wa-law.org > bill > 2023-24 > SB 5523 > Substitute Bill

SB 5523 - Forensic pathologists

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Section 1

Forensic pathologists are medically trained doctors who perform autopsies. For the last decade, there has been a persistent shortage in forensic pathologists both locally and nationally and this problem has only grown worse. It is the intent of the legislature to incentivize people to enter the profession by alleviating the student loan burden for medically trained forensic pathologists.

Section 2

The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.

  1. "Council" means the Washington state forensic investigations council created in chapter 43.103 RCW.

  2. "Department" means the Washington state department of health.

  3. "Identified shortage areas" means those areas where qualified forensic pathologists are in short supply because of geographic maldistribution or where vacancies exist that may compromise death investigations. The council, with assistance from the department, shall determine shortage areas.

  4. "Loan repayment" means a loan that is paid in full or in part if the participant renders services as a qualified forensic pathologist as defined by the department.

  5. "Office" means the office of student financial assistance.

  6. "Participant" means a board-certified forensic pathologist who has commenced working in or is committed to working in identified shortage areas in the state of Washington for their required service obligation.

  7. "Required service obligation" means an obligation by the participant to provide services as a board-certified forensic pathologist in identified shortage areas as determined by the council. Participants must provide an additional 12 months of service after receipt of their last loan repayment.

  8. "Satisfied" means paid-in-full.

Section 3

  1. The forensic pathology loan repayment program is established for board-certified forensic pathologists providing services for counties in identified shortage areas.

  2. The office, with the council, shall:

    1. Select board-certified forensic pathology participants to participate in the forensic pathology repayment program;

    2. Adopt rules and develop guidelines to administer the program;

    3. Collect and manage repayments from participants who do not meet their service obligations under this chapter;

    4. Publicize this program, to maximize participation by individuals in identified shortage areas;

    5. Solicit and accept grants and donations from the public and private resources for the program; and

    6. Develop criteria for a contract for service in lieu of the service obligation where appropriate, that may be a combination of service and payment.

Section 4

  1. The department, in consultation with the council and other pertinent stakeholders, may provide technical assistance to counties desiring to become sponsoring communities for the purposes of identification of prospective students for the forensic pathology loan repayment program, assisting prospective students to apply to an eligible education and training program, making formal agreements with prospective students to provide services as a board-certified forensic pathologist, forming agreements between rural and underserved counties in a service area to share credentialed forensic pathology professionals, and fulfilling any matching requirements.

  2. From the amounts appropriated to the department, the department shall enter into a contract for a two-year marketing plan with the Washington association of coroners and medical examiners for the sole purpose of marketing Washington state to potential board-certified forensic pathologists. The marketing plan must include, but is not limited to, a focus on rural and underserved counties. Paying for administrative expenses may not exceed two percent of the appropriated funds.

Section 5

The office shall establish a planning committee to assist in developing criteria for the selection of participants for the forensic pathology loan repayment program. The office shall include on the planning committee representatives of the department, the council, and other appropriate public and private agencies and organizations.

Section 6

  1. The department and the council, with the office, shall establish the annual loan repayment amount for each eligible board-certified forensic pathologist from the funds appropriated, based upon an assessment of reasonable eligible expenses involved in training and education up to $25,000 annually. The awards shall not be paid for more than a total of four years per participant. The annual award amount shall be established by the office.

  2. Funds appropriated for the forensic pathologist loan repayment program, including reasonable administrative costs, may be used by the office for the purposes of loan repayments. The office shall annually establish the total amount of funding to be awarded for loan repayments and such allocations shall be established based upon the best utilization of funding for that year.

Section 7

Participants in the forensic pathologist loan repayment program who are awarded loan repayments shall receive payment for the purpose of repaying educational loans secured while attending a program of training which led to a credential as a qualified forensic pathologist in the state of Washington.

  1. Participants shall agree to meet the required service obligation.

  2. Repayment shall be limited to eligible educational and living expenses as determined by the office and shall include principal and interest.

  3. Loans from both government and private sources may be repaid by the program. Participants shall agree to allow the office access to loan records and to acquire information from lenders necessary to verify eligibility and to determine payments. Loans may not be renegotiated with lenders to accelerate repayment.

