virginia board of funeral directors and embalmers person is uncertain about the cause of death he...

Term Care Administrators, De-partment of Health -Vital Re-cords & Medical ExaminersOffice, Hospital Association,Board of Medicine and theBoard of Nursing, Medical So-ciety of Virginia, Virginia Col-lege of Emergency Physiciansand the Virginia Academy ofFamily Physicians. A list ofpossible resolutions was devel-oped from this meeting and adraft legislative bill was thenprepared.The proposed legislation wouldexpand the pool to includenurse practitioners, physicianassistants and hospitalists to thelist of persons authorized tosign death certificates. Addi-tionally, if a physician or otherauthorized person is uncertainabout the cause of death heshall use his best medical judg-ment to certify a reasonablecause of death or contact theoffice of the chief medical ex-aminer in the district where the

What a productive year it hasbeen. As you know we havehad several committee meet-ings since our last boardmeeting. The board has tack-led some difficult and longstanding issues such as physi-cians not signing death cer-tificates, preneed issues, leg-islative and regulatorychanges and their effect onpolicy. I would first like tothank the board, the associa-tions and many individualsfor your outstanding commit-ment to the board and yourwillingness to dedicate yourtime and expertise as we con-tinue to work through theseissues.During this past year, I havehad the opportunity to makenumerous presentations andattend funeral associationmeetings throughout Vir-ginia. I commonly heard thedifficulties that funeral direc-tors encounter when physi-

cians do not sign a death cer-tificate in a timely manner.Although attempted before,the Board of Funeral Direc-tors and Embalmers felt thatthis was an important issue totackle and created a SpecialTask Force to work on devel-oping a solution(s) to theproblem.On April 30, 2010, the Spe-cial Task Force met and de-veloped a list of major con-cerns and a list of possiblesolutions. On May 18, 2010,board staff met with Dr.Bush, Chief Medical Exam-iner and Janet Rainey, Direc-tor, Bureau of Vital Statisticsto review the minutes fromthe previous meeting anddiscuss if the possible solu-tions may be feasible. OnJune 16, 2010, a highly pro-ductive meeting was heldwith all stakeholders, includ-ing VHCA, Board of Long-

Lisa R. Hahn, MPA, Board Executive Director

Board President-Randy Minter, FSP (2009-2010)The Board of Funeral Direc-tors and Embalmers and staffhave worked diligently onmany accomplishments thispast year. Various commit-tees of the board includingLegislative, Special Confer-ence, Internship and Continu-ing Education have had abusy and fruitful year ofwhich this report willspeak. On behalf of the

board, I would like to expressmy thanks to Lisa Hahn, ourExecutive Director, and herstaff- Annie Artis, KathyTruesdale, Missy Currier,Holly Manke, and JeannetteMeade for their finework. Our Board couldnot offer such quality publicservice if not for their colle-gial and conscientious efforts.As I complete my tenure as

President of the Board, I amhappy to introduce this newslet-ter which speaks of our accom-plishments of the past year. Iexpress my thanks to the entireboard, the funeral service asso-ciations, and funeral service pro-fessionals and establishments inour great Commonwealth in pro-viding their assistance in manyof these endeavors.

Board Members:

Michael J. Leonard, FSPPresident

Robert B. Burger, Jr., FSPVice-President

Blair H. Nelsen, FSPSecretary-Treasurer

Randolph T. Minter, FSP

Willard ‘Skip’ Tharp, FSP

Billie Watson Hughes, FSP

Barry M. Murphy, FSP

Walter S. Ball

Rev. Yvvone Jones Bibbs

Boards of Funeral Directors& Embalmers, PhysicalTherapy, & Long Term CareAdministrators Staff:

Lisa R. HahnExecutive Director

Annie B. ArtisLicensure Manager

Kathy TruesdaleDiscipline Manager

Jeanette MeadeLicensing Specialist

Holly MankeLicensing Specialist

Missy CurrierLicensing Specialist

Board of Funeral Directors andEmbalmersPerimeter Center9960 Mayland Drive, Suite 300Henrico, Virginia 23233-1463804-367-4479 Phone804-527-4413 [email protected]

SUMMER 2010Issue 4

D E P A R T M E N T O F H E A L T H P R O F E S S I O N S

VirginiaBoard of Funeral Directors and Embalmers

week of July 19, 2010.

VDH will develop a freeonline CME/CEU mod-ule on “How to Completea Death Certificate.” Alink to the module will beplaced on the Departmentof Health Professionswebsite. This modulewill be available by July23, 2010.

VDH will contact theDeans of all medicalschools in Virginia, dur-ing August 2010 andrequest that they encour-age all physicians-in-training to review theCME module.

Training will be providedto local health districtdirectors on July 28,2010 concerning properdeath certification so thatthey can be a communityresource for private phy-sicians. Local healthdistrict directors will beavailable as a 24/7 pointof contact for physiciansif they have questionsconcerning how to com-plete a death certificate.

