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COVID-19 Info for MN Funeral Directors

COVID-19 Information for Minnesota Funeral Directors

 

UPDATED GUIDANCE RECEIVED FROM MDH THANKS TO YOUR CALL TO ACTION - March 28 9:45pm


We truly are stronger together. After making your voice heard to your state representatives today, we have received the following update to the Minnesota Department of Health COVID-19: Funeral and Mortuary Science Guidance published yesterday (Friday).

 

Below is the updated language - you can view the full Guidance document here or scroll down to see it.

 

Individuals may leave home to attend funerals, whether at a place of worship, funeral home, burial site, or other similar location, provided that the gathering consists of no more than 10 attendees. The space utilized must allow for social distancing (six feet spacing between people). Venues should make accommodations for remote attendance, if possible, for others. Individuals who are at high risk from COVID-19 are strongly encouraged to attend remotely.

 

Thank you to everyone who talked to their state representative today! 

 


Saturday, March 28 - Minnesota Department of Health - COVID-19: Funeral and Mortuary Science Guidance

Essential Providers

  • Workers performing mortuary services, including funeral homes, crematoriums, and cemetery workers; including workers who coordinate with other organizations to ensure the proper recovery, handling, identification, transportation, tracking, storage and disposal of human remains are essential workers during COVID-19 response, pursuant to the Governor’s Executive Order 20-2020; and the U.S. Department of Homeland Security, and the CISA Guidance on the Essential Critical Infrastructure Workforce.

  • Funeral homes, crematories, and morticians are essential providers and authorized to perform within their scope of duty to take charge and remove deceased persons from the place of death, prepare a deceased person for final disposition in any manner, and make arrangements, provided that such arrangements comply with the Emergency Executive Order 20-2020, the March 19, 2020 Funeral and Mortuary Science Guidance; and the MDH Guidance on social distancing.

Emergency Executive Order 20-20, Directing Minnesotans to Stay at Home

  • Beginning Friday, March 27, 2020 at 11:59 pm through Friday, April 10, 2020 at 5:00 pm, all persons currently living in the State of Minnesota are ordered to stay at home in their current place of residence.

  • Individuals may leave home to attend funerals, whether at a place of worship, funeral home, burial site, or other similar location, provided that the gathering consists of no more than 10 attendees. The space utilized must allow for social distancing (six feet spacing between people). Venues should make accommodations for remote attendance, if possible, for others. Individuals who are at high risk from COVID-19 are strongly encouraged to attend remotely.

  • Funeral homes are authorized to meet with families to make arrangements for final disposition, but should do so by telephone or remotely when possible. If funeral homes must meet with families, they should do so provided they practice social distancing consistent with the Department of Health and CDC guidance.

  • Private viewing for the purpose of identifying the decedent by the person or persons with the right to control final disposition as described in Minnesota Statutes, section 149A.80, is acceptable provided that the viewing is consistent with the Department of Health and CDC guidance on social distancing.

  • Electronic or digital signatures are acceptable as long as they follow the guidelines in Minnesota Statutes, chapter 325L.

COVID-19 Funeral and Mortuary Science Guidance

  • The COVID-19 Funeral Guidance issued on March 19, 2020 is effective until Friday, March 27, at 11:59 pm. The COVID-19 Guidance for Infection Control remains in place during the duration of the COVID-19 response.

Ultimately, funeral homes and providers must comply with these guidelines in order to reduce the spread of the coronavirus, while meeting the needs of grieving families.

 


Internal Memorandum to MFDA members RE: Holding Decedents for Later Burial or Memorialization

Dear MFDA Members:

 

I write to address the nascent issue of funeral homes holding decedents for funeral/visitation/burial at a later time.  Right now, Minnesota Executive Order 20-20 expires April 10, 2020.  It is entirely possible that funeral homes and/or the families they serve may want to wait for a burial or funeral/visitation until after the current Order expires.  I can certainly understand that thinking.  However, I am very concerned that while the funeral home may have the best of intentions in wanting to serve the family and fulfill their requests, holding decedents could lead to some unexpected and unintended consequences.  As such, I strongly caution any funeral firm from agreeing to hold the decedent for funeral/visitation/burial at a later date.

 

First, we do not know when the COVID19 pandemic will end or when the “curve” of infection will flatten.  It is entirely possible- and should be anticipated- that the Governor will extend the Executive Order past April 10th.  We simply cannot know that one way or the other and I don’t want MFDA members to find themselves in a situation of holding decedents for longer than they originally anticipated.  Once you agree to hold a decedent for a family you will find it extremely difficult to convince a family that thought they could wait to have a “regular” (i.e. large) service to have a small service/graveside (ten people or less) if the Order is extended by several weeks. 

