During the multiple heat-related illness cases relating to the United States Postal Service (USPS), the Occupational Safety and Health Administration (OSHA) was able to establish extreme heat being a major workplace hazard. However, the agency neglected to provide effective abatement techniques in the case.

Due to this, the Occupational Safety and Health Administration Review Commission (OSHRC) supported the decision made by the administrative law judge to vacate citations in all but one case.

These citations were related to seven employees working during the summer of 2016 in five cities. Every letter carrier experienced illness when they were out delivering mail in the extreme heat and had to get medical treatment. OSHA claimed that six of these workers became ill due to excessive heat. Five citations were filed against USPS for these alleged violations.

The Administrative Law Judge (ALJ) vacated the five citations after finding that OSHA neglected to prove the workplace conditions were hazardous and that effective and feasible measures were accessible to abate the conditions.

In four cases, the OSHRC agreed the agency established that the extreme heat conditions posed a hazard for the workers under the general duty clause but found the abatement suggestions OSHA made for the hazardous conditions for these cases fell short.

For the fifth one, the OSHRC found that USPS indeed neglected to offer proper heat-related illness training to the supervisors. Therefore, this case was remanded for additional review.

According to OSHA, the USPS was in violation of the general duty clause as it failed to implement a proper program to manage exposure to extreme heat. Thus, OSHA suggested the following measures:

• Rest and work cycles
• Employee monitoring and emergency response plans
• Monitoring USPS data on heat-related illnesses among employees
• Decreasing the outdoor time of employees
• Equipping delivery vehicles with air-conditioning
• Acclimatization
• Providing heat-related illnesses training

However, the USPS proved that it was already following most of these measures or was already in the process of implementing them.

This recent incident highlights the significance of a detailed heat illness prevention plan. Employers must not only have a written plan implemented but also provide sufficient training to their workers. Based on guidance provided by OSHA, supervisors must be trained to:

• Identify heat hazards and control them
• Spot early signs of heat illness or stress
• Provide appropriate first aid
• Quickly initiate emergency medical services

Aside from this, the guidance also recommends employers create a heat illness prevention plan that:

• Those employees returning from a break or new employees are acclimatized and gradually build up to work a full day in the heat
• Temperature and work exertion levels are monitored, classifying levels of physical exertion as heavy, moderate, and low
• Employees are provided easy access to water and have sufficient water to stay hydrated, along with proper breaks to rest
• Shades are installed to ensure employees can rest, or cooling systems or air conditioning is provided if feasible
• The buddy system should be implemented to encourage workers to monitor each other for heat-related illness symptoms
  

Training must be provided to workers to spot stages and signs of heat illness, steps to report them, provide appropriate first aid when needed, and understand how and when to get emergency medical assistance.

The funeral industry is not exempt from start-ups and innovative ideas that go nowhere. I’m sure you could think of one yourself – one of them might even have been yours – but I won’t call out any here.
​
That’s why it’s not wholly surprising that the most common question I get from the media, regulators, and curious practitioners is “Is human composting real?” To which I say, “Yes.”
There is a unique energy around legalizing natural organic reduction, in that most legislation has been consumer-driven, with support from practitioners. As one of the most progressive organizations in this space, CANA is the first death care association to answer these questions and provide insight from a funeral profession perspective. Informed by more than 100 years of experience in emerging technologies, we were eager to host some of the earliest NOR practitioners at our events and offered opportunities for question-and-answer sessions to explore this groundbreaking idea. Now we can compile what we know – and what we have yet to figure out – here, for you.

Natural Organic Reduction, also known as, NOR and Natural Reduction are the terms used in legislation and regulations related to this process, so that’s how CANA refers to it. More commonly used terms by the media or general public are Human Composting, Soil Transformation, or Body Composting, which are descriptive and useful for understanding the process more broadly. Some practitioners have coined proprietary terms like Terramation and Recomposition to describe their specific business offerings.

NOR was first legalized in 2019 in Washington. Colorado and Oregon followed in 2021 and Vermont and California in 2022, with several other states considering the practice in the coming years. To legislators, it is a thing.

But what kind of thing? Here’s where it can get interesting.

Compost is organic material that has decomposed to a nutrient-rich soil. At home, compost is food scraps and yard waste. For farms, it might be the livestock or the crops after harvest. Soil is, in fact, a mixture of decomposed organic matter with other naturally occurring elements like gases, liquids, living organisms, etc.

Once the waste decomposes, it can’t be separated from the other soil around it to say “that’s the orange peel, that’s the eggshell, and that’s the dandelion” — it’s all one piece of earth.

Human composting is the same but different. First, you can’t add a human body to your compost barrel: it’s illegal and it’s not what most people have in mind when they think of a proper send-off. Second, humans are large animals and require a sizeable quantity of other organic material to mix with during decomposition. Plus, anyone who composts knows that you need to keep air circulating and bacteria alive so that the matter decays rather than molds or rots. For human composting, this is where the professionals come in.

The interest in composting for human disposition is not new. Mary Roach’s Stiff, first published in 2003, shares the story of Tim Evans, then a graduate student at the University of Tennessee Anthropological Research Facility, who working to find a way to compost human remains. Evans had to aerate the compost pile and acknowledged that “It was hard being out there” to properly tend to the composting remains. The real need was to make composting doable within a reasonable timeframe, in compliance with regulations regarding body disposition, and in an acceptable manner for families.

SAME BUT DIFFERENT

In all states, the law allows for cremation and burial. As we’ve discussed before, some states have expanded their cremation law to include alkaline hydrolysis (aka water cremation, Aquamation, Resomation, etc.) Burial is easiest to understand: intact body placed in the ground (or crypt, mausoleum, etc.). Cremation and alkaline hydrolysis take the intact body, put it through a process using a combination of heat and/or chemicals so that just the bone matter of the body remains. But NOR takes an intact body and goes through a process that results in soil. There are no ashes to place or keep or scatter, no DNA to identify your loved one from other soil, generally no way of preventing comingling of remains with others’ (often prohibited in all cremation laws), and maybe not even a place to visit (depending on where the soil ends up).

