Data—three new additions for 2016
Beginning in 2016, Minnesota death registration will collect
three more data elements. The Centers for Disease Control (CDC), National
Center for Health Statistics (NCHS) oversees the National Vital Statistics
System. As part of that system, the CDC created U.S. Standard Certificates of live
birth and death, and the fetal death report. These standard certificates
provide a framework for uniformity of data collection, registration and
reporting among the 57 state and territorial jurisdictions. The U.S. Standard includes
a data set that Minnesota follows. The last revision for the U.S. Standard was
in 2003. It was this standard that provided the direction for MR&C
programming and functionality.
Each jurisdiction has the authority and discretion to add
data elements as their laws and business needs require. Requests to add and
delete data elements are many. Often sources or data collection tools outside the
scope of vital records are available to meet the need. When other options are
non-existent, modifications may be considered for the Minnesota vital records
Recently, the Office of Vital Records (OVR) approved three
new data elements for death records. Actions to program MR&C are underway,
and these new fields will be in place for 2016 vital events. OVR is requiring
data to be collected to:
- Track religious objections to autopsies—medical
examiners and coroners will complete this data element with a yes or no
response to indicate whether there was a religious objection if an autopsy took
place. This addition is a result of the 2015 legislation that provides for
religious objections to autopsies. No other mechanism exists to collect this
data systematically and routinely.
- Indicate whether the decedent was embalmed—funeral
staff will complete this data element with a yes or no response regardless of
disposition choice. OVR added this element to help track demand for services
for future mortuary science educational and business needs.
- Record the current legal name of a decedent’s spouse—funeral
staff will collect this information in addition to the spouse’s name before
first marriage as part of the fact of death registration. The spouse’s current
name and name before first marriage will both print on the death certificate.
OVR added this element due to the increasing demand from surviving family to
have a certificate that resolves estate matters more efficiently.
Although the standard certificate and data set haven’t been
revised for birth, death, or fetal death for more than 13 years,
recommendations to cut certain birth and fetal death data have been made by members of the
National Association of Public Health Statistics and Information Services and
the NCHS birth data quality subgroup. OVR will be examining the use of this
data among Minnesota programs and the need to continue to collect data is that
no longer used by NCHS for national public health purposes.
Minnesota deaths due to legal intervention: literal descriptions for cause of death have direct impact on accurate coding and mortality statistics
Thousands of numeric codes are assigned to the causes of death reported on death certificates. The World Health Organization (WHO) created International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10) codes to promote international comparability in the collection, processing, classification, and presentation of mortality statistics. Coding rules improve the usefulness of mortality data.
Certain circumstances require very specific descriptions by medical certifiers when recording the cause of death. One of these circumstances is death caused by legal intervention. A death from legal intervention is a death due to injuries inflicted by police or other law enforcement agents, including military on duty, in the course of arresting or attempting to arrest lawbreakers, suppressing disturbances, maintaining order, and performing other legal actions. Legal executions are excluded from this category.
Local public health agencies use real-time death data from the Office of Vital Records (OVR) to assess their community’s health status and to monitor deaths due to infectious disease and other causes. Deaths due to legal intervention are very much in the local and national news currently. Recently, a local public health agency contacted the Midwest Medical Examiner’s Office to ask about a death that resulted from legal intervention. The decedent died after being shot by a police officer. The cause of death on the decedent’s record did not describe shooting by the police nor did it mention legal intervention. Because of this, the National Center for Health Statistics (NCHS) assigned the code for assault by other and unspecified firearm discharge. The Medical Examiner’s office contacted OVR for assistance and information on how to account for legal interventions and properly record these deaths.
NCHS advised OVR that the words “police” or “legal intervention” and a concise description of the injuries should be recorded in the injury description box (Cause of Death II screen) in MR&C. Legal interventions may include use of guns and other weapons including Tasers. ICD coding varies with the methods of legal intervention (see table).
After analyzing data from deaths in 2015, OVR determined that at least 13 legal intervention deaths have occurred so far this year but only five records include the key words to allow accurate coding. OVR will work with medical examiners to amend records to accurately reflect legal intervention and resubmit those records to NCHS for proper coding. Final published data from previous years will not be changed.
Registrar Rules—public confusion about roles and
erroneous requests for service
Requests and questions related to Minnesota Court Rule 220 have been on the rise at the Office of Vital Records (OVR) and other offices across Minnesota. Members of the public, particularly those who are interested in protecting and claiming their estates, have cited Rule 220 and expected action by vital records staff at the state and county vital records offices.
Title III of the General Rules of Practice for the District Courts does not apply to Minnesota vital records offices or functions. Rule 220 only applies to County Registrars of Title, if it applies at all. However, because Rule 220 references “Birth Certificates,” some citizens are confused and request services that vital records offices do not provide.
As documented on the Office of the Revisor of Statutes website, Rule 220 reads:
“The Registrar of Titles is authorized to receive for registration of memorials upon any outstanding certificate of title an official birth certificate pertaining to a registered owner named in said certificate of title showing the date of birth of said registered owner, providing there is attached to said birth certificate an affidavit of an affiant who states that he/she is familiar with the facts recited, stating that the party named in said birth certificate is the same party as one of the owners named in said certificate of title; and that thereafter the Registrar of Titles shall treat said registered owner as having attained the age of the majority at a date 18 years after the date of birth shown by said certificate.”
The duties and responsibilities of a Minnesota vital records office are controlled by the statutes and rules directly applicable to offices of vital records, not Title III of the General Rules of Practice for the District Courts. For those persons seeking to present documents to a Registrar of Titles consistent with their interpretation of Rule 220, all that state or county vital records staff can do is assist them in obtaining an “official” birth certificate. Vital records staff cannot provide legal advice. Furthermore, any questions regarding Rule 220, or what Rule 220 does or does not permit or require, is an issue between the individual and their County Registrar of Title.
The best practice recommendation of the Office of Vital Records when dealing with individuals asserting demands for service or action based on their interpretation of Rule 220, is to re-iterate the above points in a manner of calm, yet assertive, disengagement.