Spokane Valley funeral home director Trent Nielsen is trying to guide grieving families through the waiting game.
After the untimely death of an insured loved one, families prepare for the usual end-of-life expenses, including funeral costs. That means getting a signed death certificate, with a cause of death, to submit to insurance companies for payment of benefits.
But that process, which used to take a few weeks, is now taking, on average, closer to five or six months in Spokane County. State law requires that the county medical examiner or coroner perform an autopsy in circumstances that extend beyond just potential criminal activity or traffic fatalities, including when a person is found dead and hasn’t been to a physician in several years. In all cases, the person’s blood is tested for the presence of drugs, a procedure performed by a single laboratory in Seattle that has been inundated with cases in recent years, holding up the end-of-life process for those left behind.
That’s leaving many families with no access to money that could help cover the thousands of dollars in funeral costs, Nielsen said.
“Usually life insurance is purchased with the idea those funds will help the family press forward with their financial situation, until they get their feet back under them,” said Nielsen, managing partner and funeral director at Hennessey Valley Funeral Home and Crematory in Spokane Valley.
Because of the state laws determining when an autopsy is required, the delay is affecting families whose lives are already thrown into turmoil by an unexpected death, Nielsen continued.
“This usually isn’t someone who’s been on hospice for a number of weeks or months, it’s accidents, and maybe they hadn’t seen the doctor for a number of years,” Nielsen said. “It comes out of the blue for the family, then it hits them on the financial side. Unless they have other resources, they kind of go into a tailspin.”
The backlog of cases, which grew to nearly 6,000 in 2018, has prompted pleas from the laboratory’s staff for more money to hire additional staff. Those workers not only have to deal with the unattended deaths, which make up about 35% of their caseload, but also a mounting number of suspected driving-under-the-influence cases. The lab is run by the Washington State Patrol.
“More courts are wanting blood draws versus the (blood alcohol content) machine,” said Capt. Monica Alexander, of the Washington State Patrol’s Office of Government and Media Relations. “We’re just trying to catch up with the times, really.”
The WSP asked for an additional $3.2 million in the state’s 2019 budget, after receiving funding last summer for an additional six positions that has helped ease some of the long waits. The Spokane County Medical Examiner’s Office, which performs autopsies for 12 other counties in the region, reported wait times for drug testing results are down this year compared to last, when two cases took 318 and 288 days to be returned after the autopsy, respectively.
Alexander said the patrol shares families’ concern about wait times, but pointed out that DUI testing is also important.
“When a family is waiting for their death investigation report to come back, there’s an emotional impact,” Alexander said. “We’re very sensitive to that. When you have a DUI, or vehicular assaults, we don’t want people walking out of jail hurting someone else.”
The budget approved by state lawmakers includes just $1.3 million of the funds requested, enough to pay five of the original staff instead of expanding to nine.
State Rep. Timm Ormsby of Spokane, who chairs the House Appropriations Committee, said much of the budgetary discussion for the WSP centered on another need that’s handled by the patrol’s crime lab: DNA testing of a backlog of some 10,000 rape kits.
“The State Patrol is responsible for a lot of stuff, not just highway safety,” Ormsby said. “It seemed like the biggest priority, for the state patrol and legislators, on the lab side of things was the backlog of tested rape kits.”
The DNA testing takes place in a different facility than the toxicology labs, but both are included in the patrol’s budget request. The Legislature set aside $10 million intended to speed up testing of rape kits, and Gov. Jay Inslee signed legislation this year that requires kits to be tested within 45 days of receipt in an effort to investigate cases of alleged sexual assault more swiftly.
Ormsby said he hadn’t heard of the life insurance policy issue, and the state’s Office of the Insurance Commissioner said through a spokeswoman they hadn’t received any complaints from consumers about policies being paid out.
That may be because families eventually receive a signed death certificate with a stated cause of death and benefits are then paid out, Nielsen said. But that process is still taking months, and in the meantime, both medical examiner’s offices and private practice pathologists are seeking assistance from other labs outside the state to speed up results in certain cases.
“It was bad enough when it was 6 to 8 weeks to wait, now it’s 6 to 8 months, by the time you’re getting the tox back, you don’t even remember what the case was about,” said Eric Kiesel, a certified forensic pathologist based in Tacoma who previously served as chief medical examiner in Snohomish and Pierce counties as well as the city of Atlanta. “It’s really created some problems, keeping track of paperwork.”
Both Kiesel and the Spokane County Medical Examiner’s Office said they’ll sign death certificates as quickly as possible when the cause of death is obvious, such as in a traffic fatality when the person died from blunt force trauma. But the toxicology report is still listed as pending, which can halt the process of dealing with an estate, Kiesel said.
“The families are still stuck in limbo,” he said.
Toxicology reports aren’t just important for singular cases either, Kiesel said. They can alert law enforcement to the presence of illicit drugs in a community, or trends of substance abuse in vulnerable populations, including the elderly.
“There’s cases that, if you do the autopsy, it’s immediately going to look like heart disease,” Kiesel said. “However, many months later, it turns out there are drugs on board.”
That public health service has also been slowed by the backlog the state lab hopes to continue to chip away at. But it’s just another example of something put on hold while toxicology experts play catch-up.
“That backlog, really created what we can’t really call a trickle-down effect,” Kiesel said. “It was more of a deluge.”
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