 Welcome to Sheboygan County Government, working for you. My name's Adam Payne, County Administrator and co-host of this program with Chairman Roger Distruti and as you know every month we strive to bring a different department, a different department head as our guests to talk a little bit about their roles and responsibilities. And today we're very pleased to have our coroner, David Lafine with us. David, welcome. Thank you. I don't get a chance to interact with Dave as much as some of the other department heads. As the county elected coroner, for some reason that doesn't bother me too much, but I always find Dave one of the more interesting individuals to meet with and I'm sure you will as well today. Dave's been our elected coroner for 27 years, so certainly providing a vital role and service to the community. Dave, please start by sharing a little bit about yourself and your background. Well, I'm a product of Sheboygan, born and raised here, educated, married, wife Bonnie. In fact, it's 40 years this year, it's a long time too. I have two children, grown children, married, and a total of four grandchildren. Very good. Very good. And what originally motivated you to run to be coroner? Well, I'm a registered nurse by profession and way back when, I think in 1986 is when the election was. Some docs talked to me about running, it was election time and I thought, well, I could do that. I had the background and it would be an opportunity to give back to the community in some way. And you've been doing it ever since? It wasn't intended to be a career, but it has been a very enjoyable, so to speak, community of my life, that align these people. What qualifications does someone need to be an elected coroner? You really don't need any qualifications. I'd say unfortunately, anybody can run. We have the elected system in Sheboygan County. So what that means is you need a minimum of 500 names to get yourself on the ballot and he with the most votes wins. But there should probably be and maybe in the future, there will be some direction given towards educational background to serve in this capacity. I find that kind of remarkable. I know we've had you on this program in the past and I recall that answer that you really don't have to have any qualifications to be coroner, yet the coroner certainly has to have some knowledge and background and expertise. Give a brief snapshot of what are your roles and responsibilities? As coroner, you're the protector of the dead. You're the voice for the dead. They can't speak for themselves, so when they pass on, obviously some are very obvious causes of death and that type of thing, but others are not. So part of the job duties are the pronouncement of death when they died and what caused the death, the cause and manner of death, manner of death is one of the big factors and cause and that causes probably where the educational background is the most important. You have to have an understanding of anatomy and physiology, disease processes, medications and things like that where your lay person would not. Right, right, and obviously you've had 27 years of experience to get a better feel for that and see different situations and what situations do you get called upon? When do you need to go and pronounce someone dead? It's by state statutes. State statutes dictates that. There's obvious ones, all homicides, require the coroner to be involved, accidental deaths, deaths of strange or uncertain circumstances, fetal deaths, deaths during maternity, during a mother while she's pregnant. They all fall under state statutes, basically all non-institutional deaths, die at home, die out in the woods, die even though they may be natural causes, but they're all dictated by state statutes. And I know you don't do this all yourself, you have some coworkers or employees, how many staff are involved with your office? I have four deputies, chief deputy and three other deputies, and we all have varying degrees of medical background. Myself, I'm a registered nurse by profession, and the rest of them all have EMTs or paramedics. And you mentioned earlier, you've been obviously doing this for a long time, but this is not necessarily your only employment, I mean you don't do this 24-7, you're called upon 24-7. Well, it isn't your only job. What kind of time commitments are there for you and your deputies? Somebody is available 24-7, like you said. My deputies cover generally seven to three, while I'm at my regular job as a nurse for me and Matt Corporation in Sheboygan here. And I take call from 3 p.m. to 7 a.m., and then I take every weekend and holiday. Very good. Unless I'm out of town, then somebody else covers. And then finally, before I turn it over to Roger, what's the difference between a medical examiner and an elected coroner? I'm aware, as is Roger, and certainly board members, that every county can have either an elected county coroner or an appointed medical examiner. But what's the difference? Well, by state statutes, any county over 500,000 has to have a medical examiner system. And a medical examiner system is an appointed system, appointed by the county government at the will