EXPLANATION-Matter enclosed in bold-faced brackets [thus] in this bill is not enacted
and is intended to be omitted in the law.
FIRST REGULAR SESSION
SENATE BILL NO. 427
102ND GENERAL ASSEMBLY
INTRODUCED BY SENATOR ESLINGER.
1650S.01I KRISTINA MARTIN, Secretary
AN ACT
To repeal sections 193.145 and 193.265, RSMo, and to enact in lieu thereof two new sections
relating to death certificates.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Sections 193.145 and 193.265, RSMo, are 1
repealed and two new sections enacted in lieu thereof, to be 2
known as sections 193.145 and 193.265, to read as fol lows:3
193.145. 1. A certificate of death for each death 1
which occurs in this state shall be filed with the local 2
registrar, or as otherwise directed by the state registrar, 3
within five days after death and shall be registered if such 4
certificate has been completed and filed pursuant to this 5
section. All data providers in the death registration 6
process, including, but not limited to, the state registrar, 7
local registrars, the state medical examiner, county medical 8
examiners, coroners, funera l directors or persons acting as 9
such, embalmers, sheriffs, attending physicians and resident 10
physicians, physician assistants, assistant physicians, 11
advanced practice registered nurses, and the chief medical 12
officers of licensed health care facilities , and other 13
public or private institutions providing medical care, 14
treatment, or confinement to persons, shall be required to 15
use and utilize any electronic death registration system 16
required and adopted under subsection 1 of section 193.265 17
within six months of the system being certified by the 18 SB 427 2
director of the department of health and senior services, or 19
the director's designee, to be operational and available to 20
all data providers in the death registration process. 21
[However, should the person or entity that certifies the 22
cause of death not be part of, or does not use, the 23
electronic death registration system, the funeral director 24
or person acting as such may enter the required personal 25
data into the electronic death registration system and th en 26
complete the filing by presenting the signed cause of death 27
certification to the local registrar, in which case the 28
local registrar shall issue death certificates as set out in 29
subsection 2 of section 193.265. Nothing in this section 30
shall prevent the state registrar from adopting pilot 31
programs or voluntary electronic death registration programs 32
until such time as the system can be certified; however, no 33
such pilot or voluntary electronic death registration 34
program shall prevent the filing of a death certificate with 35
the local registrar or the ability to obtain certified 36
copies of death certificates under subsection 2 of section 37
193.265 until six months after such certification that the 38
system is operational. ] 39
2. If the place of death is unknown but the dead body 40
is found in this state, the certificate of death shall be 41
completed and filed pursuant to the provisions of this 42
section. The place where the body is found shall be shown 43
as the place of death. The date of death shall be the date 44
on which the remains were found. 45
3. When death occurs in a moving conveyance in the 46
United States and the body is first removed from the 47
conveyance in this state, the death shall be registered in 48
this state and the place where the body is first removed 49
shall be considered the place of death. When a death occurs 50 SB 427 3
on a moving conveyance while in international waters or air 51
space or in a foreign country or its air space and the body 52
is first removed from the conveyance in this state, th e 53
death shall be registered in this state but the certificate 54
shall show the actual place of death if such place may be 55
determined. 56
4. The funeral director or person in charge of final 57
disposition of the dead body shall file the certificate of 58
death. The funeral director or person in charge of the 59
final disposition of the dead body shall obtain or verify 60
and enter into the electronic death registration system: 61
(1) The personal data from the next of kin or the best 62
qualified person or so urce available; 63
(2) The medical certification from the person 64
responsible for such certification if designated to do so 65
under subsection 5 of this section; and 66
(3) Any other information or data that may be required 67
to be placed on a death ce rtificate or entered into the 68
electronic death certificate system including, but not 69
limited to, the name and license number of the embalmer. 70
5. The medical certification shall be completed, 71
attested to its accuracy either by signature or an 72
electronic process approved by the department, and returned 73
to the funeral director or person in charge of final 74
disposition within seventy -two hours after death by the 75
physician, physician assistant, assistant physician, or 76
advanced practice registered nu rse in charge of the 77
patient's care for the illness or condition which resulted 78
in death. In the absence of the physician, physician 79
assistant, assistant physician, advanced practice registered 80
nurse or with the physician's, physician assistant's, 81
assistant physician's, or advanced practice registered 82 SB 427 4
nurse's approval the certificate may be completed and 83
attested to its accuracy either by signature or an approved 84
electronic process by the physician's associate physician, 85
the chief medical officer of the institution in which death 86
occurred, or the physician who performed an autopsy upon the 87
decedent, provided such individual has access to the medical 88
history of the case, views the deceased at or after death 89
and death is due to natural causes. The person authorized 90
to complete the medical certification may, in writing, 91
designate any other person to enter the medical 92
