With few options in sight, Franklin County will soon have to make the tough decision of renewing its contract with St. Louis University (SLU) for medical examiner services at a cost of $80,000 more than last year.

Presiding Commissioner John Griesheimer says although the decision is painful, it may be the only one.

“We really don’t have a lot of options,” Griesheimer said. “As of now we are paid to the end of the year.”

The dilemma began last summer when SLU notified the county they would be raising the cost of medical examiner services by $100,000 for 2018 from $288,055 to $388,876.

On Thursday, Griesheimer reveled SLU has sent over a new contract without any explanation and the yearly rate was lower by $23,000 to $365,832, which is still $77,777 more than last year.

Commissioners met with representatives from SLU to try and negotiate the price, but until recently, SLU would not budge.

At that point, the commission decided not to renew the contract and would instead look for medical examiner/forensic services else where.

“We are still trying to figure things out,” Griesheimer said. “If we decide to stay with SLU we will pay month to month.”

According to the new contract medical examiner/forensic services would be $30,485 per month.


In late August, the county began talks with two separate doctors to fill the role currently played by SLU when deaths occur in the county.

To fill those needs, a forensic pathologist is needed to perform autopsies and chemical screenings to determine causes of death whether they be natural or suspicious.

Another doctor is needed to sign death certificates and other necessary end-of-life documentation to satisfy the state or other entities. The county had been in contact with a physician, who has a practice in Washington, to sign death certificates and perform the other basic housekeeping duties involved with deaths.

But, he backed out of the process and recommended the commission look for a doctor who was semi-retired and had more time to dedicate to the duties.

The estimated yearly costs for such a physician would be in the $125,000 to $150,000 range.

The commission is also in talks with a forensic pathologist, based in St. Francois County, who provides his services for 20 other counties in Missouri.

Griesheimer said that option is still on the table, but they are worried about time constraints and distances when there is a death in the county requiring further medical investigation.

The county has been advised to get bids from forensic pathologists with all of their ancillary costs included.


For the past 23 years, SLU has provided medical examiner services on more than 13,000 deaths at the request of Franklin County, averaging about $350 per case.

Griesheimer said projections for 2018 are 37 autopsies and 37 exams.

He added SLU currently staffs two forensic pathologists.

In 2016, Franklin County paid $18,500 for morgue services and the projected cost for 2018 is $72,150.

Last year, SLU pathologists performed 29 autopsies and 47 exams on bodies from Franklin County deaths.

For 2017, SLU projected it would perform 33.5 autopsies and 34 exams for the county.