When Katrina Spade and Recompose were exploring how to get Recomposition legalized in Washington State, the process was not legal anywhere in the world. With input from law professor Tanya Marsh, who focuses on funeral law, the company decided that the most straightforward way of bringing NOR to the public would be to create a new statute for human reduction. That’s why some states are creating a new disposition category of “reduction of human remains” with subcategories for cremation, AH and NOR. The common factor in each is that they accelerate the reduction of human remains in a facility, using specially designed equipment.
​
It is CANA’s position that natural organic reduction is a unique form of disposition, not a type of cremation, and should be regulated separately. This means there are three ways of reducing a human body more quickly than burial: cremation, alkaline hydrolysis, and reduction. Each offers a unique process that requires specific equipment and training, and provides choice for families to do what feels right to them.

The differences we’ve described, as seen in the chart above, are the reason that these three reduction methods must be regulated separately. While the core of a death care professional’s job doesn’t change with the process — they take custody of the deceased, care for their loved ones, carry out the family’s wishes, and ensure that the remains get where they need to go with dignity and care — the processes themselves are very different.

The funeral profession’s first concern is always the dignified treatment of the deceased, and in the case of new processes that requires the training and knowledge to do it right. For regulators, that means setting the standard to measure the safety and ability to perform the process. This includes considerations for location and traffic, the environment and emissions, and employee health and safety. Both funeral professionals and regulators are dedicated to providing options to the public that meet all expectations for safety and excellence.

An internet search will highlight a few practitioners in the Pacific Northwest and the American Southwest who appear in news articles discussing this new option for consumers. Because human reduction is only beginning to be legalized, there are currently few options for the public to choose NOR. Funeral homes that currently offer NOR have carefully created their own vessels and developed their own technology, processes and proprietary mixes of organic material to reduce a human body to soil. That means that the process is pretty much limited to those who are willing to undertake the same sort of research and development process themselves. The only other option is for existing practitioners who offer NOR to partner with other funeral service providers to serve their families – though some of these providers are already operating at capacity.

Current cremation and alkaline hydrolysis regulations require equipment manufactured specifically for the process (hence, purpose-built). They require this to standardize the process and ensure the health and safety of the operators and public seeking these options. The lack of manufacturers of body composting vessels is a barrier to entry for many who would add it as an option for their communities – at least for the moment.

Without the uniform equipment, each practitioner’s process is proprietary, but there are a few things about the science in current methods that are universal. First, the only things that go in the vessel are organic matter. That means the body, either bare or shrouded only in organic natural fibers, the plant matter and bacteria, and little else. Brie Smith of Return Home advises families that, “If it can go through your gut, it can go through our vessel,” meaning that families can place meaningful keepsakes in, too, so long as they can be composted. Unwrapped Twinkies? Yes! That penny you swallowed on a dare? No—or rather: it’s going to come out the other side.

The reduction of the body takes anywhere from 7 weeks to 12 months, depending on the practitioner and their process. Loved ones are encouraged to be present when the body is placed, or “laid in," and to visit during the reduction. During the transformation, the vessel will run hot, spiking more than 130°F as microbes get to work. This high temperature also kills pathogens, bacteria and viruses that might be present in the body (though some medical conditions prevent NOR and some viruses and prions are not killed by NOR). Each provider also has a proprietary method for ensuring that air and matter circulates so the compost process generates soil.

When the process is complete, families can receive approximately 27 cubic feet of soil from the reduction of their loved one – enough to fill the bed of a pickup truck. As Earth Funeral Group of Washington says, “The nutrient-rich soil created during the process is used for land restoration and improving soil health. Healthy soil is paramount to a healthy ecosystem as it filters water, provides nutrients to plants and animals, sequesters carbon, reduces landslides and flooding, and helps regulate global temperatures.”

For a farmer or gardener, this volume of soil can be wonderful. Others can choose to take a portion of the soil to use on their own property or to keep at home in an urn or jewelry or some other keepsake, just as they do with cremated remains (though the soil needs to be sufficiently dry first). Remaining soil is then spread by the practitioner in nature. The Natural Funeral in Colorado offers a “laying out” ceremony when the resulting soil is spread on personal or public lands.

Cremation has gained popularity over the past 50 years largely because it offered an alternative to burial. It offered new options and captured the imagination of people seeking a new ways of personalizing their funeral. As in life, people want to express their values in death. Providing diverse options are good for families to personalize their experience. NOR practitioners report that their early adopters are “a diverse mix of people from all over” – that’s why so many states are moving quickly to make the option legal.

While there is opposition to the practice from outside and inside funeral service, there is an energy for NOR that we don’t see very often in funeral disposition legalization. The general public is excited for the option, legislators are energized to bring innovative ideas to the fore, and practitioners are curious if the participation in CANA’s recent events is anything to go by. Some funeral homes are poised to bring NOR to their community as soon as they can.
​
Any time I’m asked about a new form of disposition, the inevitable next question is how fast it will grow. Will NOR replace cremation? Or will it speed up the decline of burials? Would early adopters have chosen burial or cremation if NOR was not an option? As I often say, my crystal ball is broken. Only time will tell. CANA’s own statistics show that, like widespread adoption of any new technology, a critical mass must make that choice before it takes off. CANA’s Annual Statistics Report will be tracking these data as the law changes to allow this form of disposition, so look for more content on the topic.

Disasters happen, often without warning, and businesses must be prepared to deal with them. A natural or manmade catastrophe could threaten your employees or customers and shut down or interrupt your operations for an indeterminate period of time. While no one wants to think about a catastrophic event impacting their workplace, planning for various disasters is the best way to be prepared to respond if they do happen.

