Laws in Missouri, Illinois and Arkansas differ on the role of coroners in each state and who has jurisdiction in deaths requiring investigations and autopsies. As a result, there appears to be an inequity in which state's taxpayers foot the bills for such expenses.
Part of the problem is the fact that Cape Girardeau has the only trauma center in the region, at Saint Francis Medical Center. As a result, individuals who have been seriously injured in Illinois usually are taken to the Cape Girardeau hospital. If those individuals die or are pronounced dead at the hospital, Illinois law says it is the Cape Girardeau County coroner's responsibility to handle the necessary follow-up. Missouri law says such costs are the responsibility of the county where the deceased came from.
Missouri's law intends to spread the cost associated with deaths involving a county coroner rather than concentrating those costs in counties that have trauma centers or other life-saving hospitals.
Several years ago, Missouri and Illinois had compatible laws. There is disagreement among officials in both states about the effectiveness of that arrangement. The current system is seen as financially favorable to Illinois counties.
A reasonable approach might be for both states to try to work out a less lopsided system.