Among the audit’s findings:
- Require the examiner to report to the county manager or Public Safety Agency.
- Require periodic reports from the examiner to commissioners and county manager.
- Cease using county employees in the ME's private practice, or obtain the required written approval.
- Designate a position responsible for ongoing monitoring of the ME contract and its provisions.
- Seek county attorney guidance on ME's private use of Cobb facilities for profit.
- Consider competitively bidding for medical examiner services, and require all future contracts to have renewal options and end dates.
No one is looking over the shoulder of Cobb medical examiner Brian Frist, whose annual contract is worth $475,500 a year and allows him to use the county’s facilities and personnel to perform autopsies for his own private business, according to a critical internal audit.
The April 8 report, written by the county’s Internal Audit Department, makes 27 recommendations for improvement, including the suggestion that the county solicit proposals from other doctors capable of doing the job.
Frist says county employees are used in his private practice only during off-hours, but the audit notes that he profits from those private autopsies and that they are performed inside county facilities at no cost to him.
By way of example, the audit notes that the DeKalb County medical examiner pays $1,485 per month to use that county’s facilities for private autopsies.
Without monitoring, Cobb County can’t be sure that its cases are being handled before Frist’s private cases, the audit says. In addition, Frist could not produce the required written approval that county employees must have before taking on outside jobs.
“The private use of the county facilities for profit could expose the county to liabilities in connection with performing those services,” the audit says. “In addition, without proper monitoring … the county cannot be assured that its cases are prioritized.”
In an interview Monday, Frist said he covers all expenses for his private work, even though he uses county employees.
“The county does not reimburse these people at all (because) they’re off the clock,” said Frist, who became the county’s medical examiner in 1999. “All (expenses) are paid for by me, not the county.”
Cobb is one of just a handful of counties in Georgia that have a medical examiner, making the switch from a coroner in 1973. The Medical Examiner’s Office is responsible for providing investigations and examinations focused on determining the cause and manner of death, which can be used by the courts.
A coroner is an elected official, and is not required to be a physician because they do not perform forensic pathological services.
By 1983, the Cobb ME contract was $150,000 from which he had to pay the salaries of a handful of office employees. By the time Frist took over the position, four county employees had been added to the office and the value of the contract had grown to $355,000.
Today, Frist’s contract specifically states that all investigators, technicians and administrative staff are paid by the county.
It’s unclear how much of the $475,000 contract goes to Frist in salary. The audit, however, points out that Frist’s biggest expenditure, which is personnel, is being covered by taxpayers.
“We were unable to determine the justification for the county assuming personnel previously paid out of the contract without a corresponding reduction to the ME contract,” the audit says.
Unlike Gwinnett and DeKalb counties, which also use medical examiners, the ME contract in Cobb has never been competitively bid, the audit says.
Frist is considered a department head, although the audit found that he has “limited knowledge or training on county policies.” Instead, Frist relies upon his office staff to manage daily operations of the office. The audit could find no evidence of periodic reporting to commissioners or the county manager.
“There is no functional oversight of the ME’s contract nor … operations,” the audit says. “Oversight of the contract and compliance to the terms and conditions … is critical to ensuring the obligations of both parties are adhered to and performance measures are met.”
After hearing the internal audit presentation Tuesday, commissioner Bob Ott said each of the commissioners will meet with Frist in the coming weeks. It’s unclear if the commissioners will act upon any of the recommendations.
Frist said it would be a mistake for the county to solicit bids for the position, but he said he would likely submit a proposal if the county takes that route.
“A professional person should be judged on his work, not on the lowest bid,” Frist said.
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