Nicholas G. Grapsas PUBLIC ADMINISTRATOR

Nicholas G. Grapsas PUBLIC ADMINISTRATOR STATE OF ILLINOIS OFFICE OF THE PUBLIC ADMINISTRATOR FORTHECOUNTYOFCOOK May 20, 2013 Honorable Toni Preckwinkle Cook County Board President 118 N. Clark Street Room 537 Chicago, IL 60602 RE: Anatomical Gift Association of Illinois' Repeated Breaches of the "Memorandum of Understanding" between Cook County and the AGA. Dear President Preckwinkle: This office has confronted several troubling and serious concerns relative to the procurement of unclaimed human remains by the Anatomical Gift Association of Illinois (AGA) from the Office of the Cook County Medical Examiner (ME). Specifically, several situations have been discovered which have, and continue to, directly compromise our ability to properly execute our statutory mandate as a result of the continuous actions in the procurement of decedents' remains by the AGA from the ME. I. Background By way of background, as you may know, notifications to this office are required on the parts of the ME and AGA by certain amendments made to the "Memorandum of Understanding between Cook County and the AGA" (MOU), approved by the Cook County Board of Commissioners on September 7, 2011. These notifications recognize the critical need to advise us of bodies to be made available to the AGA which may belong to decedents of estates to which the court shall order our appointment as administrator upon our determination and subsequent petition for Letters of Office. Unfortunately, the AGA has never complied with the notice provision to date. Perhaps the most troubling aspect of our office's exclusion from this agreed upon process is the AGA's response in each instance to our investigators' attempt to have the agreement properly complied with; our efforts were received with defiance and non-cooperation. 69 Wesr Washington Srreer, Suire 2220, (312) 603-0100 Fax (312) 603-9999 1

Since November 2012, this office has become aware of repeated instances in which the AGA has either (1) erroneously claimed decedent's remains from the ME, or (2) claimed remains without providing notice to our office and/or directly violated notice and time-limit provisions set in place and required by the MOU. As you are aware, certain specific protocols have been set in place by the MOU and the subsequent addendum to the MOU, which were approved by the Cook County Board of Commissioners on October 28, 2010 and September 7, 2011, respectively. Pursuant to the terms of the MOU and the addendum, notifications to this office are required by both the ME and the AGA. These notifications are critical because they may name the decedents whose remains may belong to open investigations in which we are locating family, securing assets and real estate, and/or handling funeral arrangements. Importantly, Section IV, Paragraph C of the MOU, specifically requires the ME to notify the AGA that it has unclaimed remains for which no relative, next of kin or authorized representatives have been located and which would require a public burial. Furthermore, the ME is required to maintain possession of such unclaimed remains for a period of 14 days from the date the ME takes possession of the remains. Moreover, Section IV, Paragraph D provides that upon expiration of the above-noted 14 day period, the AGA is authorized to and may take possession of unclaimed remains from the ME. However, in the event that the AGA does intend to receive such remains, Section V, Paragraph A of the addendum to the MOU clearly requires the AGA to notify the ME and the Office of the Cook County Public Administrator of such intent, within 48 hours of receiving notice from the ME as to the availability of such unclaimed remains. It should be emphasized that the requirement on the part of the A GA to notify the Public Administrator of the A GA 's intent to receive human remains has never been followed. II. Daniel Gillen Consequently, the AGA's continuous disregard for its obligations under the agreement has resulted in several tragic errors. First, on September 25, 2012 this office undertook an investigation of decedent Daniel Gillen. Mr. Gillen's remains were received by the ME on September 22, 2012. During a two-week investigation, we were able to identify, locate and confirm an authorized representative of the decedent who wished to handle burial arrangements. On October 10, 2012, we notified the ME that an authorized representative of the decedent under a Power of Attorney had been located and the decedent's remains were to be released to a funeral home designated by the decedent's authorized representative. It was only then that our office was first informed by the ME that the AGA had already claimed these remains and collected them on September 28, 2012. In Mr. Gillen's case, the AGA entirely failed to follow the procedures cited above. Clearly, the AGA was not authorized to take possession of these remains on September 28, 2012. In fact, pursuant to the MOU, the AGA was not authorized to take those remains until October 7, 2012, following the expiration of the 14-day period called for by the agreement. Additionally, the AGA also failed to provide this office with the required notice of its intent to receive the unclaimed remains of the decedent even after its unauthorized procurement of those remains. 2