VDH will work withstakeholders, includingthe Virginia Funeral Di-rectors Association, toidentify areas of the statethat are experiencingparticular difficultieswith respect to the timelycompletion of death cer-tificates. VDH will de-velop targeted communi-cations for those specificareas in August and Sep-tember.

VDH will develop anagency policy to governour approach for assur-ing that death certifi-cates are signed andcompleted in a timelymanner, consistent withthe requirements of theCode of Virginia, bySeptember 1, 2010.

VDH will present anoverview of this initia-tive at the upcomingmeeting of the VirginiaCollege of EmergencyPhysicians and otherrelevant medical confer-ences.

VDH will ensure thatour non-physician stake-holder organizations,including the VirginiaHospital and HealthcareAssociation, the Vir-ginia Health Care Asso-ciation, and the VirginiaAssociation of Non-profit Homes for theAging, are aware of thisinitiative during August2010.

VDH will develop amethodology to evaluatethe success of this initia-tive prior to release ofthe course and revieweffectiveness during thefirst year of operation.

We are very pleased with thecooperation and attention thathas been demonstrated bymany stakeholders thus far.We look forward to workingcollaboratively together to

ensure that these measurestaken or soon to be taken dohelp to resolve the death cer-tificate issues facing funeraldirectors and the citizens ofthe Commonwealth.

It is my pleasure to serve asthe Executive Director of theBoard and to highlight someof the board’s 2010 accom-plishments. As you can see,your board is a very strongand active board. They taketheir appointments seriouslyand pride themselves on pro-tecting the citizens of theCommonwealth.

I wish you a safe and happysummer!

Board Executive Director Continued

death occurred to obtainguidance in reaching a de-termination as to a cause ofdeath and document thesame. The proposed legisla-tion would also give a phy-sician, nurse practitioner orphysician assistant who, ingood faith signs a certificateof death, immunity fromcivil liability, absent grossnegligence or willful mis-conduct. Lastly, it is recom-mended that a signed deathcertificate be required priorto removal of a dead humanbody from a licensed hospi-tal. The legislative proposalshave been sent to all indi-viduals that are on the Pub-lic Participation GuidelineList for comment. We haveincluded the draft bill in thisnewsletter, see page 10.In addition, Dr. Karen Rem-ley, Commissioner of theVirginia Department ofHealth took the followingaction steps towards resolv-ing the ongoing issue oftimely completion and sig-natures of death certificates.These steps include: VDH will send a letter

to all physicians,nurses, funeral directorsand emergency medicalservices providers con-cerning the purpose ofdeath certificates, whythey are important, whois responsible for com-pleting them, how tocomplete the death cer-tificate form, and a de-scription of progress weare making towardsimplementing electronicdeath certificates. Theletter will also includelinks to additional train-ing resources. The let-ter will be issued the

Crematory Regulations

The Board’s current regulations,effective June 9, 2010, addressthe standards of practice for cre-matories, ensuring the integrityof the cremation process.Any person intending to own oroperate a Crematory in Virginiamust register the Crematory withthe Virginia Board of FuneralDirectors and Embalmers, atleast 30 days prior to opening.An inspection is also required.Every Crematory regardless ofhow it is owned must have amanager of record.The manager of record musthave certification by the Crema-tion Association of North Ameri-can (CANA); or International

Association (ICCFA); or othercertification recognized by theBoard.Currently the Manager of Recordfor a “Stand Alone” Crematory -meaning not part of a funeral ser-vice establishment or branch anddoes not serve the public directly,- is not required to hold licensureas a Funeral Service Provider.However, he must be in compli-ance and is fully accountable forthe operations of the crematory asit pertains to the laws and regula-tions governing the practice offuneral services.A Crematory providing cremationservices directly to the publicmust also be licensed as a funeralservice establishment.

Guidance Documents

reports, posting of licen-sure, which should alwaysbe posted in plain view ofthe public in conspicuousplace to consumers, dis-posal of waste materials,and preparation rooms.

Guidance Document 65-11provides clarification onfrequently asked inspectionquestions. You can find theDocument posted to theAgency's website.

Many questions pertainingto standards of practicemay be addressed in aGuidance Document.

All of the Board’s Guid-ance Documents arep o s t e d o n l i n e a twww.dhp.virginia.gov.

The Board has developedan Inspections GuidanceDocument in a question andanswer format.

Areas of interest includeproper handling and storageof human remains, refrig-eration, appropriate con-tainers for transporting abody to a funeral home orcrematory, crematory man-ager of record, general pricelist (GPL), embalming

Public Comment is received atthe beginning of each boardmeeting.Check the website often formeeting postings.

All board meetings are opento the public and unless oth-erwise stated, are usuallyheld at the Department ofHealth Professions on the 2ndfloor in the Conference Cen-ter. Should you wish to attenda meeting please call theboard office at 804-367-4479 the day before meet-ing to ensure there have notbeen any cancellations orpostponements.

