Drew Wilson
Gov. Ron DeSantis has signed legislation that would take some stress off palliative care physicians who guide patients through their final hours, as well as the grieving families they leave behind.
Sponsored by Republican Rep. Dana Trabulsy, HB 647 would allow Advanced Practice Registered Nurses (APRNs) to complete and file death certificates for hospice care patients.
Valid death certificates must record both time of death and cause of death before the deceased’s remains can be turned over to a funeral director. Under current law, a doctor must determine the cause of death and sign the certificate. That will remain the case after Trabulsy’s bill goes into effect July 1 for non-hospice deaths.
While a seemingly minor change, the magnitude of Florida’s physician shortage is especially stark in palliative care. With palliative care physicians stretched thin, some grieving families are left with a dayslong wait before they can fully focus on funeral preparation and, ultimately, closure.
Unlike many bills referencing both physicians and APRNs, highly trained providers with post-graduate nursing education, the proposal flew through the Legislature without opposition, earning unanimous support in both chambers before landing on the Governor’s desk.
The fast-track to statute stems from the nature of hospice, which focuses on the abatement of pain and suffering for patients succumbing to a known ailment. Though the manner of death may vary for hospice patients, the means don’t — it’s standard practice to attribute hospice deaths to the disease a patient was battling.
With hospice death certificates halfway done by default, the only obstacle remaining is time of death. Florida — and indeed the vast majority of states — agree that nurses are both capable of confirming a patient has died and telling time. Whether they can sign the resulting death certificate is the only sticking point.
Upon the bill’s signing, Florida Hospice & Palliative Care Association President and CEO Paul Ledford issued a statement praising Trabulsy and the upper-chamber sponsor, Republican Sen. Alexis Calatayud, “for skillfully guiding these bills through the process, and to all the stakeholders for coming to early agreement. These lawmakers are truly dedicated to finding solutions and getting it done for Floridians.”
Reflecting on the unanimous support for the bill, Ledford added, “I’d like to praise the recognition by lawmakers that end-of-life care is a nonpartisan issue, and to thank members of the Legislature and the Governor for recognizing the operational efficiencies of bringing members of the hospice team in to fill practical needs, and frees up hospice physicians to focus on delivering care.”
