Registration Opportunities and Challenges: Re-Vital-izing the Statutes in Vermont Gateway to the Future: Improving the National Vital Statistics System

Registration Opportunities and Challenges:Re-Vital-izing the Statutes in Vermont

Gateway to the Future:Improving the National Vital Statistics System

St. Louis, MO June 6th – 10th, 2010

The Vermont Department of HealthRichard H. McCoy

Phone (802) 651-1862

The Vermont Department of Health

Richard McCoy Genealogical Society of Vermont (802) 651-1862 October [email protected]

Richard H. McCoy

Phone (802) 651-1862



Improving the National Vital Statistics System…

In this financial period of increasingly limited resources, we are still confronted with the need to do better. Move from being “good” to “great.”

What are the obstacles within our jurisdictions to do better?

Money. Staffing levels. Knowledge and skills. Experience. Technology.

Other presentations discuss these challenges in more detail. I’m going to talk about one of the other obstacles:

Statutes

(Updating your laws – hopefully to the Model Law)

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Richard H. McCoy

Phone (802) 651-1862



Improving the National Vital Statistics System…

Sometimes, the statutes just need a little editing. A new definition added. A section modified.

Many jurisdictions have enacted versions of the Model Law or some variation. The Model Law has served many jurisdictions well. Many states have made small changes over time.

And then there are times when you have to start over with a blank slate.

That would be us – Vermont.

I’m going to tell you about our effort to completely rewrite our statutes in order to remove obstacles to performing better. And what you might encounter if you try the same thing.

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Richard H. McCoy

Phone (802) 651-1862



If you take away nothing else from this presentation…

…remember, you have to keep a sense of humor.

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The State of Vital Records’ Statutes in Vermont


Richard H. McCoy

Phone (802) 651-1862



Why did I decide that our statutes needed a complete rewrite rather than build upon existing statutes?

“Open records” state – Anyone may obtain a certified copy of a birth or death certificate.

• No identification needed;

• No purpose collected;

• No tracking required.

• Considered an impediment to accessing a public record.

Pay your $10 and receive a certified copy – no questions asked!

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Richard H. McCoy

Phone (802) 651-1862



“Decentralized system” – Vital Records Office with limited authority. 246 town clerks hold significant control over the records and processes.

• Lack of consistency with business processes;

• Minimum security and fraud controls;

• Inefficient paper-processing and slow mechanisms for reporting.

Long history (tradition) of local control and public access to community records.

Not aware of (nor equipped for) the modern challenges with identity theft and fraud.

“Such things don’t happen in Vermont.” (They could never happen in Vermont, right?)

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Richard H. McCoy

Phone (802) 651-1862



Outdated Terminology (and Technology) – Definitions and methods dictated from 50 – 100 years ago.

• Makes the implementation of more efficient processes difficult.

• Parties can always point to existing statutes and resist / refuse to change.

Section of our statutes says to “draw a line through” information on certificates to make corrections and amendments. For decades, we have literally crossed or xxxxx’d out information.

I think we still use a few of these in Vital Records.

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Richard H. McCoy

Phone (802) 651-1862



As a result of the outdated statutes, our certificates are vulnerable for misuse.

External Parties:

• Easily obtain certified copies to use as breeder documents (Passport; driver licenses)

Internal Parties:

• Decentralized model with a lack of electronic tracking and little direct oversight. (Is security paper being used appropriately? Are unusual quantities of copies being sold?)

Other issues:

• Unlimited access to the full death certificate (e.g., cause of death) can lead to:

• Individuals / organizations identifying persons who die of specific diseases (e.g., HIV / AIDS) and protest at family’s home or contacting them directly;

• Political purposes as campaign issues (child dies of drug overdose; spouse commits suicide; etc.).

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Richard H. McCoy

Phone (802) 651-1862



In 2007, I began our campaign to re-vitalize the Vermont statutes. A complete rewrite, utilizing a significant portion of the Model Law, but also borrowing the best ideas of other jurisdictions.

The first question was…can we even do this?

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It all began in 2007…


Richard H. McCoy

Phone (802) 651-1862



From 2003 – 2006, we raised concerns about the outdated statutes and need to close the loopholes.

Members of the public and our Legislature were surprised to find out that the birth and death certificates were open records – available to anyone with no questions asked.

However, the conversations were usually brief.

• Closing public records in an election year too sensitive.

• Long history / tradition.

• Public activists need access so they can discover the health problems that government misses (e.g., “cancer clusters”).

• Other legislative priorities (e.g., civil marriages).

• Intel Reform regulations – let’s wait until those show up.

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2007…


Richard H. McCoy

Phone (802) 651-1862



The Legislature requested a report on “access to public records” that would cover all state government. What works and what doesn’t. What are the privacy issues? What exemptions exist?

We provided input to the Legislative Council that prepared the report. Our recommendations included substantially rewriting the Vital Records’ portion of the statutes. Expand our authority. Limit access to the records.