2010 Meetings:

January 12, 2010 - Board Meet-ing & IFC

February 19, 2010 - Special

I n te rn sh ip P rogram Sub-Committee

February 23, 2010 - IFC

March 30, 2010 - Special Intern-ship Program Sub-Committee

April 13, 2010 - Board Meeting

April 30, 2010 -Task Force onDeath Certificates

May 10, 2010 - Special Commit-tee on Preneed Issues

May 13, 2010 - Task Force onDeath Certificates

June 11, 2010 - Telephonic Con-ference

June 16, 2010 - Task Force onDeath Certificates

June 24, 2010 - IFC

July 8, 2010 - Regulatory/Legislative Meeting

July 20, 2010 - Board Meeting

July 20, 2010 - CEU Meeting

October 22, 2010 - Board Meet-ing, 10:00 a.m.

Board meeting dates and minutesare posted to the Department’swebsite at www.dhp.virginia.govand to Town Hall’s website atwww.townhall.virginia.gov Youmay register on Town Hall toreceive email alerts of whenmeeting dates and minutes areposted. You will also receiveregulatory updates.

Board Calendar of Events

Federal Trade Commission (FTC) - Funeral Ruleintends to do with the in-formation;

The caller is not a con-sumer seeking to makefuneral arrangements withthe provider;

The call will or may profitfrom receipt of the pricinginformation requested;

The caller has not re-quested price informationin person at the funeralhome;

The caller has not re-quested price informationin writing; or

The caller has not paid afee, or agreed to pay afee, for the price informa-tion.

None of the above reasonsare grounds for non-compliance with the FederalRule in providing this infor-mation. Funeral Rule - Part453 Funeral Industry Prac-tices may be found on FTC’s

website www.ftc.gov

§ 453.2 Price disclosuresTelephone price disclosure.Tell persons who ask by tele-phone about the funeral pro-vider's offerings or pricesany accurate informationfrom the price lists describedin paragraphs (b) (2) through(4) of this section and anyother readily available infor-mation that reasonably an-swers the question.

The Definitions of personsincludes any individual, part-nership, corporation, associa-tion, government or govern-mental subdivision or agency,or other entity.

Complying with the FuneralRulehttp://www.ftc.gov/bcp/edu/pubs/business/adv/bus05.shtmAt the same time, as theGuide recognizes, funeralproviders may;

Virginia Funeral Service Pro-viders not only comply withstate statutes and regulations,but also with federal lawsand guidelines. The FTC haspublished the Funeral Rule.Under the Federal TradeCommission (FTC) FuneralRule the Funeral Providermust provide this informa-tion. Refusal of this informa-tion is considered a viola-tion of the Funeral Rule, forany reason, such as:State law does not re-

quire a funeral providerto disclose price informa-tion by telephone or per-mits a funeral provider torefuse to provide priceinformation by telephone;

Price information can beprovided only by a third-party other than the fu-neral provider (e.g., thefuneral provider’s attor-ney);

The caller will not discloseinformation about theirorganization, or what it

(1) use answering machines torecord incoming calls orto advise callers to call aspecified number duringbusiness hours to getprice information;

(2) decline to provide priceinformation outside ofregular business hours ifthat is the provider’snormal practice; and

(3) take a message if in themiddle of an arrange-ments conference, andcall back to provideprice information at alater time. In each ofthese cases, the Rule re-quires that the funeralprovider furnish priceinformation promptly byreturning the telephonecall.

These are the expressedviews of the FTC staff.

be used with program; (5)sample certificate of comple-tion for CE; and lastly (6) ad-vertising brochure for CE pro-gram.Keep in mind there will be norefund of the application feewhether approval is grantedor denied.With that being said, it is im-portant that the CE coursesubmitted complies with theregulations.Acceptable areas of studyrelating to funeral services areethics, standards of practice,preneed funeral arrange-ments, preneed contracts andfunding, Virginia laws andregulations governing the pro-fession of funeral services.Once approved as a boardCE provider, you will be re-sponsible for renewal eachyear by July 1. Renewal no-

All Continuing Education (CE)Providers that wish to be con-sidered for board approvalto offer CE should submit anapplication, application fee,and supporting documents tothe board office at least 60days prior to offering thecontinuing education course.The board is now requiringsupporting documentation onCD in PDF format (Adobe).Four (4) CDs must be includedwith the paper applicationand fee, the CDs must be“unprotected”.The CD shall include the fol-lowing information and book-marked in the order of: (1)title of course, objectives, andnumber of continuing educa-tion hours; (2) syllabus ofcourse; (3) instructional plan;(4) course instructor creden-tials; (5) evaluation forms to

tices are usually sent out atleast 30 days prior to theexpiration date; however,failure to receive a renewalnotice does not relieve theobligation to renew the CEProvider license.Failure to renew may result inlate fees and additional docu-mentation.Should you not receive therenewal notice you may sub-mit a copy of the license asevidence of intent to renew,the required renewal feealong with a statement thatthe courses and instructorsoffered for the coming yearwill not change from the previ-ous year. If there will be ad-ditions or alterations to thecontinuing education offered,resubmission of documentation,application, and a providerfee is required.

