“It’s the busiest work environment we’ve ever had to deal with,” said Uptegrove, whose multiple publicly funded jobs paid him more than $600,000 last year.
“There’s not enough people to go around to do these cases, so people have to work in different locations to help out so bodies aren’t stacked up laying around,” he said.
Coroners investigate sudden and suspicious deaths, sometimes performing or reviewing autopsies. State law requires them to be physicians, but many are not forensic pathologists who do autopsies.
Elected coroners who don’t perform their own autopsies, like in Clark County, still investigate some deaths that don’t require an autopsy, review autopsy findings to determine causes of death and file death certificates.
The Montgomery County Coroner’s Office operates what Harshbarger says is the largest referral autopsy center in Ohio, covering 20% of the state’s population and getting cases from dozens of southwest Ohio counties. Harshbarger said smaller counties don’t have the facilities to do autopsies, and the larger counties are so busy with work from their own county they don’t have capacity to do contract work.
Harshbarger said a large number of autopsies he performs are paid for by other counties, which saves Montgomery County money.
“There have been times when Montgomery County was the only entity (doing contract autopsies),” Harshbarger said.
The practice doesn’t “pass the smell test,” said Bethe Goldenfield, chair of the Warren County Democratic Party.
“It raises red flags and it behooves (Warren County) commissioners to take a closer look,” Goldenfield said about Uptegrove’s multiple jobs.
Uptegrove was a full-time forensic pathologist at Montgomery County for years until last August. He now works at the Hamilton County coroner’s office. He did contract work for Hamilton County before he was hired there, and for Montgomery County after he left.
The Warren County coroner’s office, under Uptegrove, paid Montgomery County $512,919 for autopsy services — including some autopsies Uptegrove performed himself — from 2019 through 2021 to-date.
Warren County sent a handful of cases to Hamilton and Butler counties in recent years. In April, Uptegrove increased work sent to the Hamilton County coroner’s office after he started working there. He said this was done because Hamilton County opened a facility in Blue Ash that was more convenient for cases from southern Warren County. Warren County has paid Hamilton County for 22 autopsies this year, four done by Uptegrove.
“The situation is there’s only so many places that do autopsies,” Uptegrove said.
Payroll Project: Public salaries in the Dayton area
Ethics opinion not sought
The Hamilton County Coroner’s Office this year requested an opinion from that county’s prosecutor’s office on whether Uptegrove sending Warren County cases to his employer was a conflict of interest.
In the request for an opinion, the Hamilton County coroner wrote: “It should be noted that Dr. Uptegrove is paid a static salary by Hamilton County and derives no personal financial benefit from any referred cases.”
Hamilton County Prosecutor Joe Deters responded in February with a letter advising the coroner’s office to seek an opinion from the Ohio Ethics Commission.
“It is our understanding that the primary issue that you raise is the subject of discussion throughout your profession,” the letter says.
Andrea Hatten, chief administrator with the Hamilton County Coroner’s Office, said they have not contacted the ethics commission because they were busy with other challenges “but the matter is not considered closed.”
“We have been in a position to prioritize tasks at hand, yet the discussions surrounding this issue will continue,” she said.
Paul Nick, executive director of the Ohio Ethics Commission, would not comment on this specific case, referring questions to fact sheets on the agency’s website.
“Ethics Law prohibits a public official or employee from authorizing a public contract if the official, a family member, or a business associate has an interest in the contract,” says an overview fact sheet on Ohio ethics law.
It goes on to define “business associate” as including the official’s “outside employer.”
‘Trying to do what’s best’
Uptegrove said he has followed legal guidance he was given and will change what he’s doing if the guidance changes.
“I’m just trying to do what’s best for saving money as far as transportation of bodies and having cases assigned out in a reasonable time,” he said.
Warren County Prosecutor David Fornshell wouldn’t say whether his office ever advised Uptegrove on whether the practice was proper, citing attorney-client privilege.
Montgomery County Coroner Harshbarger said that because his office didn’t make payments to other counties, he never saw it necessary to get a formal opinion. But he personally doesn’t believe there is a conflict because his employees’ compensation is unrelated to whether they are an elected coroner who pays Montgomery County.
“The workload they provide to Montgomery County is not a meaningful variable in their employment,” he said.
Harshbarger said he has done occasional, part-time forensic pathology work for Franklin County for years.
In all those years, the only time Franklin County did business with Montgomery was last year, he said. Franklin County had three COVID-positive homicide victims and paid Montgomery County for the autopsies because Franklin County didn’t yet have a bone saw with a vacuum to prevent possible spread of the virus.
Harshbarger said he was not working for Franklin County at that time.