III. Norval Turner Second, the MOU was breached again by the AGA's failures to honor its provisions in the case of decedent Norval Turner. Mr. Turner's remains were erroneously claimed by the AGA on January 11, 2013. Prior to this, our office was working and coordinating with the decedent's family and the Veteran's Administration to arrange burial. Unbeknownst to this office, the AGA claimed the remains from the ME without giving any notice to our office, in accordance with the notice requirements of the MOU. Subsequently, our office took remedial actions to retrieve the remains from the AGA. Frustratingly, our efforts were met with much difficulty and non-cooperation on the part of the AGA in delivering the remains as they were demanding prior payment by our office for transportation and embalming costs of the remains that never should have been claimed by the AGA in the first place. In other words, the AGA demanded payment for their breaches of the agreement. Our office also handled all corresponding issues and obvious concerns of the family members who needlessly had to prolong the burial of a family member and a United States Veteran. All of this could have been-and indeed, should have been-- avoided if the AGA had simply honored the protocols set in place and provided our office with the necessary notice. IV. Catherine Bolduc Third, and more recently, this office has been compelled to take remedial actions to reverse the AGA's unauthorized procurement of the remains of decedent Catherine Bolduc. Ms. Bolduc's remains came into the possession of the ME on October 1, 2012. Again, without prior notice or communication with our office, the AGA erroneously and without authority, claimed the decedent's remains only 3 days later, on October 4, 2012, in clear violation of the 14 day waiting period as delineated in the MOU. Ms. Bolduc, while having no living family, was not indigent. Rather, she actually possessed substantial assets including a pre-purchased burial plot next to that of her pre-deceased husband, as well as real estate and significant liquid assets. It is quite clear that her estate not only allowed for burial arrangements, but also required estate administration by this office as mandated by law. In fact, our office is set to open the decedent's estate and have Letters of Office issued on May 31, 2013. Nevertheless, we are again first forced to take remedial actions in retrieving the decedent's remains. To aggravate this situation, our efforts are again being met with delays, non-cooperation and frustrating difficulties with the AGA. In this matter, the AGA not only violated the 14-day waiting period by claiming the remains a mere 3 days after they were received by the ME, but they claimed a body that was clearly not eligible for donation -- as indigent or otherwise. Again, if the AGA had followed the applicable procedures, this situation could have been avoided. V. Follow-Up Investigations Caused by AGA's Lack of Notifications Recent information and records provided to our office by the ME evidences that the AGA has claimed 59 decedents' remains from the ME between May 4, 2011 and April 29, 2013. Be that as it may, the unfortunate fact of the matter remains that this office has never received any manner of notice whatsoever from the A GA stating that it intended to claim any one of those 59 remains. Of particular concern to us is that of those 59 remains, this office had absolutely no knowledge as to the existence of 7 of those 59 for which there exists a possibility that family 3

and/or assets may exist. In our ongoing efforts to remedy the AGA's avoidance of its responsibilities, our office is currently investigating the estates for those decedents in an attempt to identify any family or assets that may exist. Sadly, of those same 59 remains taken by the AGA, 11 were decedents who were eligible for public aid burials and thus not eligible for donation as indigent remains. This fact alone should cause serious concerns for anyone considering the effectiveness and feasibility of the MOU's lack of enforcement and accountability. VI. Conclusion Clearly, the AGA is failing to follow the requirements of the MOU. The AGA is repeatedly disregarding the Office of the Public Administrator in matters which require our involvement by its refusal to provide notices to which we are entitled by the terms of the MOU. More importantly, the AGA's consistent errors and lack of cooperation and communication are thwarting and, even jeopardizing, our office from fulfilling our statutory duties to those Cook County residents who come to rely on this office to prepare final arrangements and protect their assets and valuables from waste or loss. Therefore, I respectfully request that the President and the Board of Commissioners consider these facts in the course of exercising its oversight authority in the enforcement and/or re-negotiation of the MOU which has apparently been approached by the AGA merely as a document for which its compliance is purely optional. As always, I remain Very truly yours, : J. fa )), >!fa (1 1-- Nilit'o'Iis G. Grapsas Illinois Public Administrator for Cook County Cc: See Service List Attached 4

Service List Toni Preckwinkle Cook County Board President 118 North Clark-Room 537 Robert Steele Cook County Commissioner 2"d District Timothy 0. Schneider Cook County Commissioner 15th District Earlean Collins Cook County Commissioner 1st District Elizabeth "Liz" Doody Gorman Cook County Commissioner 17th District Jerry Butler Cook County Commissioner 3rd District Jeffrey R. Tobolsiki Cook County Commissioner 16th District Joan Patricia Murphy Cook County Commissioner 6th District John A. Fritchey Cook County Commissioner 12th District Bridget Gainer Cook County Commissioner l 0th District Greg Goslin Cook County Commissioner 14th District Edwin Reyes Cook County Commissioner 8th District Jesus G. Garcia Cook County Commissioner 7th District Stanley Moore Cook County Commissioner 4th District Larry Suffredin Cook County Commissioner 13th District John P. Daley Cook County Commissioner 11th District Deborah Sims Cook County Commissioner 5th District Peter N. Silvestri Cook County Commissioner 9th District Dr. Stephen Cina, M.D. Chief Medical Examiner, Cook County 2121 West Harrison Street Chicago, Illinois 60612 Kit Spenslor Illinois Department of Human Services 100 South Grand A venue East Springfield, Illinois 62762

Kathy Schultz Illinois Department of Human Services 100 South Grand A venue East Springfield, Illinois 62762 Andrea Tucker Department of Veterans Affairs Chicago Regional Office 2122 West Taylor Street Chicago, Illinois 60612 Patrick M. Blanchard Cook County Office of the Independent Inspector General 69 West Washington, Suite 1160 Martha Martinez Acting Chief of the Bureau of Administration 118 North Clark Street- Room 820