Continuing Education Providers

Current Continuing Competency Hours RequiredEmbalmers. A list of approved CEproviders and courses are online atwww.dhp.virginia.gov

PLEASE NOTE:The Board will soon be performinga random audit for the March 31,2008—March 31, 2010 licensureperiod. In the event you are au-dited, please be sure to providedocumentation of having completed10 hours of CE with at least two (2)hours in Preneed and two (2) hoursin law and regulations.

The board may conduct arandom audit after the endof each renewal period andthe licensee is required toverify compliance with therequirement for that renewalperiod.Upon request, the licenseemust provide documentationwithin 14 days of the requestfrom the board.Acceptable forms of docu-mentation include officialtranscripts showing credithours earned from an ac-credited institution; or certifi-cates of completion from ap-proved providers.NOTE: Continuing educationhours required by discipli-nary order may not be usedto satisfy renewal require-ments.The professions under theBoard responsible for CE areFuneral Service Providers(FSP), Funeral Directors, and

Issue 4

Internship Committee

“ONLY TWO

EXTENSIONSWILL BE

GRANTED TO AFUNERAL SERVICE

INTERN DURINGTHE INTERNSHIP

PROGRAM”

The Virginia Board of Funeral Directorsand Embalmers has appointed a sub-committee to address granting funeralservice internship extensions and ultimatelyimproving the program to better prepareinterns for the funeral service industry asfuneral service providers (FSP).The Special Internship Sub-Committee hasheld two meetings, February 19th and March30th; Mortuary School Program Directorswere invited to participate on the Commit-tee.Several proposals and suggestions havebeen made in the areas of educationalrequirements and the supervisory responsi-bilities for internship program.The sub-committee proposed a GuidanceDocument to address internship extensions;recommendations were:

The intern must submit a letter addressingthe impediments that are interfering withthe completion of the internship.The intern shall submit a copy of their col-lege transcripts to demonstrate hours com-pleted toward the mortuary educationalrequirement.The intern would provide a specific time-frame for the extension.

Only two (2) extensions may begranted to an intern.

The Board discussed other recommenda-tions from the Committee but they did notapprove any additional changes at thistime.

Irrevocable Trusts

FAST TRACK clarification will be made between the Code ofVirginia and the regulations related to irrevocable trusts by thefollowing proposed language:

18VAC65-30-110. Cancellation or transfer of contract. D. If the contract buyer uses an irrevoca-ble trust as the funding source, the contract buyer is not able to cancel or modify the trust after30 days following its execution except in accordance with § 55-544.11 of the Code of Vir-ginia.

2010 ELECTION OF OFFICERS

Congratulations to the following members who were elected as thenew officers for the 2010/2011 tenure:

Michael J. Leonard, FSP, President

Robert B. Burger, FSP, Vice-President

Blair Nelsen, FSP, Secretary-Treasurer

We look forward to working diligently throughout the next year withthe newly elected officers!

Disciplinary Matters

The Department’s Complaint In-take Unit receives informationfrom sources indicating that a vio-lation of law or regulation mayhave occurred. These sources mayinclude health care practitioners,employers and employees, otherlicensed professionals, law en-forcement agencies, courts, orconcerned citizens. When informa-tion appears to be sufficient to jus-tify an investigation, a case isopened, given a priority, recordedin the agency's computer trackingsystem and assigned to an investi-gator.

When information indicates that aviolation of law or regulation withinthe Department's jurisdiction mayhave occurred, a specially-trained,sworn investigator of the Enforce-ment Division interviews potential

How an Investigation is Begun

The Investigation

witnesses, obtains copies ofrelevant documents and accu-mulates evidence.Persons involved in a case cancommunicate directly with theassigned investigator. The in-vestigator may periodically con-tact sources of information toadvise them of the status of theinvestigation. It is the Depart-ment's policy to provide asmuch time and effort as is re-quired for a thorough investiga-tion.When the investigation is com-plete, the investigator writes acomprehensive report and sub-mits it, along with all the re-cords and evidence, to the ap-propriate regulatory board forconsideration and action.

When a board receives the in-vestigative report, a preliminaryreview of the case is made todetermine whether the evidence

Board Action

is sufficient to indicate that aviolation of law or regulationhas occurred. If the evidenceis not sufficient for that pur-pose, the case is then closedand no further action istaken. If the board believesthere is sufficient evidence toindicate that a violation hasoccurred, disciplinary actionmay be taken. An informalconference may be scheduledat which a committee of theboard meets with the licen-see. All informal conferencesare open to the public. Thesource of the investigatedinformation is notified of theconference and may attend.While he or she may be al-lowed to speak at the infor-mal, testimony is not re-quired at this level. If thecase is not resolved at theinformal level, a formal hear-ing will be held.

