2026 -- S 2891 SUBSTITUTE A

========

LC005345/SUB A

========

     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2026

____________

A N   A C T

RELATING TO HEALTH AND SAFETY -- OFFICE OF STATE MEDICAL EXAMINERS

     Introduced By: Senators Urso, Ciccone, Appollonio, Famiglietti, Patalano, and Raptakis

     Date Introduced: March 04, 2026

     Referred To: Senate Health & Human Services

     (Dept. of Health)

It is enacted by the General Assembly as follows:

     SECTION 1. Sections 23-4-1, 23-4-2, 23-4-3, 23-4-4, 23-4-5, 23-4-6, 23-4-7, 23-4-8, 23-

4-9, 23-4-10, 23-4-11, 23-4-13, 23-4-14 and 23-4-15 of the General Laws in Chapter 23-4 entitled

"Office of State Medical Examiners" are hereby amended to read as follows:

     23-4-1. Definitions.

     (a) “Assistant medical examiner” means a duly licensed doctor of medicine or doctor of

osteopathy appointed to assist the office of state medical examiners on a part-time basis in a medical

examiner role subordinate to the chief medical examiner.

     (b) “Autopsy” means the external inspection of a dead body and subsequent dissection of

a dead body and the removal and examination of bone, tissue, organs, and foreign objects, internal

examination and collection of specimens and relevant foreign objects, for laboratory and/or other

forensic testing as deemed necessary for the purpose of determining the condition of the body and

the cause and the manner of the death.

     (c) “Cause of death” means the agent that has directly or indirectly resulted in a death the

disease, condition, or injury that initiated the chain of events that led directly to the death.

     (d) “Death investigation” means the investigation into a death that falls to the jurisdiction

of the office of state medical examiners to the extent necessary to establish the cause and manner

of death with a reasonable degree of medical certainty. Death investigations may include, but are

not limited to, death scene investigation, review of medical records, external inspection, autopsy,

and postmortem testing.

     (e) “External inspection” means an external examination of a dead body without dissection.

Specimens such as blood may be collected during an external inspection to assist with determining

the cause and manner of death.

     (d)(f) “Inquest” means an official judicial inquiry before a medical examiner and/or

medical examiners jury for the purpose of determining the manner of death.

     (g) "Interested person" for the purposes of this Title shall mean spouse or registered

domestic partner, sibling(s) if over eighteen (18) years of age, parent(s) or guardian(s),

grandparent(s), or his or her children, grandchildren, or great grandchildren over (18) years of age,

or guardian of the deceased person at the time of the deceased person's death.

     (e)(h) “Manner of death” means the means or fatal agency that caused a death how the

death occurred. Manner of death includes, but is not limited to, homicide, suicide, natural, accident,

or undetermined.

     (i) “Physician” means any person licensed to practice allopathic or osteopathic medicine

pursuant to the provisions of chapter 37 of title 5.

     (f)(j) “Postmortem examination” means examination of the decedent’s body or remains

after death and includes an examination of the dead body and surroundings by an agent of the office

of state medical examiners but does not include dissection of the body for any purpose either an

external inspection, partial autopsy, or a full autopsy.

     (g)(k) “Work product” means preliminary drafts, notes, impressions, memoranda, working

papers, and similar documents of a governmental entity, whether in electronic or other another

format.

     23-4-2. Establishment of office.

     (a) There is established in the department of health the office of state medical examiners.

The director of health, with the advice of the state medical examiners commission, is authorized to

adopt, amend, promulgate, and enforce rules, and regulations, and standards that may be designed

to further the accomplishment of the purposes of this chapter.

     (b) The office of state medical examiners shall obtain and maintain accreditation by the

National Association of Medical Examiners (NAME) or other national accrediting organization in

the field of forensic medicine and pathology medical examiner death investigation systems.

     23-4-3. Functions.

