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November 2017
On October 1, 2017, the Office of Vital Records (OVR) implemented a "no paper policy", requiring medical certifiers or their designated staff to enter cause of death information directly into the Minnesota Registration & Certification system (MR&C).
OVR is thrilled to report at the end of October, that 99.7% of all Minnesota death records were filed in MR&C by medical certifiers or their designated staff.
Dr. Susan Viergever wrote: "Being able to enter
death certificates online has streamlined the process and been very helpful to
me. It is an easy process and decreases the clutter of additional
paperwork. It's nice to complete the death certificate in an timely
fashion when the details of the death are clear in my mind."
Thanks to all who have made 'Paper Cut' a success!
OVR staff are planning future MR&C improvements to make electronic death record filing even easier. If you need help filing a death record, locating a medical certifier, or filing cause of death – or, if you have an idea to simplify the process, please give us a call at 651-201-5993 or email health.MRCAdmin@state.mn.us.
Pilot project: Essentia
Health to initiate death records by registering medical information first
 Under
its Paper Cut Project, the Office of Vital Records (OVR) is improving death registration by maximizing
use of the Minnesota Registration & Certification (MR&C) system. In October, OVR instituted a “no paper policy”
requiring medical certifiers to enter cause of death information directly into
MR&C rather than completing a faxed paper worksheet. “By removing paper from the process, death registration no longer
needs to follow a linear progression,” Molly Crawford, State Registrar, said.
“Our new policy allows us to test out filing cause of death information first.”
Starting Monday, November 20, OVR and Essentia Health will partner in a project to register medical
information first. In the pilot project, which runs through December 21, 2017, cause of death will be filed before the fact of death for decedents who die at Essentia Health facilities.
The month-long effort
will test the feasibility of initiating a death record by registering cause of
death (COD) information before fact of death (FOD). To prepare, OVR made
several changes to MR&C to remove barriers to filing COD first. Testing
MR&C functionality for a “cause of death first” process will help OVR make "COD
first" entry as functional as the current method of "FOD first". In 2018, OVR hopes to offer
the option to enter "COD first" to medical certifiers and designated staff across the state.
Historically in Minnesota,
morticians and funeral home staff have initiated death records. Because death
registration traditionally has been a paper process, creating and completing a
death record required work to be accomplished in a certain order. Thus, when
electronic death registration was introduced to Minnesota 20 years ago, system functionality
replicated the linear process and it continued into the current system,
MR&C. “The expectation has been for funeral staff to start the death
registration process by filing demographic fact of death information first, and
the medical certifier responsible for determining cause and manner of death to
file the medical portion second,” said Krista Bauer, OVR Registration
Supervisor.
Because more than half of
Minnesota deaths occur in facilities such as hospitals, long-term care, nursing
homes, and hospices, OVR recognized an opportunity to improve and build
flexibility into death registration. When a death occurs at a facility, medical
certifiers need not wait for a prompt from MR&C telling them to complete
COD. By allowing a medical certifier who provided care to the decedent to register
the cause and manner of death first, death registration may become even more
efficient. Morticians will be relieved of the burden of identifying the medical
certifier who will provide cause of death information. In a non-linear death
registration process, medical certifiers could register and certify deaths:
- When information about the death is still fresh in their minds.
- As part of their other routine documentation activities
and responsibilities associated with the decedent’s medical record.
- Before the body is released to the custody of a
mortician or funeral home.
Positioned for success
OVR invited Essentia Health
to partner in the project because of their vital records procedures. Several years ago,
Essentia Health replicated the Cause of Death worksheet in
their electronic health record. According to Jeanne Amato, Essentia Health’s Enterprise Health Information
Service Manager, who is leading the internal effort, medical
certifiers across the Essentia system have been completing the cause of death worksheet in the decedent's electronic health record while finalizing other documentation in the decedent’s record. OVR also wanted to work with a
small project team. Essentia has a team of eight designated staff who have authority to enter cause of death information on behalf of the medical certifiers.
“Essentia was ahead of the curve,” said Crawford. “They
have all of the information ready to go. They don’t need to wait for MR&C
to alert them when a funeral home files FOD.”
Essentia Health medical certifiers provide COD
information for just under 1000
records annually. In 2016, there were 42,163 deaths in Minnesota. Only
deaths that occur at Essentia facilities are within the scope of the project. For deaths that
occur at home or outside of an Essentia facility, the funeral home will still need to file FOD
first.
Registering COD first will affect funeral
staff, medical examiners, and coroners
The
pilot will change the usual flow of a death record. When a
decedent has an Essentia medical certifier, funeral staff need to pay careful
attention when registering the fact of death. When a funeral home enters the decedent's basic information into MR&C, MR&C will check for potential matches. MR&C
will alert funeral staff if it suspects that the cause of death for the decedent has been filed already. Funeral staff should
stop and consider the potential matches before creating another (possibly duplicate) record. Funeral staff can select the existing record and complete the death
registration by filing FOD second.
During the pilot, medical examiners and coroners who serve counties with Essentia Health facilities will continue to receive email notifications for non-natural deaths, injuries,
and trigger words such as “fracture” and “abuse” (Medical Examiner referrals). Referred records can be reviewed and processed as
usual. When COD is filed first, MR&C cannot email medical examiners or coroners about cremation authorizations because the funeral establishment selects the type of disposition when filing FOD. Medical examiners / coroners will need to watch the 'Pending cremation authorization' work queue for records requiring authorization for final disposition.
