Policies_and_Procedures.pdf

ATTACHMENT A – POLICIES AND PROCEDURES

DISPOSITION OF INDIGENT AND UNCLAIMED HUMAN REMAINS

I. Definition

Chapter 406 of the Florida Statutes, Disposition of Dead Bodies, prescribes procedures for the disposition of bodies which are unclaimed or required to be disposed of at public expense because of indigency. This act provides that county commissioners assume responsibility for the disposition of indigent and unclaimed bodies, defines procedures for handling such bodies, and requires that disposition be performed in accordance with existing laws, rules, and practices.

In accordance with State of Florida law, Pinellas County assumes financial responsibility for the disposition of unclaimed or eligible indigent human remains that expire in Pinellas County. The Pinellas County Board of County Commissioners delegates disposition of indigent and unclaimed human remains to County Human Services. As such, the Human Services Department is accountable for ensuring that program guidelines comply with Florida law and meet with the approval of the Board.

The Department has implemented an Indigent/Unclaimed Cremation program with a contract provider based on the Pinellas County Attorney's legal interpretation of the Statute, and the Board's concern for preserving the integrity of the program and for protecting the interests of the public.

Florida Statute Chapter 406.49 (5) and (8) defines indigent and unclaimed persons as an “indigent person” whose family income does not exceed 100 percent of the current Federal Poverty Level prescribed for the family’s household size by the United States Department of Health and Human Services. For the purpose of Pinellas County Indigent and Unclaimed Burial Program an indigent person is considered indigent when that person is below 150 percent the Federal Poverty Level. This guideline is subject to change at the discretion of the County. An “Unclaimed remains” is defined as human remains that are not claimed by legally authorized person, other than a medical examiner or board of county commissioners, for final disposition at the person’s expense. Florida Statute Chapter 406.50 (1) requires that any person or entity that comes into possession, charge, or control of unclaimed remains that are required to be buried or cremated at public expense shall immediately notify the anatomical board, unless the unclaimed remains are decomposed or mutilated by wounds, an autopsy is performed on the remains, the remains contain a contagious disease, a legally authorized person objects to the use of the remains for medical education or research, or the deceased person was a veteran of the United States Armed

SAMPLE

Forces, United States Reserve Forces, or National Guard and is eligible for burial in a national cemetery.

The Board has clearly stated that the program must be conducted in a cost effective yet dignified manner. Therefore, the County has developed a cost effective contract stipulating program requirements. Failure to adhere to the terms of the contract will result in cancellation.

All indigent and unclaimed human remains, except for honorably discharged veterans will be cremated, unless burial is requested in writing by the Pinellas County Medical Examiner.

II. Program Criteria

The following provides specific criteria which must be met before Pinellas County will assume financial responsibility for the disposition of the remains:

A. Unclaimed

A body is considered to be unclaimed when there is no legally responsible relative or when no other person (e.g., relative, friend, organization) has accepted financial responsibility for the body. The income or assets of the deceased have no bearing on whether a body is considered unclaimed or not.

An unclaimed body is not necessarily indigent and may have assets in an estate. However, if these assets are inaccessible, the County assumes responsibility for disposition for practical reasons and will endeavor to secure reimbursement through the Probate Court process.

B. Indigent (Claimed)

The indigency criteria is met if a deceased and the legally authorized person do not have sufficient resources to provide for a cremation and no one has assumed financial responsibility for disposition of the body.

Florida Statute 497.005 (39) states that a legally authorized person is:

The decedent, when written inter vivos authorizations and directions are provided by the decedent

The person designated by the decedent as authorized to direct disposition pursuant to Pub. L. No. 109-163. S. 564 as listed on the decedent’s United States Department of Defense Record of Emergency Data, DD For 93, or its successor form, if the decedent died while in the military service as described in 10 U.S.C. s. 1481 (a)(1)-(8) in any branch of the United States Armed Forces, United states Reserve Forces, or National Guard

The surviving spouse, unless the spouse has been arrested for committing against the deceased an act of domestic violence as defined in s. 741.28 that resulted in or contributed to the death of the deceased

A son or daughter who is 18 years of age or older A parent A brother or sister who is 18 years of age and older A grandchild who is 18 years of age or older A grandparent Any person in the next degree of kinship In addition, the term may include, if no family member exists or is available, the guardian of the dead person at the time of death; the personal representative of the deceased; the attorney in fact of the dead person at the time of death; the health surrogate of the dead person at the time of death; a public health officer; the medical examiner, a county commission, or administrator acting under part II of chapter 406 or other public administrator; a representative of a nursing home or other health care institution in charge of final disposition; or a friend or other person not listed in this subsection who is willing to assume the responsibility as the legally authorized person. Where there is a person in any priority class listed in this subsection, the funeral establishment shall rely upon the authorization of any one legally authorized person of that class if that person represents that she or he is not aware of any objection to the cremation of the deceased’s human remains by others in the same class of person making the representation or of any person in a higher priority class

A deceased adult, who was unmarried and without minor children, is considered to be indigent if assets accruing to the estate are insufficient to meet the cost of the contract cremation or if assets accruing to the estate cannot be accessed for funeral purposes.