End result: report was released by the Council, but contained very little discussion about Vital Records. It did raise some of our points, but contained few of our recommendations.

First sign of progress! The Legislature modified our statutes to require the use of security paper for all certified copies, with the paper to be determined by us. (Up to this point, town clerks could issue certified copies on plain paper from a copier – no security devices.)

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2007…


Richard H. McCoy

Phone (802) 651-1862



We were disappointed that this was the only change.

But, the one small change for security paper was a positive step forward. It provided an opportunity to get the word out about the barriers created by the outdated statutes.

So, we kept our sense of humor….

…and prepared to try again in 2008.

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The black cat ears were my staff’s idea of a morale booster…


Round Two…2008


Richard H. McCoy

Phone (802) 651-1862



Based on the concerns that we raised in 2007, our hope was to work with a legislator to draft a bill that would address all Vital Records’ activities.

Opportunity: A member of the legislature was concerned that the cause-of-death was available to the public.

• Planned to introduce a bill that would limit access and make other changes to the death certificate.

• Unfortunately, was not concerned about birth certificates.

• We were just starting our EDRS roll-out and the bill did not align very well with our activities.

It was late in the 2008 legislative session. A hard decision was made - we asked that the bill not be introduced.

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2008…


Richard H. McCoy

Phone (802) 651-1862



We offered to write a Vital Records’ Status Report that would detail current operations, limitations and obstacles with the current statutes, and our recommendations for change.

The legislator agreed and indicated they would introduce a bill in 2009 based on our report.

The report would be released in advance of the 2009 legislative session (October 2008).

This was our best opportunity to propose a complete revision of our statutes and write them in a manner to improve our efficiency and protect the public:

• Centralized authority and control over issuance;

• Stricter data collection requirements and timeframes;

• Flexibility for technology.

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Richard H. McCoy

Phone (802) 651-1862



…Halloween in Vermont…or Rich is preparing for career change to heavy metal guitarist after state staffing cuts.

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Of course, some funny things happened along the way to 2009….


Round Three…2009


Richard H. McCoy

Phone (802) 651-1862



Draft report was finished in advance of the 2009 legislative session (Oct./Nov. 2008).

Leadership changes occurred at department and agency.

• Many rewritings and more parties needing to be briefed. More approvals.

2009 legislative session ended without release of the report. Reasons:

• Civil marriages law passed and we were too busy to push for a bill.

• Did not coordinate support of stakeholders in advance.

• Was not a high priority of the administration.

Invested approximately 200 hours into the Report effort – report writing; meetings; briefing documents; etc.

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Richard H. McCoy

Phone (802) 651-1862



But, we all kept smiling and planning for the next year…

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2009…


Richard H. McCoy

Phone (802) 651-1862



Leadership agreed that 2010 would be the year for the big push.

Connected with members of the legislature during the civil marriages debate.

Spent much of the Summer 2009 preparing for the 2010 “push.”

• Draft report was rewritten…eight times.

• Sent to the leadership for multiple reviews.

• Extensive work with our attorney, bill sponsors, and stakeholders.

Key difference this time – support (or neutrality) by all of our stakeholders.

Reached agreement on a new “final draft” at the end of 2009…in time for the 2010 session.

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Round Four…2010


Richard H. McCoy

Phone (802) 651-1862



A few more late changes made to the report.

Drafted our legislation – 88 pages in the bill (very large by Vermont standards).

The unexpected happens:

H1N1

VT Yankee Nuclear Reactor

Health care reform

State budget

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The 2010 Vermont Legislative session leaves Rich a bit confused after his third committee hearing about changes to the same-sex marriage law….


2010…


Richard H. McCoy

Phone (802) 651-1862



Bill not introduced. Report not released.

Side conversations with our bill sponsors and others:

• Agreement by a few members of Legislature that these records need limited access.

“Can’t we just change a couple sentences in the law?”

March 2010 – Thought the bill was dead and the Report comatose for another year. Vermont Legislative session is only January – May each year. (Don’t worry – wait until 2011.)

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2010…


Richard H. McCoy

Phone (802) 651-1862



Rich decides to take a brief week off to shovel snow…

….because what could possibly happen since the bill and report were shelved for another year?

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2010…


Richard H. McCoy

Phone (802) 651-1862



March 2010 – A bill regarding “unmarked burial sites” passes the House. The Senate takes up the bill. Committee member considers amending the bill.

“Can’t we use this to limit access to vital records’ certificates?”

April 2010 – Bill is amended, but doesn’t address access to records. Instead, amendment changes the death certificate process.

• More authority for funeral directors. PA’s and APRN’s allowed to complete cause of death and death certificate. Changes to role of town clerks and other parties.

May 2010 – We suggest this would be better addressed as part of our overhaul bill to completely rewrite Vital Records’ statutes.

• No changes made. Moves to House for vote. Disagreement on the amendments related to death certification and is sent back to Senate.

