SUMMARY OF DISCUSSION - AVSS TAG MEETING
Sacramento, California
December 17, 2002

Automated Vital Statistics System Technical Advisory Group Core Members:
Natlee Hapeman – Santa Barbara County
Pamela
Isaac - Humboldt County
Alan
Oppenheim - Office of County Health Services
Michael Rodrian - Center For Health Statistics
Mark Starr - Division of Communicable Disease Control
Ronald Williams -
University of California

1. Introduction By Attendees and Opening Statements.

Review of summary from June 13, 2002 TAG meeting. TAG summaries are available on the Web at: http://www.avss.ucsb.edu/tag.htm

2 Planning for Version 4.12.

Version 4.12 is the name for the 2002 version, which will be released early in 2003. Version 4.12 is presently being alpha tested and will be beta tested in January 2003. Release Notes were distributed at the meeting and can be viewed on the Web at http://www.avss.ucsb.edu/release.htm

Some more significant changes in Version 4.12 were reported. For example, ICD10 will replace ICD9 in the Death Record cause of death fields, more flexible rules for entering fetal death data, hospitals connected to LRD databases will be able to view the nonconfidential portions of registered birth certificates for births that occurred in their facility, a new 464-byte ASCII output file is available for CMRs, and a number of user-suggested improvements have been incorporated.

3. AVSS Modification Requests (AMRs): Review and Discussion.

02-086
: Desiree Schaan of
Alameda County presented her request to generate an ASCII output file for fetal deaths in the same way that AVSS does for births. Ron Williams described how there is a need for a state standard to follow and none presently exists for fetal deaths. Mike Rodrian acknowledged that an OVR task force is currently developing standards for fetal deaths, but that it could be some time. Meanwhile, Ron will explore the possibility of using the current birth certificate file layout and adding those fields specific to fetal deaths, such as cause of death.

02-096
: Since the death certificate will be changing in 2003 (see below) there is a need to consider changing the AVSS electronic form (the CDC) to conform to the new paper form. After some discussion TAG decided to
a. Add and prompt for a new Also Known As (AKA) field.
b. Education (Field 13) will allow both numeric and alphabetical entries to conform to the new death certificate instructions.
c. Race will be Field 16 instead of 14 and will allow multiple entries in the same way as the birth certificate.
d. A new field (113A) will be added and prompted to record if the decedent was pregnant within one year of death.
e. A program will be developed to reset the changed fields (13, 14, 15, 16, 113, 113A/B) for historical data.

02-106: John Marinko suggested that due to recent enhancements in the List To Be Sent To Health Department suboption that we remove the removed in a future version of AVSS. TAG agreed that would be a good idea.

4. New Statutes and their affect on AVSS.

Mike Rodrian presented a summary of legislation enacted in 2002, as reported in All-County Letter 02-08. Mike reported on:
AB 1139, Title: Death Certificates; Author: Thompson; Filed with Secretary of State 09/24/2002
AB 1773, Title: Personal Identifying Information; Author: Wayne; Filed 09/26/2002
AB 1872, Title: Coroners: Certificate of Death; Author: Canciamilla; Filed 09/20/2002
AB 2550, Title: Electronic Death Registration; Author: Nation; Filed 09/25/2002
AB 2837, Title: Safety in Employment; Author: Koretz; Filed 09/26/2002
SB 17, Title: Human Remains: Vital Records; Author: Figueroa; Filed 09/23/2002
SB 247, Title: Restricted Access to Vital Records; Author: Speier; Filed 09/26/2002
SB 1254, Title: Identity Theft; Author: Alpert; Filed 08/26/2002
SB 1614, Title: Birth and Death Indices; Author: Speier; Filed 09/19/2002

Mike also indicated that a separate All-County Letter will be issued for each legislative bill, and he briefly reviewed all All-County Letters issued in 2002.

Pat Andrews announced that workshops for 2003 would be held at
Lake Tahoe, April 8-10, and Costa Mesa, April 29-May 1.

5. New Death Certificate and Electronic Death Registration.

This topic was addressed in All-County Letter 02-09. Alan Oppenheim presented the revisions to the death certificate. Those revisions are displayed in the attached chart.

In response to questions about use of the worksheet on the back of the death certificate, Alan indicated that DHS prefers that the worksheet be used as a reference, without any written entries. He indicated, though, that writing that does not interfere with the legibility of the death certificate would be acceptable.
Alan presented information on interim procedures for data entry for the optional pending death certificate program.

Ron informed the group that
Merced County is the second county to participate in the EDR pilot. Santa Barbara County was the initial participant. Ventura County has indicated interest in participating in the EDR pilot.

Ron advised the group that AVSS/NET will be used for communication, in lieu of dial-up modems.

Mike presented an overview of the benefits of county participation in the EDR pilot. He indicated that OVR will meet with health departments, funeral directors, and coroners in those counties that wish to participate in the pilot.

Ron announced that Gail Cayton is leaving AVSS in February 2003 for a position with the US Department of State, and Glen Nishida has been hired for the position vacated by Gail.