From time to time, staff at theDepartment of Medical Assis-tance Services, have been toldof instances where an individ-ual purchased a pre-needburial arrangement that wassignificantly altered by familymembers at the time of theindividual's death. In suchsituations, the family optsfor less expensive burial ar-rangements and receives arefund of the difference be-tween the original pre-needagreement and the actual ar-rangement.

This is just a reminder that, ininstances where this may hap-pen, the Code of Vir-ginia requires that any moneyto be refunded would go tothe Commonwealth of Virginia,Department of Medical Assis-tance Services for reimburse-ment of medical expensespaid on the individual's be-half and not to the familymembers.

Section 55-1 9.5 of the Codeof Virginia addressestrusts. Item E. in this sectionprovides that funds remainingin an irrevocable inter vivostrust created for the purposeof paying an individual's fu-neral and burial expensesmay be exempt as a count-able resource in determiningeligibility for medical assis-tance benefits through theMedicaid program.

However, in the event that anyamount remains in the trustupon payment of the funeralor burial arrangements pro-vided for the individual, pay-ment must be made to theCommonwealth up to anamount equal to the totalmedical assistance paid onbehalf of the individual.

For policy questions pleasecontact:

Cindy OlsonEligibility Policy ManagerPolicy & Research DivisionDepartment of Medical Assis-tance Services600 E. Broad StreetSuite 1300Richmond, VA 23219(804) [email protected]

To determine if a deceasedperson was a Medicaid mem-ber and the amount that’s dueback to the program you maycontact:

Diane DabneyRecovery AnalystThird Party Liability UnitDepartment of Medical Assis-tance Services600 E. Broad StreetSuite 1300Richmond, VA 23219(804) [email protected]

A Reminder from theDepartment of Medical Assistance Services (DMAS)

Disciplinary MattersContinued from page 6

Disciplinary Action UsuallyTakes the Form of One orMore of the Following Sanc-tions:

Reprimand or censureMonetary penalty (Paid to

the Literary Fund of Virginia,not to the Department)

Remedial or corrective ac-tion

Probation with requirementsfor the licensee to completewithin a specified time

Limitations on the licensee'sprivilege to practice

Suspension of the licenseeither indefinitely or for aspecific period of time

Revocation of license

Issue 4Preneed Meeting

In May, 2010, the Board re-quested that a committee bedeveloped to address Preneedconcerns registered by one ofour legislators. A meeting washeld with the State CorporationCommission (SCC) - Bureau ofInsurance, Department of So-cial Services and the Depart-ment of Medical AssistanceServices (DMAS) to discussthese preneed matters. Thecommittee discussed how theMedicaid burial set aside worksand addressed how when a de-ceased burial wishes arechanged, that excess money (ifany) can be properly refundedback to Medicaid. Accordingto the Code of VA Section 55-19.5(E):

In the event any amountremains in the trust uponpayment of the funeral orburial arrangement pro-vided to or on behalf ofsuch individual, the com-monwealth shall receive allamounts remaining in suchtrust up to an amount equalto the total medical assis-tance paid on behalf of theindividual.

This committee met and dis-cussed the issues and possiblesolutions to the problem thatmoney is not returned to DMASwhen there is a change in thepreneed contract. A discussionwas held regarding mandatingthat Medicaid applicants orrecipients make the Common-wealth a secondary beneficiaryon their preneed policy so anyexcess funds remaining afterpayment of all funeral expensesis sent to DMAS.

Although the committee thoughtthis was a good solution, CindyOlson, Eligibility Policy Man-ager for the Department of Medi-cal Assistance Services pointedout in an article that this wouldchange the current Maintenanceof Effort (MOE) requirementsimposed by the federal govern-ment and even though it is a cur-rent requirement in State law, itwould appear to be in violationof the current Maintenance ofEffort (MOE) requirements im-posed by CMS. Two additionalmeetings were held with Staterepresentatives from DHP andDMAS. After exploring severaladditional options the followingaction steps were recommended.

DMAS will look into amendingtheir current annual Medicaideligibility audit process to in-clude validation of existing pre-need contract. This added step inthe annual audit process wouldspotlight those individuals whoterminated their preneed contractto receive a refund or those thatchanged their preneed arrange-ments in order to receive a par-tial refund. It is not anticipatedthat this would be in violation ofthe current MOE requirements.

