MOHAVE COUNTY — In a contentious meeting that stretched over four hours, the Mohave County Board of Supervisors found itself deadlocked over the future of its medical examiner services. On Aug. 5, the board voted 3-2 against approving a new three-year contract with the incumbent provider, Serenity Memorial Group, leaving the county in a state of uncertainty as the current contract nears its Nov. 30 expiration date.
The decision, or lack thereof, has thrown into sharp relief the challenges faced by rural counties in providing essential, specialized services. It has also ignited a debate about qualifications, cost-effectiveness, and the long-term vision for this critical county function.
“I believe in the integrity of the procurement process that was done,” said Supervisor Travis Lingenfelter during the meeting, “but I think that this is just continuing to kick the can down the road. I’m going to use my vote to try to put a little more emphasis on finally getting this solved.”
Background of the Current Situation
The current situation is the result of a series of decisions and circumstances dating back to 2021. At that time, Serenity Memorial Group, led by John Hassett, stepped in to provide medical examiner services when the previous examiner, Dr. Archiaus Mosley, reduced his role. The arrangement was intended to be temporary, giving the county time to develop plans for its own in-house medical examiner’s office and morgue. However, budget constraints prevented those plans from materializing, leaving Serenity in place for the past three years.
Now, with the contract’s expiration looming, the county finds itself at a crossroads. The board must decide whether to continue with Serenity, explore other private providers, or finally make the transition to an in-house department. Each option comes with its own set of challenges and potential benefits, making the decision a complex one for the supervisors.
Debate Over Qualifications
At the heart of the debate is the question of qualifications. Ryan Swap, representing a competing bid from Monolith Diagnostics, raised concerns about board certification in pathology during the public comment period. “The medical examiner shall be a physician certified in pathology,” Swap quoted from the Request for Proposal (RFP). “No one from Serenity is board certified in pathology, including Dr. Mosley.”
This point was echoed by Daniel Sudoki, another pathologist who spoke during the meeting. “Board certification in pathology has been the gold standard for demonstrating competency and qualification to practice in any aspect of our specialty since 1936,” Sudoki emphasized.
John Hassett, president of Serenity Memorial Group, addressed these concerns directly. “I have always said from the very beginning I’m not a forensic pathologist, never claimed to be,” Hassett stated. “I’ve set it on record on numerous occasions and I in no way shape or form claim to hold the qualifications that the gentleman behind me do hold.” Hassett emphasized that he approached the role from a business standpoint, partnering with experienced pathologists to provide the required services.
Challenges in Rural Healthcare Provision
The qualifications debate highlights a larger issue facing Mohave County and other rural areas: the challenge of attracting and retaining highly specialized medical professionals. Board-certified forensic pathologists are in short supply nationwide, and convincing them to relocate to less populated areas can be difficult. This reality has forced counties like Mohave to consider alternative models for providing these essential services.
County Attorney Jason Mitchell provided clarity on the legal requirements for medical examiners in Arizona during the meeting. “Title 11 deals with the definition of a medical examiner,” Mitchell explained. “It states that a medical examiner means a forensic pathologist who performs or directs the conduct of death investigations.” He noted that while the statutes require extensive experience in performing forensic autopsies, they don’t specifically mandate board certification.
Procurement Process and Competition
The competition for the contract has intensified since 2021. When Serenity was initially awarded the contract, they were the only respondent to the RFP. However, in March 2024, the board voted to solicit new bids, resulting in a competitive proposal from Monolith Diagnostics, a group of pathologists based in Kingman.
Dr. Ryan Swapp of Monolith Diagnostics told the board, “We’ve thought about approaching the county for many years … but the timelines, for us and for them, just never seemed to sync up. I feel like we finally, for the first time ever, have some bandwidth where we could take on a job like this.”
Financial Implications and Alternative Proposals
The financial implications of the medical examiner services are significant for Mohave County. Serenity’s current contract pays $92,500 per month, amounting to $1,110,000 annually. This substantial cost has led some supervisors to question whether there might be more cost-effective alternatives.
Supervisor Lingenfelter suggested exploring a partnership with Kingman Regional Medical Center (KRMC). “I’ve been having conversations with Kingman Medical Center, and it may be possible for us to get a hospital lease while hiring doctors who are board-certified pathologists,” Lingenfelter said. “We should convert medical examiner’s staff into county employees … and if we use KRMC, we could save the county millions of dollars.”
Geographic Challenges
The geographic realities of Mohave County present unique challenges for medical examiner services. As the fifth-largest county in the United States, covering 13,470 square miles, Mohave County requires a decentralized approach to ensure timely responses to death investigations across its territory.
The county is currently divided into four regions: Kingman, Bullhead City, Lake Havasu City, and the northern area covering Colorado City. Each region is served by investigators who live in the area to facilitate rapid response times. Any solution, whether it’s a continuation of the current contract, a new provider, or an in-house department, must account for this vast and diverse geography.
Options on the Table
As the board grapples with this complex issue, several options are on the table. These include:
- A one-year extension of Serenity’s contract to buy more time for long-term planning
- Awarding a new contract to Monolith Diagnostics or another qualified provider
- Leasing space from a local hospital and hiring board-certified pathologists directly
- Converting current medical examiner staff to county employees and gradually transitioning to an in-house department
Each of these options comes with its own set of pros and cons, further complicating the decision-making process.
The Road Ahead
As the November deadline approaches, the pressure is mounting on the Board of Supervisors to reach a decision. The board is set to revisit the issue at its next meeting, where it will consider both an amendment to the current contract for a one-year extension and the possibility of a new three-year contract with Serenity.
Chairwoman Hildy Angus summed up the complexity of the decision: “I’m waiting to hear everything in this matter. It’s been a very contentious contract, and I plan to vote in the way I feel is best for Mohave County.”
As populations in these areas grow and change, county governments are increasingly being called upon to provide services traditionally associated with more urban areas. As the clock ticks down to the contract expiration, all eyes are on the Board of Supervisors. Their decision will not only affect the immediate future of medical examiner services in the county but could also shape the long-term direction of county governance and service provision in Mohave County for years to come.
—Jeremy Webb
