In July 2020, Gov. Mike Parson signed into law a potentially sweeping change for coroners across the state of Missouri, many of whom lack medical or forensic training. The law, which creates a governor-appointed commission to write new standards and training for coroners, was written in response to the botched investigation into the 2011 death of 27-year-old Jayke Minor in Fayette and pressure from the Missouri Coroners’ and Medical Examiners’ Association.
Once formed, the commission would create mandatory training for all of Missouri’s county coroners. The commission is funded by a $1 fee on certified death certificates, with more than $388,000 in its state account so far.
But more than a year passed before the Parson administration appointed anyone to the commission. On Monday, two coroners who were appointed in September received a confirmation hearing before a Missouri Senate committee — but, even if they win confirmation from the full Senate, the board still wouldn’t have enough members to meet and begin its work.
Steve Murrell, president of the Missouri Coroners’ and Medical Examiners’ Association, which represents county coroners, said his association and its members are “very frustrated” with the delay in appointments and ready to start “what needs to be done.”
As it stands, Missouri has few requirements for those who run to become elected county coroners.
The only qualifications are that you’re 21 years of age; live in Missouri for at least a year; and live in the county you’re serving for at least six months. Missouri county coroners have little-to-no medical training and less than 20% of the state’s coroner offices are certified by the two largest accreditation organizations, according to Documenting COVID-19’s analysis of a recent Department of Justice survey of medical examiner and coroners offices across the country.
The lack of training and certification of coroners means that their tools and practices vary wildly from county to county.
“You have 100-some coroners doing things 100-some different ways,” Murrell said in an interview.
Signed into law on Aug. 28, 2020, House Bill 2046 created the Coroner Standards and Training Commission within the Department of Health and Senior Services. After the commission develops new coroner standards, they will be published on a state website and coroners will not be able to assume office until the required training is completed and a certificate issued.
Comprised of eight members, including an employee of DHSS as a nonvoting member, only four spots on the committee have been filled. The commission needs at least one more voting member, appointed by the governor, to be able to form a quorum and begin making decisions.
Sidney Conklin, coroner of Randolph County, which includes Moberly in northern Missouri, was one of the two members of the commission who received a confirmation hearing on Monday. He said he’s spoken with the commission’s other members, but declined to specify what types of training and standards the committee will prioritize.
In an interview, Conklin said one responsibility of a county coroner is critical, above all else: “They better serve the public.”
The other coroner who received a confirmation hearing Monday — Saline County Coroner William Harlow — declined to discuss the commission’s work. If Conklin and Harlow win committee approval, they must still be approved by the full Senate.
‘Were you a part of the Hells Angels?’
The only two coroners tapped by Parson to serve on Missouri’s new commission come from much-different backgrounds.
Conklin, elected as Randolph County’s coroner in January 2021 as a Republican, served in the U.S. Army and then worked for Missouri law enforcement agencies for more than 35 years, including the Missouri State Highway Patrol, where he retired as a lieutenant and assistant director of its criminal division. Conklin also served as chief investigator for the Missouri State Board for the Healing Arts, which oversees the licensing of physician assistants, surgeons and physical therapists.
Harlow has worked in a family-run funeral home in his hometown of Marshall, Missouri, since 1995, and has worked as a funeral director and embalmer. He was elected as the coroner of Saline County, located along the Missouri River between Kansas City and Columbia, in 2005, and has served as the legislative liaison of the Missouri Coroners’ and Medical Examiners’ Association.
During the hearing, Conklin was asked about his career with the Missouri State Highway Patrol, including his time surveilling outlaw motorcycle gangs:
“Were you a part of the Hells Angels?” asked Sen. Mike Moon.R-Ash Grove.
“Never,” Conklin answered, in jest.
When Moon pressed Conklin for more details on his experience, he divulged a bit more: “If you open your imagination, I had a lot of hair, and I had a long beard and earrings. And there are tattoos — all in compliance with Highway Patrol Standards, of course.”
Moon couldn’t resist prodding the other nominee, Harlow, either. Moon asked Harlow if he knew why they put fences around cemeteries.
The punchline: Everyone is dying to get in.
“I’m waiting for someone to make new funeral jokes,” Harlow said, laughing.
Lack of training and funding hampers Missouri death investigations
Lisa Cox, spokeswoman for the DHSS, said the department can’t “speak to the timing, importance or standards of the appointments process” and will only answer questions about the commission once a commission is in place.
Parson’s office did not respond to comment about why he has yet to finish appointments for the commission or when he will fill the final few seats.
Last summer, the Documenting COVID-19 project and the Kansas City Star reported on a coroner in Macon County, Missouri, who admitted he did not list COVID-19 as the cause of death on at least a half-dozen death certificates in cases where he could justify a different cause of death.
In December, The Missouri Independent, Documenting COVID-19, and the USA TODAY Network investigated unexplained spikes in deaths that could reveal hidden COVID deaths. Cape Girardeau County had one of the highest percentages of unexplained increases in the country, and the coroner there said his office doesn’t “do COVID deaths” because they don’t have the resources to investigate and instead only rely on families to supply test results.
Most coroners, including Murrell, and the CDC say death certificates shouldn’t be influenced by family members.
“I have told many families that I don’t put what I want, and I don’t put what you want. I put the truth, and sometimes the truth hurts,” Murrell said.
But many of the issues with Missouri death certificates can be traced back to a lack of training and funding, coroners say.
According to Documenting COVID-19’s analysis of a recent Department of Justice survey of medical examiner and coroners offices across the country, Missouri coroner offices have lower budgets than most of the country and 84% report not having a computerized system to file and manage cases.
Missouri coroners also perform autopsies in fewer cases than coroners in almost any other state, according to the same survey. The only states that rank lower than Missouri in the number of autopsies performed by coroners: South Dakota and Mississippi.
Coroners often don’t have the medical history of the people whose death they are investigating readily available, and autopsies can be one of the most powerful tools for their job, especially in complicated cases. But autopsies can cost tens of thousands of dollars, and Murrell attributes the low amounts of autopsies to county commissioners who pressure their coroners not to autopsy so that the county can cut costs to their budget.
“We have a lot of commissioners out there that really pressure their corners not to do autopsies, and when you do that, you’re playing with fire,” Murrell said.
Lack of funding for autopsies could be one of the problems that the commission tackles, by giving coroners a set of clear standards to abide by, regardless of cost.
