2007 Legislation
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SENATE BILL NO. 1069 – Cause of death, certification

SENATE BILL NO. 1069

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Bill Status



S1069.................................................by HEALTH AND WELFARE
VITAL STATISTICS - Amends and adds to existing law relating to vital
statistics to permit physician assistants and advanced practice
professional nurses to certify cause of death and to sign certificates of
stillbirth; to provide reference to the coroner when death is due to
natural causes and an authorized person is not available or is physically
incapable of signing and for circumstances of  stillbirths.
                                                                        
01/30    Senate intro - 1st rdg - to printing
01/31    Rpt prt - to Health/Wel
02/06    Rpt out - rec d/p - to 2nd rdg
02/07    2nd rdg - to 3rd rdg
02/09    3rd rdg - PASSED - 32-0-3
      AYES -- Andreason, Bair, Bastian, Bilyeu, Broadsword, Burkett,
      Cameron, Corder, Darrington, Fulcher, Gannon, Geddes, Goedde,
      Hammond, Heinrich, Hill, Jorgenson, Kelly, Keough, Langhorst, Little,
      Lodge, McGee, McKague, McKenzie, Pearce, Richardson, Schroeder,
      Siddoway, Stegner, Stennett, Werk
      NAYS -- None
      Absent and excused -- Coiner, Davis, Malepeai
    Floor Sponsor - Lodge
    Title apvd - to House
02/12    House intro - 1st rdg - to Health/Wel
03/09    Rpt out - rec d/p - to 2nd rdg
03/12    2nd rdg - to 3rd rdg
03/19    3rd rdg - PASSED - 68-0-2
      AYES -- Anderson, Andrus, Barrett, Bayer, Bedke, Bell, Bilbao, Black,
      Block, Bock, Boe, Bolz, Brackett, Bradford, Chadderdon, Chavez, Chew,
      Clark, Collins, Crane, Durst, Edmunson, Eskridge, Hagedorn, Hart,
      Henbest, Henderson, Jaquet, Killen, King, Kren, Labrador, Lake,
      LeFavour, Loertscher, Luker, Marriott, Mathews, McGeachin, Mortimer,
      Moyle, Nielsen, Nonini, Pasley-Stuart, Patrick, Pence, Raybould,
      Ring, Ringo, Roberts, Ruchti, Rusche, Sayler, Schaefer, Shepherd(2),
      Shepherd(8), Shirley, Shively, Smith(30), Snodgrass, Stevenson,
      Thayn, Trail, Vander Woude, Wills, Wood(27), Wood(35), Mr. Speaker
      NAYS -- None
      Absent and excused -- Harwood, Smith(24)
    Floor Sponsor - Bilbao
    Title apvd - to Senate
03/20    To enrol
03/21    Rpt enrol - Pres signed - Sp signed
03/22    To Governor
03/28    Governor signed
         Session Law Chapter 244
         Effective: 07/01/07

Bill Text


                                                                        
                                                                        
  ]]]]              LEGISLATURE OF THE STATE OF IDAHO             ]]]]
 Fifty-ninth Legislature                   First Regular Session - 2007
                                                                        