     The office of state medical examiners shall be responsible for:

     (1) The investigation of deaths occurring within the state that, in its judgment, might

reasonably be expected to involve causes or manners of death enumerated in this chapter;

     (2) For the conduct of inquests when requested by the attorney general;

LC005345/SUB A - Page 2 of 15

     (3) For the performance of autopsies postmortem examinations, including the retention,

examination, and appropriate disposal of tissue, when appropriate, for deaths that, in its judgment,

might reasonably be expected to involve causes or manners of deaths enumerated in this chapter;

     (4) For the written determination of the causes and manners of death investigated pursuant

to this chapter;

     (5) For the presentation to the courts of Rhode Island of expert testimony relating to the

cause and manner of death enumerated in this chapter;

     (6) For the keeping of complete records, including names decedent name, places location

of death, circumstances of death, and causes and manners of all deaths, of deaths investigated and

reported, copies of which shall be delivered to the attorney general and of which written

determinations of causes of death shall be made available for public inspection;

     (7) For the burial of bodies for which there is no other existing legal responsibility to do so

For approving organ and tissue donation to the extent possible from decedents whose deaths are

being investigated by the office of state medical examiners; provided that, such donation will not

interfere with the ability to determine cause or manner of death with a reasonable degree of medical

certainty;

     (8) For the development and enforcement of procedures for the pronouncement of death

and for the transplantation of organs from bodies of persons who have died within the state For

making available the death investigation case information necessary to compile the case studies

that will be reviewed by the respective multidisciplinary death review teams enumerated in this

chapter;

     (9)(i) For supporting a multidisciplinary team review of child fatalities administered by the

department of health with the goal to decrease the prevalence of preventable child deaths and report

recommendations for community- and systems-intervention strategies. A child death-review team

shall include, but is not limited to, representation from state agencies, health care, child welfare,

and law enforcement; and

     (ii) The work product of the child death-review team shall be confidential and protected

under all applicable laws, including the federal Health Insurance Portability and Accountability Act

of 1996 and the Rhode Island confidentiality of health care information act (chapter 37.3 of title 5)

and shall be exempt from the provisions of chapter 2 of title 38 and shall be deemed privileged

pursuant to § 23-17.21-8;

     (10) The department of health shall work with the department of children, youth and

families and the office of the child advocate to develop a process to ensure the timely availability

of autopsy reports on child deaths;

LC005345/SUB A - Page 3 of 15

     (11)(i) For supporting a multidisciplinary team review of drug-related overdose deaths

administered by the department of health with the goal of reducing the prevalence of these deaths

by examining emerging trends in overdose, identifying potential demographic, geographic, and

structural points for prevention, and other factors. The multidisciplinary team for review of drug-

related overdose deaths may include, as determined by the director of the department of health,

representatives from the department of health; the department of the attorney general; the Rhode

Island state police; the department of corrections; the department of behavioral healthcare,

developmental disabilities and hospitals; the Rhode Island Police Chiefs Association; the Hospital

Association of Rhode Island; an emergency department physician; a primary care physician; an

addiction medicine/treatment provider; a mental health clinician; a toxicologist; a recovery coach

or other representative of the recovery community; and others as may be determined by the director

of the department of health;

     (ii) The work product of the multidisciplinary team for review of drug-related overdose

deaths shall be confidential and protected under all applicable laws, including the federal Health

Insurance Portability and Accountability Act of 1996 and the Rhode Island confidentiality of health

care information act (chapter 37.3 of title 5), and shall be exempt from the provisions of chapter 2

of title 38, not subject to subpoena, discovery, or introduction into evidence in any civil or criminal

proceeding, and not subject to disclosure beyond the team members (except to authorized

employees of the department of health as necessary to perform its official duties pursuant to this

subsection (11));

     (iii) The multidisciplinary team shall report on or before December 1 of each year to the

governor, the speaker of the house, and president of the senate, which report shall summarize the

activities of the team, as well as the team’s findings, progress towards reaching its goals, and

recommendations for any needed changes in legislation or otherwise;

     (iv) [Deleted by P.L. 2021, ch. 21, § 1 and P.L. 2021, ch. 22, § 1.]

