VITAL RECORDS DEATH CERTIFICATE REGISTRATION

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VITAL RECORDSDEATH CERTIFICATE REGISTRATION

• Presentation by

Steve
Whisnant
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• To search for Arkansas Statutes
• www.arkleg.state.ar.us/SearchCenter/Pages/arkansas
  code.aspx
• To download Rules Regulations
• www.healthyarkansas.com/

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• Historically, Arkansas Field Rep visited annually
  each funeral home, hospital, and local health
  unit to review records/filing system.
• Health Department auditors now monitor Vital
  Records forms at the health units.

Local Registrars may NOT reveal, nor permit any
person to inspect information that is contained
in vital records, unless authorized by the State
Registrar in writing. POL-3
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• Arkansas Compliance
• Current law 10 days to file a death certificate
• (future electronic filing 3 days)

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Warning!

• After several months, if the first letter had no
  affect, a warning letter is mailed using stronger
  language.
• Again, after several months, if the warning
  letter failed, then Vital Records either gives a
  verbal warning or files a complaint with the
  Arkansas Board of Embalmers and Funeral Directors.

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Edits

• Modern technology allows better monitoring.
• SAS Programs,
• Hospital Discharge Data System,
• Improved birth/infant death match,
• Future electronic filing.

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Training

• Training is centrally located at key cities to
  bring in everyone involved in filing a vital
  record. I have two PowerPoint presentations one
  for birth and one for death.
• Birth presentation outlines stillbirth
  miscarriage forms since hospital staff normally
  completes this paperwork.
• Goal is to cross-train so everyone knows what
  everyone else is doing. Hopefully this will
  create better communication in the field.

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• Approved to offer credit hours/CEU to
  participants. Examples include funeral
  directors, nurses (hospice labor and delivery),
  EMT, and health information/medical records
  employees (American Health Information Management
  Association, Dan, 312-233-1100 ext 1128).
• Give out certificates with CEU approval number.
• Gain their trust, buy-in, and prove you know what
  youre talking about.

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• Incomplete certificates often result in a family
  member of the deceased having to fix it at a
  later date. This often delays the family from
  getting financial resources such as life
  insurance.

Funeral directors, please double check with
family to make sure the death certificate has no
mistakes before filing.
Cynthia and Faye process on average 100 death
certificates per day and take many phone calls
from funeral directors.
Yeah, no mistakes!
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Problem Certifiers

• 20-18-601 (c) states
• The medical certification shall be completed,
  signed, and returned to the funeral director
  within two (2) business days after receipt of the
  death certificate by the physician in charge of
  the patients care for the illness or condition
  which resulted in death, except when inquire is
  required -- (see coroners laws).

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FYI

• Fifty-six percent of all death certificates are
  signed by physicians.
• Current state average at filing death
  certificates with the local Health Department is
  9.9 days. The median is 8 days.
• This implies that most certifiers are signing
  death certificates in time for the funeral
  director to meet the 10 day rule.

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• LEGAL PROTECTION
•  
• 20-18-303 (b) states, Any person or
  institution that in good faith provides
  information required by thisVital Records
  Lawshall not be subject to any action for
  damages. Emphasis added.
• Other protection includes
• Amend certificate if an error occurs,
• Do Pending, and
• Note Probable by cause of death.

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STEPS FOR PROCESSING DEATH CERTIFICATES

• What should the funeral director do on getting
  the death certificate certified?
• Find out from informant, e.g., family and/or
  hospital medical records (Release of Decease
  form), who all might be appropriate to sign the
  death certificate. This may include specialists,
  family physician, coroner, etc.
• If unsure, call the person and ask if he/she will
  certify before mailing the death certificate.
  Send the certificate to a contact person in the
  certifiers office.

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FYIER DEATHS

• Check with the Primary Care Physician and coroner
  first to see if he/she will sign. ER physicians
  can sign, but they often dont know the cause of
  death and many hospitals have an unwritten policy
  that they dont sign. Also, check if there were
  specialists that saw the deceased. The ER
  physician should sign only after exhausting all
  attempts to get another certifier. Reference
  Rules Regulations 6.2.

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• Rules Regulations Pertaining to Vital Records
  6.2 states
• (a) When a death occurs in a hospital or other
  institution and the death is not under the
  jurisdiction of the medical examiner or coroner,
  the person in charge of such institution, or his
  or her designated representative, shall be
  responsible for obtaining the medical
  certification. (This responsibility does not
  include DOA in the hospital emergency room.)