certification information into the electronic death 93
registration system if the person authorized to complete the 94
medical certificate has physically or by electronic process 95
signed a statement stating the cause of death. Any persons 96
completing the medical certification or entering data into 97
the electronic death registration system shall be immune 98
from civil liability for such certification completion, data 99
entry, or determination of the cause of death, absent gross 100
negligence or willful misconduct. The state registrar may 101
approve alternate methods of obtaining and processing the 102
medical certification and filing the death c ertificate. The 103
Social Security number of any individual who has died shall 104
be placed in the records relating to the death and recorded 105
on the death certificate. 106
6. When death occurs from natural causes more than 107
thirty-six hours after the deced ent was last treated by a 108
physician, physician assistant, assistant physician, 109
advanced practice registered nurse, the case shall be 110
referred to the county medical examiner or coroner or 111
physician or local registrar for investigation to determine 112
and certify the cause of death. If the death is determined 113
to be of a natural cause, the medical examiner or coroner or 114 SB 427 5
local registrar shall refer the certificate of death to the 115
attending physician, physician assistant, assistant 116
physician, advanced pra ctice registered nurse for such 117
certification. If the attending physician, physician 118
assistant, assistant physician, advanced practice registered 119
nurse refuses or is otherwise unavailable, the medical 120
examiner or coroner or local registrar shall attes t to the 121
accuracy of the certificate of death either by signature or 122
an approved electronic process within thirty -six hours. 123
7. If the circumstances suggest that the death was 124
caused by other than natural causes, the medical examiner or 125
coroner shall determine the cause of death and shall, either 126
by signature or an approved electronic process, complete and 127
attest to the accuracy of the medical certification within 128
seventy-two hours after taking charge of the case. 129
8. If the cause of death cannot be determined within 130
seventy-two hours after death, the attending medical 131
examiner, coroner, attending physician, physician assistant, 132
assistant physician, advanced practice registered nurse, or 133
local registrar shall give the funeral director, or person 134
in charge of final disposition of the dead body, notice of 135
the reason for the delay, and final disposition of the body 136
shall not be made until authorized by the medical examiner, 137
coroner, attending physician, physician assistant, assistant 138
physician, advanced practice registered nurse, or local 139
registrar. 140
9. When a death is presumed to have occurred within 141
this state but the body cannot be located, a death 142
certificate may be prepared by the state registrar upon 143
receipt of an order o f a court of competent jurisdiction 144
which shall include the finding of facts required to 145
complete the death certificate. Such a death certificate 146 SB 427 6
shall be marked "Presumptive", show on its face the date of 147
registration, and identify the court and the date of decree. 148
10. (1) The department of health and senior services 149
shall notify all physicians, physician assistants, assistant 150
physicians, and advanced practice registered nurses licensed 151
under chapters 334 and 335 of the requirements regardin g the 152
use of the electronic vital records system provided for in 153
this section. 154
(2) On or before August 30, 2015, the department of 155
health and senior services, division of community and public 156
health shall create a working group comprised of 157
representation from the Missouri electronic vital records 158
system users and recipients of death certificates used for 159
professional purposes to evaluate the Missouri electronic 160
vital records system, develop recommendations to improve the 161
efficiency and usabi lity of the system, and to report such 162
findings and recommendations to the general assembly no 163
later than January 1, 2016. 164
11. Notwithstanding any provision of law to the 165
contrary, if a coroner or deputy coroner is not current with 166
or is without the approved training under chapter 58, the 167
department of health and senior services shall prohibit such 168
coroner from attesting to the accuracy of a certificate of 169
death. No person elected or appointed to the office of 170
coroner can assume such elected office until the training, 171
as established by the coroner standards and training 172
commission under the provisions of section 58.035, has been 173
completed and a certificate of completion has been issued. 174
In the event a coroner cannot fulfill his or her dut ies or 175
is no longer qualified to attest to the accuracy of a death 176
certificate, the sheriff of the county shall appoint a 177
medical professional to attest death certificates until such 178 SB 427 7
time as the coroner can resume his or her duties or another 179
coroner is appointed or elected to the office. 180
193.265. 1. For the issuance of a certification or 1
copy of a death record, the applicant shall pay a fee of 2
fourteen dollars for the first certification or copy and a 3
fee of eleven dollars for each additional copy ordered at 4
that time. For the issuance of a certification or copy of a 5
birth, marriage, divorce, or fetal death record, the 6
applicant shall pay a fee of fifteen dollars. No fee shall 7
be required or collected for a certification o f birth, 8
death, or marriage if the request for certification is made 9
by the children's division, the division of youth services, 10
a guardian ad litem, or a juvenile officer on behalf of a 11
child or person under twenty -one years of age who has come 12
