BOISE — The Ada County coroner sees Ada County residents at the end of things.

The coroner’s office provides death certificates, takes care of investigations for suspicious deaths and settles the hows and whys of the final moments in life.

But the office’s reach is a lot further than many might expect.

Ada County is in the process of re-upping contracts with 33 Idaho counties and three reservations to provide autopsies and forensic investigations. So while Coroner Dotti Owens oversees Ada County deaths, her two full-time forensic pathologists deal not just with individuals from Ada County, but all over the state of Idaho.

The services in the contracts include autopsies, toxicologies, partial examinations and forensic inspections. These post-death examinations need to be done by trained forensic pathologists, with medical transcribers and a whole suite of necessary examination tools and materials on site. That’s an expensive list of items.

The cost of having forensic pathologists on staff is prohibitive. With some counties not having even hospitals in their jurisdictions, many counties and reservations contract with Ada County for more complicated medical procedures.

“A lot of smaller jurisdictions don’t have the funding or place to house a forensic pathologist, and we’re also talking about a medical transcriptionist, a forensic technician,” and other people who get involved during an autopsy, Owens said. “There’s a lot more to it.”

According to Ada County coroner records, since 2015, Ada County has performed 2,411 forensic procedures for Ada County cases. In that same time frame, Ada County has provided forensic or pathology services for 604 out-of-county cases.

Ada County charges $2,000 per full autopsy, $1,450 for a limited autopsy and $1,150 for a forensic inspection along with toxicology and X-ray fees, depending on the case, according to the Ada County Coroner’s Office.

From financial year 2015 to now, Ada County has reaped $1,210,568 in fees from contracts with counties and reservations for forensic procedures.

“We operate as a regional facility,” Owens said, and that arrangement is normal for most of the United States.

Only 11 Idaho counties don’t have a contract with the Ada County Coroner’s Office. Of those, Canyon County has its own forensic pathologist on staff, and the rest have contracts with Spokane’s coroner, Owens said. In a pinch, someone from a county or reservation will make the long drive to Ada County to bring a body in for an autopsy.

Former Ada County Coroner Mike Johnson said the reason Ada County is in the position to utilize its forensic pathologists for out-of-county cases can be traced back to hospital pathologists no longer wanting to do criminal death autopsies due to subpoenas and other legal issues.

“Historically, all autopsies were done by hospital pathologists until somewhere around 2000,” Johnson said. “Due to the demand of court proceedings and all of that, they decided to go with forensic pathologists.”

Autopsies determine the medical cause of death. Owens said Ada County forensic services do not determine where, when or why deaths occurred in out-of-county cases. Those responsibilities remain with the coroner in whose county or reservation the death occurred. Coroners are elected officials.

Pam Garlock is the coroner for Boise County. Garlock has worked with Ada County’s forensic team since 2002 and makes the decision about when to send in a person for an autopsy.

“It depends on the circumstances around the death,” Garlock said, “if it’s undetermined how the person died, if they haven’t seen a doctor, if it’s anybody under the age of 18 (unless they were dealing with cancer or some other disease), unwitnessed deaths, people in automobile accidents. … It depends.”

Garlock said the body is usually transported to Ada County by contracted drivers, but she’s had to drive one in on more than one occasion.

“It’s pretty well-standardized,” she said about the forensic process.

Garlock sees the logic in making the trip to Ada County for an autopsy.

“It doesn’t make sense for each county to have its own autopsy facility,” Garlock said. “My county doesn’t even have a hospital.”