Headquartered in
Duluth, Essentia Health has more than 15,000 employees, including 1,900
physicians and advanced practitioners, who serve patients in Minnesota,
Wisconsin, North Dakota, and Idaho. Essentia Health has 15 hospitals, 75
clinics, six long-term care facilities, three assisted living facilities, three
independent living facilities, five ambulance services and one research
institute.
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The U.S. Department of Health and Human Services and all states recognize the importance of permanent homes and families by promoting and celebrating adoptions during the month of November. The Minnesota Department of Health MDH), Office of Vital Records OVR) plays a key role in supporting adoptions. OVR staff:
- Make sure that the birth records for children born in Minnesota are updated after adoptions.
- Collect fees to support the Minnesota Children’s Trust Fund.
- Register men and conduct searches of the Minnesota Fathers’ Adoption Registry.
- Protect and manage original birth records.
Updating birth records
In Minnesota, birth parents, adoptive parents, adoption agencies and courts must take certain actions before a court can grant a petition for prospective adoptive parents to adopt a child. Adoption creates a new legal parent-child relationship and it involves complex social and emotional issues. Both birth parents and adoptive parents make many important decisions that affect them and their child’s future.
Adoptions may involve a public or non-governmental agency, may be private, may be international, and may involve stepparents or relatives.
When an adoption takes place in a state different from where the child was born, the vital records office in the ‘birth state’ receives adoption documentation to update the original birth record. After an adoption is finalized for a child born in Minnesota, the district court completes a Certificate of Adoption form and mails it along with a $40 fee to OVR. OVR uses the information provided on the Certificate of Adoption form to create a new birth record showing the adopted birth information. The original birth record is replaced, and it, along with all correspondence pertaining to the original birth record, is considered confidential and released only under very limited circumstances.
If a child is born in a foreign country and adopted by Minnesota residents, the parents file the adoption documents with the district court in the county where they live. Based on the Certificate of Adoption form completed by the court, OVR creates a Minnesota birth record. A certificate issued for this type of record clearly states that it is not evidence of U.S. citizenship.
As of September 2017, according to the Minnesota Department of Human Services, 1,514 children are under state guardianship; 766 children of these children are in need of adoptive families immediately.
Support to strengthen families
OVR collects fees to support the Minnesota Children’s Trust Fund. For every Minnesota birth certificate sold, $4 of the $26 fee, goes to the Minnesota Children’s Trust Fund. As part of the Minnesota Department of Human Services child protection system, the Children’s Trust Fund works to prevent child abuse and neglect by working with national and local partners to strengthen children, families and communities. It supports child safety and permanent living situations, including adoption.
Minnesota Fathers’ Adoption Registry
In Minnesota, the court requires a search of the Minnesota Fathers' Adoption Registry (MFAR) before finalizing an adoption. MFAR allows possible biological, but not as yet legal fathers to receive notice of pending adoption proceedings for their children. By registering within 30 days of his child's birth, a 'putative' father ensures that he will be able to participate in the decisions that relate to his child. MFAR balances the interests of the mother, child, and father when an adoption plan is being considered and stabilizes the adoption process by placing time limits on a putative father's opportunity to assert his rights.
Access to original birth records
In Minnesota, after an adoption, the original birth record becomes confidential. Access to an original birth record after an adoption is restricted. A birth parent may, at any time, give or deny permission to release the original birth information to the adopted person when the adopted person has reached age 19. To do this, the birth parent completes and submits an Affidavit of Disclosure or Non-Disclosure Regarding an Original Birth Certificate of an Adopted Person (PDF) to OVR.
An adopted person, age 19 or older, who was born in Minnesota, may request a non-certified copy of the original birth record by completing the Adoptee's Request for Original Birth Record Information and Search for Affidavit of Disclosure or Non-Disclosure (PDF) form. When OVR receives the request, staff will search for an Affidavit of Disclosure/Non-Disclosure according to Minnesota Statutes, sections 144.2252 and 259.89.
- If a birth parent has given permission to release the original birth information to the adopted person, OVR will send the adopted person a non-certified copy of the original birth record.
- If the parent filed an Affidavit of Non-Disclosure, OVR will inform the adoptee that a court order is required.
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If the birth parent did not file an Affidavit of Disclosure or Non-Disclosure, OVR will notify the adopted person that it cannot release a non-certified copy of the original birth record. At the same time, OVR will also notify the Minnesota Department of Human Services to conduct a search for the birth parent(s) according to Minnesota Statutes, section 259.89. The search may take up to six months. OVR will contact the adopted person when the search is complete.
When an adopted person makes a request for a non-certified copy of the original birth record, or when OVR notifies the Minnesota Department of Human Services about such a request, the Department of Human Services forwards the request to the adoption agency to search for the birth parent(s). Before searching, the adoption agency will contact the adopted person to explain the search services and the fee required to attempt to locate the birth parent(s). If the adopted person goes ahead with a search and the adoption agency finds and notifies the birth parent, the birth parent has the right to file within 31 days an affidavit stating that the information on the birth record should not be disclosed. However, a parent may consent to disclose the information any time, without a time limit. If the birth parent consents, OVR notifies the adoptee of the results.
OVR has 1,341 affidavits of non-disclosure and 13,451 affidavits of disclosure on file for birth records going back to 1935.
Additional information
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