Bill Summary – FastDemocracy

SECOND REGULAR SESSION
                       HOUSE BILL NO. 2093
                              103RD GENERAL ASSEMBLY


                             INTRODUCED BY REPRESENTATIVE CROSSLEY.

    5330H.01I                                                                    JOSEPH ENGLER, Chief Clerk


                                               AN ACT
    To repeal sections 193.015, 193.175, 193.275, 194.119, 194.200, 194.265, 194.350, 194.360,
           194.381, 214.270, 214.280, 333.011, 333.042, 475.120, 513.430, 574.160, and
           595.010, RSMo, and to enact in lieu thereof nineteen new sections relating to the
           disposition of human remains, with penalty provisions.


    Be it enacted by the General Assembly of the state of Missouri, as follows:

            Section A. Sections 193.015, 193.175, 193.275, 194.119, 194.200, 194.265, 194.350,
 194.360, 194.381, 214.270, 214.280, 333.011, 333.042, 475.120, 513.430, 574.160, and
 595.010, RSMo, are repealed and nineteen new sections enacted in lieu thereof, to be known
 as sections 193.015, 193.175, 193.275, 194.007, 194.009, 194.119, 194.200, 194.265,
 194.350, 194.360, 194.381, 214.270, 214.280, 333.011, 333.042, 475.120, 513.430, 574.160,
 and 595.010, to read as follows:
            193.015. As used in sections 193.005 to 193.325, unless the context clearly indicates
 otherwise, the following terms shall mean:
         (1) "Advanced practice registered nurse", a person licensed to practice as an advanced
 practice registered nurse under chapter 335, and who has been delegated tasks outlined in
 section 193.145 by a physician with whom they have entered into a collaborative practice
 arrangement under chapter 334;
         (2) "Alkaline hydrolysis", the reduction of human remains to bone fragments
 and essential elements in a hydrolysis facility, as defined in section 194.007, using heat,
 pressure, water, and base chemical agents;



