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Wos, senators spar over death records

Posted November 18, 2014

Sen. Tommy Tucker, R-Union

— The state's vital records system doesn't usually generate a lot of excitement among lawmakers or the public, but it led to raised voices at an oversight meeting Tuesday morning.

The heated exchange between Sen. Tommy Tucker, R-Union, and Secretary of Health and Human Services Aldona Wos is just the latest skirmish in an intensifying feud between Senate leaders and Gov. Pat McCrory's administration. 

As part of their planned reports to the Joint Legislative Oversight Committee on Health and Human Services, Wos and her team from the Vital Records Division gave a presentation calling for the modernization of North Carolina's outmoded death records system. 

North Carolina's birth records system is fully electronic, but its death records are still processed and transferred in hard copy using a system that dates back 84 years.

According to DHHS, North Carolina is one of only six states still using handwritten, typed, mailed documents. About 83,000 people die every year in the state.

State Registrar Catherine Ryan told lawmakers the current process for certifying a death is "very cumbersome.”

The funeral director fills out most of the death certificate, with input from the medical examiner where needed. It then goes to a medical professional for certification of the cause of death. Then it goes to the county health department, which finishes filling out the certificate and keeps a copy for its own records. After that, the original goes to the state vital records office in Raleigh, where the accuracy of the record must be verified.

Each transfer of the document is either manual or by U.S. mail. By the time the certificate has worked its way to Raleigh, the process can take 90 days or longer. Estates cannot be filed in court until the certificate is completed. 

"Some of our key technology is about a decade behind the rest of the nation," Wos told lawmakers. "Our customers – our citizens – do not receive the records they need in a timely fashion."

According to Ryan, upgrading the system would improve the turnaround time to seven days or less. It also would keep sensitive personal information more secure from identity thieves or scammers, she said, and would better allow the state to track and respond to emerging public health threats.

Also, it would bring in more money from the federal Social Security Administration, which Ryan says would reimburse the state $3.01 for each timely submitted electronic death certificate, much more than the current rate of 84 cents each. 

However, that increase wouldn't cover the price of a new system. Reese Edgington, information technology project management director for DHHS, estimated a commercially developed system would cost around $5.8 million, plus $427,000 a year for support.  A system developed in-house would be slightly cheaper, but support costs would be higher in the long run and it would take longer to put into place.

Ryan and Edgington said the upgrade would probably allow DHHS to "redirect" three or four staffers, saving $140,000. But they couldn't immediately say how much the manual system is costing, in part because much of the work is done by non-state employees. 

Tucker said he thinks more positions could be eliminated, and he blasted Ryan and Edgington for not having more specific numbers.

"When businesses go to software, they want to see savings," he said.

"Senator, the reason to do this is not a matter of saving money on one or two or 10 or 50 salaries. This has to be done for the future of the state," Wos responded vehemently. "It’s simply the right thing to do toward our citizens.

"Citizens have a right to have a birth certificate and a death certificate in a reasonable amount of time," she added, saying the current system "does not pass the common sense test.”

"Don't talk down to me," Tucker retorted. "I'm responsible to the taxpayer to see if there's any savings."

"We will continue to give you whatever information you like," Wos answered. "We will present our business case more accurately if this was not sufficient. " 

"I would suggest, when you make these presentations to this committee, you have the final data," Tucker shot back. "We need something from a business analysis standpoint."

19 Comments

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  • skeeter II Nov 22, 2014

    I have gone to the county where a sister died and obtained a copy of her death certificate. She died in 1935. I do not know if I could get her death certificate from the county if she died this year. This was a walk-in, furnish the name, pay a small fee, and get the death certificate.

    I have obtained a death certificate for my grandfather from the Raleigh office. I think I have to give the name and my relationship to the deceased and pay the fee. I did not get the death certificate that day. Do not remember if they mailed it or I had to go back to get it. If the preparing of the death certificate is computerized with everyone entering their part of the information, will this allow us to walk-in to the Raleigh office (or order by e-mail and pay by credit/debit card) to get the death certificate that day? If so, that would improve the system. If not, any improvement will be invisible to those requesting a death certificate.

  • Matt Wood Nov 20, 2014
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    I can't believe I'm saying this, but I agree. It would probably take as much money to find out the data he wants (since it would involve incorporating funeral directors, medical examiners, etc. across the state) as it would to just implement the system. It's actually a pretty cheap price tag compared to the amount spent on other DHHS systems.

    "When businesses go to software, they want to see savings," he said.

    This is the fundamental flaw in his logic: government is not a business and should not be treated as such.

  • James Daniels Nov 19, 2014
    user avatar

    The governor should have fired Wos a long time ago. She comes across as arrogant and has violated normal state procedures and signed a number of no bid contracts with cronies. Also, Wos is so sure that NC will privatized Medicaid (since it works so well for mental health) that a number of top advisors have moved to the private sector to work for companies that manage Medicaid for other states. Wos may think that she is always the smartest person in the room; but, legislators can write funding legislation to trim upper management at DHHS. The Guv is in denial about Wos or he has friends that will benefit from privatization of Medicaid. Maybe we can privatize Wos' job as well. LOL

  • miseem Nov 19, 2014

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    You do realize that Wos is appointed by the Governor and that only he has the say so to fire her, right?

  • Eq Videri Nov 19, 2014
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    Most politicians don't care about long-term value.

  • Paul Donovan Nov 19, 2014
    user avatar

    Contrary to popular opinion, implementing IT to take the place of a manual system does not necessarily reduce personnel costs. It shifts the headcount needed to professionals needed to maintain and run the system. It will increase efficiency once the bugs have been worked out.

  • Eq Videri Nov 19, 2014
    user avatar

    Truly, these two deserve each other.

  • iopsyc Nov 19, 2014

    Secretary Wos should have predicted the inevitable questions of how much can the state save and can we cut positions after the proposed upgrade?

    When you're asking for several million dollars, those are predictable questions that you should have answers for before you walk in the room..

  • Michael Hart Nov 19, 2014
    user avatar

    Don't much care for Wo's , but seeing both My Mother-in-law and my Nephew wait for a Death Certificate is painful to say the least...no matter how prepared you are before your passing, Nothing can be down without that little slip of paper...... She's got this one right!

  • Holly Atkins Nov 19, 2014
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    BAHAHAHAHAHA!! FIRED?? REALLY?? After all this time she hasn't been fired YET and should have been.

    Just nice to see them taking her to task by telling her to come back with FINAL figures and not some "Maybe" numbers.

    Wish they'd hold her to task for the Alvarez contract and ask exactly what $6.8 MILLION is getting us that couldn't be done in house.

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