Liberal Forum

Texas funeral directors anxious over state’s new requirement to bury or cremate fetal remains.

With Texas set to implement rules requiring the burial or cremation of fetal remains, it’s not just health care providers who are anxious about the recently adopted requirements.

Funeral directors in the state are joining the chorus of medical professionals and reproductive rights activists who have raised concerns about the rules.

Though it hasn’t taken a formal position on the requirements, the Texas Funeral Directors Association says it’s concerned about how they’ll affect the families they serve and the costs associated with compliance.

Starting Dec. 19, Texas will require hospitals, abortion clinics and other health care facilities to ensure that fetal remains be cremated or buried — regardless of the period of gestation — and prohibit them from disposing of fetal remains in sanitary landfills, a common practice for medical waste.

State health officials have contended that the “minimum costs in complying with the rules” would total $450 a year per health care facility, arguing that those costs would be offset by the elimination of the cost of landfill disposition.

But Michael Land, a funeral home director and spokesman for the association, said that’s unrealistic and that the costs associated with compliance are likely a “higher dollar amount than what they’re projecting.”

Cremations through a third-party crematorium range from $75 to $100 per specimen.

If individuals choose burials, the minimum cost of a small space in a cemetery is $500 and caskets of the appropriate size would likely cost $100, Land said.

If you add labor on the part of the funeral home, the fees could go into the thousands of dollars, he added.

Responding to those concerns, a spokeswoman for the Texas Health and Human Services Commission said the rules don’t require that “these processes” go through funeral homes.

Health care providers can work directly with crematoriums or medical waste companies to comply with the rules, said spokeswoman Carrie Williams.

“[Funeral homes] don’t have a mandatory role, and funerals are not required by these rules,” Williams said. “Incineration is still available as an option.”

But the rules indicate that incineration of fetal remains must be followed by interment.

State health officials define interment as the “disposition of pathological waste using the process of cremation, entombment, burial, or placement in a niche or by using the process of cremation followed by placement of the ashes in a niche, grave, or scattering of ashes as authorized by law.”

Among the few exceptions to the rule are miscarriages or abortions that occur at home.

But fetal remains from miscarriages that occur at health care facilities will still require interment — even if the patient does not desire it.

For those in the funeral business, the increased demand for cremations could mean ending their practice of charitably cremating the tissue from a miscarriage for parents who wished to have a funeral.

“What had always been pretty much a charitable process is now going to become costing quite a bit of money,” Land said.

It’s estimated that 10 to 20 percent of pregnancies end in miscarriage.