Polk County Supervisors Hear State Proposal to Share Autopsy Services; No Decision Made

Polk County supervisors on Oct. 12 discussed a potential partnership with the Iowa Department of Health and Human Services and the State Medical Examiner's Office that would shift routine forensic autopsy work to the state while Polk County would retain a county medical examiner and local investigators.

The discussion, which included presentations from Kelly Garcia, director of the Iowa Department of Health and Human Services, Dennis Klein, Iowa State Medical Examiner, and Polk County Medical Examiner Dr. Diehl, focused on staffing sustainability, facility capacity, accreditation benchmarks and impacts on prosecutors, funeral directors and law enforcement. No formal action or contract was proposed; the board directed staff to continue work and bring additional documents and stakeholder input back to the board.

Why it matters: Supervisors were presented with a case that combining county and state capacity could reduce recurring staffing risk and produce economies of scale in equipment and training, including a proposed fellowship and an ongoing state expansion project the state described as fully funded. Locally elected officials, the county attorney's office and funeral directors stressed the need to protect timeliness, family services and local accountability.

State and county officials said the current arrangement is strained. "This relationship is unsustainable as it exists today," Kelly Garcia told the board, saying the state is planning facility and staffing expansions to handle larger caseloads and to build training pipelines.

Klein, who has led the state medical examiner's office for two decades, described recent staffing investments at the state level and said the office is planning capacity to manage higher case volumes and to provide more training for county examiners. He said the state facility has five autopsy tables and the office has added part-time pathologists and locum contracts to reduce backlog risk.

Dr. Diehl, Polk County's medical examiner, gave local context, including current caseload and staffing. He said Polk County currently performs about 500 postmortem examinations per year and that, with population growth, the office could approach volumes where three forensic pathologists would be appropriate. "...about 500 per year," he said when describing current autopsy volumes.

Prosecutors and law enforcement cautioned that rapid turnover or changes in where autopsies are performed can slow investigations. Megan Gunz, bureau chief at the Polk County Attorney's Office, praised Diehl's early work with prosecutors and argued timely local forensic support is important for homicide and child-death investigations. "Dr. Diehl has absolutely impressed us at the Polk County Attorney's Office with his professionalism," she said.

Funeral directors and family-service providers urged the board to prioritize timeliness and family access. John Jacobson, a local funeral director, told the board: "maintain it and let this guy cook because he is the right guy for it," arguing Polk County-based service is most responsive to local families. Another director, Alex Wright, said his chief concern is avoiding multiday delays that keep grieving families from viewing decedents.

Costs and facilities were central to the discussion. Officials described a state-funded expansion of the state medical examiner's facility — the packet presented to the board listed a $36,000,000 expansion at the state campus that the director said is fully funded. Board members and staff cited other recent facility projects around the country as cost comparisons: $33,000,000 (Iowa state project), $22,000,000 (Milwaukee), $16,000,000 (Escambia County facility cited), and $45,000,000 (Pima County). Polk County staff noted earlier local budgeting that included roughly $7,000,000 set aside for an office facility and that county reserves are governed by a 25% reserve policy.

Officials discussed accreditation standards. Klein said accredited offices are measured on timeliness benchmarks (examples cited: performance for completion within 48 and 72 hours) and that Polk County’s recent performance improved after staffing stabilized. Broadlawns Medical Center was described as Polk County’s current autopsy location; participants said Broadlawns currently provides two autopsy tables, a single cooler with approximately eight-body capacity and shared radiology services.

Board members asked staff to continue the analysis and to bring back documentation and stakeholder feedback. Supervisor Connolly and others requested the county receive draft contract language, a timetable for any transition, and more direct consultation with funeral directors and law enforcement before any final decision. The meeting closed with supervisors asking for additional written materials and follow-up meetings with stakeholders.

No motion or vote was taken at this meeting.