of the county government. They can hire, they can fire. An appointed system is an elected system, elected by the people for your commitment. You don't, when the election, you're no longer the coroner. Right. And when we talked a little bit off cameras, of course, there's going to be quite a difference in expense associated as well. Absolutely. An elected coroner, you earn per diem, and personally I think it's a modest compensation for the important work that's done, whereas a medical examiner, they can have a salary and it can be certainly more extensive. You're subject to all the benefits, correct? Right. Although there, you have more control over the qualifications. You can make sure you're hiring someone that has a registered nurse background or has a feel for this versus someone that comes in cold and has no really idea what's all involved with being a coroner. And more and more counties are seeing that light and going to it. Probably out of the 72 counties, I would venture to say probably a good 30 to 40%, if not more, have gone through the medical examiner system by actuality only one has to, and that would be Milwaukee. Right. All right. Very good. Good background. Thank you. Roger. I may not want to wish to think about the coroner arriving at their doorstep. Death is a part of life, and it impacts all of us. Like to get to more of the specifics of what you and your staff do. For instance, I understand there are five manners of death. What are they? Right. There's natural death, accidental death, homicide, suicide, and undetermined. Just on a sidebar, a physician, any physician can only sign out natural deaths. Anything other than natural has to be signed up with a coroner or medical examiner. Accidental death can be anything from a car accident to accidental electrician or electrocution to falling down the steps and hitting their head and having a subdural hematoma. Suicide is obvious. Someone taking their own life. Undetermined is a situation where you just can't put your finger on one cause. Even after autopsy or drug tests or various other things, there's just something missing. You can't say it was due to natural causes, and you can't say it was suicide, and you can't say it was accidental. So you leave it as undetermined. Something just not there yet. And how many deaths a year does your office investigate? It's going up every year. And the reason being, your post-world war one babies are now in their 90s. They're dying at a rapid rate. Your baby boomers, us, were in our 60s, except for Adam's, a little bit younger. The deaths are increasing. Statistically, they predict a 10% to 15% increase in deaths this coming as time goes on, 2015, 2014, 2050. So to answer your question, I believe we did about 553 deaths last year. And right now, at this time, we are at, I believe, was 342. So we're right on track to be at that number if not even a little bit more. And of those 500 plus a year, how many do you need to have an investigation to determine the cause of death? Well, we determine all of them, but a more extensive investigation, such as an autopsy. I've always been very conservative with autopsies, and limited autopsies to things that need a direct clarification or for legal matters. We probably do somewhere between, well, we're at 18 autopsies this year right now. And that's the highest we've been probably in the last five, six years, if not more. Nothing we've ever gone over 18, but this year it will be. And the reason there, we're having more drug deaths. And with drug deaths, we have the law enforcement who wants to pursue to get the individual that supplied that drug to that individual that caused, resulted caused that death by providing that. So in order to do that, they need an autopsy to make their case stick, if you would, that someone can't come along and say, well, they died from a heart attack or they died from a brain aneurysm, or some other means, it's just to keep everything in order, dot the I's, cross the T's type of thing. So we'll do autopsy, we'll do toxicology, homicides, we'll always do an autopsy on homicides. Again, it's a legal situation where you want to put that perpetrator behind bars. If we have any deaths of an inmate that's required by state statute, that their deaths are covered under autopsy, again, to protect the innocence of the person, to protect the system. So there are no unanswered questions. And Dave, many people may not know, but we do have a county morgue, and why don't you explain to the viewers where it's located and how often do you use it? The county morgue is located in the basement of the county courthouse in the back of the courthouse in between the annex and the actual courthouse. And use it, we use it every time we have an autopsy, obviously. We use it if we have a death, but we have no family member to turn to to ask them direction on where they want their loved one to go. So we would use it for that. We would also use it for tissue harvesting. And tissue harvesting is when an individual wishes to give tissue to the medical research to for medical intervention, things like they use skin for for persons with cancer, they use bone