A fire is the most common type of emergency for which employers must prepare. The emergency action plan must detail how employees will be alerted to a fire or other emergency so that they can evacuate or take other actions. In addition to alarms, which should have both a sound and visual element, companies could use an emergency communications system such as a public address system or portable radio unit to provide additional information. Employees must also be trained in how to report emergencies, both to other employees and to fire, medical, and rescue services.

Employees should be educated about the threats and hazards that could occur in your workplace, and they need to be trained in their individual roles and responsibilities in an emergency. Training should be repeated at least annually, and new employees should be brought up to speed in the procedures soon after hire. If there are changes to the workplace that impact your plan – for instance, a redesign of the layout or the introduction of new hazardous materials – the plan should be altered, and employees retrained accordingly.

Most people find it difficult to think clearly and logically in a crisis.  A well-considered plan to guide their actions can go a long way in keeping them safe.

We all go into business with aspirations for success—but organizing and addressing the details to make success a reality can be daunting. How do we continuously improve our client family experience? Are there internal operating procedures that inhibit service delivery? Is employee morale positive? How do we clearly differentiate ourselves from our competition? Is our pricing consumer friendly? Are we as profitable as we could be? Are we moving the company forward?

Whether you’re looking to improve customer service, the workplace, the marketplace, or financial management, you want to start with a strategic plan to accomplish your goals.

Strategic planning, in its simplest terms, is determining where your business needs to go and how you are going to get there. The process involves owners and senior management assessing current performance, analyzing the market, setting goals, defining actions, identifying resources, and reviewing the level of accomplishment once the plan has been enacted. Simply put, to be successful with your plan, you must first define what is important, then create the measurements for success, then manage it to success!

Our consultants are seasoned professional experts who have led numerous clients through strategic planning sessions, all to an impactful resolution. Based on that store of experience, here are eleven key points that will ensure your company’s Interactive Strategic Planning Session is a success:

1. SET THE OBJECTIVE
Setting the Objective is the same as defining a North Star – the end to which all key company initiatives should lead. In other words, begin with the end in mind. Bring together the owners and key leaders of your company and motivate the group to envision the full potential of the funeral business! Together during this session, you will create compelling business objectives along with specific tactical actions and resources needed to achieve them.

2. TAKE IT OFFSITE!
Meet offsite somewhere where there are no distractions. Make it a day-long meeting with breakfast and lunch. Only in this environment will you be able to effectively address the most critical issues confronting the company.

3. WHERE TO BEGIN?
Begin the session with a review of the company’s current year successes and failures.

4. SWOT YOURSELF!
Assess the company’s internal strengths and weaknesses. After that, focus on recognizing both the external opportunities that exist as well as what external threats are looming. (Strengths, Weaknesses, Opportunities, and Threats… SWOT)

5. DEFINING WHAT’S NEXT
Now it’s time for the leadership team to articulate the business objectives or goals needed to reach optimum performance based on the prior observations. These goals are to be crystal clear, indisputable and should be the core priorities of the leadership team.

6. ACTION!
With objectives and goals created, it’s time to put strategies and actions together that are needed to achieve the goals.

7. WHOSE JOB IS IT?
You’ve created the actions needed, now who’s going to do it!? Now is the time for the appropriate leadership team member to be responsible for the action.

8. WHEN DOES IT NEED TO BE COMPLETED?
It is said that a goal without a due date is just a dream. This is a VERY important phase of the process. It is time to decide upon a timeline for completion by each responsible team member. During this segment, additional resources – such as increased marketing, more training, or employee development – needed to successfully execute the strategies and actions are identified.

9. MEASURE IT!
If your goals of the company are to grow and be more profitable, you must be sure that every action you identify and every timetable you set is put in place to accomplish one or both of those goals. Better yet, you need to identify just what the expected return or outcome of achieving each goal is. Once that is accomplished, you can now quantify actions, and performance metrics can be established.

10. GET OUT OF MY WAY!
Before you are finished, it is wise to discuss any potential barriers to achieving the goals in the strategic plan. Discuss these potential roadblocks and discuss whether contingency plans should be made.
​
11. THE RESULT?
You are now ready to draft and prepare your written Strategic Plan. The plan consists of the current business assessment, the new business objectives and goals, the Tactical Action Plan (the steps needed to complete a key company initiative, including timelines, selection of responsible parties, and the identification of any resources needed to complete the steps) and the Key Performance Metrics to be achieved (Key Performance Metrics are the same as Key Performance Initiatives. These are the ways businesses can define and measure the success of a key company initiative sometimes referred to as KPI – Key Performance Initiatives). By doing this, you will see an interesting outcome… The leadership team immediately begins implementation of the strategic plan!

The key points above will help put your strategic plan in place, but the role of regular accountability is just as important. You should now meet every 30 days (no more than 60) to measure the progress and timelines and adjust when necessary. During this time, progress is measured with the Key Performance Metrics report. If done effectively, leadership team members are held accountable for accomplishing tasks within the established timelines assigned to them in the Tactical Action Plan and any additional actions needed are taken to ensure targeted objectives are achieved and the Strategic Plan is successfully implemented.

To conclude, I can guarantee that successful Strategic Planning will change the direction, performance, and your funeral business value. Remember that those companies that plan, no matter how large or small the business is, will do better than those that do not! That being said, it is only logical that you should develop a strategic plan, yet so many businesses do not.
​
My father calls this logic the Scarlett O’Hara Syndrome. That is, “I’ll worry about that tomorrow.” In case you needed to know, tomorrow is here as the service and financial landscapes of our profession continue to change. Get your strategic plan created, your future depends on it!

Without suppliers, we have nothing. Can I get an amen on that?
​
We need these guys to run our businesses, we need these guys to run our businesses well. This is a new session from CANA. And I'm kind of excited about it. It's all about innovation.

