SAN FRANCISCO -- The San Francisco Office of the Chief Medical Examiner (OCME) was officially granted provisional accreditation status by the National Association of Medical Examiners (“NAME”). OCME achieved accreditation following an implementation of key reforms, investments in staffing, and the adoption of new policies and initiatives aimed at improving efficiency. As a result, 80% of final death certificates are now completed within 90 days, bringing more expeditious closure to decedent’s loved ones.
NAME is the premier accreditation organization for medical examiner and coroner offices nationwide and the foremost authority promoting the highest quality forensic pathology practice and medicolegal death investigation in the world. Currently, San Francisco is one of three medical examiner offices in California to have achieved NAME accreditation.
“I am proud of the work done so far by the Office of the Chief Medical Examiner to achieve NAME accreditation and, above all, to provide responsive and compassionate services to our residents,” said City Administrator Carmen Chu. “Together, we are committed to laying a strong foundation to continue OCME’s path to full accreditation.”
In May 2021, after conducting an extensive national search, City Administrator Carmen Chu appointed forensic pathologist Dr. Christopher Liverman, M.D., Ph.D, to serve as San Francisco’s Chief Medical Examiner. Since his appointment, Dr. Liverman has prioritized regaining accreditation by implementing changes that best serve residents of San Francisco. These changes include prioritizing issuance of final death certificates, using toxicology testing to certify cause of death in fatal accidental overdose cases, implementing new policy to triage autopsies, and modernizing internal operating systems.
“The NAME accreditation validates our team’s dedication to the community and commitment to meeting the highest standards. I am grateful for the work done by our team of dedicated public servants to achieve accreditation during a historic caseload amid the COVID-19 and opioid crises,” said Chief Medical Examiner Dr. Christopher Liverman. “Our focus in 2022 will be achieving full accreditation by continuing to prioritize case closures and quality improvements.”
To achieve full accreditation by NAME, OCME will need to fulfill the remaining requirements within the one-year provisional time period ending in late 2022. These requirements include shortening the time to produce toxicology and postmortem examination reports, as well as lowering medical examiners’ average caseloads. OCME will address these needs by hiring and training new staff, equalizing workload, and reducing administrative delays in completing reports.
OCME worked closely with leaders in the City Administrator's Office, which oversees OCME’s budget, to make sure the Office is well resourced to meet with the City’s increasing needs. Starting in 2018, OCME experienced a marked increase of caseloads, mainly due to drug-related deaths. In 2021, the Office investigated approximately 1,600 cases, compared to 1,148 cases in 2018. In addition, the Office also received over 700 cases involving public intoxication, driving under the influence, and drug-facilitated sexual assaults for forensic toxicology testing.
In Fiscal Year 2021-22, OCME received a budget investment of nearly $2 million, which allowed the Office to hire more Medical Examiners, autopsy technicians, and investigators to meet the increasing workloads.
“A series of investigatory hearings and a Budget & Legislative Analyst audit identified the OCME’s lapse in accreditation as an impediment to hiring and retaining staff and ensuring the highest training standards,” said Supervisor Aaron Peskin, who has been working with the City Administrator since to oversee the implementation of audit recommendations. “After a recent tour of the Office, I’m pleased to see the progress being made toward delivering on key benchmarks, including a full NAME accreditation. The pandemic highlighted the critical role of the OCME, and I’m grateful to the staff who helped us weather the worst of the COVID crisis.”
The OCME is responsible for the investigation and certification of any sudden, unexpected, and violent deaths of legal or public health interest, including determining the cause, circumstances, and manner of death. OCME also provides useful reports, such as the monthly Accidental Overdose Reports and the Homeless Death Count, to inform public health experts and policymakers. For more information, please visit OCME’s website here.