Report Title:

Registration of Vital Statistics

Description:

Permits a more timely reporting of cause-of-death and related medical information of deceased individuals. Facilitates a more timely registration of deaths and the issuance of death certificates and burial-transit permits by conversion from a paper-based to an electronic registration process. Redefines the term "fetal death" (stillborn) and alters the recording of fetal death events from a certificate-based to a report-based system.

THE SENATE

S.B. NO.

1356

TWENTY-SECOND LEGISLATURE, 2003

 

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

RELATING TO REGISTRATION OF VITAL STATISTICS.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. Chapter 338, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§338- Compulsory report of fetal deaths and intentional terminations of pregnancy. A report of every fetal death or intentional termination of pregnancy performed in accordance with section 453-16 shall be substantially completed and filed with, and in the form and manner prescribed by, the department of health within thirty days after the fetal death occurred or intentional termination of pregnancy was performed, by the administrator or designated representative of the birthing facility, or physician, or midwife, or other legally authorized person in attendance at the fetal death; or if not so attended, by one of the parents; or a nurse or other employee based upon the physician's records for an intentional termination of pregnancy."

SECTION 2. Section 338-1, Hawaii Revised Statutes, is amended by amending the definition of "fetal death" to read as follows:

""Fetal death" is death prior to the complete expulsion or extraction from its mother of a product of conception, [irrespective of the duration of pregnancy,] of twenty completed weeks gestation or more, calculated from the date on which the last normal menstrual period began to the date of delivery that did not, after complete separation from the mother, breathe or show any other evidence of life such as beating of the heart, pulsation of the umbilical cord, or movement of voluntary muscle."

SECTION 3. Section 338-8, Hawaii Revised Statutes, is amended to read as follows:

"§338-8 Compulsory registration of deaths [and fetal deaths]. A certificate of every death [or fetal death] shall be filed with, and in the form and manner prescribed by, the department of health [in Honolulu or with the local agent of the department of health in the district in which the death or fetal death occurred or a dead body was found] within [three days] forty-eight hours after the death [or fetal death] occurred or the dead body was found. In every instance, a certificate shall be filed prior to interment or other disposition of the body."

SECTION 4. Section 338-9, Hawaii Revised Statutes, is amended to read as follows:

"§338-9 Filing and preparation of death [and fetal death] certificates. (a) [The person in charge of the disposition of the body shall file with the department of health in Honolulu or with the local agent of the department of health in the district in which the death or fetal death occurred, or a dead body was found, a certificate of death or fetal death within three days after the occurrence, except that reports of intentional terminations of pregnancy performed in accordance with section 453-16 may be deferred for up to one month.] The following persons shall file a certificate of death with the department of health:

(1) If the death is from natural causes and occurs in or en route to a hospital, the administrator or designated representative of the hospital;

(2) If the death is from natural causes and occurs elsewhere than in or en route to a hospital, the person in charge of the disposition of the body; or

(3) If the death is from other than natural causes and investigated by the medical examiner's or coroner physician's offices, and jurisdiction over the body or human remains is assumed by the office, the medical examiner or coroner physician or designated representative of the medical examiner's or coroner physician's office.

(b) [In preparing a certificate of death or fetal death the person in charge of the disposition of the body shall:

(1) Obtain and enter on the certificate the personal data and other information pertaining to the deceased person required by the department from the person best qualified to supply them;

(2) Present the certificate of death to the physician last in attendance upon the deceased, or to the coroner's physician, who shall thereupon certify the cause of death to the physician's best knowledge and belief, or present the certificate of fetal death to the physician, midwife, or other person in attendance at the fetal death, who shall certify the fetal death and such medical data pertaining thereto as can be furnished; provided that fetal deaths of less than twenty-four weeks or intentional terminations of pregnancy performed in accordance with section 453-16 may be certified by a nurse or other employee based upon the physician's records; and

(3) Notify immediately the appropriate local agent, if the death occurred without medical attendance, or if the physician last in attendance fails to sign the death certificate. In such event the local agent shall inform the local health officer, and refer the case to the local health officer for immediate investigation and certification of the cause of death prior to issuing a permit for burial, or other disposition of the body. When the local health officer is not a physician or when there is no such officer, the local agent may complete the certificate on the basis of information received from relatives of the deceased or others having knowledge of the facts.

