On Monday, October 3, 2016, the Hennepin County Medical Examiner’s Office implemented a new “no paper” policy. Hennepin County Medical Examiner’s Office is no longer accepting paper or faxed cremation requests. All requests for cremation authorization, including the cause and manner of death, must be filed and approved in the MR&C system. The change impacts physicians, licensed morticians, and funeral homes needing cremation authorizations for deaths that have occurred in Hennepin, Dakota and Scott counties.
The movement to rely on and maximize the use of MR&C started in January 2016. Some large medical examiner offices began a soft approach by requiring the cause and manner of death to be registered in MR&C for the records that they were asked to authorize for cremation as the final method of disposition. In February 2016, the Ramsey County Chief Medical Examiner, Dr. Michael McGee, established a no-paper policy for cremation authorizations; he required cause of death to be filed in MR&C and he required requests for cremation authorization to be made and approved electronically in MR&C as well. This move had a cascading effect among clinics and hospitals in the 16-county jurisdiction.
In 2015, fifty-five percent of the deaths in Minnesota occurred in the 19 counties over which the Ramsey County Medical Examiner’s and Hennepin County Medical Examiner’s offices have jurisdiction. More than 60% of those deaths required cremation authorization by the medical examiner’s office.
The Office of Vital Records is pleased with the results from the new policies and has directed resources to support physician recruitment and users of the MR&C system. In fact, OVR established a new helpdesk with three new staff for just this purpose. Other medical examiners are expected to require electronic registration with cause of death in MR&C before authorizing dispositions soon. Under the Paper Cut Project, OVR will institute a statewide “no paper policy” effective September 30, 2017.
New Tax Credit Available to Parents
Beginning in tax year 2016, parents who experience the stillbirth of a child in Minnesota may be eligible for a tax credit. Late last session, legislators passed a new law (Minnesota Statutes, section 290.0685), which allows a credit of $2,000 to individuals for each stillbirth in the taxable year for which a Certificate of Birth Resulting in Stillbirth has been issued. To be eligible, parents must have:
- experienced a stillbirth in 2016 (stillbirths before this year are not eligible),
- received a Certificate of Birth Resulting in Stillbirth from the Minnesota Department of Health (MDH), Office of Vital Records (OVR), and
- would have claimed the child as a dependent if the child had been born alive.
To operationalize the tax credit, representatives from the Minnesota Department of Revenue (DOR) reached out to both the MDH Legal Office and OVR for help. “We wanted to create a process that was respectful to families experiencing a loss while allowing the agencies to validate tax claims,” said Molly Mulcahy Crawford, State Registrar, “We’ve worked in partnership to do just that.”
To meet DOR requirements to process claims for the stillbirth tax credit, OVR is revising the application form that parents use to request a Certificate of Birth Resulting in Stillbirth. Parents will send notarized application forms to OVR, the only vital records office authorized to issue Certificates of Birth Resulting in Stillbirth.
To claim the credit, parents must have a Certificate of Birth Resulting in Stillbirth and must complete tax form Minnesota
Schedule M1PSC. Parents will provide unique identifying information from the certificate on the tax form.
Certificates of Birth Resulting in Stillbirth have been issued by OVR for more than a decade. They are issued for fetal deaths of 20 weeks or more gestation that are required to be reported under Minnesota Statutes,
section 144.222. In previous years, hospitals have reported fewer than 500 of these deaths annually. Like other vital events, fetal deaths are required to be reported within five days of the event. Fetal deaths of less than 20 weeks may be reported voluntarily. OVR’s responsibilities as they relate to reports of fetal deaths, fetal death records, and the process for parents to request a Certificate of Birth Resulting in Stillbirth Certificate are outlined in Minnesota Statutes,
OVR encourages professionals involved in the vital records system to help inform families of the new tax credit. For more information about the credit, go to the Minnesota
Department of Revenue website or call 651-296-3781 or 800-652-9094.
Fetal Death Registration: Roles and Responsibilities
Understanding your role in the vital records system as it relates to fetal deaths is important. The Office of Vital Records (OVR) collects data about births, deaths, and fetal deaths that occur in Minnesota. Within the vital records system, fetal deaths may touch many professionals including hospital birth registrars, licensed morticians, funeral staff, physicians, medical examiners, and OVR. Being clear and precise is critical to accurate reporting of fetal deaths.
The Centers for Disease Control and Prevention (CDC) defines fetal death as “the spontaneous intrauterine death of a fetus at any time during pregnancy.” Sometimes fetal deaths are called miscarriages or stillbirths and sometimes infants who die quickly after their births are mistakenly called fetal deaths. What is important to understand, is that fetal deaths, are not live births. Fetal deaths do not have a birth record or death record. A fetal death report becomes a fetal death record when a Certificate of Birth Resulting in Stillbirth is issued.
- Fetal deaths of 20 weeks or longer gestation are required to be reported to OVR within five days of the death of a fetus. About 500 are reported annually.
- Fetal deaths of 20 weeks or longer gestation unattended by a physician are required to be reported to the medical examiner for evaluation.
- Fetal deaths of less than 20 weeks gestation may be voluntarily reported to OVR.
- Fetal deaths are reported in the MR&C System by users who access MR&C through the birth module.
- Fetal death reports can be corrected or amended if cause of death information becomes available after the initial report of a fetal death.
- OVR sends data from required fetal death reports to the Centers for Disease Control, National Center for Health Statistics.
- OVR issues Certificates of Birth Resulting in Stillbirth to parents only for fetal deaths that are required to be reported.
- A tax credit is available to parents who experience a stillbirth in 2016 or later and who have obtained a Certificate of Birth Resulting in Stillbirth.
Funeral staff may be contracted to provide dignified disposition such as burial or cremation for fetal remains. When providing services for a fetal death, funeral staff do not register information in MR&C, but instead access the Fetal
Death Disposition Permit from the MDH website and seek authorization for cremation from the medical examiner.
New OVR Help Desk Supports Partners and the Public
After weeks of intensive training, three new Health Program Representatives started taking calls and responding to emails at the Office of Vital Records (OVR) this month. The Help Desk is the result of OVR’s vision to improve customer service by creating a first point of contact for partners who use the MR&C System and people with questions about vital records in Minnesota and the Minnesota Father’s Adoption Registry. The Help Desk provides operational support and serves as the frontline for community engagement with agents who speak multiple languages including English, Hmong, and Spanish.
Although the vision for the Help Desk has deep roots, it became reality with funding from the Centers for Disease Control under the Paper Cut Project. The Paper Cut project is OVR’s intensive effort to maximize use of the MR&C System and improve data quality and timeliness through electronic death registration. The new staff provide technical assistance and detailed program information to customers, professional partners, and users of the statewide electronic vital records application, MR&C. They administer MR&C user accounts; reset passwords, onboard new users, and assist with outreach and education.
Incorporating a full-service Help Desk now helps support strategic “no paper policies” recently implemented by medical examiners. Medical examiners are increasingly requiring requests for cremation authorizations to be made through the MR&C System which relies on cause of death information to be available electronically on death records.
With the creation of the Help Desk, OVR is centralizing its more than eight published phone lines and multiple email addresses to a single point of contact. Before the Help Desk, each functional unit in OVR published its own phone numbers and email address. Now OVR can list one all-purpose phone number, 651-201-5970, and be confident that there’s adequate coverage to meet partner and customer needs.
As OVR fully implements the Help Desk, it is exploring technology that may further increase efficiency. OVR may introduce new options, such as a call tree to callers to track data about the nature of inquiries an integrated voice response system, or a CISCO call center to manage call distribution and track other data such as wait time.