Typically, the Bexar County medical examiner’s office expects to see its caseload increase 5% each year as the area’s population increases. But in 2020, that workload increase skyrocketed to 17%, Chief Medical Examiner Dr. Kimberley Molina told county commissioners at their Tuesday meeting.

To address the increase, commissioners unanimously approved hiring temporary personnel to the tune of $238,471.

Both population growth and the coronavirus pandemic contributed to the medical examiner office’s increased workload, Molina told commissioners. However, the medical examiner’s office takes on cases where an individual dies “suddenly, violently, [or] unexpectedly,” and most COVID-related deaths don’t go through the medical examiner’s office. They are recorded as natural deaths.

A County spokesperson told the San Antonio Report that Molina was not answering additional questions.

Molina told commissioners that her office investigates about 80% of the deaths in Bexar County.

Molina, who started as the chief medical examiner in July and is also the county’s first female chief medical examiner, said the morgue’s average body count – “the number of bodies we have in our morgue at any one time” – was 48 in 2019. That number increased to 59 in 2020. And 2021’s daily average body count has been 89 so far – and the morgue’s maximum capacity is 113 bodies.

“The reason this is an issue is because, as the bodies build up in our office … we no longer have room,” Molina said. “And unfortunately, if we run out of room then we can’t maintain the integrity of these bodies and of these decedents.”

The approved $238,471 will fund an office assistant, two medical investigator clerks, and some part-time medical examiners between March 1 and Sept. 30. After that, when next year’s budget process begins, Molina said she intends to request four more full-time personnel to be added to the medical examiner’s office.

“Just for comparison, the Harris County medical examiner’s office investigated 15,000 deaths last year in 2020,” she said. “The Bexar County medical examiner’s office investigated 16,000 deaths. … Their medical examiner’s office has a staff of 160 people to investigate their 15,000 deaths. We have a staff of 56. So we investigated more deaths with less than half the staff.”

The County also must add medical examiner staff to keep the office accredited, Molina said. The National Association of Medical Examiners recommends medical examiner offices have enough staff so that no doctor needs to conduct more than 250 autopsies a year. If that workload increases to the point where each doctor must do more than 325, the office risks losing accreditation. The workload per doctor in Molina’s department currently exceeds that, she said. And being accredited affects examiners’ testimony in court when they are called upon to provide it.

“When we testify in court we are an accredited office, which means we have met those criteria and our testimony holds a great deal of weight,” she said.

Commissioners also unanimously approved Tuesday a one-time COVID-related expense of $4 million directed to the Center for Health Care Services, which is dedicated to addressing mental health and substance abuse issues. President and CEO Jelynne Burley said that money would go toward equipment for ventilation, scanners, and additional staffing during the coronavirus pandemic to allow for social distancing.

“The largest amount is going to finish out additional space on the second floor of the Paul Elizondo building so that we can continue to bring all of our patients back to the center … construction should be completed by the end of May,” Burley said.

Jackie Wang covered local government for the San Antonio Report.