Texans are waiting for birth and death certificates amid health agency understaffing

“Texans are waiting for birth and death certificates amid health agency understaffing” was first published by The Texas Tribune, a nonprofit, nonpartisan media organization that informs Texans — and engages with them — about public policy, politics, government and statewide issues.

Thousands of Texas families are waiting on birth and death certificates as an understaffed state agency works through a backlog of requests.

The Texas Department of State Health Services says that as of March 22, there were 60,873 requests for records, including birth certificates, death certificates, divorce records, and verifications of marriages and adoptions that the department had not yet fulfilled. That also includes requests for corrections to these records.

The backlog — which stems from a longtime staffing problem and was exacerbated by the state’s switch in January to a new computer system for processing records — comes as the agency vies for a boost in funding to more quickly process requests. Meanwhile, families anxiously wait to move forward with logistics around passports, inheritances and paying funeral expenses.

Among the family members waiting was Universal City resident Jennifer Lambrecht, who on Dec. 20 lost the grandmother she describes as “superwoman.” Gerda Hughes was a strong, independent woman who would chop down trees on her Canyon Lake property and haul them herself to a burn pile, her granddaughter said. Hughes died unexpectedly after a lung biopsy, and the family received her death certificate — but it was missing a cause of death. The amended certificate took three months to arrive.

“It kind of just keeps that wound open and takes you longer to heal,” Lambrecht said.

The delay meant the family couldn’t move forward with accessing Hughes’ bank accounts and distributing inheritances, Lambrecht said. Without a death certificate, people who lose a loved one in Texas cannot disburse inheritances, process wills, receive money from retirement and life insurance plans, or access bank accounts to pay off bills.

“She had everything written out in her will,” Lambrecht said. “On her part, she did everything that she needed to do and was supposed to do.”

When the state switched to the Texas Electronic Vital Events Registrar, or TxEVER, a $14.1 million state system for processing records, some funeral home directors, justices of the peace, medical examiners and doctors say they were initially unable to submit information for death certificates. State officials say that the learning curve for the new system caused a slowdown. Users who did not update their account information before it was migrated to the new system had problems, said Lara Anton, a spokeswoman for the Texas Department of State Health Services.

“Every part of the vital records registration process was slower in January as all 20,000+ users were learning to navigate the new system but in recent weeks the death registration process has been taking the same amount of time as it was last year in the old system,” Anton said in an email.

Meanwhile, the number of requests for important records has increased, but the number of state employees available has not, causing delays that have been years in the making. The average number of days for workers to fulfill a request for birth records, death certificates and other vital records has nearly tripled since fiscal year 2015, from 10 days to 29 days, according to Texas Department of State Health Services data.

“The issue with DSHS Vital Statistics being unable to fulfill requests for vital records quickly existed before TxEVER launched,” Anton said.

There are several steps that take place before a death certificate reaches a family. The medical certifier — a justice of the peace, medical examiner or doctor – fills out various parts of the death certificate, and then the funeral director orders copies from the Texas Department of State Health Services’ Vital Statistics Unit. The agency then releases death certificates to local registrars. Several factors can affect how long it takes the state to process a death certificate, including when and where the person died and if autopsy results need to be added.

The department receives 900 death certificate orders per day. Anton said the agency “has no control” over how long it takes for medical certifiers to complete their parts of death certificates and that once they do, it takes time to process, print and ship the orders securely.

“A month from when the death occurred to when the funeral director receives the copies of the death certificate is normal processing time and unrelated to the launch of the new system,” Anton said.

Funeral directors and family members can go to the local registrar in the county where the death occurred or to the agency’s main office in Austin and leave with a registered copy of the death certificate four hours after the funeral director sends the death record if they need it quickly.

Chuck Robertson, president of the Texas Funeral Directors Association, says the organization has been in touch with state officials about the system’s problems and the group’s frustrations over long waits for copies of death certificates.

“For lack of a better term, it’s a nightmare, and hopefully this nightmare will be alleviated in the next month or so and they can fix these hiccups,” Robertson said. “I hate to say hiccups, but that’s the G-rated term for what I was going to say.”

Robertson, who also owns Robertson Funeral Directors in Clarendon, 60 miles southeast of Amarillo, said the death certificate delays are “giving us a black eye” with families.

“We suffer with them at restaurants, we go to church with them, we go to football games with them, that type of deal,” Robertson said. “When they walk into our doors mad at us, it puts a real sour taste in my mouth.”

His funeral home performs 200 services a year and has done 52 funerals this year. He is waiting on 11 death certificates. That means frustrated families and delayed payments. Robertson said he is waiting for $40,000 from burial insurance plans, which are used by people who paid for their funerals in advance. Robertson won’t get paid until he files a claim with a death certificate.