     (v) The multidisciplinary team, or Rhode Island department of health state employees

appointed by the director of the department of health, shall, as relatives of the deceased are willing,

be empowered to gather information from such consenting relatives regarding the circumstances of

the decedent’s death. The information gathered shall remain confidential and publicly released as

aggregate de-identified information. The information gathered will be utilized to help identify

specific prevention and intervention strategies to prevent further deaths. The information gathered

shall not be subject to subpoena, discovery, or introduction into evidence in any civil or criminal

proceeding, and shall not be subject to disclosure beyond the team members except to authorized

employees of the department of health as necessary to perform its official duties pursuant to this

LC005345/SUB A - Page 4 of 15

subsection (11), and except as aggregate de-identified information;

     (12)(i) For supporting a multidisciplinary maternal mortality review committee

administered by the department of health for review of maternal deaths of women that occur during

pregnancy, delivery, or within one year of the end of pregnancy with the goal of reducing the

prevalence of such deaths by examining emerging trends in such deaths, identifying potential

demographic, geographic, and structural points for prevention, and other factors. This committee

has the authority to request and receive data from vital records, healthcare providers, healthcare

facilities, pharmacy records, and any other agencies or officials having information that is necessary

for the committee to carry out its duties under this section. The multidisciplinary maternal mortality

review committee shall include, but not be limited to, as determined by the director of the

department of health, representation from state agencies; an obstetric provider from each hospital

that delivers obstetrical care; a neonatal specialist; individuals or organizations that represent the

populations that are most affected by pregnancy-related deaths or pregnancy-associated deaths and

lack of access to maternal healthcare services; a perinatal pathologist; and a maternal fetal medicine

specialist. This committee shall develop recommendations for the prevention of maternal deaths

and disseminate findings and recommendations to policy makers, healthcare providers, healthcare

facilities, and the general public;

     (ii) The work product of the maternal mortality review committee shall be confidential and

protected under all applicable laws, including the federal Health Insurance Portability and

Accountability Act of 1996 and the Rhode Island confidentiality of health care information act

(chapter 37.3 of title 5) and shall be exempt from the provisions of chapter 2 of title 38 and shall

be deemed privileged pursuant to § 23-17.21-8; and

     (13)(i) For supporting a multidisciplinary team review of suicide deaths administered by

the department of health with the goal of reducing the prevalence of these deaths by examining

trends in demographic, geographic, community, and structural protective and risk factors. The

multidisciplinary team may include, as determined by the director of the Rhode Island department

of health (RIDOH), representatives from the office of the state medical examiners, RIDOH’s

violence and injury prevention program, the department of behavioral healthcare, developmental

disabilities and hospitals, emergency medical services, law enforcement, health care, and others as

may be determined by the director of the department of health;

     (ii) The work product of the adult suicide fatality review team shall be confidential and

protected under all applicable laws, including the federal Health Insurance Portability and

Accountability Act of 1996 and chapter 37.3 of title 5 (the “Rhode Island confidentiality of health

care communications and information act”) and shall be exempt from the provisions of chapter 2

LC005345/SUB A - Page 5 of 15

of title 38 (“access to public records”) and shall be deemed privileged pursuant to § 23-17.21-8,

not subject to subpoena, discovery, or introduction into evidence in any civil or criminal

proceeding, and not subject to disclosure beyond the team members (except to authorized

employees of the department of health as necessary to perform its official duties pursuant to this

subsection (13));

     (iii) The multidisciplinary team shall be responsible for developing annual

recommendations for the state suicide prevention coalition and/or the state agency(ies) responsible

for suicide prevention in Rhode Island. The recommendations should align with the Rhode Island

suicide prevention state plan and shall outline, based on suicide fatality case review data, potential

strategies to increase protective factors and decrease risk factors to reduce suicide deaths in Rhode

Island.

     23-4-4. Jurisdiction.

     The office of state medical examiners shall have the authority to make postmortem

examinations conduct death investigations, to undertake inquests, and to perform autopsies

postmortem examinations in all deaths occurring in Rhode Island where there may be in its

judgment a reasonable belief that the manner of death could be pronounced as:

     (1) Death by a homicide, suicide, or casualty accident, undetermined or unusual manner;

     (2) Death due to a criminal abortion;

     (3) Death due to an accident involving lack of due care on the part of a person other than

the deceased;

     (4)(2) Death which is the immediate or remote consequences of any physical or toxic injury

incurred while the deceased person was employed;

     (5)(3) Death due to the use of addictive illegal drugs, prescription drugs, non-prescription

drugs, medicinal substances, or other identifiable or unidentifiable chemical agents, including

toxins and toxicants; or

     (6)(4) Death due to an infectious agent capable of spreading an epidemic within the state;

or

     (5) Death that is sudden or unexpected when the decedent was in apparent good health;

     (6) Death that occurred under circumstances reportable to the office of state medical

examiners as enumerated in this chapter or as described in rules promulgated by the department.