Did cremations go up during the pandemic? The problem with higher capacity, and even with the dispensation by some of the governors who waived all the environmental capacity limits, is what happens to cremation equipment? It breaks. How do you get it fixed if no one can travel? Keeping the wheels turning in creative ways can be just as important.

FT had to come up with a protocol to keep themselves safe and to keep their customers safe. All of our technicians were vaccinated early. And we had strict instructions from Europe – a five-page document that everybody was required to sign off on. Kelly Vinning and I were back on the road in May of 2020 going out to see customers. We had to do daily reports on what we did to maintain safety, and we have not had anybody contract COVID in our company at all.

It wasn't also just emergency services work – we were able to maintain all of our preventive maintenance schedules throughout. So we did not miss any preventative maintenance from Canada, throughout the US, Mexico, and Puerto Rico. We made every PM on time.

Cremation Systems is a division of Armil CFS which is also an industrial furnace manufacturer. But, during the pandemic, we really didn't have a tremendous amount of the typical casting/forge/heat-treat style business. So, the engineering guys had some time, and we had to occupy their time. We got a call from a disabled veteran of the US Army who had good connections supplying the Federal Emergency Management Agency (FEMA). He said, “Do you guys think that you could move a retort and building, and put it wherever you want relatively quickly?” And we developed the modular, on-site crematorium – the MOCx™.
​
We've had a number of people go to FEMA, but the federal government doesn't do anything very quickly. So we are selling them to independent businesses now. But it showed us some advantages on where it could go, and people are talking to us about it. It'll fit on a small footprint, so putting this on a small space would work quite well. But again, it's ready for that C-word that none of us like to say: COVID.

We do digital marketing for funeral homes, and as all of you know, when COVID broke out, everybody put their foot on the brake in terms of how they were communicating with their community. People were scared, people were sensitive, people didn't know how to respond to the new reality we were going into.

A lot of our funeral homes were worried about how they're being perceived by the community. How can you go out and have proactive marketing when people are dying? So, we went through Facebook posts and emails and email newsletters and even websites to modify the content to speak sensitively to that. Additionally, we modified content to make sure that we were providing them solutions on how to do grief support or how to contact offices when you can't actually go in or you can't talk to somebody.
​
It was a tough time. We are still producing a lot of this content for different parts of the country, like how to grieve from a distance or how to memorialize when you can't have a traditional service. We've throttled back on some of that, but as we see the different waves of this pandemic go on, we'll have to adjust accordingly to what each funeral home really feels like they need to do to relate to their community.

During the pandemic, if any of you tried to process any insurance claims, guess what happened with the insurance companies? They had the same issues that we all did: they had people who were working from home, they were backlogged, and they were doing more cases than they ever had in their history. And so that caused a problem for us that do life insurance assignments. So we came up with a program called Quick Claim.

It really started at the end-user – the funeral director or the providers – where you could literally put the information in in 90 seconds. The complete data would go in, what was returned immediately with us was all the documents you needed to have in order to process that claim for that particular company. So we were able to assign life insurance policies for funeral providers and cremation providers in a much more timely manner than we had done in the past.

When the pandemic really hit in March, we were about four months into our business. We had built our whole business with this really specific model to empower the funeral homes with the selling tools they needed to sell in-person to families. We had just started to see families really being impacted by having a form of remains they could touch and hold. And then, all of a sudden, families were no longer going into funeral homes and funeral directors were redesigning how they were communicating with families over the phone, over email, over Zoom.

So our innovation is that we built a suite of tools for the funeral directors to use that included affiliate links so that our partners could use our website as a selling tool to educate the families. We created PowerPoint presentations, we did trainings on how to use these tools and communicate with families. By the time those stay-at-home orders lifted in June 2020, our funeral homes started to see increased sales and the families were happy.

We don't really have a product innovation, but one of the things that we did do, because it was very important to us, is to develop a webinar that would educate funeral professionals about what actually takes place at post-cremation metal recycling. We have an open-door policy, if you're ever nearby please come and you can view the whole thing.
​
I'm very passionate about education. So the purpose of this webinar is to educate every funeral professional about what takes place with metal recycling, because you need to have the correct answers. Somebody in our profession did a YouTube video on what happens if there's gold and says, “well, that all melts, so there's nothing left.” Well, that is incorrect. So again, you need to have the correct information.

We at Matthews saw the double-edged sword of supplies during COVID spikes. The supplies you need are quadrupling and supply chains are breaking down – so the backlog of everything is expanding. Our supply program – the Burn Box – works with the facility. We talk about what caseload you have, what kind of caseload you're expecting to have, what your usage rate is for different supply items, what supply items you use a lot, what you use very little, and we basically break down a shipping schedule for the coming year. So your supplies are showing up right before you need to call and order them again.
​
It has been extremely convenient for our customers. Owners and operators know that there's a few things that you need without fail when cremating: your rollers, your temporary cremation containers, utility urns, and your mailers. Having those come on a cycle without you having to think about it means you can dedicate all your time to your families and the million other things happening right now in the cremation space. It really makes life easier for the operator, the crematory managers, and the facilities themselves.

We train celebrants all over the world. We have about 4,500 people who've been through celebrant training in the last 20 years. And a lot of us are very actively involved in offering services on a very regular basis. And so, when lockdown happened, I went, “this is going to change how we do service. It's going to change so much about how we reach out to families, and how we talk about death in this time.”

So I just sent out a call to Celebrants, and we brainstormed over a weekend and put together a resource book. if you go through celebrant training, you get a 600-page resource book full of full services. This one was about 40 pages of suggested services, suggested words, suggested ceremonies that you could do that would still be effective on Zoom or from a distance. And we called it Ceremonies to Celebrate Together from Afar. We just put it together, we sent it out, and we said “we want you to have this, we want you to have words.” Because, in my world, words are the most powerful thing we can have.
​
We're still having to deal with having services that are unique, different or distanced. We still understand that these times are requiring us to think differently about ceremony and how we do things. So we put this together and have offered it to anybody who wants it. We try so hard to create meaningful things that you can use with your family. So take it, use it, and think of celebrants: Ceremonies to Celebrate Together from Afar.