for cancer again, they use connective tissue, knee joints, ligaments for injured persons. And we do that down there. And a few years ago we had renovation and remodeling of the morgue, do you want to explain that a little bit? Yeah. When I took over 27 years ago we had what was called the marble morgue table. Very antiquated, the whole morgue was antiquated. We now have a beautiful state-of-the-art morgue, we have a walk-in cooler which is certainly nice before we had an antiquated wall unit where you had a physically lift the individuals on trays into the cooling system, we can now just roll them in, lighting is excellent down there, it's air-conditioned, heated, ventilation system. Anybody that's been in the courthouse knows that if sometimes you have orders that maybe aren't conducive to things but now with their ventilation system that certainly makes a big difference. Now that after the renovation was done is the county morgue used for some of the autopsies then? Sure. All the autopsies are used down there, I have a pathologist, Dr. Wittic, who comes in from Kenosha County, he's a freelance pathologist, he's been under the local pathologist, do autopsies anymore at the hospitals, they do theirs elsewhere, so Dr. Wittic comes in, does our autopsies here? Oh, thank you for your service, Dave, and I'll turn it over to Adam now. And that morgue, probably is one of the things you'll be able to look back on in your career and know that you really made a difference because I can recall years ago when we were discussing upgrades to that morgue and I didn't even know at the time we had a morgue, it really is tucked away there and it's not used every day of course but when I toured that with you and others, I couldn't believe, it was time, it was time, as you said, just to handle the bodies and I can recall you sharing that if it was a larger individual or just a situation where you almost had to go in and crawl in there with the body, it was just time and obviously your leadership, your staff and then certainly Roger Distruty and the county board, they said, you know what, we need to make these upgrades and I'm pleased to hear you say it's a state of the art and a much better facility. And it provides us office based on there for meeting with families, for families that come in to view the DCs if we need a positive identification, we have a shower and dressing room down there to take care of matters if we need it. Yeah, you know, as Roger said, death is a part of life yet for I think most people, it's a very sad time, it's very uncomfortable, we don't spend a lot of time talking about death yet obviously again a part of life and very important to the family that the body be treated with the utmost respect and I can only imagine the challenging experiences that you must have had during your tenure and the different environments or situations you walked into, but talk a little bit about the next steps after you've made a decision on the manner of death, whether you've had to do an autopsy or not, what have you, but then what are the next steps to care for the body? Well, after we've investigated on scene or at the home, wherever it is, we've done our preliminary work, talk with the family, find out where their wishes are as far as where they want their loved one to go, which funeral home, funeral home will then come, make the removal of that body and take it into their care, family will meet with the funeral home either that day or the next day and the process goes on. And then I understand there's four forms of disposition, what are they? You have burial, earth burial, you have cremation, you have scientific, and you have, you've got me thinking you're, Adam, burial, entombment, mausoleans. Which we probably don't see as frequently here or do we? Cremation, cremation is taking up 45% right now. Burial is probably, the next as entombment probably split it, 25, 25 and 10% is probably scientific donation. But cremation now is the most common form of disposition. I'll be darned, it seems to me we've done this program maybe 10 years ago and it was second. And it increases about 5%, 8% every year. I'll be darned. And then with a cremation situation that you also need to sign off for that. Right. Why is that? The reason for that is with burial or entombment you can always bring the body back from the earth, bring the body out of the mausoleum if there is question. Something comes up, somebody confesses to a murder. The body can be exhumed and reexamined with autopsy. Once you cremate, all you have is the ashes, you cannot go back. So the coroner, the medical examiner does an examination and looks into the cause and manner of death to verify the fact that yes, it was a natural death because again, physician can only sign out naturals and that there is nothing unusual or suspicious about that death. Okay, so if there was something unusual, suspicious or it's undetermined, are those situations where you would then turn to the family and say, I'm sorry but I can't sign off on cremation, you're going to have to do burial or entombment? Well, correct. But if there was something suspicious, we would probably take