DHP will request the FuneralService Licensee to include noti-fication to the contract buyer thatif preneed arrangements forMedicaid burial set aside arereduced from the original con-tract, that DMAS is entitled toreceive the remainder of thefunds. Likewise, if the contractis modified or terminated to re-duce the original set asideamount, DMAS is entitled toreceive any remaining fundsresulting from the termination or

modification of thecontract. (Boardapproved this actionstep on 7/20/10)

There were addi-tional issues raisedin the initial letterhaving to do withinsurance policies and ownershiprights. It is our understanding thatmeetings were held with BOI andDMAS to discuss and resolve theseissues.

Third Party Sellers of Preneed

It appears that §54.1-2810 regard-ing licensure of funeral establish-ments may be misunderstood inthat marketing practices of thirdparty sellers is being applied to thissection.

The Special Preneed Committeesuggested that alternative wordingbe developed to clarify the verbi-age from “employee of “ to“employed by”. The Committeebelieves that this would providebetter understanding of the intentof the law and clarify any misun-derstandings.

The following section of the Codewere referenced for this discussion:

§ 54.1-2810. Licensure offuneral establishments (4); Anoperator of a funeral establish-ment shall not allow any per-son licensed for the practice offuneral service to operate outof his funeral establishmentunless the licensee is the op-erator or an employee of theoperator of a licensed funeralestablishment.

Out of sight out of mind

Issue 4Legislative Proposals

certificate shall be filed in theregistration district in whichthe dead body is found in ac-cordance with this section.The place where the deadbody is found shall be shownas the place of death. If thedate of death is unknown, itshall be determined by ap-proximation, taking into con-sideration all relevant infor-mation, including but not lim-ited to, information providedby the immediate family re-garding the date and time thatthe deceased was last seenalive, if the individual died inhis home; and2. When death occurs in amoving conveyance, in theUnited States of America andthe body is first removed fromthe conveyance in this Com-monwealth, the death shall beregistered in this Common-wealth and the place where itis first removed shall be con-sidered the place of death.When a death occurs on amoving conveyance while ininternational waters or airspace or in a foreign countryor its air space and the body isfirst removed from the con-veyance in this Common-wealth, the death shall be reg-istered in this Commonwealthbut the certificate shall showthe actual place of death inso-far as can be determined.B. The licensed funeral direc-tor, funeral service licensee,office of the state anatomicalprogram, or next of kin asdefined in § 54.1-2800 whofirst assumes custody of adead body shall file the cer-tificate of death with the reg-istrar. He shall obtain the per-sonal data, including the so-cial security number of the

deceased or control numberissued to the deceased by theDepartment of Motor Vehi-cles pursuant to § 46.2-342,from the next of kin or thebest qualified person orsource available and obtainthe medical certification fromthe person responsible there-fore.C. The medical certificationshall be completed, signed inblack or dark blue ink, andreturned to the funeral direc-tor within 24 hours after deathby the physician in charge ofthe patient's care for the ill-ness or condition which re-sulted in death except wheninquiry or investigation by amedical examiner is requiredby § 32.1-283 or 32.1-285.1,or by the physician that pro-nounces death pursuant to §54.1-2972.In the absence of the physi-cian or with his approval, thecertificate may be completedand signed by an associate orpartner of the physician, or bya nurse practitioner or physi-cian assistant supervised bythe physician, the chief medi-cal officer of the institution inwhich death occurred, a hos-pitalist employed or engagedby the facility where the deathoccurred or the physician whoperformed an autopsy uponthe decedent, if such individ-ual has access to the medicalhistory of the case and deathis due to natural causes.D. When inquiry or investiga-tion by a medical examiner isrequired by § 32.1-283 or32.1-285.1, the medical ex-aminer shall investigate thecause of death and shall com-plete and sign the medicalcertification portion of the

death certificate within 24hours after being notified of thedeath. If the medical examinerrefuses jurisdiction, the physi-cian last furnishing medicalcare to the deceased shall pre-pare and sign the medical certi-fication portion of the deathcertificate.E. If the physician, nurse practi-tioner or physician assistant isuncertain about the cause ofdeath, he shall use his bestmedical judgment to certify areasonable cause of death orcontact the office of the chiefmedical examiner in the districtwhere the death occurred andobtain guidance in reaching adetermination as to a cause ofdeath and document the same.If the cause of death cannot bedetermined within 24 hoursafter death, the medical certifi-cation shall be completed asprovided by regulations of theBoard. The attending physicianor medical examiner shall givethe funeral director or personacting as such notice of the rea-son for the delay, and final dis-position of the body shall not bemade until authorized by theattending physician or medicalexaminer.F. A physician, nurse practitio-ner or physician assistant who,in good faith, signs a certificateof death or determines the causeof death shall be immune fromcivil liability absent gross negli-gence or willful misconduct.§ 54.1-2809.1. Requirementfor a signed death certificate.

Prior to removal of a dead hu-man body from a licensed hos-pital, a funeral service estab-lishment or a surface transpor-tation and removal service shallhave a signed death certificatefor the decedent.

