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Special Meeting Minutes Monday, September 30, 2013 Board Members 10:00 AM Andrew Kunasek, Chairman, District 3 Denny Barney, Vice Chairman, District 1 BOARD OF SUPERVISORS Steve Chucri, District 2 Maricopa County, Arizona Clint Hickman, District 4 (and the Boards of Directors of the Flood Control Mary Rose Wilcox, District 5 District, Library District, Stadium District, Improvement Districts, Housing Authority of Maricopa County, Housing Authority of Maricopa County and/or Board of County Manager Deposit) Tom Manos Clerk of the Board Fran McCarroll "The mission of Maricopa County is to provide regional leadership and fiscally responsible, necessary Meeting Location public services to its residents so Sullivan Conference Room they can enjoy living in healthy 301 W. Jefferson, 10th Floor and safe communities” Phoenix, AZ 85003 BOARD OF SUPERVISORS The Board of Supervisors of Maricopa County, Phoenix, Arizona, convened in Special Session at 9:00 AM on Monday, September 16, 2013, in the Supervisors' Conference Room, 301 W. Jefferson, 10th Floor, Phoenix, AZ 85003, with the following members present: Denny Barney, District 1; Steve Chucri, District 2; Clint Hickman, District 4; Mary Rose Wilcox, District 5, absent; Andrew Kunasek, Chairman, District 3. Also present: Constance Copeland, Deputy Clerk of the Board; Tom Manos, County Manager; and David Benton, Legal Counsel. Minutes compiled by Shirley Million, Minutes Coordinator. Board Action 1. MARKET RANGES Pursuant to A.R.S §§11-251.38 and 251.51, approve the addition and/or replacement of Market Ranges to the authorized comprehensive listing of employee compensation Market Ranges previously approved by the Board of Supervisors and approve the addition and/or replacement stipends for management/professional assignments (MPA). Ranges: - Chief Medical Examiner: $83.10-$123.21 ($172,848-$256,277) - Deputy Chief Medical Examiner: $82.18-$112.13 ($170,934-$233,230) - Medical Examiner: $81.26-$101.50 ($169,021-$211,120) MPA Biweekly Stipends: n/a (C-31-14-010-6-00) Tom Manos said County Medical Examiners were given a market-study salary increase in 2006. Citing the heavy workload caused by current unfilled positions, Mr. Manos asked the Board for an additional market range increase to attract more doctors when hiring additional professional staff in the County’s Office of the Medical Examiner (OME). He explained that there are only 500 Board Certified Forensic Pathologists practicing full time in the United States. Two percent of them are in Maricopa County. In 2012 the Special Meeting Minutes Monday, September 30, 2013 Page 2 of 3 Board authorized two new Medical Examiner positions due to the high workload. This raised the total number of examiners to twelve; however, the Office has not been able to fill more than 10 positions at any given time. The County’s Office currently has three vacant Medical Examiner positions. The heavy caseload was cited as a major factor by those who resigned. Without mitigating the circumstances caused by these vacancies, the average caseload for each remaining County Medical Examiner is estimated to be approximately 404 cases per year. The increasing difficulty in recruiting and retaining Medical Examiners is a national concern. After four years in medical school many doctors do not want to undertake the additional training in Forensic Pathology. The National Association of Medical Examiner (NAME) standard for an acceptable caseload is less than 250 cases per pathologist per year. The workload is significantly higher in Arizona and some cases can take as long as 140 days to complete. Maricopa County Forensic Pathologists are on call nights and weekends. Mr. Manos said this, in combination with the heavy caseload and low salary range offered by the County, helps to explain the Office’s 24% turnover in personnel in 2012 and the difficulty in filling those vacancies. Dr. Johnson, Chief Medical Examiner, said that Resident Pathologists are usually Anatomic Pathologists, dealing with tissue diagnosis of disease rather than being Forensic Pathologists who deal with questions arising from crime scenes or litigation. Arizona has defined a Medical Examiner as being a Forensic Pathologist rather than an Anatomic Pathologist. Dr. Johnson described a particular problem for the County. When a doctor leaves the Medical Examiner’s Office with open cases, another Examiner has to complete the additional caseload often including court testimony. The County conducted a national study and has adjusted the O.M.E. salary range with regards to the cost of the labor differential in the County. This adjustment would raise the current minimum starting salary for doctors entering at the Medical Examiner level by approximately $17,000. An additional special duty pay is pending discussion in the near future. Premium pay is already being received for weekend work. There are currently three vacancies in the Medical Examiner’s Office. One candidate has been approved but must comply with a three-month clause in her present contract before coming to the County, and another probable hire must complete special training. Offices with a high case load usually offer premium pay for weekend and holiday work. Darrien Ellison, Employee Compensation Manager, explained that premium pay would be discussed at a future meeting. Supervisor Barney noted that Maricopa County has 2% of the Medical Examiners in the nation, more than our share by population. This is a highly competitive field. Discussion ensued regarding reasons for high caseloads and suggestions to attract more candidates. Supervisor Barney asked if besides higher salaries would N.A.M.E. accreditation help attract pathologists. Dr. Johnson responded that Maricopa County already sets a high quality example for forensic authority and offers very good facilities. Special Meeting Minutes Monday, September 30, 2013 Page 3 of 3 Other suggestions for attracting more Medical Examiner candidates included: Adding a resident and/or Fellowship program as St. Joseph’s Hospital is phasing out their residency program Hiring retired pathologists who may be attracted to Arizona and willing to re- enter the job market on a shorter contract Chairman Kunasek asked what the current log time is from intake to filed reports. Dr. Johnson responded three months is the average log time. Motion to approve by Supervisor Chucri, seconded by Supervisor Hickman Ayes: Kunasek, Barney, Chucri, Hickman Absent: Wilcox MEETING ADJOURNED There being no further business to come before the Board, the meeting was adjourned. __________________________________ Andrew Kunasek, Chairman of the Board ATTEST: ________________________________________ Constance Copeland, Deputy Clerk of the Board