     23-4-5. Chief medical examiner — Assistants and other staff.

     (a) The office shall be under the immediate supervision of a chief, who shall be known as

the “chief medical examiner” and who shall be a physician licensed under the provisions of chapter

37 of title 5, and a qualified forensic pathologist certified by the American Board of Pathology in

LC005345/SUB A - Page 6 of 15

both anatomic and forensic pathology and who has had forensic training or pathology experience.

He or she shall be appointed by the director of health as shall the deputy chief medical examiner

with the advice of the medical examiner’s commission. The chief medical examiner shall be in the

unclassified service and the deputy chief medical examiner shall be in the classified service.

     (b) The chief medical examiner shall appoint, with the approval of the director of health,

assistant deputy medical examiners and shall hire other staff as necessary to carry out the provisions

of this chapter.

     (c) Persons employed full time at the time of enactment of this chapter within the division

of medical examiners in the department of the attorney general shall be transferred to the office of

state medical examiners with their former rights and privileges of employment. For members

eligible to retire on or before June 30, 2012, such members shall be eligible for retirement benefits

after the age of fifty (50) years and service of twenty (20) years, including service within the

division of medical examiners. For members eligible to retire on or after July 1, 2012, such

members shall be eligible for retirement benefits in accordance with chapters 8 through 10 of title

36.

     23-4-6. State medical examiners commission. State postmortem advisory commission.

     (a) There is established the state medical examiners postmortem advisory commission. The

commission shall hear and determine appeals to decisions by the chief medical examiners examiner

regarding the undertaking of investigations, inquests, and autopsies, and shall advise the chief

medical examiner on matters of public concern cause and manner of death.

     (b) The commission shall consist of twelve (12) a panel of seven (7) members, three (3) of

whom shall be ex officio members, viz., the director of health, the attorney general, the

superintendent of state police, and nine (9) citizens of the state to be to include the Rhode Island

attorney general or designee from the office of attorney general, with the remainder of members

appointed by the governor with the advice and consent of the senate for the a term of three (3)

years. Criteria for appointment must include that the remaining members be a physician, preferably

with experience in performing autopsies to determine cause of death and who must not have been

or currently employed or retained as an independent contractor by the office of state medical

examiners within one year after employment or retainment as an independent contractor has ceased.

The governor shall give due consideration to any recommendations for nominations submitted to

him or her by the president of the Rhode Island Medical Society, the president of the Rhode Island

Society of Pathologists, the president of the Rhode Island Bar Association, board-certified

pathologists, preferably forensic pathologists, and the vice president of Brown University Division

of Biological and Medical Sciences and the president of the Rhode Island Funeral Directors

LC005345/SUB A - Page 7 of 15

Association. Each citizen member shall hold office for the term of his or her their appointment and

until his or her successor is appointed. Vacancies for citizen members shall be filled by appointment

for the unexpired term only The members shall serve without compensation. If a commission

member has a conflict of interest, that member must recuse themselves from hearing and

determining appeals to decisions by the chief medical examiner regarding the cause and manner of

death. The administrator of the office of the state medical examiners, or the administrator’s

designee, shall serve as administrator of the commission to provide technical and administrative

support.

     (c) The director of health and the attorney general shall be the chairperson and vice

chairperson, respectively, of the commission. The chief medical examiner of the office of state

medical examiners shall serve as the executive secretary of the commission, and the expenses of

the commission shall be a responsibility of the department of health. The board may elect from

among its members such other officers as it deems necessary. Seven (7) members of the board shall

constitute a quorum and the vote of a majority of those present and voting shall be required for

action. The commission shall meet at the call of its chairperson and at least four (4) times each year,

the time and the place for each meeting to be fixed by the chairperson. Except in a case of a finding

of homicide, a person of interest may request the office of state medical examiners to make

amendments to findings and conclusions on the cause and manner of death recorded on a certificate

of death within sixty (60) days after a medical examiner certifies the death certificate. The request

to amend the findings and conclusions of a death certificate shall:

     (1) Be in writing to the chief medical examiner;

     (2) Clearly describe the requested amendment;

     (3) State the reason for the change; and

     (4) Provide a return address.