​WA quick case study: We were helping a lady who was taking care of her husband. As she was helping him out of the tub, she fell and broke her hip right when COVID hit. Her husband was on hospice care and he passed away a few days later. Unfortunately, the intern who was helping report her information reported to social security that she had passed away, not her husband. So, as we start helping with the benefits, we call Social Security, they figure out that they have the wrong death report and they cut off all of her benefits.

Normally, we would need to go and take the death certificate into the Social Security Office, but with everything closed, they couldn't do that. So we reached out to the Senator from Alaska (which is where this lady lived) in Washington D.C., and the next thing I know is the social security administrator from Washington D.C. called my cell phone and said, “I need to get this fixed.” It ended up being a happy story: we got her benefits turned back on.

A lot of our innovation came from helping families and trying to help them work with companies that were shut down or people working from home and they didn't know how to work with their systems. So we helped keep families safe by allowing the family to be at home while Full-Circle deals with all of the companies and government agencies.

CANA’s website caters to both the profession looking for resources and the general public learning about cremation services. Satisfying both groups’ interests, the Transporting Cremated Remains page consistently ranks among most visited of CANA’s website. Staff frequently get calls for advice on carrying and shipping cremated remains domestically and internationally. Yet too often, we see articles about cremated remains mishandled or lost with families desperate to find their loved one. Unfortunately, transporting the dead can be complicated, with different rules for every mode of transport, for every origin and destination, all of which is further clouded by a general lack of awareness about the funeral profession and the work we can do.

At Fairfax Memorial Funeral Home and Crematory, CANA’s President-Elect Archer Harmon has the staff and experience to help get the dead where they need to go. Being so close to Washington D.C., Fairfax Memorial is frequently called on to help families all over the world. Archer has addressed members of the College of Consulates, a group of international consular staff, on procedures for transporting the dead. These attendees are seasoned professionals for whom the United States posting was not their first. They had extensive education and training for this posting, but to the one, they were surprised and unprepared to handle the variety of inquiries regarding repatriating casketed or cremated remains to their respective countries. In several cases, Archer has actually helped the consulate repatriate a citizen when the staff were uncertain on how to proceed.

The laws and regulations exist, but death is fraught with cultural interpretations and misunderstandings. For most countries, cremated remains are subject to the same guidelines that apply to a casketed body. The paperwork is extensive and may include some, or all, of the following:

Understandably, this is a complicated process, made more difficult if a business isn't near the nation's capital or doesn’t have a staff with experience in this work. CANA estimates that only a handful of funeral homes, cemeteries, or crematories in the US handle repatriation alone. Families without professional expertise are at a greater disadvantage without the experience and network to get their loved one safely on their way. This difficulty is why CANA gets so many phone calls, and our first step is to refer to reference books like the Redbook. We also reiterate the same guidelines we provide on our webpage: ship to a funeral home, not a private residence; contact the consulate/embassy first; get duplicates of all paperwork; carry rather than ship when possible; etcetera, etcetera. Even then, one CANA faculty member used to warn, too often you can expect your international postal shipment of cremated remains to be returned to the sender.

We recommend reaching out to the professionals who have dedicated staff monitoring the many variables of transportation and shipping, who are experienced in this work, and come with an international network to help. Shipping via an agent or air cargo may be more expensive, but well worth the peace of mind.
​
CANA Members that specialize in transporting remains offered these valuable insights:

Of course, this complicated process is further challenged by a pandemic: travel restrictions between countries, canceled flights, closed offices, and more. Here's what CANA Members say:

Inman Shipping: Travel restrictions and embargos during the pandemic are significantly impacting shipping and transporting remains. Inman works closely with our sister company, Eagle’s Wings Air receiving hourly updates as airlines continue to delay and cancel flights. Inman constantly monitors all of these factors and provide up-to-date information to the receiving funeral home. Due to the pandemic, many airlines have significantly reduced their flight schedules. We advise to not set services until the remains have arrived at your funeral home. We are also asking for your patience while waiting to receive permits and death certificates. Many of our funeral homes are located in cities with lockdowns and have local health departments which may be currently closed. Additionally, due to airlines needing to furlough both reservation and cargo staff, certain airlines are unable to book flights during the weekend. Unfortunately, certain airlines will not allow COVID-positive remains to ship internationally. We continue to work closely with the airlines to monitor what is available to our customers.
​
MacKinnon & Bowes: The pandemic has provided some new realities that must be taken into account for shipping bodies or cremated remains.

National Mortuary Shipping (NMS): For the most part it is getting much easier to ship and transport human remains then it was at the beginning of the pandemic. Airlines are starting to have more flights and loosen up their restrictions some. However, there may still be time delays because even though the airlines are regaining traffic there may be less available flights and some cargo stations are still closed. Some International destinations are not always available and often very delayed.

And even when everything settles into a new normal, don't forget that the seasons will still change, and the weather with it. In the same way you plan your travel and gift shipments, advise families that they will need to plan well ahead, and delay making plans until remains safely arrive. CANA Members suggest:

Inman Shipping: Winter weather issues, post office delays, and seasonal holidays can cause delays in shipping and mailing of cremated remains. With the dramatic decline in available flights and only cargo space for two human remains onboard a flight, it is necessary to set proper expectations for family members awaiting the return of their loved one. While families may wish to proceed with quickly setting services, it is very important that services are not arranged until body has been received into the care of the local funeral home. Most cremated remains are returned home via the US Post Office, which has also caused unexpected delays due to slower Post Office service.