A deceased, who was unmarried and had minor children, is considered to be indigent if assets accruing to the estate do not exceed $2000, or if assets accruing to the estate cannot be accessed for cremation purposes.

A deceased, who was a dependent child or married adult, is considered to be indigent if the family unit's income does not exceed 150% of the FPL and assets do not exceed $2000.

A deceased, who was married but separated is considered to be indigent if the spouse is unwilling to assume responsibility for disposition.

III. Program Procedures

A. Department & Provider Responsibilities

The Board has stated its intent that the program be conducted in an efficient manner. As such, it is essential that the County's contract provider and the Department maintain open communication and comply with established procedures.

Information should be shared immediately upon receipt, and problems or issues should be resolved expeditiously. In most situations phone contact and written communication should suffice, however meetings should be scheduled whenever there is a significant change in policies, procedures, or a major issue has surfaced.

While a case is pending, each entity must advise the other of any changes in circumstances or other relevant information. Such information may include requests from relatives, request to release the body, unusual incidents, etc.

Each entity is also responsible for maintaining a record of every case referred to the County. Department records must include a list of all contacts, investigative efforts and findings, release forms, final disposition of the deceased, and any other relevant information. Contract provider records must include release forms, cost of services, method of disposition, disposition of remains and any other relevant information.

The contract provider will transport human remains from the location where the body is found or from the Pinellas County Medical Examiner's office to the mortuary, embalm or refrigerate and store the body until an investigation is completed or the body is released, and publish an obituary in the local newspaper, unless relatives request otherwise.

The contract provider will conduct an investigation to determine if the human remains are eligible for disposition at Pinellas County expense. Such an investigation will be comprehensive, expedient, and include:

Contact with friends, relatives or essential others Contact with other counties Contact with law enforcement agencies Contact with individuals who might have knowledge pertaining to the location of relatives or a legal guardian Determination of available assets and income Determination of any lump sum payments due the estate Review of public records Contact with the County Veterans Service office or regional office of the United States Department of Veterans Affairs

Once the investigation is completed, the contract provider will send the Statement of Goods, Cremation Authorization form, and any information used in the investigation to the department through the use of secured email accounts established by the department. Department will advise the contract provider as to the method of disposition. The contract provider will then release the body or dispose of it in accordance with Florida Statutes. The contract funeral home will accept the contract amount for disposition when a deceased is determined to be indigent or unclaimed, but death benefits meet or exceed the contract amount.

B. Non-Residents Expiring in Pinellas County

In compliance with State of Florida law, the County shall assume responsibility for the disposition of any unclaimed or indigent person whose death occurs in Pinellas County. Human remains will be disposed of according to the terms of the contract for disposition of indigent or unclaimed human remains. When cremains are requested by legally authorized individual residing outside of Pinellas County, the cost of postage and handling shall be the responsibility of the requesting party.

C. Residents Expiring In another County

According to State of Florida law, unclaimed or indigent Pinellas County residents who die in another Florida County shall be the financial responsibility of the county in which they expired. Therefore, Pinellas County residents expiring in another county, state, or country shall not be eligible for assistance from Pinellas County for disposition expenses or transportation back to Pinellas County.

D. Unclaimed Human Remains

An unclaimed human remains will be released to an individual or representative of any fraternal society, charitable or religious organization, or governmental agency who assumes financial responsibility for disposition. An individual or organization who is willing to pay for funeral services may elect to use the funeral home or direct disposer of their choice. If a provider other than the County's contract provider is selected, the body will be released to the selected funeral home and all costs will be the sole responsibility of the individual or organization that has assumed financial responsibility of the deceased.

In instances where cremation was properly authorized and the cremains remained unclaimed for a period in excess of one hundred and twenty (120) days, the contract provider will dispose of the cremains in a dignified manner at sea or other legal and dignified manner, in accordance with Florida Statute

497.607 (2).

Neither the County nor the contract provider have the authority to release the personal possessions of an unclaimed body to an individual or organization. In such cases, the contract provider will maintain the possessions in a secure location until such time that a court order for release is received.

E. Contract with St. Petersburg College

The contract provider will notify staff at St. Petersburg College that an unclaimed body is available and in good condition in order for the embalmment by College Funeral Services students.