it to the next step, take it back into our jurisdiction, open up an inquest into the cause and manner of death again. Right, but as you said, sometimes you don't learn about something 10, 15 years later. How common is that? I got to mention it's pretty infrequent that you... Not necessarily around here, some of your bigger cities, more common. And as you look back at your 27 years as coroner, what are some of the biggest changes that you've seen over the years? Well, there's been probably the technology changing, the cooperation between law enforcement, the cohesiveness of the different departments has gotten better over the years, we learn from each other, we're no longer keeping everything to ourselves, we're sharing, that's a big plus. What have you found the most gratifying in this form of public service? The people, we've laughed together, we've cried together, we've prayed together. It's just the feeling that you're helping these families in a time of need. Sometimes it's just a touch of a hand. Sometimes it's an explanation in lay terms, just being there for them. Well, I can't tell you how much we appreciate the work you do and how important the work is. You dropped a little bomb with me during the budget review the other day and said that you're thinking this might be your last term as an elected coroner. So when would your term end? I would be done the first Monday in January 2015. Fall of 2014 would be the election. So that person would take over the first Monday in 2015. Give you an opportunity to sleep through the night without having to necessarily respond to a call. Yeah, yeah, between a coroner for 27 years and operating room nurse for 20 years. My wife is tired of the phone ringing. Yeah, I'm sure, I'm sure. Well, we appreciate you joining us today and talking about the roles and responsibilities of being the county coroner. And on behalf of Roger and myself, again, we thank you for your service. I can only imagine the different scenes you've been a part of and the situations you've been a part of. And it takes a special person, I think, to be able to handle all that. If you ultimately stay to your plans here and choose not to run again, what do you envision as we go forward? Do you think that we should continue? If you're advising the county board today, do you think they should continue with the elected form? Do you think they should have a discussion of whether it's time to go to a medical examiner? What are your thoughts on that? I think they should have a discussion. Obviously, there is a greater cost to a medical examiner system or a potential greater cost. But I think it needs to be looked at, needs to be discussed. There are things in the Wisconsin Corners and Medical Examiner Association that they're looking for throughout our state to maybe go to a regional system. We have one person who oversees three, four or five counties, but then again you would still have people within that county that would handle the day-to-day type of things. But that may still be a ways off. But yeah, I think that the county should sit down and talk, look at it openly. I think that would be a good idea. That's something we may have to do, at least discuss sooner rather than later. Throw out some ideas, pop it over. Well, if you watch this program today and you have an interest in being the corner in the future, or we're thinking, you know, if this day ever retires, I might just throw my hat in the ring. I would encourage you to call David and get a feel for his role's responsibilities and the benefit of his insight and what's all involved and certainly for your four deputies that you have on staff. We certainly appreciate their role as well. I don't know if one of them is going to have an interest in this, but collectively again you're providing such a vital service to the community and it's appreciated. So thanks for joining us today. Thank you. Next month we're going to hear from another very important department head and that's our finance director. David is one of 19. Finance director Terry Hansen is going to be here to talk a little bit about our budget process. Thus far it's going pretty well. Chairman Tostruti once again has established a goal that we're going to strive to hold the line with property taxes, just take net new construction, which is less than 1%. So we're operating a budget with about $130 million, $45 million of which is property tax levy, supporting over 200 programs and services, 825 employees, and striving to maintain quality programs and services with less than a 1% increase in the property tax levy. So a lot of good work being done by our department heads and our team as a whole. And again Terry will be here next month to share a little bit about where we're at and where we're heading and hopefully keep our very successful track record going. So until then, if you have any questions for Mr. David Lafine or any suggestions for this program or would like to learn more about the roles and responsibilities of county governments, certainly don't hesitate to contact your county board supervisor, myself, David, and if not, we'll see you next month. Thanks for joining us.