MacKinnon & Bowes: Winter months in northern US and Canada represent challenges for delayed and cancelled flights due to weather. Even flights from the south could be impacted by interruptions caused by delays in the overall system and aircraft that does not arrive at the point of departure in time for scheduled departures and connections. Holidays represent times when most Airlines provide diminished service capabilities. Advance planning and anticipated potential for disruption should always be taken into account when forecasting arrivals, services, and dispositions.

National Mortuary Shipping (NMS): It is important that everyone understands that time can be a sensitive issue when shipping. There are times that doctors and health departments as well as distance may create delays in shipping. Another factor is the hours and location of airline cargo facilities as well as delays caused by weather and other circumstances. These may be unavoidable and create unanticipated delays in shipping. We know it is difficult when a family requests services be set for a specific day; however, we always recommend because of these potential delays to try to avoid deciding for services until the deceased has arrived at his or her location.

Like seasons, political situations also change with countries falling in and out of favor with one another. This can impact the ability to cross borders, even for the dead. As an example, when shipping to Cuba from the US was limited, Canada often provided a necessary layover where Canadian companies could take possession and arrange the final leg of the journey.

As CANA's founder, Dr. Hugo Erichsen, said, "Cremation is preparation for memorialization." This idea is also immortalized in CANA's Code of Cremation Practice. When discussing plans for permanent, dignified placement of cremated remains abroad, it is important to plan ahead and allow time for arrangements to be finalized. That way, everyone gets the homegoing they deserve, surrounded by the people that loved them.

CONTACT THE EXPERTS

For more from CANA’s member experts in shipping and transportation:

Inman Shipping Worldwide is the oldest and largest repatriation company in the country. We are the experts in returning a loved one home for ceremony. We address the needs of an increasingly mobile society. As careers and retirement take us to all corners of the country and even the world, Inman addresses the need to return the remains of a deceased loved one home for ceremony. Inman coordinates the transport of the deceased from any part of the world to their final resting place. We oversee the entire process, regardless of the distance involved, so that the sensitivities of the survivors are fully protected.
At Inman Shipping we provide round the clock support to our customers. Our team of professionals are available any time of the day or night to begin a new domestic or international shipment, or answer a question related to a shipment. Our website, www.shipinman.com, is also available to request a quote for transportation or start a new shipment. We can assist your funeral home with an out of town direct cremation as well as full body repatriation.

MacKinnon & Bowes Limited is an assistance firm that provides support services to funeral providers, crematoriums and cemeteries for a wide array of services including flight bookings, shipments, cremations and repatriations from countries all over the world. MacKinnon & Bowes is a family owned funeral service company staffed by licensed funeral directors and has been a proud CANA member for over 25 years. For more information on MacKinnon & Bowes please check our website or give us a call.
MacKinnon & Bowes continues to provide those services and consultations that they are known for both pre and during pandemic. Flight bookings, international and domestic shipment coordination, cremation services and shipment of cremated remains are those things that funeral providers have come to rely on MacKinnon & Bowes for over the years. Over the road transportation for longer distance requirements have become more frequently relied upon by those that rely on and engage MacKinnon & Bowes. A comprehensive support system for shipments, cremations and repatriations from far away is at the fingertips of those that call for assistance.
​
National Mortuary Shipping and Cremation (NMS) assists hometown directors with out-of-town deaths. NMS has been the funeral industries trusted source as a full service provider for close to 40 years. We are proud to offer:
Domestic and International shipping, cremations, removal services, embalming, livery, airline transfers, flight booking, graveside services and disinterment’s as well as assistance with shipping requirements, death certificates, and airline requirements.
Our knowledgeable staff is available 24 hours a day, 7 days a week to provide you service you can count on. We are always available to help funeral homes with their out-of-town needs or questions. Even if a funeral home does not have an out-of-town death, we welcome them to call our office and ask any questions that may help them better prepare should a need arise. We also offer many resources on our website as well as a phone app that allows funeral homes to contact us electronically.

In deciding Bostock, the Court considered a trio of cases: two involving gay men – Gerald Bostock, who was fired from his job as a child welfare advocate in Clayton County, Georgia, and Donald Zarda, who was fired as a skydiving instructor in New York – and one involving a transgender woman. All three plaintiffs were longtime employees who were fired shortly after their employer learned of their orientation or gender identity—this was allegedly the only basis for the employee’s termination. Much of the attention surrounding Bostock has focused on Aimee Stephens, a transgender woman who was fired from her job as a funeral director in Michigan after notifying her employer that she intended to “live and work full-time as a woman.”

Stephens began working at R.G. & G.R Harris Funeral Homes, Inc. as an apprentice before becoming a funeral director/embalmer. During her employment, Stephens presented as a man and used her then-legal name, William Stephens. Before departing on a vacation, Stephens gave her employer a letter that stated that she had struggled with “a gender identity disorder” her entire life, and that she had “decided to become the person that [her] mind already [was].” As part of this decision, she informed her employer that, after her vacation, she would return “as [her] true self…in appropriate business attire.”
​
Though her employer was not religiously affiliated, the owner stated that he had been “called [by God] …to serve grieving people” and that his life’s purpose was “to minister to the grieving.” In line with his faith, he informed Stephens that her proposal was “not going to work out” and fired her. In the underlying case, her employer testified that he believed that “permit[ting] one of [the funeral home’s] male funeral directors to wear the uniform for female funeral directors at work” would make him complicit “in supporting the idea that sex is a changeable social construct rather than an immutable God-given gift.”