    EXPLANATION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is
    intended to be omitted from the law. Matter in bold-face type in the above bill is proposed language.
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         (3) "Assistant physician", as such term is defined in section 334.036, and who has
 been delegated tasks outlined in section 193.145 by a physician with whom they have entered
 into a collaborative practice arrangement under chapter 334;
         [(3)] (4) "Dead body", a human body or such parts of such human body from the
 condition of which it reasonably may be concluded that death recently occurred;
         [(4)] (5) "Department", the department of health and senior services;
         [(5)] (6) "Final disposition", the burial, interment, cremation, reduction by alkaline
 hydrolysis, natural organic reduction, removal from the state, or other authorized
 disposition of a dead body or fetus;
         [(6)] (7) "Institution", any establishment, public or private, which provides inpatient
 or outpatient medical, surgical, or diagnostic care or treatment or nursing, custodian, or
 domiciliary care, or to which persons are committed by law;
         [(7)] (8) "Live birth", the complete expulsion or extraction from its mother of a child,
 irrespective of the duration of pregnancy, which after such expulsion or extraction, breathes
 or shows any other evidence of life such as beating of the heart, pulsation of the umbilical
 cord, or definite movement of voluntary muscles, whether or not the umbilical cord has been
 cut or the placenta is attached;
         [(8)] (9) "Natural organic reduction", the contained, accelerated conversion of
 human remains to soil;
         (10) "Physician", a person authorized or licensed to practice medicine or osteopathy
 pursuant to chapter 334;
         [(9)] (11) "Physician assistant", a person licensed to practice as a physician assistant
 pursuant to chapter 334, and who has been delegated tasks outlined in section 193.145 by a
 physician with whom they have entered into a collaborative practice arrangement under
 chapter 334;
         [(10)] (12) "Spontaneous fetal death", a noninduced death prior to the complete
 expulsion or extraction from its mother of a fetus, irrespective of the duration of pregnancy;
 the death is indicated by the fact that after such expulsion or extraction the fetus does not
 breathe or show any other evidence of life such as beating of the heart, pulsation of the
 umbilical cord, or definite movement of voluntary muscles;
         [(11)] (13) "State registrar", state registrar of vital statistics of the state of Missouri;
         [(12)] (14) "System of vital statistics", the registration, collection, preservation,
 amendment and certification of vital records; the collection of other reports required by
 sections 193.005 to 193.325 [and section 194.060]; and activities related thereto including the
 tabulation, analysis and publication of vital statistics;
         [(13)] (15) "Vital records", certificates or reports of birth, death, marriage, dissolution
 of marriage and data related thereto;
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       [(14)] (16) "Vital statistics", the data derived from certificates and reports of birth,
death, spontaneous fetal death, marriage, dissolution of marriage and related reports.
           193.175. The funeral director or person in charge of final disposition of a dead body
shall, prior to the interment of such dead body, affix on the ankle or wrist of the deceased and/
or in a capsule or other container placed in the casket or, if the dead body is cremated or
reduced through the process of alkaline hydrolysis or natural organic reduction, on the
inside of the vessel containing the remains, a tag encased in durable and long-lasting material
containing the name of the deceased, the date of birth, date of death and Social Security
number of the deceased.
           193.275. 1. Every person in charge of an institution shall keep a record of data
concerning each person admitted or confined to such institution as may be required for the
filing of a certificate of birth and death or report of spontaneous fetal death which occurs in
the institution. The record shall be made from information provided by the person being
admitted or confined, but when it cannot be so obtained, the information shall be obtained
from relatives or other persons acquainted with the facts. The name and address of the person
providing the information shall be a part of the record.
       2. When a dead body or dead fetus is released or disposed of by an institution, the
person in charge of the institution shall keep a record showing the name of the decedent, date
of death, name and address of the person to whom the body or fetus is released, and the date
of removal from the institution. If final disposition is made by the institution, the date, place,
and manner of disposition shall also be recorded.
       3. A funeral director, embalmer, sexton, or other person who removes from the place
of death, transports, or makes final disposition of a dead body or fetus, in addition to filing
any certificate or other report required by sections 193.005 to 193.325, or regulations
promulgated hereunder, shall keep a record which shall identify the body, and such
information pertaining to his or her receipt, removal, delivery, burial, [or] cremation,
reduction by alkaline hydrolysis, or natural organic reduction of such body as may be
required by regulations adopted by the department.
       4. Records maintained under this section shall be retained for a period of not less than
five years and shall be made available for inspection by the state registrar or his designee
upon demand.
       5. Any person having knowledge of the facts shall furnish such information as he may
possess regarding any birth, death, spontaneous fetal death, marriage, or dissolution of
marriage upon demand of the state registrar.
           194.007. As used in this chapter, unless the context requires otherwise, the
following terms mean:
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         (1) "Alkaline hydrolysis", the reduction of human remains to bone fragments
 and essential elements in a hydrolysis facility using heat, pressure, water, and base
 chemical agents;
         (2) "Final disposition", the disposition of human remains by entombment,
 burial, cremation, alkaline hydrolysis, natural organic reduction, or removal from the
 state;
         (3) "Human remains" or "remains", the body of a deceased person, including
 remains following the process of cremation, alkaline hydrolysis, or natural organic
 reduction. The term "human remains" or "remains" also includes the body in any
 stage of decomposition;
         (4) "Hydrolysis facility", a structure, room, or other space in a building or
 structure containing one or more hydrolysis vessels to be used for alkaline hydrolysis;
         (5) "Natural organic reduction", the contained, accelerated conversion of
 human remains to soil.
             194.009. A person may use alkaline hydrolysis or natural organic reduction for
 the final disposition of human remains or as a step in the final disposition of human
 remains.
             194.119. 1. As used in this section, the term "right of sepulcher" means the right to
 choose and control the burial, cremation, reduction by alkaline hydrolysis, natural organic
 reduction, or other final disposition of a dead human body.
         2. For purposes of this chapter and chapters 193, 333, and 436, and in all cases
 relating to the custody, control, and disposition of deceased human remains, including the
 common law right of sepulcher, where not otherwise defined, the term "next-of-kin" means
 the following persons in the priority listed if such person is eighteen years of age or older, is
 mentally competent, and is willing to assume responsibility for the costs of disposition:
         (1) An attorney in fact designated in a durable power of attorney wherein the
 deceased specifically granted the right of sepulcher over his or her body to such attorney in
 fact;
         (2) For a decedent who was on active duty in the United States military at the time of
 death, the person designated by such decedent in the written instrument known as the United
 States Department of Defense Form 93, Record of Emergency Data, in accordance with 10
 U.S.C. Section 1482;
         (3) The surviving spouse, unless an action for the dissolution of the marriage has been