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2010…


Richard H. McCoy

Phone (802) 651-1862



The very final vote of the 2010 legislature session is this bill. It passes. Death certification process will change for Vermont…on January 1, 2012.

No overhaul of vital events’ statutes.

Agreement on next steps:

• Release the report this summer 2010. (Almost three years after first version.)

• Meet with key legislators and bill sponsors, reach agreement on bill language, and introduce at the very start of the 2011 session.

Current leadership agrees this is an important priority for the next session.

Lots of footwork to do ahead of 2011 legislative session.

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Lessons / Advice ?


Richard H. McCoy

Phone (802) 651-1862



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1) Talk with the stakeholders early and obtain their support…or at least their neutrality.


Richard H. McCoy

Phone (802) 651-1862



Vermont genealogists

VSARA (State Archives / Secretary of State’s Office)

VT League of Cities and Towns

City/town clerks and their associations

Funeral directors / crematoriums and their associations

Law enforcement (e.g., Public Safety)

Key legislators

Media / Press

Your staff (including other state agencies)

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2) Provide examples from other jurisdictions. Show that you are the outlier.


Richard H. McCoy

Phone (802) 651-1862



Are you not following best practices or standards adopted by most other jurisdictions?

What problems have other jurisdictions encountered that didn’t change? Financial costs? Liability / legal costs?

What would the media or the public think if it was widely known?

Our argument was strengthened because….

• Some jurisdictions closed access to their records as we went through our leg. process.

• We had some examples of fraud / criminal cases with Vermont certificates…and a recent attempt at creating a fraudulent Delayed Birth Certificate.

• We could show that resources were being used inefficiently.

Bottom line: Legislators want numbers and examples of real world events.

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3) Educate the decision-makers. Expect that leadership and legislators have no idea what you do or how it affects their lives.


Richard H. McCoy

Phone (802) 651-1862



Why do you collect data on abortions and fetal deaths? How is that public health?

What is your agenda? (e.g., fetal deaths bill)

How much work is it to store a bunch of certificates?

I have five minutes – tell me what you folks do. (“elevator speech”)

I don’t have time to read your memo (or report, or bill draft, or…).

Important: Expect to do the whole thing all over again as leadership changes!

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4) You cannot predict every world event or scenario that may push you down the priority list. Use them as opportunities for future change.


Richard H. McCoy

Phone (802) 651-1862



Everything else went on hold with H1N1, VT Yankee Nuclear Reactor, national politics of health care reform, state budget, etc.

Each one is an opportunity to showcase your value…and your resource needs.

H1N1: death certification; EDRS; rapid-reporting and real-time monitoring

VT Yankee: mortality data (regional trends / rates); dataset linkages

State budget: birth rates (future school enrollments); maternal/child health trends

Health care: leading causes of death; location of death (hospice care)

Establish your expertise. Create a level of trust. Serve as an ongoing resource.

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5) Watch out for “hot” topics and sensitive words.


Richard H. McCoy

Phone (802) 651-1862



Try to avoid using these words or phrases when talking about your program (unless specifically asked or discussing with a knowledgeable professional):

• Abortion

• Fetal death

• Tracking or Surveillance

• “Matching people” or “linking datasets”

• Mandate

• And try not to mention…. fee increase.

May lead to killing your bill (too controversial) or turning it into something else (agenda that has nothing to do with Vital Records).

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6) Be prepared to compromise. You may need to do more in the short-term in order to gain what you want in the long-term.


Richard H. McCoy

Phone (802) 651-1862



We offered to take on more work, knowing that it would allow us to apply better business controls over important processes.

Everyone is being required to do more. They may jump at your offer to take over something that was traditionally their role if:

• No loss of income/receipts for their office.

• No decrease in service to the customer.

• They are not held accountable if anything goes wrong on your side.

Easier to apply standards, less groups to coordinate or monitor, greater flexibility for change, etc. In the long-run, it can mean less work and less headaches.

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7) Consider it a game and learn how to play it. Rest and recharge between attempts.


Richard H. McCoy

Phone (802) 651-1862



It is hard to “lose” graciously after the third or fourth year playing the game…but absolutely necessary!

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Celebrate the little “wins” along the way. Keep your morale up and focus on the positive accomplishments.


8) Keep your sense of humor.


Richard H. McCoy

Phone (802) 651-1862



When you hit an obstacle or setback, sometimes all you can do is laugh.

Humor will get you through the frustrations when politics often

beats common sense.

It may take you a few attempts

to get your legislative changes

or Model Law passed.

Be persistent, but patient.

And keep smiling…

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Richard McCoy Public Health Statistics Chief

[email protected]

Phone: (802) 651-1862


Vital Records in Vermont: Contacts


Richard H. McCoy

Phone (802) 651-1862



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Documents

Registration Opportunities and Challenges: Re-Vital-izing the Statutes in Vermont Gateway to the Future: Improving the National Vital Statistics System