Section 641.127.7. County medical examiner investigators.

         127.7(1) Appointment. A county medical examiner may appoint one or more county medical examiner investigators upon approval by the board of supervisors and the state medical examiner.

         127.7(2) Qualifications.

            a.                Prior to appointment, a CME-I should possess a minimum of two years of experience as a licensed or certified nurse or medical care provider. A certified peace officer may be appointed to the position of CME-I if a nurse or medical care provider is not available.

            b.                A CME-I shall satisfy the following criteria:

       (1)       Prior to or within two years of appointment, attend the St.          Louis University School of Medicine Basic Medicolegal Death Investigation Course or its state medical examiner-approved equivalent; and

             (2)              Prior to or within five years of appointment, obtain certification at the registry-level as a death investigator by the American Board of Medicolegal Death Investigators.

            c.                A CME-I is not required to meet the requirements of paragraph “a” or “b” if the individual has functioned in the capacity of a CME-I for a period of five years as of January 1, 2002.

            d.                If a CME is unable to appoint a CME-I who possesses the qualifications required by paragraph “a,” “b,” or “c,” the CME may request a waiver. Waiver requests shall be submitted in writing to the state medical examiner and shall include the efforts undertaken by the CME to locate a CME-I who meets the above qualifications; the qualifications of the individual willing to serve in the capacity of CME-I; and the period of time for which the waiver is requested, not to exceed two years. The state medical examiner has sole discretion to waive the requirements of this rule and may withdraw or modify a waiver request upon a finding that the CME-I has failed to adequately perform the duties of the position or for other good cause.

            e.                If a CME-I is unable to meet the eligibility requirements for obtaining registry certification due to the small number of cases requiring investigation in the county of appointment, then a waiver shall be obtained from the state medical examiner in order for the investigator to continue his or her duties. The county medical examiner shall submit a request for a waiver in writing with documentation of the number of deaths occurring in the county of appointment which require death investigation. The waiver must be renewed every five years if the required number of investigations has still not been achieved.

         127.7(3) Duties. A CME-I shall assist in death investigations. A CME-I acting under the supervision of a county medical examiner may sign the Form ME-1. A CME-I shall not sign a certificate of death or a Form ME-5.

         127.7(4) Supervision. A CME-I shall serve under the supervision of a county medical examiner. A CME-I provides services under the direction of a county medical examiner or state medical examiner’s office. A CME-I shall at all times perform services in a manner which is consistent with the protocol outlined in the most current edition of the County Medical Examiner’s Handbook and any policies or protocols of the supervising county medical examiner.

         127.7(5) Fees. Fees for the services provided by a CME-I shall be paid by the county of appointment or by the county of the decedent’s residence. A CME-I shall also receive from the county of appointment or the county of the decedent’s residence reimbursement for actual expenses. The fee and expenses shall be submitted by the CME-I to the county of appointment, which may immediately pay the invoice or forward the invoice to the county of the decedent’s residence for payment to the CME-I. If the CME-I does not receive payment from the county of the decedent’s residence within 60 days of receiving the invoice, the county of appointment shall pay the invoice.

[ ARC 8526B , IAB 2/10/10, effective 3/17/10;    ARC 2841C , IAB 12/7/16, effective 1/11/17]