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Polk County approves 28E agreement to send autopsies to Iowa State Medical Examiner after heated debate
Summary
The Polk County Board of Supervisors voted 3–2 to approve a 28E autopsy-services agreement sending autopsies to the Iowa Office of the State Medical Examiner, after weeks of discussion about costs, accreditation and local control. Supporters cited capacity and accreditation; opponents warned of losing statutory authority.
The Polk County Board of Supervisors on a 3–2 vote approved a 28E agreement to send autopsies and related services to the Iowa Office of the State Medical Examiner.
Board supporters said the county has struggled with staffing turnover, lost accreditation and an aging facility that cannot be cost-effectively expanded. County staff told the board the county’s annual medical-examiner office budget is about $4,300,000 and that autopsies alone were budgeted at roughly $1,000,000. Supporters argued the state’s expansion offers capacity, established accreditation, specialized lab resources and a fellowship pipeline that could help Polk County stabilize services.
“Part of their expansion is to do that; they intend to maintain their national accreditation,” a county staff member said, describing a multi-county transition many jurisdictions have adopted.
Opponents questioned whether the county would cede statutory forensic authority and whether contract fees and report costs were finalized. One supervisor said the board was "taking the statutory forensic authority away from the county," and asked whether the state had signed the agreement or committed to full accreditation. County staff responded that the 28E on the agenda was a first step for board deliberation and, if approved, would then proceed to the state for its approval and signature. Staff also said the autopsy contract allows either party to opt out within 12 months.
The board’s debate ranged across projected fees for testimony and technical services, potential part-time staffing models for local medical-examiner roles, and the cost of building or renovating a county facility—staff cited $25 million to $45 million as a rough estimate for building an in-county lab to handle autopsies and related services.
On the final roll call the votes in favor came from Supervisors Holm, Altringer and Chair McCoy; Supervisors Hawkinsmith and Connolly voted no.
Next steps: the approved 28E will go to the state for consideration and any final signatures, and the county said it would continue to employ investigators and retain some local medical-examiner personnel while autopsies are performed at the state facility.