                                                                        
                                       IN THE SENATE
                                                                        
                                    SENATE BILL NO. 1069
                                                                        
                              BY HEALTH AND WELFARE COMMITTEE
                                                                        
  1                                        AN ACT
  2    RELATING TO VITAL STATISTICS; AMENDING SECTION 39-260, IDAHO CODE,  TO  PERMIT
  3        PHYSICIAN  ASSISTANTS AND ADVANCED PRACTICE PROFESSIONAL NURSES TO CERTIFY
  4        CAUSE OF DEATH, TO PROVIDE FOR REFERENCE TO THE CORONER WHEN DEATH IS  DUE
  5        TO  NATURAL  CAUSES AND AN AUTHORIZED PERSON IS NOT AVAILABLE OR IS PHYSI-
  6        CALLY INCAPABLE OF SIGNING, TO PERMIT PHYSICIAN  ASSISTANTS  AND  ADVANCED
  7        PRACTICE  PROFESSIONAL  NURSES TO SIGN CERTIFICATES OF STILLBIRTH, TO PRO-
  8        VIDE FOR CIRCUMSTANCES FOR REFERENCE OF STILLBIRTHS TO THE CORONER AND  TO
  9        MAKE  TECHNICAL  CORRECTIONS;  AND AMENDING SECTION 39-268, IDAHO CODE, TO
 10        PERMIT PHYSICIAN ASSISTANTS AND ADVANCED PRACTICE PROFESSIONAL  NURSES  TO
 11        AUTHORIZE FINAL DISPOSITION OF DEATHS AND STILLBIRTHS, TO REVISE CODE REF-
 12        ERENCES AND TO MAKE TECHNICAL CORRECTIONS.
                                                                        
 13    Be It Enacted by the Legislature of the State of Idaho:
                                                                        
 14        SECTION  1.  That  Section  39-260, Idaho Code, be, and the same is hereby
 15    amended to read as follows:
                                                                        
 16        39-260.  REGISTRATION OF DEATHS AND STILLBIRTHS.  (a1)  A  certificate  of
 17    each  death which occurs in this state shall be filed with the local registrar
 18    of the district in which the death occurs, or as  otherwise  directed  by  the
 19    state registrar, within five (5) days after the occurrence. However, the board
 20    shall,  by rule and upon such conditions as it may prescribe to assure compli-
 21    ance with the purposes of the vital statistics act, provide for the filing  of
 22    death  certificates  without medical certifications of cause of death in cases
 23    in which compliance with the applicable  prescribed  period  would  result  in
 24    undue hardship; but provided, however, that medical certifications of cause of
 25    death  shall  be  provided  by  the certifying physician, physician assistant,
 26    advanced practice professional nurse or coroner to the vital  statistics  unit
 27    within fifteen (15) days from the filing of the death certificate. No certifi-
 28    cate  shall  be deemed complete until every item of information required shall
 29    have been provided or its omission satisfactorily accounted  for.  When  death
 30    occurs  in  a  moving  conveyance  in  the United States and the body is first
 31    removed from the conveyance in this state, the death shall  be  registered  in
 32    this  state  and the place where the body is first removed shall be considered
 33    the place of death. When a death occurs on a moving conveyance while in inter-
 34    national air space airspace or in a foreign country or its air space  airspace
 35    and  the  body  is  first removed from the conveyance in this state, the death
 36    shall be registered in this state but the certificate shall  show  the  actual
 37    place  of death insofar as can be determined. If the place of death is unknown
 38    but the dead body is found in this state, the certificate of  death  shall  be
 39    completed  and filed in accordance with this section. The place where the body
 40    is found shall be shown as the place  of  death.  If  the  date  of  death  is
 41    unknown, it shall be determined by approximation.
 42        The  person in charge of interment or of removal of the body from the dis-
 43    trict shall be responsible for obtaining and filing the certificate. Said per-
                                                                        
