POLICY TRANSMITTAL LETTER - MELRAP.DOCX

Policy Transmittal Letter
Policy Number: #####
Title: Medical Examiner Loan Repayment Assistance Plan
Type of change
Revision ☐ New ☒ Rescind ☐
Owner of Policy
Department Name: Office of the Medical Examiner
Point of Contact for Revision
Name: Lee Ann Bohn
Email: bohnl@mail.maricopa.gov
Collaborating Department(s)
Name(s): MaryEllen Sheppard, Assistant County Manager
Executive Summary - Reason for New, Updated or Rescinding this Policy:
Background
The Office of the Medical Examiner (OME) competes with all other medical examiner and coroner offices for
physicians to perform autopsies and author reports. The available pool of forensic pathologists qualified to
perform this work is insufficient to meet the national need. In order to attract and retain talented forensic
pathologists, OME must differentiate itself from other jurisdictions. While the Office has received funding
and approval for additional medical examiners over the last two fiscal years, the long recruitment process
(typically 8-9 months) paired with turnover (1-3 annually) means that the Office is in an almost constant
cycle of recruitment.
OME’s salary range for medical examiners is competitive with other offices nationally. Unfortunately, it is
believed that the sheer volume of work performed in Maricopa County’s Medical Examiner’s Office detracts
some from applying and incentivizes others to leave after only a short tenure for positions with equal pay
and less case volume. OME proposes implementing a Medical Examiner Loan Repayment Assistance Plan
(MELRAP) as one way to distinguish our Office from others.
Strategy
Loan repayment plans do not appear to exist in medical examiner and coroner offices. However, they are
used at the federal and state levels as a tool to attract physicians to work in underserved geographic areas
and in the armed forces (see Attachment A). While the OME is not in a geographically underserved area, the
field of forensic pathology is underserved due to the shortage of qualified physicians. As such, we believe
that these programs can reasonably be used as a benchmark for the MELRAP. The federal and state
programs referenced in Attachment A provide annual assistance amounts ranging from $25,000 - $40,000.
Lifetime payment amounts range from $70,000 -$125,000. We propose using the lower end of the annual
range, $25,000, along with a lifetime maximum benefit of $100,000. We also propose a service requirement
of one year following the last repayment, with a partial repayment penalty for early separation.
8/15/2017

Policy Transmittal Letter
The language used in the MELRAP policy is largely based on the existing Attorney Loan Repayment
Assistance Plan (ALRAP). This Plan has been in use since 2010 and has been a successful recruitment and
retention tool for attorneys. We expect similar positive results if the MELRAP is approved.
Funding
The FY 2018 Non-Departmental Budget includes $3.3 million for compensation issues, including but not
limited to compensation strategies for medical examiners. The OME has seventeen approved medical
examiner positions for FY 2018. If all medical examiners were eligible for the Program and participated fully,
the annualized cost would be $425,000.
Stakeholder Review & Approval
Department Head
Name: Lee Ann Bohn Date: 8/15/2017 Signature: __Lee Ann Bohn________
Collaborating / Reviewing Dept. (if applicable)
Name: Date: Signature: ______________________
Collaborating / Reviewing Dept. (if applicable)
Name: Date: Signature: ______________________
Collaborating / Reviewing Dept. (if applicable)
Name: Date: Signature: ______________________
Maricopa County Attorney's Office
Name: Date: Signature: ______________________
Assistant / Deputy County Manager
Name: Date: Signature: ______________________
County Manager / Board of Supervisors
Name: Date: Signature: ______________________
8/15/2017

Policy Transmittal Letter
Attachment A: Physician Loan Repayment Programs
Institution/Program Amount Annual Average Requirements
National Institute of Health $35,000/year $ 35,000 Agree to minimum of two-year contract to
perform research funded by a non-profit in
the U.S.
National Health Service $50,000/2 years $ 25,000 Work at least two years in NHCS-approved
Corps site; can apply for extension beyond two
years. Tax-free and paid at beginning of
service commitment to maximize interest
savings.
Students to Service $120,000/3 $ 40,000 Agree to three years at NHSC-approved site.
Program years
Army: Active Duty Health $120,000/3 $ 40,000 Active duty, paid out in $40,000 increments
Professions Loan years over three years.
Repayment Program
Army: Health Professionals $75,000/3 years $ 25,000 Reserve members who have completed a
Special Pay residency in a qualifying specialty. Paid out in
$25,000 increments over three years.
Navy: Practicing Physician Range:
Sign-On Bonus $220,000 -
$400,000
Navy: Health Professionals $40,000/year $ 40,000 Taxes typically 25%.
Loan Repayment Program
Arizona Loan Repayment $125,000/four $ 31,250 $65k at end of second year; $35k at end of
Program years third year; $25k at end of fourth year. Agree
to minimum of two-year contract serving in a
federally designated health professional
shortage area or AZ medically underserved
area.
8/15/2017