As part of the management and performance audit of the Medical Examiner"s Office, the Budget Analyst conducted a public interaction survey to assess the Medical Examiner Office"s interaction with private companies and public agencies, as well as with the public at-large. The survey was designed to obtain qualitative information on whether Medical Examiner staff who interacted with the public were knowledgeable of general procedures and of policies for interacting with next of kin, especially in regards to meeting families cultural and religious needs.

Conducting the public interaction survey involved selecting 15 agencies and contacting those agencies by telephone. Of the agencies contacted, 13 responded to questions by phone or via fax. The 13 respondents included ten funeral homes, one hospice, and two public programs. Not responding to the survey was one funeral home and the Visiting Nurses of San Francisco.

All of the agencies chosen, with the exception of the Department of Public Health"s AIDS Project, also interact with the public at-large. Because of their interaction with the Medical Examiner"s Office and the public at-large, these agencies have the ability to observe the Medical Examiner Office"s interaction with the public from a customer service perspective.

Individuals or families who have had interaction with the Medical Examiner"s Office due to the death of a friend or family member were not contacted for this survey. The Budget Analyst"s audit team concluded that direct communication with individuals or families may infringe upon their privacy, as well as cause them unnecessary personal hardship.

The ten funeral homes and the one hospice, which are located in San Francisco, were chosen randomly. The two public agencies were chosen specifically because of their ability to observe or receive feedback from the public regarding the Medical Examiner"s interaction with the public. In summary, all 13 respondents stated that Medical Examiner staff had adequate knowledge of procedures. Although, one funeral home indicated that administrative staff who answer the telephone and interact with the public were not as well informed about procedures as the investigators. In addition, all 13 respondents indicated that the Medical Examiner"s Office met families" cultural and religious needs, and 12 of the 13 respondents indicated they were satisfied with the performance of the Medical Examiner"s Office.

However, three of the ten funeral directors (as noted by the asterisks) stated that they did not agree with the Medical Examiner"s removal policy. The Medical Examiner"s removal policy consists of charging funeral home $100 per removal of a deceased person and the funeral home is required to bring the check at the time the body is released. These three companies report that the M.E. Office does not inform the family of the removal fee and places this responsibility on the funeral director to communicate and collect the removal fee from the family. If the family doesn"t pay the removal fee, the funeral directors are responsible for reimbursing the Medical Examiner"s Office for the cost of the body removal.

According to the Administrative Coroner, the removal fee policy is communicated to funeral homes when they call in to report a case. The Administrative Coroner reports that the objective is to not burden the families with monetary issues when they come to the coroner"s office. If a family is faced with a financial hardship, the family is encouraged to call the Medical Examiner"s Office and the fee will be waived if financial hardship can be proven.

The following pages contain narrative responses to the question regarding the Investigators" sensitivity to religious and cultural needs of families, raw responses to the survey questions and a listing of the agencies surveyed.

Narrative responses from funeral directors to the question: "Are Medical Examiner personnel respectful of a family"s cultural and religious needs?"

Neptune Society of Northern California
Ms. Kristine Anderson, Manager
"I"ve been very impressed with the [Medical Examiner] Office"s response to different cultures. Herb Hawley will bend over backwards to get things done quickly, and he"s very good at explaining procedures to families."

Sinai Memorial Chapel
Mr. Kaufman, Manager
"The Medical Examiner"s staff bends over backwards to be respectful of both cultural and religious concerns. I do not recall any problems regarding this issue. Families that we have worked with have reported that deputies are very polite and sensitive. We think that the M.E. staff is highly professional."

Valente Marini Perata & Co.
Mr. Matthew Taylor, Manager
"I only remember one incident where a family mentioned that a deputy had been insensitive to their needs, but this is over many, many years."

California Funeral Services
Mr. Kevin Nichols, Owner
"I have not heard any complaints from families about interaction with the [Medical Examiner] staff"s regarding cultural and religious concerns."