6. New Birth Certificate in 2005?

Mike discussed Task Force and stakeholder meetings being conducted in preparation for changes in the birth certificate in 2005. The federal government has issued a model birth certificate, which is available on the NCHS website. Mike advised the group that each element in the birth certificate is mandated by statute, so any changes will require legislation to be enacted.

7. Future of AVSS, including AVSS/NET.

The description of AVSS/NET is available on the AVSS website. A handout describing AVSS/NET was distributed to the group. Ron reviewed the background to AVSS/NET and the benefits of the system. Several counties are currently operating AVSS/NET or in the process of installing the program:
San Luis Obispo, Humboldt, Stanislaus, San Joaquin, and Calaveras.

8. Confidential Morbidity Report (CMR).

Stan Bissell presented information on the CMR, based on materials handed out at the meeting (see below). AVSS release notes describe changes in CMR.

9. Equipment/operating system recommendations.

This topic was deferred to a later meeting.

10. AVSS technical assistance.

The group was advised that meeting materials included a table displaying amounts paid by each LRD for AVSS technical assistance from FY 96-97 through FY 02-03 (to date).

11. New topics.

Dan Peak, Sacramento County Health Department, offered the use of his conference room for future meetings of the AVSS TAG.
Meeting adjourned at
3:09 p.m.

Acknowledgement: This summary was written by Jessica McCarroll.

Certificate of Death Revision – VS -11 (Rev 1/03)
Chart of Major Changes

As discussed in All County Letter 02-09, the following fields have been added, deleted or revised:

AKA

Also known as

This item has been added to reduce the number of amendments and therefore to make complete, certified copies available on a more timely basis. Include the full AKA (first, middle, and last name).

13

Education

This item has been revised to include a brief narrative description of the level of completed education. To standardize the descriptions, please use the worksheet located on the back of the certificate to gather information that best describes the highest degree or level of school completed at the time of death. Enter the education information on the front of the certificate in box 13.

14/15

Was decedent Spanish/Hispanic/Latino?

This item now precedes the Decedent’s Race item. Please use the worksheet located on the back of the certificate to gather standardized information on Spanish/Hispanic/Latino origin.

16

Decedent’s Race

This item now follows the Spanish/Hispanic/Latino item. Please use the worksheet located on the back of the certificate to gather standardized information on decedent’s race.

 

Note: Usual Employer information (formerly item 16) is no longer collected.

22

County/Province

This item has been revised to collect Canadian Provinces in addition to United States’ counties.

44

Name of funeral establishment

This item has been revised. The title of the field has been renamed from "name of funeral director" to "name of funeral establishment" to appropriate identify the request for name of funeral establishment.

103

If other than hospital, specify one

This item has been revised to rename facilities and add hospice and decedent’s home. The categories are now: hospice, nursing home/LTC, decedent’s home, and other.

107

Cause of death

Although the legend "DO NOT ABBREVIATE" has been added, acceptable abbreviations will not result in certificate rejection by the local registration district or by the State Registrar. Acceptable abbreviations are listed in the handbook.

113A

If female, pregnant in last year?

This item has been added. AB1139 requires that a death certificate include information indicating whether the decedent was pregnant at the time of death, or within the year prior to death, if known, as determined by observation, autopsy, or review of the medical records in order to determine pregnancy. Allowable entries for female decedents are: Yes, No, and Unknown. Please leave this item blank for male decedents.

CMR Topics - AVSS TAG December 17, 2002
Stan Bissell, Acting Chief, Surveillance and Statistics Section,
Cal DHS
(916) 445-5948; sbissell@dhs.ca.gov; http://www.dhs.ca.gov/ps/dcdc/dcdcindex.htm

1.         SSS Updates
-- Budget: State shortfalls; CDC Bioterrorism Preparedness and Response program
-- CMR form revisions and full regulation (Title 17 sec. 2500, 2505, etc.) changes still pending (comments welcome)
-- Reminder: Case report forms available in PDF format (view/print only; many are now fillable)
on our web-site (above) - Click on Publications, then scroll to FORMS
section and click on the link; Username: cdforms, Password: broadstreet
-- Electronic document management system for case history forms now operational. Backlog of case review is diminishing.
-- 1999-2000 CD Report still in progress (this report will include some narratives).
-- Electronic laboratory-based reporting (ELR) / California Electronic Laboratory disease Alert and Reporting (CELDAR) system: Pilot system targeted for operation by end of Summer. CDC bioterrorism funding.
-- National Electronic Disease Surveillance System (NEDSS): Grant-funded (CDC)
project to use data and architecture standards in surveillance systems
-- SSS will be moving to the new "East End Complex," tentatively scheduled for May 2003.
-- About to phase in automated e-mail LHD-specific weekly feedback reports for morbidity reports received by SSS (example handout and initial sign-up sheet).

2.         Old Business
-- 3rd "Annual" Morbidity Meeting (CMR Users Group),
May 15, 2002 (SoCal) and June 14, 2002 (NoCal) was a success.
-- AVSS-CMR: AVSS foreign data import – pilot plans?
AVSS CMR output file
Combined AVSS/Reporting Manual – still a good idea, no recent progress.

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