BG C.S.H.B. 2866 75(R)BILL ANALYSIS PUBLIC HEALTH C.S.H.B. 2866 By: Chavez 4-10-97 Committee Report (Substituted) BACKGROUND A death certificate serves two purposes. First, it establishes the legal fact of death which is necessary for estate handling and life insurance proceedings. Second, it is tool by which to derive mortality data which is a primary public health indicator. The Texas Department of Health (TDH) registers and certifies deaths for the state of Texas through the Bureau of Vital Statistics. This process has changed little since the 1930s: the actual certificate is initiated by the funeral home, the medical certification is completed by the physician or coroner, and the funeral home gets it back and then files the record. The statutory time limit for this process is ten days from the date of death. According to TDH, certain basic statutory changes are needed. Though actual statistics are not kept, TDH receives an average of ten to 20 complaints a week involving problems with delays stemming from conflicts between physicians and justices of the peace, who each believe the other is responsible for signing death certificates, or certifier's delays in filings. The lack of a statutory definition for "death with medical attendance" leads to confusion and is particularly problematic in situations involving contract emergency room physicians and physician practice groups where no one physician is responsible for the patient. PURPOSE C.S.H.B. 2866 establishes new procedures for obtaining information for purposes of filing a death certificate and provides guidelines for the registration of deaths that occur more than ten days but less than one year before the date of application for registration. RULEMAKING AUTHORITY It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency or institution. SECTION BY SECTION ANALYSIS SECTION 1. Amends Sections 193.004(a) and (b), Health & Safety Code, by deleting references to medical certification from the physician who was last in attendance at a death or fetal death. Makes conforming changes. SECTION 2. Amends Section 193.005, Health & Safety Code, as follows: Sec. 193.005. PERSONAL INFORMATION. Subsection (a) retitles the section; requires a person required to file a death certificate or fetal death certificate to obtain required medical certification from a treating physician if the death occurred under medical attendance for the care and treatment of the condition or disease that contributed to the death. Subsection (b) requires the attending physician to complete the medical certification not later than three days after receipt of the death certificate. Subsection (c) establishes circumstances under which an associate physician, chief medical officer or physician who performed an autopsy may complete the medical certification. Subsection (d) requires the person required to file the death or fetal death certificate to notify appropriate authorities under specified circumstances. Subsection (e) establishes procedures which must be followed by a person conducting an inquest required by Chapter 49, Code of Criminal Procedure. Subsection (f) establishes procedures which must be followed by a person conducting an inquest if the identity of the decedent is unknown. Subsection (g) requires the person required to complete the medical certification to give notice to the funeral director or designee if the certification cannot be completed in a timely manner; prohibits final disposition of the body unless specifically authorized by the person responsible for completing the medical certification. Subsection (h) requires the person completing the medical certification to attest to its validity either by signature or an electronic process approved by the state registrar. Subsection (i) requires the appropriate certifier, upon receipt of autopsy results or other information that would change the information in the medical certification, to immediately report the change in a manner prescribed by TDH to amend the death certificate; removes existing provisions which would be inconsistent with the changes proposed by this Act. SECTION 3. Amends Section 193.007, Health & Safety Code, as follows: Sec. 193.007. DELAYED REGISTRATION OF DEATH. (a) Allows a death that occurred more than 10 days but less than one year before the registration application date to be recorded on a death certificate and submitted for filing with the appropriate local registrar. Subsection (b) Replaces reference to "the period provided by Section 193.003" with the words "within one year of the date death" to remain consistent with changes proposed by this Act. Subsections (c), (d), (e), and (f) are relettered to conform. SECTION 4. Establishes that this Act takes effect September 1, 1997. Provides applicability to deaths that occur on or after the effective date and any procedure relating to the administration of death records on or after the effective date to which the change would not cause undue disruption of services or administrative inconvenience. SECTION 5. Emergency clause. COMPARISON OF ORIGINAL TO SUBSTITUTE In SECTION 2, CSHB 2866 revises the heading of Sec. 193.005, Health and Safety Code from "Medical Information" to "Personal Information" in order to more accurately reflect the section's content. The word "attending" is inserted once and substituted for "treating" several times in order to clarify the responsible physician. "Or fetal death" is added in regards to the death certificate filing requirement in the substitute bill, to clearly establish that the person filing the death or fetal death certificate shall notify the appropriate authority.