                                       2
                                                                        
  1    son shall obtain the required information from  the  following  persons,  over
  2    their respective signatures:
  3        (1a)  Personal data shall be supplied by the person best qualified to sup-
  4        ply them; and
  5        (2b)  Except  as otherwise provided, medical data shall be supplied by the
  6        physician, physician assistant or advanced practice professional nurse who
  7        attended the deceased during the last illness, who shall  certify  to  the
  8        cause  of  death  according  to his best knowledge, information and belief
  9        within seventy-two (72) hours from time of death. In the  absence  of  the
 10        attending physician, physician assistant or advanced practice professional
 11        nurse  or  with  said physician's person's approval the certificate may be
 12        completed and signed by said physician's person's associate, physician who
 13        must be a physician, physician assistant or advanced practice professional
 14        nurse, the chief  medical  officer  of  the  institution  in  which  death
 15        occurred,  or  the  physician  who performed an autopsy upon the decedent,
 16        provided such individual has access to the medical history  of  the  case,
 17        views the deceased at or after death, and death is due to natural causes.
 18        (b2)  The person in charge of interment or of removal of the body from the
 19    district  shall  refer  the  following  cases to the coroner who shall make an
 20    immediate investigation, supply the necessary medical data, and certify to the
 21    cause of death:
 22        (1a)  When no physician, physician assistant or advanced practice  profes-
 23        sional nurse was in attendance during the last illness of the deceased; or
 24        (2b)  When  the  circumstances suggest that the death occurred as a result
 25        of other than natural causes; or
 26        (c)  When death is due to natural  causes  and  the  physician,  physician
 27        assistant  or  advanced  practice  professional  nurse  who  attended  the
 28        deceased during the last illness or said person's designated associate who
 29        must be a physician, physician assistant or advanced practice professional
 30        nurse, is not available or is physically incapable of signing.
 31        (c3)  When  a death is presumed to have occurred within this state but the
 32    body cannot be located, a death certificate may be prepared by the state  reg-
 33    istrar  upon  receipt  of  an  order of a court of record of this state, which
 34    shall include the finding of facts required to complete the death certificate.
 35    Such a death certificate shall be marked "presumptive" and shall show  on  its
 36    face  the  date  of  registration and shall identify the court and the date of
 37    decree.
 38        (d4)  Each stillbirth, defined as a spontaneous fetal death of twenty (20)
 39    completed weeks gestation or more, based on a clinical estimate of  gestation,
 40    or  a  weight  of three hundred fifty (350) grams (twelve and thirty-five hun-
 41    dredths (12.35) ounces) or more, which occurs in this state  shall  be  regis-
 42    tered  on a certificate of stillbirth within five (5) days after delivery with
 43    the local registrar of the district in  which  the  stillbirth  occurred.  All
 44    induced  terminations  of pregnancy shall be reported in the manner prescribed
 45    in section 39-261, Idaho Code, and shall not be reported  as  stillbirths.  No
 46    certificate  shall be deemed complete until every item of information required
 47    shall have been provided or its omission satisfactorily accounted for.
 48        (1a)  When a stillbirth occurs in an institution, the person in charge  of
 49        the  institution or a designated representative shall prepare the certifi-
 50        cate, obtain the  signature  of  the  physician,  physician  assistant  or
 51        advanced  practice  professional nurse in attendance, (except as otherwise
 52        provided in subsection 39-260(e), Idaho Code) (5)  of  this  section,  who
 53        shall  provide the medical data, and forward the certificate to the morti-
 54        cian or person acting as such. In the absence of the attending  physician,
 55        physician  assistant  or advanced practice professional nurse or with said
                                                                        