Anton said that the agency anticipated problems with the new system. She pointed out that the agency held 130 training sessions prior to the launch, scheduled daily conference calls and webinars in January and February, and has a web page with user guides and video tutorials.

“We know that a large number of stakeholders did not participate in those training sessions and were not prepared to navigate the new system when it launched,” Anton said. “TxEVER has new workflows which initially caused some confusion for untrained users.”

Texas Department of State Health Services Commissioner John Hellerstedt told legislators during a Senate Finance Committee hearing Feb. 5 that the backlog was due to the demand for records and the TxEVER rollout.

“We do want to decrease the backlog, and the transition over to TXEVER was something that required a great deal of our staff time,” Hellerstedt said. “And so now we’re working back through that backlog, and yes, the backlog is longer than when we would want it to be.”

The backlogs are also spotlighting the agency’s staffing troubles. The department has 61 employees to process what it projects will be 2.2 million records in fiscal year 2019.

The agency’s budget request for 2020-21 includes $3 million to hire 17 new Vital Statistics Unit employees to help with the backlog and customer service requests. The department’s goal is to take two or three weeks to process requests instead of five.

The department’s understaffing is a key factor in the backlog of birth records. Staffers who typically process birth records for hospitals were able to familiarize themselves with TxEVER faster because of the volume of records they usually deal with, according to Anton.

Texas parents are not required to order birth certificates immediately after a child is born and can order one online at any point. There is not a significant delay for birth certificates.

But birth certificate amendments — such as correcting a typo in the child’s name; name changes after an adoption; and adding, removing or replacing a parent’s name — are an ongoing problem. Amendments to birth certificates take longer to process, and it’s now taking the agency nearly three months to do so, down from six months in early 2017. People requesting changes often don’t have the proper documentation, so it takes longer to process the requests.

Lindsey Hart, financial coordinator for Adoption Advocates, an agency in Austin, said it has been difficult to get birth certificate amendments for adoptive families.

“They have been struggling with mainly trying to get Social Security numbers, passports, health insurance and things like that for the baby,” Hart said.

Anton said the agency often rejects birth certificate amendment applications for not having the required supporting documents and that “these applications take longer to process because they require a higher level of scrutiny.”

“Applicants are requesting changes to a legal document that can be used to get other forms of legal identification such as a passport,” Anton said. “DSHS must verify that the person making the request is who they say they are and that they are eligible to make the requested change.”

People seeking information about delayed documents say it’s been difficult to get information from the state.

Judge David M. Cobos, a justice of the peace in Midland, said just weeks ago he had several death certificates he could not complete because the funeral homes he was working with were unable to log in to TxEVER. He said families called him asking for a timeline on when to expect the death certificates but that he couldn’t give them one. He hasn’t had problems with the system recently, but he said the lack of response from the Department of State Health Services hasn’t helped — no one from the agency ever called or emailed him back.

“I’m not trying to drop them in the grease, but you got to be responsive to your citizens,” Cobos said.

Cobos, who is also president of the Texas Justices of the Peace and Constables Association, said that in the weeks after TxEVER launched, every justice of the peace he talked to had trouble with the system or with contacting someone from the agency.

“I started just going down the list and dialing numbers until somebody answered, and I think I wasn’t too pleasant when someone else answered,” Cobos said.

Anton said that agency staff worked overtime or were reassigned to provide extended call center coverage on weekdays and Saturdays for the first three weeks after TxEVER launched, responding to more than 18,000 phone calls and 29,000 emails. The call wait times have dropped from 30-35 minutes to less than 10 minutes. Agency staff have also worked overtime to respond to email help requests, and the turnaround time for responses is now less than one business day, she said. The majority of the calls the agency is now receiving are from the public.

Melissa Laws was waiting in Crawfordsville, Indiana, for her husband’s death certificate to come from Texas. Her husband died Dec. 29 of complications from leukemia in Houston, where he was being treated at MD Anderson Cancer Center. Laws said her husband “was wonderful, very hardworking, very supportive and a present father.”

She didn’t receive the death certificate until Feb. 16. Laws had called the funeral home weekly, but its staff could not tell her when to expect the certificate. She said she would be in serious trouble if it weren’t for a cushion in their bank account.

“There was nothing I could do,” Laws said. “The life insurance policy, the 401(k), Social Security, nothing could happen. He has a truck loan that’s in his name. Nothing could happen without the death certificate, and we have six kids, five under the age of 18, so I’ve been able to do nothing.”