     (d) Members of the commission shall be removable by the governor pursuant to the

provisions of § 36-1-7 of the general laws and for cause only, and removal solely for partisan or

personal reasons unrelated to capacity or fitness for the office shall be unlawful. Within sixty (60)

days of receiving the request in writing, the chief medical examiner shall provide the person of

interest written notice of the action taken.

     (e) Within ninety (90) days after the end of each fiscal year, the commission shall approve

and submit an annual report to the governor, the speaker of the house of representatives, the

president of the senate, and the secretary of state, of its activities during that fiscal year. The report

shall provide an operating statement summarizing meetings or hearings held, including meeting

minutes, subjects addressed, decisions rendered, appeals considered and their disposition, rules or

LC005345/SUB A - Page 8 of 15

regulations promulgated, studies conducted, policies and plans developed, approved, or modified,

and programs administered or initiated; a consolidated financial statement of all funds received and

expended including the source of the funds, a listing of any staff supported by these funds, and a

summary of any clerical, administrative or technical support received; a summary of performance

during the previous fiscal year including accomplishments, shortcomings and remedies; a synopsis

of hearing, complaints, suspensions, or other legal matters related to the authority of the

commission; a summary of any training courses held pursuant to this chapter; a briefing on

anticipated activities in the upcoming fiscal year; and findings and recommendations for

improvements. The report shall be posted electronically on the websites of the general assembly

and the secretary of state pursuant to the provisions of § 42-20-8.2. The director of the department

of administration shall be responsible for the enforcement of the provisions of this subsection. If

the chief medical examiner denies the written request to amend findings and conclusions on the

cause and/or manner of death, the person of interest may appeal the denial in writing within fifteen

(15) days to the director of health. The director shall refer the matter within fifteen (15) days of the

receipt of the appeal request to the state postmortem advisory commission.

     (f) The commission shall conduct a training course for newly appointed and qualified

members within six (6) months of their qualification or designation. The course shall be developed

by the chair of the commission, be approved by the commission, and be conducted by the chair of

the commission. The commission may approve the use of any commission and/or staff members

and/or individuals to assist with training. The training course shall include instruction in the

following areas: the provisions of chapters 42-46, 36-14 and 38-2; and the commission’s rules and

regulations. The director of the department of administration shall, within ninety (90) days of June

16, 2006, prepare and disseminate training materials relating to the provisions of chapters 42-46,

36-14, and 38-2. The state postmortem advisory commission shall conduct a hearing on the denial

and on the establishment of the amendments to the findings and conclusions on the cause and/or

manner of death.

     (g) Upon reviewing the findings of fact submitted to the state postmortem advisory

commission, the commission shall recommend a decision to the director of health. The director

shall issue a final administrative order within sixty (60) days to:

     (1) Adopt the recommendation of the commission; or

     (2) Reject the recommendation of the commission and affirm the original findings of the

chief medical examiner.

     (h) The director’s order shall constitute a final administrative order. If the director rejects

the recommendation of the commission, the person of interest may appeal the final administrative

LC005345/SUB A - Page 9 of 15

order to the Rhode Island superior court.

     (i) If the final decision of the director, or the decision upon final adjudication on appeal

establishes a different finding or conclusion on the cause or manner of death, the chief medical

examiner shall amend the death certificate to reflect the change in finding or conclusion. The chief

medical examiner shall send a request to amend the death certificate to reflect the final decision to

the state registrar of vital records pursuant to § 23-3-4. The registrar of vital records shall amend

the death certificate to reflect the final decision.

     (j) The final decision of the director, or of the court, may not give rise to any presumption

concerning the application of any provision of or the resolution of any claim concerning a policy

of insurance relating to the deceased.

     (k) If the findings of the chief medical examiner are upheld by the director, the appellant

is responsible for the costs of the contested case hearing based on the billing rates established by

the department of health pursuant to § 23-4-13.

     23-4-7. Reporting of certain deaths required — Violations — Penalties.