If the circumstances of the case suggest that the death or fetal death was caused by other than natural causes, the local agent shall refer the case to the coroner for investigation and certification.] A certificate of death shall be prepared and filed as follows:

(1) If the certificate is filed under subsection (a)(1), the administrator or designated representative of the hospital shall initiate preparation of the certificate, for filing within forty-eight hours after the death occurred, by entering the deceased person's name; social security number, when obtainable from hospital records; and cause of death to the physician's best knowledge and belief and other medical information required by the department of health. The administrator or designated representative shall obtain the cause of death and other medical information from the cause of death certification statement, which shall be timely prepared and signed by the licensed physician last in attendance upon the deceased or the physician's duly authorized medical associate, if a review of the medical records of the decedent by the physician finds no evidence of suspicious or unusual circumstances. The administrator or designated representative shall, in addition, file the cause of death certification statement with the department of health no later than two business days after the initial preparation and the disposition of the body shall complete and finalize the preparation of the certificate, prior to filing of the certificate. The person in charge of the issuance of a burial-transit permit in accordance with section 338-23, by obtaining and entering other personal information and the disposal of human remains information pertaining to the deceased person and required by the department of health from the person or persons best qualified to supply them. If the circumstances of the case suggest that the death was caused under any of the circumstances set forth in section 841-3, the administrator or designated representative or the person in charge of the disposition of the body shall refer the case to the coroner for investigation.

(2) If the certificate is filed under subsection (a)(2), the person in charge of the disposition of the body shall prepare the certificate in entirety, for filing within forty-eight hours after the death occurred and prior to the issuance of a burial-transit permit in accordance with section 338-23, by obtaining and entering the deceased person's name, social security number, other personal information, and the disposal of human remains information pertaining to the deceased person and required by the department of health from the person or persons best qualified to supply them; and cause of death to the physician's best knowledge and belief and other medical information required by the department of health. The person in charge of the disposition of the body shall obtain the cause of death and other medical information from the cause of death certification statement, which shall be timely prepared and signed by the licensed physician last in attendance upon the deceased or the physician's duly authorized medical associate, if a review of the medical records of the decedent by the physician finds no evidence of suspicious or unusual circumstances. The person in charge of the disposition of the body shall, in addition, file the cause of death certification statement with the department of health no later than two business days after the preparation and filing of the certificate. If the circumstances of the case suggest that the death was caused under any of the circumstances set forth in section 841-3, the person in charge of the disposition of the body shall refer the case to the coroner for investigation.

(3) Subsequent to the filing of the certificate of death under subsection (a)(1) or (2) and prior to issuing a permit for burial or other disposition of the body, the department of health shall refer the case to the coroner for investigation if the circumstances of the case suggest that the death was caused under any of the circumstances set forth in section 841-3.

(4) If the certificate is filed under subsection (a)(3), the medical examiner or coroner physician or designated representative of the medical examiner's or coroner physician's office shall initiate preparation of the certificate, for filing within forty-eight hours after the death occurred, by entering the deceased person's name, social security number, if the information can be obtained from office records, and cause of death and other medical information required by the department of health from the cause of death certification statement prepared and signed by the medical examiner or coroner physician. The medical examiner or coroner physician or designated representative of the medical examiner's or coroner physician's office shall, in addition, file the cause of death certification statement with the department of health no later two business days after the initial preparation and filing of the certificate. The person in charge of the disposition of the body shall complete and finalize the preparation of the certificate, prior to the issuance of a burial-transit permit in accordance with section 338-23, by obtaining and entering other personal information and the disposal of human remains information pertaining to the deceased person and required by the department of health from the person or persons best qualified to supply them.

