(Source MIRS.news, Published 05/16/2024) Doctors would be required to upload death certificates electronically, under legislation taken up in a House committee Thursday, something funeral director Sarah Jensen Vatter said would address issues that arise from forcing religious families to wait on burial plans.
Vatter, a funeral director with Palmer, Bush and Jensen Funeral Homes, said when families are forced to wait for a death certificate to be certified by a physician, it can go “against the very core of their beliefs.
“We have families of the Hindu belief that it is required in their faith to be cremated within 24 to 48 hours,” she said. “We have families of the Jewish faith. They (are) require(d) to be buried within 48 hours of death. We have families that can't even think about meeting with us to plan a service because, without a death certificate, they can't finance or access the finances of the deceased to take care of the arrangements.
“I can tell you, one of the most frustrating parts of my profession is having to delay a family's wishes because I'm waiting on one signature,” she said.
Vatter was referring to the process of having a death certificate signed, by either a physician or medical examiner, a process that she said can become backlogged by many physicians choosing not to utilize the state’s Electronic Death Registration System (EDRS), instead relying on a hard copy that’s later scanned in.
She said of the hundreds of physicians in the Lansing area that her funeral home sees signing death certificates, only about a dozen utilize the EDRS.
“When I sit down with a family and I know that one of those physicians is the one signing the death certificate, I breathe easy, knowing that they won't experience any delays or have any issues with planning the celebration of their loved one's life,” she said.
House Health Policy Chair Julie Rogers (D-Kalamazoo) said currently, both a licensed physician and a funeral director are required to complete a medical certification of death, with the physician’s portion mandated to be completed within 48 hours of being presented.
However, when they are filled out physically, complications can arise from certificates lost in the mail, illegible handwriting or a failure to fill out all required fields.
“If this was all done electronically, it would be hand typed and entered in,” she said. “When we receive a hand-signed medical certificate, we have to then physically upload it into the electronic death registry system.
“It essentially is doing the work twice,” she said.
“When a physician utilizes the electronic death registry system, as they would in these bills presented to you, they simply log in wherever they are,” Vatter said. “They are only provided the boxes they are allowed to fill out, and then it's saved and ready for the funeral home of the family's choice.”
Rogers’ HB 5043 would require medical certifications be submitted using the online system starting one year after the bill’s passage. Those who complete medical certifications would have to complete Department of Health and Human Services (DHHS) training on using the online system.
Rogers said the intent behind the bills is to “modernize the medical certification of death certificates and to address a significant frustration” stemming from a backlog of death certificates during the COVID-19 pandemic.
Rep. Mike Mueller (R-Linden)’s companion bill, HB 5044, would also address the backlog, he said, by erasing confusion surrounding when a physician versus a medical examiner must sign a death certificate.
“One of the primary causes of delay in obtaining medical certification is the imbued ambiguity in current law regarding who is actually responsible for the certification in specific cases,” Mueller said.
Medical examiners certify deaths in cases where an individual dies by violence, a death is unexpected or an individual dies without medical attendance by a physician.
However, “there's currently no timeframe in statute for when someone dies without medical attendance by a physician,” Mueller said, which “leads to much confusion on whether a primary care physician or a medical examiner is responsible for the medical certification.”
His bill would establish a 12-month timeline, meaning if an individual is seen by a physician within 12 months before their death, the physician would be responsible for signing the death certificate.
If it’s been longer than a year, a medical examiner is then responsible.
Mueller said the 12-month timeline is becoming a national standard, and will end the process of medical examiners and doctors “point(ing) fingers at who’s supposed to do this.
“In the meantime, you're standing here with some dead person trying to figure out who's going to come collect the body,” he said.
The legislation, which was supported by the Michigan Funeral Directors Association, the Michigan Association of Medical Examiners and the Michigan State Medical Society, also replaces the misdemeanor penalty for physicians who fail to certify death records with medical license sanctions.
The bill was not taken up for a vote Thursday.
Rep. Reggie Miller (D-Belleville) asked about the potential to address the backlog by allowing physician’s assistants to also certify death certificates, which Rogers said was included in similar legislation last term and held up the bills' progress.
“I am open to… future bills that would address that type of thing,” Rogers said.
