Indigent Burials Are on the Rise - NYTimes.com

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By KATIE ZEZIMA

Coroners and medical examiners across the country are reporting spikes in the number of unclaimed bodies and indigent burials, with states, counties and private funeral homes having to foot the bill when families cannot.

The increase comes as governments short on cash are cutting other social service programs, with some municipalities dipping into emergency and reserve funds to help cover the costs of burials or cremations.

Oregon, for example, has seen a 50 percent increase in the number of unclaimed bodies over the past few years, the majority left by families who say they cannot afford services. “There are more people in our cooler for a longer period of time,” said Dr. Karen Gunson, the state’s medical examiner. “It’s not that we’re not finding families, but that the families are having a harder time coming up with funds to cover burial or cremation costs.”

About a dozen states now subsidize the burial or cremation of unclaimed bodies, including Illinois, Massachusetts, West Virginia and Wisconsin. Most of the state programs provide disposition services to people on Medicaid, a cost that has grown along with Medicaid rolls.

Financing in Oregon comes from fees paid to register the deaths with the state. The state legislature in June voted to raise the filing fee for death certificates to $20 from $7, to help offset the increased costs of state cremations, which cost $450.

“I’ve been here for 24 years, and I can’t remember something like this happening before,” Dr. Gunson said.

Already in 2009, Wisconsin has paid for 15 percent more cremations than it did last year, as the number of Medicaid recipients grew by more than 95,000 people since the end of January, said Stephanie Smiley, a spokeswoman for the Wisconsin Department of Health Services.

In Illinois, Gov. Pat Quinn tried to end the state’s indigent burial program this year, shifting the financing to counties and funeral homes, but the state eventually found $12 million to continue the program when funeral directors balked.

The majority of burials and cremations, however, are handled on the city, county, town or township level, an added economic stress as many places face down wide budget gaps.

Boone County, Mo., hit its $3,000 burial budget cap last month, and took $1,500 out of a reserve fund to cover the rest of the year. While the sum is relatively low, it comes as the county is facing a $2 million budget shortfall, tax collections are down 5 percent and the number of residents needing help is expected to grow.

“We’ve had a significant increase in unemployment, wages are dropping, industrial manufacturing jobs go away and companies scaled back or even closed their doors,” said Skip Elkin, the county commissioner. “But we feel an obligation to help families who don’t have any assets.”

The medical examiner of Wayne County, Mich., Dr. Carl Schmidt, bought a refrigerated truck after the morgue ran out of space. The truck, which holds 35 bodies, is currently full, Dr. Schmidt said. “We’ll buy another truck if we have to,” he said.

Many places are turning to cremation, which averages a third to half the price of a burial. However, they will accommodate families’ requests for burial.

Clyde Gibbs, the chief medical examiner in Chapel Hill, N.C., said the office typically averaged 25 to 30 unclaimed bodies each year. At the end of the 2008 fiscal year there were at least 60, Dr. Gibbs said. The office cremates about three-quarters of the remains, and scatters the ashes at sea every few years.

In Tennessee, medical examiner and coroners’ offices donate unclaimed remains to the Forensic Anthropological Research Center, known as the “Body Farm,” where students study decomposition at the University of Tennessee. The facility had to briefly halt donations because it had received so many this year, said its spokesman, Jay Mayfield.

The increase in indigent burials and cremations is also taking a toll on funeral homes, which are losing money as more people choose cremation over burial. In 2003, 29.5 percent of remains were cremated; by 2008 the number had grown to 36 percent, according to the Cremation Association of North America, and it is expected to soar to 46 percent by 2015, according to the association’s projection of current trends.

Don Catchen, owner of Don Catchen & Son Funeral Homes in Elsmere, Ky., who handles cremations of the poor in Kenton County, said the $831 county reimbursement for cremations was “just enough to cover the cost of what I do — I donate my time.”

In Florida, where counties switched to cremation a few years ago to save on costs, Prudencio Vallejo, general manager of the Unclaimed Bodies Unit of the Hillsborough County Medical Examiner’s Office, said cremations were $425, compared with $1,500 for a burial. They have risen about 10 percent this year, Mr. Vallejo said.

“Most people, the first thing that they say is ‘We wouldn’t be coming to you if we could afford to do it ourselves,’ ” he said.

Broward County, Fla., paid for the cremation of Renata Richardson’s daughter, Jazmyn Rose, who was born stillborn on Sept. 25, 2008. Ms. Richardson, 26, lost her job at an advertising agency in July and could not afford to pay.

The county spent about $1,000 on a cremation and pink urn, engraved with the baby’s birth and death date, and a Bible passage. It now sits in the bassinette where she was to sleep.

“I was strapped for cash, I was in mourning, and I didn’t know what they were going to do with her,” Ms. Richardson, of Davie, Fla., said. “I was honored that they went that far to help me.”