     (a)(1) Where any person shall die in any manner to suggest the possibility of a criminal act

or as the result of violence or apparent suicide, or from a criminal abortion or in any suspicious or

unusual manner or circumstances enumerated in § 23-4-4, it shall be the duty of any person having

knowledge of those deaths to immediately notify the police of the city or town where the body of

the deceased person lies or to notify the office of state medical examiners. The same procedure

shall be followed upon discovery of anatomical material suspected of being or determined to be a

part of a human body.

     (2) Any person who willfully neglects or refuses to report that death or who without an

order from an agent of the office of medical examiners willfully touches, removes, or disturbs the

body of that dead person, or willfully touches, removes, or disturbs the clothing or any article upon

or near that body, shall be guilty of a misdemeanor shall be reported to the appropriate law

enforcement agency. The body shall not be disturbed without authorization of the medical examiner

except in those cases in which a possibility of life remains, whereupon the law enforcement officer

or appropriate emergency medical services personnel on the scene shall initiate and facilitate such

lifesaving procedures as may be appropriate. After death is declared or pronounced, the body is not

to be disturbed, and nothing is to be removed from the body without authorization of the medical

examiner.

     (b) If any person buries or causes to be buried the dead body of a person supposed to have

come to a violent death before giving notice as stated in subsection (a) and before inquiry is made

into the manner and circumstances of the death, that person shall be guilty of a misdemeanor that

LC005345/SUB A - Page 10 of 15

person shall be reported to the appropriate law enforcement agency.

     (c) When any person may appear to have met death when unattended by a physician, or in

any unnatural manner, or as the apparent result of the negligence of another person, or as the

consequence of any physical or toxic injury incurred while employed, or from the use of any

addictive or unidentifiable chemical agent, or from accidental hypothermia, or from an infectious

agent capable of spreading an epidemic within the state circumstances or manners enumerated in §

23-4-4, it shall be the duty of any physician, law enforcement officer, funeral director, hospital

official having knowledge of the death, or of any other person having responsibility for burial or

cremation of the deceased person to notify the office of the state medical examiners. In the case of

any prisoner committed by law to the custody of the department of corrections or in the department

of behavioral healthcare, developmental disabilities and hospitals who dies or in the case of a person

who dies while in the custody of the state police or local police departments of law enforcement as

defined by the U.S. Department of Justice, the person charged with the responsibility for that

custody shall have the duty to immediately notify the office of the state medical examiners. Any

person charged with the responsibility of notifying the office of state medical examiners of any of

the deaths stated in the first sentence of this subsection who neglects to give that notice shall upon

conviction be guilty of a misdemeanor be reported to the office of the attorney general.

     (d) If an agent of the office of state medical examiners is of the opinion that a death was

caused by the act of neglect of some person other than the deceased, he or she shall at once notify

the attorney general, and the police of the city or town where the body was found or in which it

lies. If any person shall be arrested and charged with causing any death by the act of neglect, the

person so arrested shall be entitled to receive a copy of the record of the autopsy, upon written

request delivered to the attorney general.

     (e) Where any person age sixty-five (65) years or older may appear to have died from

accidental hypothermia or hyperthermia, the death shall be reported to the department of elderly

affairs office of healthy aging by the state medical examiner. or

     (f) when When any person, under the age of eighteen (18) shall die, the physician signing

medical professional pronouncing the death certificate shall report the death to the state medical

examiner’s office within twenty-four (24) six (6) hours of the death.

     (f)(g) Any person who violates any of the provisions of subsection (a) or (b) of this section

and does so with the intention upon conviction of concealing a felony crime or having knowledge

of the commission of any felony offense, shall be guilty of a felony and, upon conviction, shall be

fined or imprisoned for a term of not more than five (5) years or fined ten thousand dollars

($10,000), or both in accordance with § 11-1-5.

LC005345/SUB A - Page 11 of 15

     23-4-8. Procedure for investigation of deaths.

     (a) When the office of state medical examiners has notice that there has been found or is

lying within this state the body of a person who is supposed to have come to his or her death by

violence, or in any manner or circumstances as stated in § 23-4-7 this chapter or in rules

promulgated by the department, an agent of the office of state medical examiners shall immediately

proceed to the place where the body lies and take charge of it, view it, and make personal inquiry

into the cause and manner of death determine the medicolegal authority of the case, and if accepted,

the office of the state medical examiners shall take jurisdiction of the body and initiate a

postmortem investigation. If the body is found at the residence of the deceased, the agent of the

office of state medical examiners shall not remove the body from the residence unless necessary

for further postmortem examination or autopsy further investigation.