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• Track all correspondence (use a worksheet). Note
  who you talked with each time. Send by
  Registered mail if necessary.
• Follow up with the certifier in a few days if
  there is any question whether he/she will sign.
  Document that the certifier has had the
  certificate for over two business days.
• If it becomes clear that the certifier is
  dragging his/her feet, notify the County
  Registrar in the county of death as soon as
  possible, especially before 10 days since the
  date of death. Request help from the Registrar
  if needed.

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NOTIFICATION LIST VR-117

• Regulation 6.0 states
• The funeral director is to notify the local
  county registrar on death certificates that
  cannot be filed within ten (10) days.

Debbie Bruner review death certificates at the
Union County Health Unit.
Washington County Local Health Unit
Craighead County Local Health Unit
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• ASSISTANCE TO FUNERAL DIRECTORS
• AND MEDICAL CERTIFIERS
• When notified that a Death Certificate will be
  late, the County Registrar must notate the call
  on the Notification Log of Death Certificates
  (VR-117). The County Registrar then determines
  why the certificate is late and assists the
  funeral director in getting it completed. This
  may include calling the medical certifier for the
  funeral director or contacting the Field
  Representative or State Registrar in Vital
  Records for advice/assistance. POL-7.

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• The Registrar/Deputy Registrar should then make
  an effort (1 or 2 phone calls) to the certifier
  in an attempt to investigate the problem and get
  him/her to complete the death certificate.
• Vital Records in Little Rock should be notified
  when this effort fails, or for chronic problems.

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• 20-18-601 (c) (1) states
• In the absence of the physician, or with his or
  her approval, the certificate may be completed
  and signed by his or her associate physician, the
  chief medical officer of the institution in which
  death occurred, by the pathologist who performed
  an autopsy provided the individual has access
  to the medical history of the case, views the
  deceased at or after death, and the death is due
  to natural causes.

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• Block 10-Marital Status. Check only one box.
• If a married couple died at the same time and
  Time of Death in item 3b is the same for both,
  Widowed or Married may be used on both
  certificates. If a married couple both died
  around the same time but time of death in item 3b
  differs, the first to die was Married and the
  second to die was Widowed.

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• FYI Arkansas recognizes any legal union between
  one man and one woman as husband and wife that is
  treated as a marriage under the laws of another
  state, territory, or Indian tribe (e.g. Common
  law).
• FYI Regulation 14.5 states, A court order
  shall be required to change marital status on
  death certificates except when persons
  responsible for the completion of the item make
  an error.

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Most Recent (immediate cause of death) Next
Oldest (cause of condition on line a) Oldest
(cause of condition on line b) Underlying Cause
of Death
Days Months Years Years
Other Conditions
You need to complete only as many lines as it
takes to identify the etiology of death (from the
UNDERLYING cause to the immediate cause.) If
the immediate cause of death was also the
underlying cause of death, report it on line (a)
.
Consult Dorene Harris for assistance
501-661-2369 or e-mail Margaret.Harris_at_arkansas.c
om
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Examples of conditions which do not, by
themselves, identify UNDERLYING cause of death
include

• Anoxia/hypoxia
• Arrhythmia
• Asystole
• Cardiac arrest
• Cardiopulmonary failure
• Debility

• Exhaustion
• Failure, any organ
• Failure to thrive
• Heart failure
• (incl. congestive!)
• Multi organ failure
• Respiratory arrest

AVOID MODES OF DEATH AS THE ONLY CAUSE LISTED
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Coma Metastatic Carcinoma to the
Brain Adenocarcinoma of the Lung
Days 6 Months 2 Yrs.
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??? But I dont KNOW theCAUSE of death!!!
Cause of Death Training Library http//www.naphsi
s.org/index.asp?bid1155
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HELPFUL NUMBERS

• Mike Adams (Dir.) 501-661-2371
• Grace Carson (Asst. Dir.) 501-661-2275
• Steve Whisnant 501-661-2635
• Faye McLelland 501-661-2348
• Cynthia Bedford 501-661-2390
• Myra Broaddus (Correction and
• Amendment) 501-661-2715

Call me, Stewart Matthews, at 501-661-2637 if you
need a PDF version of the 2008 Death Certificate.
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Thank you