St. Petersburg College staff will pick up the body from the contract provider, deliver it to St. Petersburg College for embalmment by students, and return the body to the contract provider normally within the same day.

The contract provider will determine if the body is suitable to be offered to the Anatomical Board, in accordance with the Florida Statutes.

F. Anatomical Board Acceptance of Unclaimed Human Remains

1. An unclaimed body that meets the criteria of the Anatomical Board will be offered to the Florida Division of Universities of the Department of Education by the contract provider in accordance with Florida Statutes. Once a decision is received from the Anatomical Board, the contract provider will notify the County as to the method of disposition.

The contract provider will arrange for transporting the body, and provide the Anatomical Board with written verification that no living relatives exist. The County will pay for the cost of transportation. The contract provider will prepare the body, release the body for transport, and provide the death certificate, the transit permit, and the Medical Examiner's authorization for cremation, dissection, or burial at sea.

2. Anatomical Board Rejection of Unclaimed Human Remains

The Anatomical Board will not accept human remains when a family member objects. The Anatomical Board will not accept an unclaimed body that is: 1) known to have been a veteran; 2) an infant; 3) known to have an infectious disease; 4) is in a deteriorated state; 5) subject to an autopsy; 6) subject to a crushing injury.

An unclaimed body that does not meet the criteria of the Anatomical Board will be cremated unless the deceased person is known to be an honorably discharged veteran or unless the Medical Examiner has instructed that the body be buried. An unclaimed body, which is known to have been an honorably discharged veteran, will be buried at the National Cemetery at Sarasota.

G. Indigent (Claimed) Human Remains

An indigent claimed body will be released to a relative who assumes financial responsibility for disposition. Relatives may elect to use the funeral home or direct disposer of their choice. If a provider other that the County's contract provider is selected, the body will be released to that funeral home. If the contract provider is unable to collect the “removal fee” from the family, the County will pay the fee with proper documentation that reasonable efforts were made to collect the fee from the selected funeral home.

When cremains are requested by an authorized party residing in Pinellas County, the contract provider will make cremains available for pick up.

Relatives who are unwilling or unable to pay for funeral services may elect to have the body offered for anatomical purposes or cremated. If the body is offered for anatomical purposes, the cremated remains will be returned to the family at their discretion.

The cremated remains container will be sift-proof or similar-type container that is in good taste and meets US Postal Services shipment requirements. The inner container must be sealed and placed inside a second, durable outer container.

H. Estates

If an estate is left, the County Attorney’s office will be so advised and will be responsible for petitioning the court for reimbursement of any costs incurred by the County. If the estate exceeds the contract amount, the remaining amount will be transferred to the Department of Education.

I. Other Procedures

The County will provide payment for removal fees and transportation to the National Cemetery at Sarasota for honorably discharged veterans, in accordance with Florida Statutes and the contract terms.

Unusual or special requests will be considered by the County.

IV. Funeral Home & Related Procedures

A. The completed referral form shall be emailed to the appropriate County office no later than 24 hours after removal of the remains from the place of demise within Pinellas County.

B. If determined eligible for the Social Security Lump Sum Death Benefit, the surviving payee will be asked to reimburse the contract provider for the amount received from Social Security Administration. The contract provider will then reimburse the County in the form of a credit.

C. An obituary notice shall be published as soon as possible. In the case of an unclaimed body, contract provider must wait five days before requesting authorization for cremation.

D. The family will be advised that payment cannot be authorized until eligibility for disposition at public expense is determined. The County will notify the contract provider as soon as possible of the status of eligibility and disposition of the body if eligible.

E. The contract provider will submit a request to the Veterans Administration for reimbursement via the VA Burial Benefit utilizing the VA-form 21P-530 for all honorably discharged veterans. If the amount approved by the VA does not cover the entire cost of the burial, the contract provider may charge the County for the remainder, up to the approved contract amount. If the VA claim is denied, the department will pay the contract provider entire contracted amount for the proper burial.

F. Cremated remains may be released to family members if known. Unclaimed remains from a cremation must be retained for a period of 120 days prior to disposition, however, the funeral home may release the cremains to “legally authorized” persons as defined in Florida Statutes. Examples of a legal relationship would include Power of Attorney, relationship by marriage, a child in common with the deceased, or authorized by the deceased in a will or other legal document to receive the cremated remains. If unrelated to the deceased, and no legal relationship exists, the cremated remains may not be released to non-family members. These unclaimed remains will be disposed of in accordance with the terms of indigent funeral contract.

G. Upgrades in services are not permitted.

H. Any monies paid by any source for disposition of human remains will be deducted from the amount paid by Pinellas County.