     (b) A health care facility, healthcare provider, educational institution, correctional

institution, or law enforcement agency shall disclose any and all relevant information in its

possession including, but not limited to, medical records, educational records, and incident reports,

requested by the state medical examiner or his or her agent in connection with the death

investigation of the death of a decedent who was a current or former patient, student, or subject of

a law enforcement report or case file to the extent necessary as determined by the office of the state

medical examiners, in order to assist the medical examiner in determining the cause and manner of

death. Law enforcement agencies responding to the scene of a death are required to provide the

office of state medical examiners with copies of all related law enforcement reports including, if

requested, photographs and videos related to the incident.

     23-4-9. Deaths in public places.

     In the event that a person dies suddenly on a public highway or elsewhere in the public

view and the death appears to be from natural causes or the result of injuries received from a

highway accident, an agent of the office of the state medical examiners, or the state police or any

superior officer of the local police or an agent of the office of state medical examiners, in

consultation with and with permission from the office of the state medical examiners may order the

removal of the body from the place of death, upon completion of their investigation as to the cause

and manner of death, to the funeral home designated by a family representative of the deceased or

to the state morgue or any hospital to the office of the state medical examiners or to an alternate

location as directed and approved by an agent of the office of state medical examiners.

     23-4-10. Disposition of deceased bodies.

     (a) The office of state medical examiners shall, after any postmortem external examination

or any autopsy, promptly release the deceased body to the relatives, representatives, or domestic

LC005345/SUB A - Page 12 of 15

partners or other persons authorized by law to make arrangements for the disposition of the

decedent’s remains. The cost of transporting the deceased body to the office of state medical

examiners shall be borne by the state if the autopsy was required to be performed as provided in

this chapter. If the relatives, representatives, or domestic partners of the decedent or other person

authorized by law to make arrangements for the disposition of the decedent’s remains:

     (1) Fails or refuses to claim the body within fourteen (14) days of receiving notice of the

death of the decedent; or

     (2) Fails or refuses to make arrangements with a funeral home for the removal of the body

from the state medical examiner’s morgue within thirty (30) days of receiving notice of the death

of the decedent, then the body shall be deemed unclaimed and shall be buried in accordance with

§ 40-6-3.10. If there are no known relatives, representatives or domestic partners, after reasonable

public notices, the body shall be deemed unclaimed and the office of state medical examiners shall

cause the body of the deceased person to be buried in accordance with § 40-6-3.10. The general

treasurer of the state shall have first priority in recovering the expenses of burial from the estate of

the deceased person.

     (b) For the purpose of this chapter, “domestic partner” shall be defined as a person who,

prior to the decedent’s death, was in an exclusive, intimate, and committed relationship with the

decedent, and who certifies by affidavit that their relationship met the following qualifications:

     (1) Both partners were at least eighteen (18) years of age and were mentally competent to

contract;

     (2) Neither partner is married to anyone else;

     (3) Partners were not related by blood to a degree that would prohibit marriage in the state

of Rhode Island;

     (4) Partners resided together and had resided together for at least one year at the time of

death; and

     (5) Partners were financially interdependent as evidenced by at least two (2) of the

following:

     (i) Domestic partnership agreement or relationship contract;

     (ii) Joint mortgage or joint ownership of primary residence;

     (iii) Two (2) of the following:

     (A) Joint ownership of motor vehicle;

     (B) Joint checking account;

     (C) Joint credit account;

     (D) Joint lease; and/or

LC005345/SUB A - Page 13 of 15

     (iv) The domestic partner had been designated as a beneficiary for the decedent’s will,

retirement contract, or life insurance.

     (c) The office of the state medical examiners shall, in the event of a multiple or mass

fatality, after consultation with the lead investigative agency for the incident, have the authority to

order the cremation of recovered comingled remains that were not genetically linked to any single

decedent.

     23-4-11. Effects and property of deceased.