This proposal is a resultof the collaborative ef-forts of multiple meet-ings held this spring ad-dressing death certificateissues.A bill to amend and re-enact § 32.1-263 of theCode of Virginia andenact § 54.1-2809.1,relating to requirementsfor signed death certifi-cates.Be it enacted by theGeneral Assembly ofVirginia:1. That § 32.1-263 is

amended and reenactedand § 54.1-2809.1 isenacted as follows:§ 32.1-263. Filing deathcertificates; medicalcertification; investiga-tion by medical exam-iner.A. A death certificate,including, if known, thesocial security number orcontrol number issued bythe Department of MotorVehicles pursuant to §46.2-342 of the de-ceased, shall be filed foreach death which occursin this Commonwealthwith the registrar of thedistrict in which thedeath occurred withinthree days after suchdeath and prior to finaldisposition or removal ofthe body from the Com-monwealth, and shall beregistered by such regis-trar if it has been com-pleted and filed in accor-dance with the followingrequirements:1. If the place of death isunknown, but the deadbody is found in thisCommonwealth, a death

You may provide comments on this proposal in writing to the board officeby August 16, 2010 to the attention of Lisa R. Hahn, Executive Director

A second legislative proposal hasbeen approved by the board to besubmitted for consideration. This billwill change the CE requirementsback to an annual requirement inorder to eliminate the confusion overan annual and a biennial requirement.The bill will also exempt licenseesduring their renewal cycle from hav-ing to take CE during their first yearof practice.

A bill to amend and reenact § 54.1-2816.1 of the Code of Virginia per-taining to continuing education re-quirements.

Be it enacted by the General As-sembly of Virginia:

1. That § 54.1-2816.1 of the Codeof Virginia is amended and reen-acted as follows:§ 54.1-2816.1. Continuing educationrequirements; promulgation of regu-lations.A. The Board shall promulgate regu-lations governing continuing educa-tion requirements for funeral serviceslicensees, funeral directors and em-balmers licensed by the Board.B. The Board shall approve criteriafor continuing education courses,requiring no more than five hoursper year, that are directly related tothe respective license and scope ofpractice of funeral service licensees,funeral directors and embalmers.Approved continuing educationcourses shall include, but not be lim-ited to, at least one hour per year cov-ering compliance with laws and regu-lations governing the profession, andat least one hour per year coveringpreneed funeral arrangements.Course providers may be required toregister continuing education courseswith the Board pursuant to Board

regulations. The Board shall notallow continuing educationcredit for courses where theprincipal purpose of the courseis to promote, sell or offergoods, products or services tofuneral homes.

C. All course providers shallfurnish written certification tolicensees of the Board attendingand completing respectivecourses, indicating the satisfac-tory completion of an approvedcontinuing education course.Each course provider shall re-tain records of all persons at-tending and those persons satis-factorily completing such con-tinuing education courses for aperiod of two years followingeach course. Applicants forrenewal or reinstatement oflicenses issued pursuant to thisarticle shall retain for a periodof two years the written certifi-cation issued by any Board-approved provider of continu-ing education courses. TheBoard may require course pro-viders or licensees to submitcopies of such records or certi-fication, as it deems necessary,to ensure compliance with con-tinuing education requirements.D. The Board shall have theauthority to grant exemptions orwaivers in cases of certifiedillness or undue hardship. Alicensee shall be exempt fromthe requirement for continuingeducation at the first renewalfollowing initial licensure byexamination.E. The Board may provide foran inactive status for those li-censees who do not practice inVirginia. The Board may adopt

regulations reducing or waivingcontinuing education require-ments for any licensee grantedsuch inactive status. However,no licensee granted inactivestatus may have their licensechanged to active status withoutfirst obtaining additional con-tinuing education hours as maybe determined by the Board. Noperson or registrant shall prac-tice in Virginia as an embalmer,funeral director, or funeral ser-vice licensee unless he holds acurrent, active license._________________________

Legislative Proposals Continued

Issue 4

You may provide comments on this proposal in writing to theboard office by August 16, 2010 to the attention of Lisa R. Hahn,Executive Director

The Board filed in January, 2010, aNotice of Intended Regulatory Actionto increase licensure fees. This No-tice will be published on August 16,2010 and public comment will beaccepted through September 15,2010.

The board has submitted another No-tice of Intended Regulatory Action inorder to establish a maximum num-ber of hours credited for taking anonline CE course. Public comment isnow being accepted.

The board has also submitted an ex-empt action change regarding CEproviders due to a conflict in theCode of Virginia. The section re-quires CE providers to maintaindocumentation of the course titlesand objectives and licensee atten-dance records for a period of twoyears instead of three years.