 

Second, I am concerned that once a funeral home agrees to hold a decedent for one family the funeral home will find most of the families they serve requesting the same treatment.  This could lead to both a “holding space” issue as the decedent must be sheltered in an appropriately secured facility, and an extreme backlog of services and burials when we can again have regular services and gravesides.  I recall my own work as a funeral director in northern Wisconsin before the winter burial rule went into effect.  For those who have had the experience of a large number of “spring burials” they know that it is an unenviable situation to be in. 

 

Each funeral firm has to make its own business decisions and we do not have a modern historical model we can look to for lessons.  My concern is that MFDA members be cognizant that just because the current Executive Order is set to expire on April 10th does not mean that another Order will not extend that date out several more weeks.  We don’t know, and my job as your General Counsel is to think several moves ahead and provide advice and counsel for what is an uncertain future.  With this in mind, you will have to rely on your own good judgment, proactively set expectations for the community you serve, and do your best to serve your families’ needs while balancing ethical, legal, and public health concerns.

 

Best of luck to all of you in these trying times.

 

Respectfully submitted,

Michael D. Sharkey, Esq.

MFDA General Counsel

Direct Dial:  952-525-6990

Fax:  952-546-0628

Email:  msharkey@cvmmlaw.com

 


Internal Memorandum to MFDA Members: Communicable Disease Disclosure Under HIPPA

 

I write to discuss a topic that has been around for almost 16 years, but which has only just now come back into the spotlight due to the COVID19 pandemic.  The topic is “does a hospital or long term care facility (nursing home) or other care facility have to tell you, the funeral director, that an individual died from COVID19?”  The answer is- of course- not perfectly black and white.

 

HIPPA rules prevent hospital and other care facilities from disclosing information about patients.  However, there are exceptions to this rule.  One of the exceptions is found at 45 CFR 164.512(g).  “CFR” means “Code of Federal Regulations” and is a fancy way of saying “federal law.”  A hospital or care facility has an obligation to protect the “PHI” (private health information) of a patient even after the patient dies.  Among the exceptions to this rule are that a hospital or care facility may tell a funeral director about a communicable disease because the communicable disease impacts the funeral director or embalmer’s handling of the decedent.  “Covered entity” means a hospital, nursing home, care facility, etc.   The black letter law reads as follows:

 

45 CFR 164.512(g) Standard: Uses and disclosures about decedents.

 

(2) Funeral directors. A covered entity may disclose protected health information to funeral directors, consistent with applicable law, as necessary to carry out their duties with respect to the decedent. If necessary for funeral directors to carry out their duties, the covered entity may disclose the protected health information prior to, and in reasonable anticipation of, the individual's death.

 

The good news for funeral service is that there is a very clear exception to HIPPA privacy disclosures for a funeral director seeking information regarding whether or not a person died of a communicable disease.  The bad news is two-fold: 1) Most hospital staff have no idea that there is a HIPPA exception for funeral directors; and 2) The rule says “may” not “shall,” so the hospital cannot be forced to make the disclosure.   In other words, there is nothing preventing the hospital or other care facility from telling you, the funeral director, that the decedent was COVID19 positive (or any other communicable disease for that matter).  However, there is also nothing that legally forces the hospital to do such. 

 

Do you have a right to know?  Yes, you do.  Is it an enforceable right? No, it is not.

 

You are, of course, free to tell the hospital or care facility that you will not make the removal unless they disclose whether or not the deceased had a communicable disease.  You are also free to tell the family that the hospital or care facility refuses to provide this information.  Whether you choose to do such is a business/professional judgment decision that you have to make for yourself. 

 

As a two-state licensed funeral director for more than 20 years I am fully aware of the mantra “you treat all decedents as if they have an infectious disease.”  I am also fully aware- just as I used to do myself when I would embalm- that we always use PPEs, practice universal precautions, and abide by the rules and principles of OSHA’s Bloodborne Pathogen Standard.  We all agree with this.  However, we also all know that if an individual is known to have something like antibiotic-resistant tuberculosis that body is treated differently by the funeral home and embalming staff (this is just an example- there are other communicable diseases that also have heightened handling standards).  I make no comment on whether or not a COVID19 positive body should be handled with increased precautions- you can review the CDC and WHO guidelines and recommendations (which, notably, differ) and make your own decisions about that.  I do know that I would want to know beforehand if an individual is COVID19 positive if for no other reason than the clean-up procedures are, per guidelines, somewhat different than standard.

 

I am including a PDF for everyone with the exact language taken from the original Code of Federal Regulations and the language germane to funeral directors highlighted for your ease of reference.  I suggest you print this off (print it off in color so the highlighting comes through) and have it available to show to any hospital or care facility staff who refuse to tell you if a decedent has a communicable disease or not.  Again- the problem is that while there is no legal reason why they cannot tell you a body has COVID19, there is no law that makes them tell you. 