In the cases before the Supreme Court, all three employers acknowledged that they had terminated their employees for being homosexual or transgender, a fact many plaintiffs often struggle to establish in court. The employers argued, however, that Title VII’s bar on some forms of employment discrimination did not prohibit them from taking such an action.
Passed in 1964, Title VII prohibits an employer from discriminating against an individual “because of [the] individual’s race, color, religion, sex, or national origin.” Under the law, to “discriminate against” means to treat an individual employee worse than other employees who are otherwise similarly situated to the employee. By prohibiting discrimination “because of” sex, for example, the law prohibits sex from being a “but-for” cause of the employer’s action. That is, the employer would not have taken the adverse action in the absence of, but-for, the employee’s classification (i.e., sex). In sum, the law prohibits an employer from considering an employee’s sex when taking an adverse employment action (e.g., firing the employee). This is true even if sex is not the sole or even primary cause of the adverse action—the law prohibits sex from being a factor at all.

Though the law does not explicitly identify “sexual orientation” or “gender identity” as protected categories, in Bostock, the Supreme Court determined that discrimination based on these categories was prohibited by Title VII because it is impossible to separate them from sex: an employer who fires an employee for being homosexual or transgender necessarily and intentionally does so, at least in part, based on the employee’s sex. This is so, the Court stated, because in taking its action, the employer is applying sex-based rules or stereotypes, and, thus, is discriminating based on sex. To explain the concept, the Court used the example of two employees who are both attracted to men. In the employer’s eyes, the employees are nearly identical in all respects except one is a man and the other a woman. If the employer fires the male employee for no other reason than the fact that he is a man that is attracted to men, the employer has necessarily discriminated against the male employee for exhibiting traits or actions that it tolerates in the female colleague. This is prohibited by Title VII.
​
The Court acknowledged that several questions remained unanswered by its decision; most notably, the boundaries between Title VII and the Religious Freedom Restoration Act, which prohibits the federal government from “substantially burdening” a person’s exercise of religion in many cases. Aimee Stephen’s employer initially raised the law but did not appeal an earlier, adverse lower court ruling to the Supreme Court.

In some parts of the country, Bostock should have little practical effect: 22 states already had laws in place that prohibited discrimination based on sexual orientation or gender identity. The ruling, however, now removes any doubt about Title VII’s applicability and prohibits discrimination based on sexual orientation or gender identity at all entities covered by the law; generally, “employers” with at least fifteen employees.
Though each workplace is different, following the Court’s ruling, employers should take a moment to:

REVIEW PRACTICES.
Review practices, policies, and procedures (including employee handbooks) to ensure that they reflect the current law. If not already explicit, anti-discrimination and anti-harassment policies should be revised to specifically prohibit discrimination on the basis of sexual orientation or gender identity.

REVIEW UNIFORM REQUIREMENTS.
In a lower court opinion, it was noted that Aimee Stephens had been fired after notifying her employer that she would begin wearing a skirt, and her employer testified that he disagreed with Stephens’ decision to “dress like a woman,” and fired her, in part, because of it. Though not expressly addressed by Bostock, the opinion indicates that gender-specific uniforms or workplace attire requirements will likely be viewed skeptically.

TRAIN WORKERS.
Ensure that employees, especially managers and supervisors, have been trained regarding anti-discrimination and anti-harassment policies and will act to stop discrimination in the workplace. Employers can be held vicariously liable for the actions of their employees. If a supervisor objects or refuses to ensure that the workplace remains free of discrimination, employers should consider whether the risk of creating a demoralized or hostile workplace, or the risk of litigation, is worth the supervisor’s continued employment.

EXAMINE EMPLOYEE BENEFITS.
​Less formal benefits should be reviewed. In a lower court opinion, it was noted that Aimee Stephens’ employer provided clothing allowances to public-facing male employees but did not provide an allowance for public-facing female employees. Employers should ensure that benefits such as these are equally available regardless of gender.

No matter a family’s religion or cultural background, there will be times when it is appropriate for a family to see the disposition to completion, wherever it may be. When I served my first Hindu family during my internship, I was struck by the reverence, the beauty and meaning imbued in the ritual of the sendoff at the crematory. Perhaps the West Coast is unique in that many of the families we served in that region were already familiar with witness cremation, even if they did not have a religious requirement to do so. It was not until I moved back to the Midwest that I learned that so many funeral directors and consumers found the concept of going to the crematory shocking.

Families’ imagination is often far worse than the reality of cremation. Many may envision a stark, cold, clinical environment that smells like a hospital. They may imagine a chamber full of flames, and that the entire process is short, lonely, and perfunctory. This is why families are less likely to ask, When will we be able to watch the cremation? as they would be to ask, When will we be able to watch the lowering of the casket into the grave? Typically, this is an offer that the funeral director poses to the family who may need time to decide if that is something they can handle.

Is the consumer to blame for direct cremations? Or, as a profession, have we urged families away from ceremonial cremation in the hope that families who desire more time and a chance to say goodbye will opt for casketed burial instead? It is my belief that we are doing a disservice to families who select cremation if we do not offer them an opportunity to witness their loved one being laid to rest. Most funeral directors will invite the surviving family to be present at the graveside service. Witnessing the remains being placed into the chamber is like watching a casket be lowered into the grave, but for cremation. Similarly, this event creates a lasting memorial and final farewell for the family.

Offering ceremonial witness cremations to families allows a unique, hands-on experience that creates an additional opportunity for the family to gain closure in a meaningful way. When we set up a graveside service, we plan for ceremonial comforts: a tent, chairs, perhaps an ice bucket filled with bottled water and, more often than not, someone to officiate the ceremony whether this is a clergy member, celebrant, family member or the funeral director. There is a prescribed and widely accepted order to the event. To appropriately create this memory of physical separation from a loved one’s remains for our families who select cremation, we need to ask ourselves some questions and shift our own perspectives.