under the jurisdiction of the juvenile court under section 13
211.031. All fees collected under this subsection shall be 14
deposited to the state department of revenue. Beginning 15
August 28, 2004, for each vital records fee collected, the 16
director of revenue sh all credit four dollars to the general 17
revenue fund, five dollars to the children's trust fund, one 18
dollar shall be credited to the endowed care cemetery audit 19
fund, one dollar for each certification or copy of death 20
records to the Missouri state coron ers' training fund 21
established in section 58.208, and three dollars for the 22
first copy of death records and five dollars for birth, 23
marriage, divorce, and fetal death records shall be credited 24
to the Missouri public health services fund established in 25
section 192.900. Money in the endowed care cemetery audit 26
fund shall be available by appropriation to the division of 27
professional registration to pay its expenses in 28
administering sections 214.270 to 214.410. All interest 29
earned on money deposited in the endowed care cemetery audit 30 SB 427 8
fund shall be credited to the endowed care cemetery fund. 31
Notwithstanding the provisions of section 33.080 to the 32
contrary, money placed in the endowed care cemetery audit 33
fund shall not be transferred and placed to the credit of 34
general revenue until the amount in the fund at the end of 35
the biennium exceeds three times the amount of the 36
appropriation from the endowed care cemetery audit fund for 37
the preceding fiscal year. The money deposited in the 38
public health services fund under this section shall be 39
deposited in a separate account in the fund, and moneys in 40
such account, upon appropriation, shall be used to automate 41
and improve the state vital records system, and develop and 42
maintain an electronic birth and death registration system. 43
For any search of the files and records, when no record is 44
found, the state shall be entitled to a fee equal to the 45
amount for a certification of a vital record for a five -year 46
search to be paid by the applicant. For the processing of 47
each legitimation, adoption, court order or recording after 48
the registrant's twelfth birthday, the state shall be 49
entitled to a fee equal to the amount for a certification of 50
a vital record. Except whenever a certified copy or copies 51
of a vital record is required to perfect any claim of any 52
person on relief, or any dependent of any person who was on 53
relief for any claim upon the government of the state or 54
United States, the state registrar shall, upon request, 55
furnish a certified c opy or so many certified copies as are 56
necessary, without any fee or compensation therefor. 57
2. For the issuance of a certification of a death 58
record by the local registrar, the applicant shall pay a fee 59
of fourteen dollars for the first certificat ion or copy and 60
a fee of eleven dollars for each additional copy ordered at 61
that time. For each fee collected under this subsection, 62 SB 427 9
one dollar shall be deposited to the state department of 63
revenue and the remainder shall be deposited to the official 64
city or county health agency. The director of revenue shall 65
credit all fees deposited to the state department of revenue 66
under this subsection to the Missouri state coroners' 67
training fund established in section 58.208. 68
3. For the issuance of a certification or copy of a 69
birth, marriage, divorce, or fetal death record, the 70
applicant shall pay a fee of fifteen dollars; except that, 71
in any county with a charter form of government and with 72
more than six hundred thousand but fewer than seven hund red 73
thousand inhabitants, a donation of one dollar may be 74
collected by the local registrar over and above any fees 75
required by law when a certification or copy of any marriage 76
license or birth certificate is provided, with such 77
donations collected to be forwarded monthly by the local 78
registrar to the county treasurer of such county and the 79
donations so forwarded to be deposited by the county 80
treasurer into the housing resource commission fund to 81
assist homeless families and provide financial assist ance to 82
organizations addressing homelessness in such county. The 83
local registrar shall include a check -off box on the 84
application form for such copies. All fees collected under 85
this subsection, other than the donations collected in any 86
county with a charter form of government and with more than 87
six hundred thousand but fewer than seven hundred thousand 88
inhabitants for marriage licenses and birth certificates, 89
shall be deposited to the official city or county health 90
agency. 91
4. A certified copy of a death record by the local 92
registrar can only be issued [within twenty-four hours of 93
receipt of the record by the local registrar. Computer- 94 SB 427 10
generated certifications of death records may be issued by 95
the local registrar after twenty -four hours of receipt of 96
the records] after acceptance and registration with the 97
state registrar. The fees paid to the official county 98
health agency shall be retained by the local agency for 99
local public health purposes. 100
5. No fee under this section shall be required or 101
collected from a parent or guardian of a homeless child or 102
homeless youth, as defined in subsection 1 of section 103
167.020, or an unaccompanied youth, as defined in 42 U.S.C. 104
Section 11434a(6), for the issuance of a certification, or 105
copy of such certification, of birth of such child or 106
youth. An unaccompanied youth shall be eligible to receive 107
a certification or copy of his or her own birth record 108
without the consent or signature of his or her parent or 109
guardian; provided, that only one certificate under this 110
provision shall be provided without cost to the 111
unaccompanied or homeless youth. For the issuance of any 112
additional certificates, the statutory fee shall be paid. 113