                                       3
                                                                        
  1        physician's person's approval the certificate may be completed and  signed
  2        by said physician's person's associate, physician who must be a physician,
  3        physician  assistant  or  advanced  practice professional nurse, the chief
  4        medical officer of the institution in which the  stillbirth  occurred,  or
  5        the  physician  who  performed an autopsy on the stillborn fetus, provided
  6        such individual has access to the medical history of the  case  and  views
  7        the  fetus  at or after stillbirth. The mortician or person acting as such
  8        shall provide the disposition information and file  the  certificate  with
  9        the local registrar.
 10        (2b)  When  a  stillbirth  occurs outside an institution, the mortician or
 11        person acting as such shall complete the certificate, obtain  the  medical
 12        data  from  and  signature  of the attendant at the stillbirth, (except as
 13        otherwise provided in subsection 39-260(e), Idaho Code) (5) of  this  sec-
 14        tion,  and  file the certificate. If the attendant at or immediately after
 15        the stillbirth is not a physician, physician assistant or  advanced  prac-
 16        tice  professional  nurse, the coroner shall investigate and sign the cer-
 17        tificate of stillbirth.
 18        (3c)  When a stillbirth occurs in a moving conveyance in the United States
 19        and the stillborn fetus is first  removed  from  the  conveyance  in  this
 20        state,  the  stillbirth  shall  be  registered in this state and the place
 21        where the stillborn fetus is first removed shall be considered  the  place
 22        of  stillbirth.  When  a stillbirth occurs in a moving conveyance while in
 23        international air space airspace or in a foreign country or its air  space
 24        airspace  and  the stillborn fetus is first removed from the conveyance in
 25        this state, the stillbirth shall be registered in this state but the  cer-
 26        tificate  shall  show  the  actual  place  of stillbirth insofar as can be
 27        determined.
 28        (4d)  When a stillborn fetus is found in  this  state  and  the  place  of
 29        stillbirth is unknown, it shall be reported in this state. The place where
 30        the stillborn fetus was found shall be considered the place of stillbirth.
 31        (5e)  The name of the father shall be entered on the certificate of still-
 32        birth as provided by section 39-255, Idaho Code.
 33        (5)  The  person  responsible  for  the  preparation  or completion of the
 34    stillbirth certificate as stated in subsections (4)(a) and (b) of this section
 35    shall refer the following cases to the coroner who  shall  make  an  immediate
 36    investigation,  supply  the necessary medical data and certify to the cause of
 37    stillbirth:
 38        (ea)  When the circumstances suggest that the  stillbirth  occurred  as  a
 39        result of other than natural causes, (excepting legally induced abortions,
 40        as defined by section 39-241, Idaho Code), the local registrar shall refer
 41        the  case to the coroner in the county where the stillbirth occurred. Said
 42        coroner shall make an immediate investigation, supply the necessary  medi-
 43        cal data, and certify to the cause of stillbirth; or
 44        (b)  When  death  is  due  to  natural causes and the physician, physician
 45        assistant or advanced practice professional  nurse  in  attendance  at  or
 46        immediately  after the stillbirth or said person's designated associate is
 47        not available or is physically incapable of signing.
                                                                        
 48        SECTION 2.  That Section 39-268, Idaho Code, be, and the  same  is  hereby
 49    amended to read as follows:
                                                                        
 50        39-268.  AUTHORIZATION  FOR FINAL DISPOSITION. (a1)  The mortician or per-
 51    son acting as such who first assumes possession of a dead  body  or  stillborn
 52    fetus  shall  make  a written report to the registrar of the district in which
 53    death or stillbirth occurred or in which the body or stillborn fetus was found
                                                                        
