have ever participated in emergency response
drills?

Probe2. Do you view this question as important?

F5. Does your office have access to the following investigative technologies, either
internally or externally?

Technology

Yes

No

a. Computerized axial tomography (CAT) scan

O

O

b. Magnetic resonance imaging (MRI)

O

O

c.

O

O

Non-targeted forensic toxicology analysis

Probe1. What does it mean for you to have “access to” an investigative technology?

Probe2. What are some other technologies you have or would like to have access to?

Probe3. What does “non-targeted forensic toxicology analysis” mean to you?

27

F6. What other investigative technologies not listed here does your office have access
to?
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

F7. Does your office have access to the following specialized investigative teams, either
externally or internally?

Specialty Area

Yes

No

a. Child fatality

O

O

b. Drug case review/surveillance

O

O

c.

O

O

Vulnerable adult fatality review

Probe1. What does it mean to have access to specialized investigative teams?

Probe2. Would you answer yes to a specialty team if you have never used them but knew that you
could if you needed to?

Probe3. Can you think of any other investigation teams we should add to this list?

28

F8. To what extent are the following resources needed to improve your ability to
complete cases?

Not at all

To some
extent

To a
moderate
extent

To a great
extent

a. Death investigation staff (e.g., medical
examiners, coroners, death
investigators, anthropologists,
histologists, forensic toxicologists)

O

O

O

O

b. Administrative and ancillary staff (e.g.,
technicians, autopsy technicians,
photographers, administrative
assistants, accountants, drivers)

O

O

O

O

c.

O

O

O

O

d. Laboratory/facility space

O

O

O

O

e. Administrative and evidence storage
facilities

O

O

O

O

O

O

O

O

g. Analytical instrumentation and
laboratory supplies

O

O

O

O

h. Access to literature resources (e.g.,
books, journals, electronic mailing lists,
databases)

O

O

O

O

O

O

O

O

Resources

f.

i.

Training

Office equipment (e.g., computers,
software)

Other (please specify)
_______________________________

Probe1. What do you think this question is asking?

Probe2. What do you think we mean by “ability to complete cases”?

Probe3. Are there any additional resources we should add to this list?

Probe4. What did you think of the examples provided in the table? Were they helpful?

29

Probe5. Would it make a difference to you if we listed the resources in a different order?

F9. Does your office currently participate in any of these data collection efforts?

Data Collection

Yes

No

Don’t
know

a.

Combined DNA Index System (CODIS)
Sponsor: Federal Bureau of Investigation (FBI)

O

O

O

b.

Fatality Analysis Reporting System (FARS)
Sponsor: National Highway Traffic Safety Administration
(NHTSA)

O

O

O

c.

National Crime Information Center (NCIC)
Sponsor: Federal Bureau of Investigation (FBI)

O

O

O

d.

National Forensic Laboratory Information System (NFLIS)
Sponsor: Drug Enforcement Agency (DEA)

O

O

O

e.

National Missing and Unidentified Persons System (NamUs)
Sponsor: Department of Justice (DOJ)

O

O

O

f.

National Violent Death Reporting System (NVDRS)
Sponsor: Centers for Disease Control and Prevention (CDC)

O

O

O

g.

State or local data collections

O

O

O

h.

Other data collection

O

O

O

Probe1. Have you heard of all of these data collection efforts?

Probe2. Have you participated in any of these in the past?

Probe3. IF STATE/LOCAL OR OTHER, What is the other data collection effort you participate in?

30

F10. Does your office have access to the following support services, either externally or
internally?
Support Service

Yes

No

a. Advocates for families of victims

O

O

b. Grief and bereavement services for survivors
(e.g. counseling or therapy, homicide survivor
groups)

O

O

O

O

O

O

c.

On-scene support or advocacy for bystanders or
other family and friends of the deceased

d. Other (please specify)
_______________________________

Probe1. What does it mean to “have access” as it is used in this question?

Probe 2. What does “On-scene support or advocacy for bystanders or other family and friends of
the deceased” mean to you?

Probe3. IF YES TO ANY, How do you have access to these services? Internally? Externally?

Probe4. IF NO, Do you know of any of these services that exist that you don’t have access to?

F11. Is your office located within another business, such as a funeral home?

O Yes
O No

F12. Does your office have a Department Originating Agency Identifier Number or, ORI
number?

O Yes
O No
O Don’t know
If you do not have a Department Originating Agency Identifier Number (ORI), SKIP to END.

31

Probe1. IF NO, Have you heard of a Department Originating Agency Identifier Number or ORI
number?

F13. What is your Department Originating Agency Identifier Number or ORI
number?


END. Thank you for your participation in the 2018 Census of Medical Examiner and
Coroner Offices (CMEC). Your feedback is very important to us!
GENERAL PROBES
1. How long do you think it would take to complete the survey, including gathering all of the
data necessary to answer these questions?

2. Overall, what did you think of this survey?

3. Were there any questions that were unclear or confusing that we did not already talk
about?

4. What did you think about the “estimate” checkboxes? What about the “don’t know”
checkboxes? (Examples: D3-D6)

a. Would any of your answers have been different if those checkboxes weren’t there?

b. If you weren’t sure of an answer, would you estimate and use the checkbox or
would you leave it blank?

5. Did you notice that some questions had words in italics for emphasis? (See F8)

6. When completing this survey, would you provide your exact numbers or would you guess
and estimate?

7. IF NOT ALREADY DETERMINED: How many people would be involved in supplying the
answers to these questions?

8. Who at your office would be responsible for completing this survey? Do you think

32

you/they would prefer to fill it out on paper or on the web?

9. If we were to ask about the size of the population you serve, what would be the best way to
collect those data? Do you think that is important to ask?

10. What could we do to make it easier or more likely for you to complete the survey?

11. Can you let me know if these questions are responsive to BJS’s goals? POINT OUT GOAL
SHOWCARD.

12. Would you be willing to complete the survey if you were sent one next year?

On behalf of BJS and RTI, thank you so much for your time. Those are all of the questions I have. If you
think of anything else that would be helpful for us to know as we refine this survey, please don’t hesitate
to send us an email.

33

Appendix F
BJS’s 2018 Census of Medical Examiner and Coroner Offices Goals Showcard

BJS’s Goals for the 2018 CMEC
1. Generate statistics that will help
develop a detailed understanding of
the U.S. Medicolegal Death
Investigation (MDI) system.
2. Gather information that will help
address training, staffing, or
jurisdictional coverage needs in the
MDI system.
3. Further develop an understanding
of the relationship between law
enforcement agencies and medical
examiners and coroner offices
(MECs).

Appendix G
IRB Submission Confirmation

Smiley-McDonald, Hope
From:
Sent:
To:
Subject:

noreply.IRBExpress@rti.org
Friday, July 27, 2018 2:39 PM
Smiley-McDonald, Hope
STUDY00020259 is not human research

Template:RTI_IRB_T_Post-Review_NotHumanResearch

Notification of Not Human Research Determination
To:

Hope Smiley-McDonald

Link:

STUDY00020259

P.I.:

Hope Smiley-McDonald

Title:

Census of Medical Examiner and Coroner Offices (CMEC)

Description: The RTI IRB reviewed this submission and made a determination that this does not constitute
research with human subjects. For additional details, click on the link above to access the project
workspace.

1