Montgomery County Commissioner Debbie Lieberman said Montgomery County is lucky to have a coroner who is a forensic pathologist, but she’s not aware of any discussions about potential conflicts with contracting with other counties.
“I would think that this is a decision for the ethics commission as to whether or not it’s a conflict,” she said.
Clark County Coroner Susan Brown worked as a forensic pathologist for Montgomery County long before being appointed coroner in 2018 and elected in 2020. When she took office, Clark County was sending all of its autopsy work to Montgomery County and she didn’t change that policy.
In 2019, 2020 and so far in 2021 Montgomery County performed 391 autopsies for Clark County at a charge of $1,600 each, she said.
Montgomery County paid Brown $259,462 last year, making her the county’s second highest-paid employee. Clark County paid her $56,458 as the elected coroner, according to her ethics form.
“I don’t believe there is any conflict,” she said, reached at work in Montgomery County. “I’m not benefiting financially in any way by bringing Clark County work over here.”
She said Clark County doesn’t have its own morgue. She uses Montgomery County because it’s nearby, which saves transportation costs and adds convenience for families and funeral homes.
“The other reason I choose Montgomery County is because they provide quality work,” she said. “I have to send them someplace.”
Clark County Commissioner Rick Lohnes said every time they review it, they find Montgomery County is the most affordable option. Building or leasing morgue space also would be more expensive, he said. But he said he will ask the Clark County prosecutor to look into it.
“It’s not been an issue. It was a long-standing practice before she was elected and it was cost-driven,” he said. “I suppose we could change it and spend more money. We will look into it.”
The Ohio Revised Code dictates how much elected coroners are paid. In counties with a population under 175,000, like Clark County, the coroner is assumed to have a private medical practice on the side and is paid less. In larger counties, coroners must choose whether to be paid less and maintain a private practice, or be paid more and forego a private practice.
Both Harshbarger and Uptegrove take full pay, and have jobs on the side. This raised Harshbarger’s base pay as elected coroner last year from $86,650 to $144,054, and Uptegrove’s from $76,887 to $140,638. Coroners get a 50% pay raise if they perform at least 75 autopsies for their county, which Harshbarger does.
Uptegrove maintains he doesn’t have a private practice because all of his work is for public entities. He was paid $644,852 last year with his salaries as an elected official, employee in Montgomery and Hamilton counties, and contract work he did for Butler and Hamilton counties through his company, Russell Uptegrove MD. Inc.
As an elected official, Uptegrove is required to file financial disclosure forms with the Ohio Ethics Commission stating sources of income. Forms for 2016 through 2020 list a source of income as “review of medical records” at “Misc. law firms.” In 2017 he also listed “private autopsy, organ removal” for “private entities.”
Uptegrove did not respond to questions about this private work.
Warren County Prosecutor David Fornshell said he has not researched the matter. But he said the previous county prosecutor, after talking to the state coroners association, provided guidance that Uptegrove’s outside work did not count as the private practice of medicine because that requires there to be a live patient.
Uptegrove said he can perform all of these jobs because he’s a hard worker.
“If this country had more people that were hard working, it would probably be a better place,” he said.
Harshbarger side jobs
Harshbarger doesn’t do private autopsies, because he believes that would constitute a private practice. But in addition to working in Franklin County, he does consulting work for the Department of Veterans Affairs and through his company First Forensic Inc. He was also paid $12,000 last year as medical director of Lifeline of Ohio, according to his ethics form.
“I don’t do the diagnosis, which is the practice of medicine part,” he said of why he doesn’t have to take the lower pay for having a private medical practice.
“My obligations as the Montgomery County coroner are completely met and far exceeded, and, yes, it is a huge benefit to our citizens to have a forensic pathologist in the coroner’s role,” he said.
“My statutory compensation from the general fund has traditionally been just above half the current market value of an experienced certified forensic pathologist as it is based solely on the many tasks involved with running the system of which only a part is the performance of autopsies.”
Most coroners of large counties take the full pay rate, according to officials with the Ohio Coroners Association.
This includes Butler County Coroner Lisa Mannix, who lists no other jobs on her ethics disclosure form, and Hamilton County Coroner Lakshmi Sammarco, who did consulting work in 2020, according to her ethics form.
David Corey, executive director of the coroners association, said his agency maintains that if a coroner isn’t seeing live patients, it’s not a private practice of medicine. He said they haven’t reviewed the issue of elected coroners paying other counties they also work for.
“The bigger issue isn’t this thing, it is there’s such a shortage of forensic pathologists in the country,” he said. “Especially now with COVID, and with homicide rates in Ohio going up, with suicide going up, with drug overdose deaths going up, we need forensic pathologists. If we start running these guys out of here, we’re going to be up (expletive) creek.”