TRURO — Richard Pask, 72, came to the select board on Aug. 27 distraught. His wife, Carol Harris, 69, who had ALS, had died at home in hospice care on July 18, he said, and the town had still not issued a death certificate.
Without the certificate, Pask could not access his late wife’s pension payments, manage their mutual assets, update annuity contracts, or cancel service accounts in her name. The Social Security Administration, which has continued to issue payments to Harris — a death certificate is required to stop them — had launched an investigation into possible fraud, according to correspondence reviewed by the Independent.
Using the public comment period at the select board meeting to plead for help wasn’t Pask’s first attempt to resolve the matter, he told the board. He said he had been in contact with Town Clerk Elisabeth Verde and members of the select board about the problem and the troubles the delay was causing him, but to no avail.
“I’ve been unable to get resolution to this,” said Pask. “I just feel like I’m on my own. It’s not right.”
Select board chair Susan Areson was the first to speak after Pask finished. “Carol was a treasured member of this community,” said Areson. “We will look into it with the town manager.”
It is the town clerk’s job to issue death certificates along with other vital records including birth and marriage certificates.
In Massachusetts, all deaths are recorded in the state’s Electronic Death Registration System, which only town clerks, funeral homes, medical examiners, and medical facilities can access.
In an email, Verde told the Independent that a host of problems had contributed to her failure to issue Harris’s death certificate: the timing of the death during her vacation, her workload related to the state primary, the type of burial the family had chosen, and difficulty finding people with experience handling these matters.
Verde wrote that, in this particular case, she did not initially know whether she had the authority to generate a death certificate because Harris had died in hospice care and her family had not used a funeral home.
But Massachusetts law does not require that families use a funeral home. In a case like Harris’s, pursuing the certification of the death can fall to a special designee who takes on a role that would have otherwise been the funeral director’s. And the type of burial is irrelevant to the issuing of a death certificate.
According to the Mass. Dept. of Health’s Registry of Vital Records and Statistics, physicians, nurse practitioners, medical examiners, and physician assistants qualify as medical certifiers.
The special designee in Harris’s case was Pask, and the medical certifier was Margaret Beaudry, a VNA hospice nurse, according to correspondence reviewed by the Independent.
Pask’s duties following Harris’s death, which was documented by Beaudry, were practical, ceremonial, and administrative. For many of these matters, he sought guidance from Dawn Walsh, the executive director of Lily House, which offers end-of-life care and support to Outer Cape residents.
Walsh said that she pointed Pask, Verde, and Holly Ballard-Gardner, chair of the Truro Cemetery Commission, to online resources provided by the state for families not working with a funeral home. Those include the documents they would need to fill out and submit to the town clerk. There is also a quick guide for town clerks on how to prepare those records.
Following the state’s guidance, Pask completed the documentation required for a town clerk to issue a death certificate and submitted it to Verde on July 22. This included a medical certifier worksheet with the time, place, and cause of death and an informant worksheet with Harris’s biographical information.
Walsh told the Independent she also helped Pask plan a green burial for Harris, providing him with a cardboard casket, educational material about green burial, and instructions on how to prepare the body for burial.
“These components are part of a rethinking of how we do death as a culture and reclaiming our human right and our legal right to take care of our loved ones after death,” said Walsh. “I was so inspired by Richard’s fortitude and determination to care for Carol in this way.”
Ballard-Gardner sold Harris and Pask a green burial plot at Old North Cemetery in Truro and issued the burial permit after Harris died. Issuing a burial permit does not require having a death certificate. Carol Harris was buried in the natural burial area at the cemetery on July 19.
Since then, Ballard-Gardner said, she has tried to support Pask, including in multiple follow-up communications with Verde about the status of the death certificate. “We encounter people at a profound stage of life,” said Ballard-Gardner. “We feel a strong sense of duty to lighten the burden.”
A Backlog and Uncertainty
When Pask submitted the initial paperwork for Harris’s death certificate on July 22, Verde was on vacation. She told the Independent that when she returned on July 29 she faced a backlog of work and needed to prioritize statutory deadlines for the state primary election on Sept. 3.
“This was my first introduction to this type of burial and there seem to be very few resources available,” wrote Verde. “I now understand that I was essentially completing the tasks that a funeral home normally handles, but with no education or experience in this. This was complicated by very cumbersome software that the State’s Vitals System uses.”
As of midday Sept. 3, Pask had still not received a death certificate from the clerk, according to Ballard-Gardner. Verde told the Independent that day that she was still missing Harris’s cause of death and that she was waiting for Outer Cape Health Services to complete a worksheet with that information. Verde added that she hoped to receive it this week.
“We’re a small town, and we haven’t had a lot of people not use a funeral home,” said Ballard-Gardner.
“It’s a learning curve for all of us,” added Walsh. “We need all of us to learn how to do this together as a community.”
As the Independent was about to go to press late on Sept. 3, Truro Town Manager Darrin Tangeman sent a text message to the newspaper. “The death certificate was completed this afternoon,” it read.