Additionally, the Board of FuneralDirectors and Embalmers approved amotion to publish emergency regula-tions in response to House Bill 319which amended Section 54.1-2818.1-Prerequisites for Cremation. Therevised regulatory language in 18VAC 65-20-436 will follow:

18VAC65-20-436. Standards forregistered crematories or funeralestablishments that operate a cre-matory

A. Authorization to cre-mate.

2. The cremation authoriza-tion form shall include anattestation of visual identifi-cation of the deceased from aviewing of the remains or aphotograph signed by theperson making the identifica-tion. Visual identificationmay be made by viewingunique identifiers or mark-ings on the remains. Theidentification attestation shalleither be given on the crema-tion authorization form or onan identification form at-tached to the cremation au-thorization form.3. In the event visual identifi-cation is not feasible, a cre-matory may use positiveidentification of the deceasedin consultation with the medi-cal personnel, a medical ex-aminer or law enforcementpursuant to § 54.1-2818.1 ofthe Code of Virginia.

Regulatory Changes

Issue 4

Lastly, the board passed a mo-tion to submit an exempt regu-latory action for approval torepeal Section 18VAC65-20-530 from its regulations in lightof the passage of HB201. Theregulation was in conflict withthe Code of Virginia. The regu-lation will be repealed once theexempt action is approved.

We recommend that you regis-ter on the Town Hall to keepinformed of regulatory actionsand meetings. There is a link toTown Hall from the Board’swebsite. You may also contactthe board and be added to thePublic Participation Guidelinelist in order to receive proposedlegislation.

DHP

spective licensees, consum-ers, etc. with out incurringpostage or paper cost.The board encourages allits licensees to log ontowww.dhp.virginia.gov, tostay abreast of regula-tory changes and require-ments, board meetings,and other industry news.The board uses e-mail tocommunicate with our li-censees such as we notifythem that the latest news-letter has been posted tothe website. It is impor-tant that you provide andkeep your e-mail addresscurrent with the boardoffice. If you do not havea computer you may goto your local library andtype in our web addressto see what the board isdoing.There are e-mail accountsyou may register withoutany charge to you.

Technology has become avery important and practicaltool in life, simply because itmakes things easier andmore accessible. NowadaysGrandma is keeping in touchwith the family via email andsharing photos on one of thesocial websites. No one isimmune to its presence. As abusiness owner technology isalmost a vital element forsuccess. A website can directconsumers to your business,product and services.The Virginia Board of Fu-neral Directors and Embalm-ers has taken advantage oftools offered by the Internetand other software servicesto cut cost. Licensees mayrenew online, send addresschanges via e-mail and theboard’s applications, forms,regulations, laws, and otherpertinent information on itswebsite. This enables theBoard to reach a broaderpopulations of licensees, pro-

Technology - A Business Tool Available to You

Dr. Dianne Reynolds-Cane,Agency DirectorDepartment of Health Professions

9960 Mayland DriveSuite 300Henrico, VA 23233-1463

Board of Funeral Directors &EmbalmersPhone: 804-367-4479Fax: 804-527-4413Email: [email protected]

We’re on the Web!www.dhp.virginia.gov

The Virginia Board of Funeral Directors and Embalmers falls under the Agency umbrella of the Vir-

ginia Department of Health Professions. Our Agency’s mission is to ensure safe and competent pa-

tient care by licensing health professionals, enforcing standards of practice, and providing informa-

tion to health care practitioners and the public. The Virginia Board of Funeral Directors and Em-

balmers is mandated to ensure fair and competent practice of funeral services and the delivery of

those services with integrity and with accountability to the Virginia laws and regulations that govern

the funeral industry.

Virginia Board of Funeral Directors and Embalmers

D E P A R T M E N T O F H E A L T H P R O F E S S I O N S

Test your Knowledge!

Question #1 – How many continuing education hours are currently required in a two year period?

Question #2 – A licensee is required to maintain original CE documentation for a period of _____ yearsafter renewal?

Question #3 – The crematory shall maintain the remains in refrigeration at _____degrees Fahrenheit orless, unless the remains have been embalmed?

Question #4 – Price lists shall be retained for ____ years after the date on which they are no longer effec-tive?

Question #5 – If someone terminates their preneed contract within ____days, you shall refund all pay-ments, plus any interest or income earned.

Question #6- An internship shall consist of at least ______hours to be completed within no less than 12months and not more than _____ months.

Question #7-The intern, the supervisor and the establishment shall submit a written report to the board atthe end of every___hours of training. The report shall be received in the board office no later than ___daysfollowing the completion.

Question #8 – Guess what the two most common inspection violations are?

Question #9 - Every crematory shall have a manager of record who has achieved certification by CANA orICCFA by _________.

Question #10- At the time of the Preneed inquiry, licensees shall furnish to each person inquiring aboutpreneed arrangements a copy of ___________ and ________________.

AnswerKey:1.102.23.40degrees4.35.306.3000,487.1000,108.incorrectpricelistonGPL,incorrectpricerangeslisted9.July8,201010.GPL,Preneeddisclosure