DPH, AIDS Project
Laura Hormel, Analyst
"I go to the MEO every Wednesday from 8 a.m. to 11:00 a.m. to gather data for the project. I sit in the front office and have been able to observe staff interact with families. I have never observed unprofessional or inappropriate interaction from staff with the families. Investigators understand protocol and procedures, and investigators seem very helpful and respectful to families."

"The only problem we have had with the department is related to administrative matters. The department does not follow through with obtaining or accessing work order funds."

Survey Questions

1. Does the _____ funeral home/agency interact with the San Francisco Medical Examiner"s Office?

1a. If yes, how many removals per month?

2. What is the scope of the interaction with the M.E. Office?

3. Which staff personnel do you work with?

4. Are personnel knowledgeable of the procedures and/or legal requirements involved in the interaction?

5. Are personnel respectful of a family"s cultural/religious needs?

5a. Describe your observation of M.E. personnel interacting with next of kin.

6. Did the office perform its work satisfactorily?

6a. Did the office meet your company"s expectations?

Public Interaction Survey
Company	No. of removals per month (avg.)	Personnel Interaction	Adequate knowledge of procedures	Meet families" cultural/Religious needs	Is the dept"s. work satisfactory?	Did M.E. Office meet expectations.
Bayview Mortuary	5	Admin. Cor./deputy	yes	yes	yes*	yes
Valente Marini Perata & Co.	5	deputy/admin.staff	deputy-yes admin-sometimes	yes	yes*	yes
Neptune Society	25	Admin.Cor./deputy	yes	yes	yes	yes
Anderson"s Funeral Parlors	3	admin. staff/ autopsy techs	yes	yes	yes	yes
Daphne Funerals (responded by fax)	6	admin. staff/autopsy techs/deputy	yes	yes	did not answer	yes
Sinai Memorial Chapel	3	deputy/admin. staff	yes	yes	yes	yes
California Funeral Services	13	deputy/autopsy techs	yes	yes	yes*	yes
Sullivan"s	3	deputy/admin. staff	yes	yes	yes	yes
Hospice by the Bay	15	Coroner	yes	yes	yes	yes
McAvoy O"Hara Mortuary	10	deputy	yes	yes	yes	yes
Driscoll"s Mortuary	info not available	deputy/admin. staff	yes	yes	yes	yes
UCSF Willed-Body Program	3	admin coroner	yes	Program has not received any complaints.	yes	yes
DPH, AIDS Project	60 blood samples	pathologists/admin	yes	yes	yes	yes

Public Interaction Survey

California Funeral Service
Mr. Kevin Nichols, Owner
647-3900 1465 Valencia Street, S.F.

Anderson"s Funeral Parlors
Mr. Alan Haley. Mgr.
647-0150 1387 Valencia Street, S.F.

Bayview Mortuary
Mr. James Leverett, Mgr.
822-2820 5187 Third Street

Valente Marini Perata & Co Funeral Driectors
Mr. Matthew Taylor, Mgr.
333-0161 4840 Mission

Neptune Society of Northern California
Ms. Kristine Anderson, Mgr.
771-0717 2740 Hyde Street

Cathay Wah Sang
Ms. Nikki Daphne, Owner
982-1213

Washington Mortuary
Mr. Washington, Owner
(Did not respond to survey)
648-4585 1641 LaSalle Ave

Mc Avoy O"Hara Co- Evergreen Mortuary
Mr. Dan O"Hara, Owner
668-0077 4545 Geary Blvd.

Driscoll"s Mortuary Chapel
Mr. Andrew Spyrow, Manager
826-6300 1096 South Van Ness Ave.

Sinai Memorial Chapel
Mr. Kaufman, Manager
921-3636 1501 Divisadero

Sullivan"s
Mr. Jim Sullivan, Co-Owner
621-4567 2254 Market Street

Visiting Nurses of San Francisco
Ms. Ellen Allan, Director
(Did not respond to survey)
750-4404

Hospice by the Bay
Mr. Bob Osborne, Patient Care Coordinator
626-5900

U.C.S.F."s Willed Body Program
Ms. Dori Tico, Curator
476-1981

City of San Francisco Depart. of Public Health
AIDS Project
Julian Nari, Laura Hormel, Analysts
554-2880