 

I again wish you all the best of luck in your hard work and noble endeavors at such a tough time for the Dismal Trade. 

 

Take care,

 

Michael D. Sharkey, Esq.

MFDA General Counsel

 

  


Recommendations of the Minnesota Funeral Directors Association to Facilitate the Transfer of Deceased Patients from Nursing Homes, Long Term Care Facilities and Hospice Houses

 


Read our letter to MDH and Governor Walz's Office on behalf our MFDA members

 


Additional resources to help you stay informed and protected

 


MFDA Requests Minnesota Governor Tim Walz request to use emergency powers to identify deathcare workers amongst essential critical infrastructure workers

 

Inclusion of Deathcare Professionals in All COVID-19 Orders - Letter #1 - March 20, 2020

Time-sensitive request to use emergency powers to identify deathcare workers amongst essential critical infrastructure workers - Letter #2 - March 22, 2020

 


Minnesota Department of Health COVID-19 Funeral and Mortuary Science Guidance - March 19, 2020


Infection Control for the Funeral Home

  • Standard infection control practices should be used for someone who had died from COVID-19.
  • Use of standard personal protective equipment (PPE) including the use of facial protection to protect eyes, nose, and mouth should be worn by the mortician when preparing the body or embalming, especially if splashing of fluids is expected.
  • If shrouding, directly handling or washing the body are important religious or cultural practices, families are encouraged to work with their community cultural and religious leaders and funeral home staff on how to reduce their exposure as much as possible. Families should be encouraged to wear personal protective equipment if possible (such as disposable gown, face shield or goggles and facemask). Especially important would be for them to wear facial protection and perform hand hygiene when they are done.
  • Follow routine cleaning and disinfection procedures using an EPA-registered, hospital-grade disinfectant to clean the mortuary work area.

Funeral Guidance

  • Decedents can be buried or cremated following current state requirements.
  • It is possible to have a funeral but it should be limited to 50 and the venue must be able to accommodate social distancing of 6 feet per person.
  • Services with more than 10 people where the majority of participants are at higher risk for severe illness from COVID-19 should be postponed or cancelled.
  • Funeral homes should discourage families from providing food or beverages.
  • A suggestion to the families could be to postpone the funeral until the restrictions on numbers of attendees are lifted; this might be for several months or longer.
  • Funeral directors could offer livestreaming as an option for these services/viewings.
  • There is currently no known risk associated with being in the same room at a funeral or visitation service with the body of someone who has died of COVID-19. People should consider not touching or kissing the body of someone who has died of COVID-19 so this can be a recommendation to the funeral attendees.
  • People who feel sick or who are part of an at-risk population (e.g., the elderly, immune-compromised, etc.) should stay home per MDH recommendations.
  • Funeral homes should encourage families to practice social distancing at the service, wash their hands, and cover their coughs.
  • Encourage families to scale back direct contact like handshakes, hugging, and kissing at the service or funeral.
  • Funeral homes should supply tissues and alcohol- based hand rubs for the families to use.
  • Funeral homes should stock adequate supply of soap and paper towels in the rest rooms.

Ultimately, funeral homes will have to determine how they will best balance the guidance with the needs of their families. Each funeral home develop a plan to manage challenges presented with the current situation. The funeral home management should stay informed regarding current recommendations to protect their staff and families of the deceased.

References:


VA National Cemeteries and COVID-19 Update

March 23, 2020

 

All Department of Veterans Affairs (VA) National Cemeteries are open and will continue to provide interments for Veterans and eligible individuals. However, the National Cemetery Administration is continuing to adjust its services in light of the best practices urged by the CDC in response to the COVID-19 pandemic.

 

Starting March 23, 2020, as a matter of public health and safety, committal services and the rendering of military funeral honors, whether by military personnel or volunteer organizations, will be discontinued until further notice at VA national cemeteries. Immediate family members (limited to 10 individuals) of the deceased may choose to witness the interment if desired. Cemeteries will work to schedule a committal or memorial services at a later date for those families that choose to continue with the direct interment.

 

The National Cemetery Scheduling Office in St. Louis will continue to provide scheduling services for the duration of the current emergency. To schedule a burial, please call 800-535-1117, option 1.

 

We strongly urge all guests to obey local travel restrictions and avoid unnecessary travel. Visitors should expect that certain portions of a cemetery typically open to the public may be closed (for example, public information centers, chapels). Please contact the local cemetery for more information.

 

Updates on the operating status of individual national cemeteries are posted at https://www.cem.va.gov/alerts.asp 

 

Social media pages:  Facebook and Twitter


For more information about VA’s response to COVID-19 please visit: https://www.coronavirus.gov

 


Details are evolving daily and we will do our best to post helpful resources on our website. Feel free to let us know if you are aware of other helpful resources for us to post.

 


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