     An agent of the office of state medical examiners, as the case may be during the course of

investigation of a death, may shall take into his or her their possession all articles and property of

the deceased on or about the body as well as other items at the scene that are deemed relevant to

the investigation and shall deliver them to the office of the chief state medical examiner examiners

if an autopsy or a postmortem examination is ordered, will be performed. but shall otherwise deliver

them to a member of the family taking a receipt for them. Provided, however, any The original or

a copy of a letter, note, or any other written instrument, the contents of which relate to the manner

or cause of the death of the deceased, shall be permanently retained in the files of the office. If an

autopsy is ordered, the chief medical examiner shall upon completion of the investigation deliver

all other articles or property to a member of the family of the deceased taking a receipt from that

family member and, if any dispute exists among members of the family, he or she shall hold the

other articles or property for the executor or administrator of the estate of the deceased when

appointed. When a funeral home livery service picks up a decedent from the state morgue whose

death was investigated by the office of state medical examiners, any personal property of the

decedent that was removed prior to or during postmortem examination by the office of state medical

examiners shall be released with the body except for personal property that is being held for law

enforcement investigation of a crime. Prior to release, the funeral home livery personnel shall sign

an itemized receipt of the decedent’s personal property in possession of the office of the state

medical examiners. In the event that If death shall have occurred in a hotel or other public place

where possessions of the deceased may be lying, an agent of the office of state medical examiners

the responding law enforcement agency shall make suitable arrangements for the protection of the

property.

     23-4-13. Establishment of fees.

     The director of the department of health shall is authorized to establish fees for autopsy

copies of documents such as postmortem reports, cremation certificates, and statistics for

authorization of cremations. The director shall is also authorized to establish and impose fees, at an

hourly or daily rate, to give testimony in civil suits under this chapter. All fees are as set forth in §

LC005345/SUB A - Page 14 of 15

23-1-54. The director is authorized to establish in regulation reasonable fees for copies of additional

documents or other case file contents or archive searches not otherwise specified in this section.

All of these fees shall be collected and deposited as general revenues; provided, however, that no

city or town Rhode Island state agency, or any agency office or department of a city and or town

within the state, or the department of human services law enforcement agencies from other states,

federal agencies, and hospitals licensed pursuant to chapter 17 of title 23 entitled by law to such

documents or other case file contents, shall be required to pay any fees established by the director

pursuant to this section.

     23-4-14. Preservation of reports — Tabular reports. Annual reports.

     The director of the department of health shall cause the returns received by the office of

state medical examiners and reports made by that office on causes of death for each year, in

accordance with this chapter, to be bound together with an index to the volume. The director of

health in his or her capacity as ex officio state registrar shall prepare or cause to be prepared from

the returns tabular results that will render them of practical utility, and shall annually report thereof

in connection with the report of births, marriages, and deaths required by chapter 3 of this title. The

office of the state medical examiners shall produce an annual statistical report of all deaths

investigated after all cases are closed for a calendar year. The report shall be publicly posted.

Annual reports generated shall be retained in keeping with the state’s retention schedule.

     23-4-15. Morgue.

     A centrally located An office and morgue shall be provided with laboratories, furniture the

necessary staffing, equipment, records, and supplies that may be required in the to conduct the

duties and obligations of the office of state medical examiners as described within this chapter,

rules promulgated by the department, and in keeping with applicable accreditation requirements.

     SECTION 2. Section 23-4-12 of the General Laws in Chapter 23-4 entitled "Office of State

Medical Examiners" is hereby repealed.

     23-4-12. Compensation for recovery of body from water.

     When services are rendered in bringing to land the dead body of a person found in any of

the harbors, rivers, or waters of the state, compensation for services as he or she deemed reasonable

may be allowed; but this privilege shall not entitle any person to compensation for services rendered

in search for a dead body.

     SECTION 3. This act shall take effect upon passage.

========

LC005345/SUB A

========

LC005345/SUB A - Page 15 of 15

EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HEALTH AND SAFETY -- OFFICE OF STATE MEDICAL EXAMINERS

***

     This act would clarify and update language in the office of state medical examiners statute

to address outdated or ambiguous language, outdated practices, outdated position

titles/qualifications, and ensure compliance with federal HIPAA requirements.

     This act would take effect upon passage.

========

LC005345/SUB A

========

LC005345/SUB A - Page 16 of 15