(c) A death certificate may be filed and prepared, in the form and manner prescribed by the department of health, by the next of kin [and accepted by the local agent] without meeting the requirements set forth above when there has been a judicial finding and declaration by a court of record that a person is dead[; provided that the certificate is in a form approved by the department and has been certified by the clerk of court]."

SECTION 5. Section 338-10, Hawaii Revised Statutes, is amended to read as follows:

"§338-10 Late determination of the cause of death. If the cause of death cannot be determined within [three days] forty-eight hours, the [certification of its] cause of death certification statement may be prepared and filed after the prescribed period, but the [attending physician or coroner's physician] person responsible for filing the certificate of death shall notify [in writing] the [local agent of the] department of health [of the district in which the death occurred], in the form and manner prescribed by the department, of the reason for late [filing,] determination of the cause of death, in order that a permit for the disposition of the body may be issued.

As used in this section, "late" means more than [three days] forty-eight hours after the [date of death.] death occurred or the dead body was found."

SECTION 6. Section 338-25, Hawaii Revised Statutes, is amended to read as follows:

"§338-25 Prerequisite for permit. No permit under section 338-23 shall be issued until a certificate of death or report of fetal death, as far as it can be completed under the circumstances of the case, has been filed and until all the [regulations] rules of the department of health in respect to the issuance of [such] the permit have been complied with."

SECTION 7. Section 338-29.5, Hawaii Revised Statutes, is amended to read as follows:

"§338-29.5 Late registration of death[, fetal death,] or marriage[, and divorce]. (a) When a death[, fetal death,] or marriage[, or divorce] occurring in this State has not been registered, a certificate may be filed in accordance with rules adopted by the department of health. The certificate shall be registered subject to any evidentiary requirements that the department adopts by rule to substantiate the alleged facts of death[, fetal death,] or marriage[, or divorce].

(b) Certificates of death[, fetal death,] or marriage[, or divorce] registered one year or more after the date of occurrence shall be marked "late" and shall show on the face the date of the late registration.

(c) As used in this section, "late" means one year or more after the date of the death[, fetal death,] or marriage[, or divorce]."

SECTION 8. Section 841-7, Hawaii Revised Statutes, is amended by amending subsection (b) to read as follows:

"(b) [Upon receipt of a certificate of death from the person in charge of the disposition of the body, the] The coroner's physician shall [thereupon state] prepare a cause of death certification statement and initiate preparation of a certificate of death, for filing within forty-eight hours after the death occurred or dead body was found, by entering the name of the disease or condition directly leading to the death; other significant conditions contributing to the death; day on which the death occurred; and [such] any other information [as may be] that is required [on the certificate of death] by section 338-9 or the director of health in order to classify the death. The [local agent of the] department of health shall be notified [in writing of the reason for the delay,] as required by section 338-10 if the cause of death cannot be determined within [three days.] forty-eight hours."

SECTION 9. Section 841-8, Hawaii Revised Statutes, is amended to read as follows:

"§841-8 Duty to forward copy of reports to any county or prosecuting attorney. [and to person in charge of disposition of body.] (a) Every coroner, or deputy coroner, shall, without delay, forward to the county attorney in the case of coroners for the counties of Maui and Kauai, and the prosecuting attorney in the case of coroners for the city and county of Honolulu and the county of Hawaii, a true and correct copy of the inquisition.

[(b) The coroner's physician shall, in addition, make available without delay the death certificate of the person whose death was investigated to the person in charge of the disposition of the body so that the person in charge may file the death certificate with the local agent of the department of health as required by section 338-9.]"

SECTION 10. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 11. This Act shall take effect on January 1, 2004.

INTRODUCED BY:

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