                                       4
                                                                        
  1    within twenty-four (24) hours after taking possession of the body or stillborn
  2    fetus, on a form prescribed and furnished by the state registrar and in accor-
  3    dance with regulations rules promulgated by the board. Except as specified  in
  4    subsection  (b2)  of this section, the written report shall serve as permit to
  5    transport, bury or entomb the body or stillborn fetus within this state,  pro-
  6    vided  that the mortician or person acting as such shall certify that the phy-
  7    sician, physician assistant or advanced practice professional nurse in  charge
  8    of  the patient's care for the illness or condition which resulted in death or
  9    stillbirth  has  been  contacted  and  has  affirmatively  stated  that   said
 10    physician,  physician assistant or advanced practice professional nurse or the
 11    physician's  designated  associate  according  to  section  39-260(a1)(2b)  or
 12    (d4)(1a), Idaho Code, will sign the certificate of death or stillbirth.
 13        (b2)  The written report as specified in subsection (a1) of  this  section
 14    shall not serve as a permit to:
 15        (1a)  Remove a body or stillborn fetus from this state;
 16        (2b)  Cremate the body or stillborn fetus; or
 17        (3c)  Make  disposal  or disposition of any body or stillborn fetus in any
 18        manner when inquiry is required under chapter 43, title 19, Idaho Code, or
 19        section 39-260(b2) or (e5), Idaho Code.
 20        (c3)  In accordance with the provisions of subsection (b2)  of  this  sec-
 21    tion, the mortician or person acting as such who first assumes possession of a
 22    dead  body or stillborn fetus shall obtain an authorization for final disposi-
 23    tion prior to final disposal or removal from the state of the body  or  still-
 24    born fetus. The physician, physician assistant, advanced practice professional
 25    nurse  or  coroner responsible for signing the death or stillbirth certificate
 26    shall authorize final disposition of the body or stillborn fetus,  on  a  form
 27    prescribed  and  furnished  by  the state registrar. If the body is to be cre-
 28    mated, the coroner must also give additional authorization.  In  the  case  of
 29    stillbirths,  the hospital may dispose of the stillborn fetus if the parent(s)
 30    so requests; authorization from the coroner is not necessary unless the  coro-
 31    ner is responsible for signing the certificate of stillbirth.
 32        (d4)  When a dead body or stillborn fetus is transported into the state, a
 33    permit  issued  in  accordance with the law of the state in which the death or
 34    stillbirth occurred or in which the body or stillborn fetus  was  found  shall
 35    authorize the transportation and final disposition within the state of Idaho.
 36        (e5)  A  permit  for  disposal shall not be required in the case of a dead
 37    fetus of less than twenty (20) weeks gestation and  less  than  three  hundred
 38    fifty  (350)  grams  or twelve and thirty-five hundredths (12.35) ounces where
 39    disposal of the fetal remains is made within the institution where the  deliv-
 40    ery of the dead fetus occurred.

Statement of Purpose / Fiscal Impact


                         STATEMENT OF PURPOSE

                               RS 16540

Section 39-260, Idaho Code, spells out which health care professionals 
(physicians and county coroners) can certify a death or a stillbirth 
certificate and Section 39-268, Idaho Code, allows only certain health 
care professionals (physicians and county coroners) to give 
authorization for final disposition or removal of dead bodies and 
stillborn fetuses.  Section 54-1102, Idaho Code, was changed in 2004 
to allow advanced practice professional nurses to work with no 
physician supervision.  Since then, the Bureau of Health Policy and 
Vital Statistics has received certificates signed by advanced practice 
professional nurses that had to be rejected because they are not 
authorized to certify death or stillbirth certificates according to 
section 39-260, Idaho Code.  This legislation would allow advanced 
practice professional nurses to sign death and stillbirth certificates 
and to authorize final disposition or removal of dead bodies and 
stillborn fetuses. 

Additionally, physician assistants cannot certify death and stillbirth 
certificates or authorize final disposition or removal of dead bodies 
and stillborn fetuses.  In some areas of the state, physicians are not 
available to sign these certificates and only the county coroner can 
sign the certificates or authorize final disposition.  The Bureau of 
Health Policy and Vital Statistics has received certificates signed by 
physician assistants that had to be rejected because they are not 
authorized to certify death or stillbirth certificates according to 
section 39-260, Idaho Code.  This legislation would allow physician 
assistants who are providing health care to sign the certificates and 
to give authorization for final disposition or removal of dead bodies 
and stillborn fetuses.

In some circumstances, where the person in attendance is not available 
to sign the certificates, the certificates cannot be completed until 
the person is available again, often after the time frame for 
submission of the certificates has passed.  This legislation would 
allow coroners to sign certificates in these circumstances so that 
families are not being inconvenienced while waiting for the person in 
attendance to return.

This legislation requires the definitions in section 39-241 that are 
being proposed.


                               FISCAL NOTE

No fiscal impact.



CONTACT
Name:	Greg Heitman
Agency:	Health and Welfare
Phone:	208-334-5986

STATEMENT OF PURPOSE/FISCAL NOTE                          	S 1069