  4. Repayment of loans established pursuant to the forensic pathologist loan repayment program shall begin no later than 90 days after the individual has become a participant. Payments shall be made quarterly, or more frequently if deemed appropriate by the office, to the participant until the loan is repaid or the participant becomes ineligible due to discontinued service in an identified shortage area, or after the required service obligation when eligibility discontinues, whichever comes first.

  5. Should the participant discontinue service in an identified shortage area, payments against the loans of the participants shall cease to be effective on the date that the participant discontinues service.

  6. Except for circumstances beyond their control, participants who serve less than the required service obligation shall be obligated to repay to the program an amount equal to the unsatisfied portion of the service obligation, or the total amount paid by the program on their behalf, whichever is less. This amount is due and payable immediately. Participants who are unable to pay the full amount due shall enter into a payment arrangement with the office, including an arrangement for payment of interest. The maximum period for repayment is 10 years. The office shall determine the applicability of this subsection. The interest rate shall be determined by the office and be established by rule.

  7. The office is responsible for the collection of payments made on behalf of participants from the participants who discontinue service before completion of the required service obligation. The office shall exercise due diligence in such collection, maintaining all necessary records to ensure that the maximum amount of payment made on behalf of the participant is recovered. Collection under this section shall be pursued using the full extent of the law, including wage garnishment if necessary.

  8. The office shall not be held responsible for any outstanding payments on principal and interest to any lenders once a participant's eligibility expires.

  9. The office shall temporarily or, in special circumstances, permanently defer the requirements of this section for eligible students as defined in RCW 28B.10.017.

  10. The office shall establish an appeal process by rule.

Section 8

The forensic pathologist loan repayment account is created in the custody of the state treasurer. All receipts from the program must be deposited in the account. Only the office, or its designee, may authorize expenditures from the fund. The fund is subject to allotment procedures under chapter 43.88 RCW, but no appropriation is required for expenditures.

Section 9

The department of health shall contract with the Washington association of coroners and medical examiners to: Conduct a study of the critical shortage of board-certified forensic pathologists and recommend to the legislature what steps the state can take to foster a robust forensic pathology community. The study shall cover issues related to Conrad 30 J-1 visa waivers and measures to encourage enrollment in the University of Washington and Washington State University forensic pathology residency programs. This study must also include recommendations on how to create two new forensic pathology fellow slots, one in conjunction with the University of Washington and one in conjunction with Washington State University. The Washington association of coroners and medical examiners shall directly report its findings and recommendations to the governor and the appropriate committees of the legislature by October 1, 2024.

Section 10

(1) Money in the treasurer's trust fund may be deposited, invested, and reinvested by the state treasurer in accordance with RCW 43.84.080 in the same manner and to the same extent as if the money were in the state treasury, and may be commingled with moneys in the state treasury for cash management and cash balance purposes.

Section 11

  1. The cost of autopsy shall be borne by the county in which the autopsy is performed, except when requested by the department of labor and industries, in which case, the department shall bear the cost of such autopsy.

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    1. Except as provided in (b) of this subsection, when the county bears the cost of an autopsy, it shall be reimbursed from the death investigations account, established by RCW 43.79.445, as follows:

      1. Up to 40 percent of the cost of contracting for the services of a pathologist to perform an autopsy;

      2. Up to 30 percent of the salary of pathologists who are primarily engaged in performing autopsies and are (A) county coroners or county medical examiners, or (B) employees of a county coroner or county medical examiner;

      3. 100 percent of the cost of autopsies conducted under RCW 70.54.450; and

      4. Up to 40 percent of the cost of transportation of remains to and from facilities accredited pursuant to RCW 36.24.210 for the purpose of autopsy services.

    2. When the county bears the cost of an autopsy of a child under the age of three whose death was sudden and unexplained, the county shall be reimbursed for the expenses of the autopsy when the death scene investigation and the autopsy have been conducted under RCW 43.103.100 (4) and (5), and the autopsy has been done at a facility designed for the performance of autopsies.

  3. Payments from the account shall be made pursuant to biennial appropriation: PROVIDED, That no county may reduce funds appropriated for this purpose below 1983 budgeted levels.

  4. Where the county coroner's office or county medical examiner's office is not accredited pursuant to RCW 36.24.210, or a coroner, medical examiner, or other medicolegal investigative employee is not certified as required by RCW 36.24.205 and 43.101.480, the state treasurer's office shall withhold 25 percent of autopsy reimbursement funds until accreditation under RCW 36.24.210 or compliance with RCW 36.24.205 and 43.101.480 is achieved.


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