 filed and is pending in a court of competent jurisdiction;
         (4) Any surviving child of the deceased. If a surviving child is less than eighteen
 years of age and has a legal or natural guardian, such child shall not be disqualified on the
 basis of the child's age and such child's legal or natural guardian, if any, shall be entitled to
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 serve in the place of the child unless such child's legal or natural guardian was subject to an
 action in dissolution from the deceased. In such event the person or persons who may serve
 as next-of-kin shall serve in the order provided in subdivisions (5) to (9) of this subsection;
         (5) (a) Any surviving parent of the deceased; or
         (b) If the deceased is a minor, a surviving parent who has custody of the minor; or
         (c) If the deceased is a minor and the deceased's parents have joint custody, the parent
 whose residence is the minor child's residence for purposes of mailing and education;
         (6) Any surviving sibling of the deceased;
         (7) The next nearest surviving relative of the deceased by consanguinity or affinity;
         (8) Any person or friend who assumes financial responsibility for the disposition of
 the deceased's remains if no next-of-kin assumes such responsibility;
         (9) The county coroner or medical examiner; provided however that such assumption
 of responsibility shall not make the coroner, medical examiner, the county, or the state
 financially responsible for the cost of disposition.
         3. The next-of-kin of the deceased shall be entitled to control the final disposition of
 the remains of any dead human being consistent with all applicable laws, including all
 applicable health codes. The next-of-kin may delegate the control of the final disposition of
 the remains of any dead human being to an agent through either a specific or general grant of
 power in accordance with section 404.710 if, at the time of delegation, the next-of-kin was
 eighteen years of age or older and mentally competent and the principal or agent is taking
 financial responsibility for the disposition.
         4. A funeral director or establishment is entitled to rely on and act according to the
 lawful instructions of any person claiming to be the next-of-kin of the deceased; provided
 however, in any civil cause of action against a funeral director or establishment licensed
 pursuant to this chapter for actions taken regarding the funeral arrangements for a deceased
 person in the director's or establishment's care, the relative fault, if any, of such funeral
 director or establishment may be reduced if such actions are taken in reliance upon a person's
 claim to be the deceased person's next-of-kin.
         5. Any person who desires to exercise the right of sepulcher and who has knowledge
 of an individual or individuals with a superior right to control disposition shall notify such
 individual or individuals prior to making final arrangements.
         6. If an individual with a superior claim is notified in person or by written notice with
 delivery confirmation to such person's last known address by a person with an inferior claim
 that such person desires to exercise the right of sepulcher and the individual so served does
 not object within forty-eight hours of such notice, such individual shall be deemed to have
 waived such right. An individual with a superior right may also waive such right at any time
 if such waiver is in writing and dated.
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         7. If there is more than one person in a class who are equal in priority and the funeral
 director has no knowledge of any objection by other members of such class, the funeral
 director or establishment shall be entitled to rely on and act according to the instructions of
 the first such person in the class to make arrangements; provided that such person assumes
 responsibility for the costs of disposition and no other person in such class provides written
 notice of his or her objection. If the funeral director has knowledge that there is more than
 one person in a class who are equal in priority and who do not agree on the disposition, the
 decision of the majority of the members of such class shall control the disposition.
         8. For purposes of conducting a majority vote under subsection 7 of this section, the
 funeral director shall allow voting by proxy using a written authorization or instrument.
             194.200. 1. As used in this section, the following terms mean:
         (1) "Final disposition", the burial, entombment, cremation, reduction by alkaline
 hydrolysis, natural organic reduction, delivery to an educational or medical institution for
 donation, delivery to the state anatomical board or removal from the state of the remains of a
 deceased person;
         (2) "Parents", either or both the biological mother or father of a stillborn child, but
 such term shall not include an unknown or unidentified biological father;
         (3) "Stillborn child", a child who is dead at birth.
         2. If a hospital or other health care facility transfers a stillborn child to a funeral
 establishment for final disposition, the hospital or health care facility shall contact one or both
 of the parents of such child within twenty-four hours of such transfer for instructions on the
 method of final disposition of the child. If the hospital contacts and receives instructions
 from at least one of the parents, the hospital shall convey such instructions to the funeral
 establishment which shall proceed as directed by such instructions. If the funeral
 establishment receives instructions from at least one of the parents, the funeral establishment
 may arrange for the final disposition of the child in accordance with such instructions without
 contacting the other parent. If the parents of the child do not provide instructions for the final
 disposition within five days, the funeral establishment shall conduct the most cost-effective
 method of final disposition of such child and the hospital shall be responsible for the cost of
 such final disposition. The hospital shall be entitled to collect the cost of such disposition
 from the parents. If the parents select the manner of final disposition, the parents shall be
 responsible to the funeral establishment for the costs of such disposition.
         3. Any person who violates the provisions of this section is guilty of a class A
 misdemeanor.
             194.265. 1. When a hospital refers an individual at or near death to a procurement
 organization, the organization shall make a reasonable search of any donor registry and other
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 applicable records that it knows exist for the geographical area in which the individual resides
 to ascertain whether the individual has made an anatomical gift.
         2. A procurement organization must be allowed reasonable access to information in
 the records of the department of health and senior services and department of revenue to
 ascertain whether an individual at or near death is a donor.
         3. When a hospital refers an individual at or near death to a procurement organization,
 the organization may conduct any reasonable examination necessary to ensure the medical
 suitability of a part that is or could be the subject of an anatomical gift for transplantation,
 therapy, research, or education from a donor, potential donor, or a prospective donor. During
 the examination period, measures necessary to ensure the medical suitability of the part may
 not be withdrawn unless the hospital or procurement organization knows a contrary intent had
 or has been expressed by the individual or an agent of the individual, or if the individual is
 incapacitated and he or she has no agent, knows a contrary intent has been expressed by any
 person listed in section 194.245 having priority to make an anatomical gift on behalf of the
 individual.
         4. Unless prohibited by law other than sections 194.210 to 194.294, at any time after
 a donor's death, the person to which a part passes under section 194.255 may conduct any
 reasonable examination necessary to ensure the medical suitability of the body or part for its
 intended purpose.
         5. Unless prohibited by law other than sections 194.210 to 194.294, an examination
 under subsection 3 or 4 of this section may include an examination o