When was the last time you had a client family ask for a three-day viewing in a Promethean bronze casket with limos for everyone and a plot in the highest spot in the cemetery that overlooks the lake? The fact is that we will continue to serve a growing number of cremation families in the future. Why not create a standard of excellence in your market for cremation ceremonies imbued with meaning and ritual.
​
Regardless of the type of disposition, families want to ensure that the remains they are entrusting into your care are that of their loved one. Witness cremation ceremonies offer both an opportunity to gather in remembrance of the departed as well as rapport-building transparency with positive identification of the deceased. Families will consider your firm as more credible if you have nothing to hide, and many will want to participate in the hands-on experience of saying goodbye. Seeing their loved one right before the cremation—and potentially participating by initiating the cremation process—will help create a peace of mind, dispel fears about the process, and create greater goodwill and trust. It will allow the families you serve to recognize the permanence of death (Wolfelt, 2016).

As the public becomes more familiar with “do-it-yourself” and hands-on experiences, while self-educating about cremation, it makes sense to offer private crematory experiences as part of our standard services just as we include visitations and graveside ceremonies.

Let’s consider the optics of practicing witness cremation ceremonies. When my mother passes, I plan on being present at the crematory to see my mother one last time. Will I be comfortable with her being cremated in a cardboard alternative container? I consider myself a pragmatist, but it would be much harder for me to select a minimum cardboard container over an alternative cremation option that comes with a pillow and is the same color as all her furniture. Even though I know, rationally, that it will be consumed during the cremation, the likelihood of upgrading my mother to a ceremonial cremation container is 100%.

Even if not embalmed, setting a decedent’s features and performing a minimum preparation of remains should be planned for regardless of whether the family has expressed a desire to view the remains at the crematory. The majority of crematory operators I have worked with in the past have told me that if a family is willing to travel to the crematory, then there is a greater chance that they may wish to view the remains at the time of the cremation even if they were previously undecided about viewing.

As with planning any other type of service, it is important to allot enough time and set expectations and constraints to the family, the funeral home, and the crematory. This will require clear communication between all parties involved to schedule a well-organized event. Families want a memorable and favorable experience; they do not want to feel rushed.

As the families we serve become increasingly participative, including them in the planning and tone of this event lends them a greater sense of control. Survivors may opt to place special photos, letters, or trinkets into the cremation container; they may wish to have a significant song played while their loved one is being placed into the chamber. The benefits outweigh the additional time and effort spent planning the service.

Fear comes from a loss of control. Not having a realistic picture of what the crematory looks like, feels like, smells like, or sounds like will cause undue stress. It is important for practitioners to help their client families understand what to expect so they will know what the outcome of the event will be and rest at ease knowing that nothing terrible will happen, like their imagination suggests.

There are several opportunities to convey the value and experience of witness cremation ceremonies: wherever you explain what services you offer. This service should appear on your General Price List, under the Services tab of your website, and be addressed during the arrangement conference with every family who selects cremation. Several funeral homes have the witness cremation option built in to their cremation authorization form, where the authorizing agent will initial “Yes, we want to witness the cremation and here are the names of the people who will be present”, or “No, we would like to opt out of that ceremony.” If appropriate, a gallery of photos or YouTube video can give a sense of the crematory, so you do not have to schedule a pre-cremation tour of the space (although an open-door policy is a recommended best practice).
​
When making funeral arrangements, a consumer may not have enough background information to understand what you are asking if you say, “Do you want to witness the cremation?” Without context, this sounds more like a threat, rather than an invitation. Over time, a funeral arranger can become more familiar with how to present witness cremation experiences by explaining the ceremony and inviting the family to be present for the event. Here’s a sample script:

Whether your crematory space is “industrial,” or built specifically to host families for witness ceremonies, managing that expectation is key. Would heavy rain deter you from attending the graveside of your spouse or parent? If not, then a “no-frills” functional crematory space should not be a deterrent for a family, but having a weather forecast and knowing ahead of time to bring rain boots is always appreciated.

In an ideal world, every family who selects cremation would be present to see their loved one. If that were the case, the chances of an erroneous cremation would be nearly impossible. Realistically, the percent of families who choose to be present at the graveside to see the casket lowered is likely what you can expect of families to witness cremations.

As with a burial or any ceremony in funeral service, there must be an order of events to ensure a smooth cremation. Funeral directors must partner with crematory operators and schedule times for witnesses at the crematory’s discretion (e.g., “The crematory operator says that we can plan the witness ceremony on Tuesday at 1:00 pm. Does that work for your family?”).

If you have a distrusting family who does not want to “receive someone else’s ashes”, crematory experiences are the solution. You can collaborate with the crematory operator to allow the family to be present for the transfer of their loved one’s cremated remains to the urn, giving the family a greater sense of trust and peace of mind. It is critical to coordinate the scheduling with the crematory. It may make sense to hold the witness cremation as the last one of the day and schedule the pickup of the urn for first thing in the morning; this gives the crematory operator ample time for overnight cooling and an additional opportunity for the family to watch the identification process post-cremation.

Many funeral service providers may be reluctant to offer witness cremation ceremonies because it is more work. But you would be surprised by the number of “direct cremation” families who are ready and willing to see their loved one, they just did not know it was an option. We don’t know what we don’t know. It doesn’t hurt or cost anything to ask those you serve if they want to press a button, place the cremation casket into the chamber, insert a letter or drawing from a child in the cremation container, or order flowers when they see a photo of an all-concrete crematory space.
Giving the consumer a say in the cremation service helps add value to the experience. It offers another opportunity to mourn and be together in a difficult time. Plenty of funeral homes routinely ask the family if they want to see the lowering of the casket during a graveside service. Why not start with witness cremation ceremonies?

At the end of February, CANA hosted our annual Cremation Symposium in Las Vegas. That’s right, we encouraged people to travel to meet up with more than one hundred people and network in a popular tourist destination — it was a different time. Unsurprisingly, the topic of discussion on the floor was the coronavirus pandemic, or the spread of COVID-19.
Fortunately, the US Center for Disease Control (CDC) has released guidelines with information on handling infected, or potentially infected, cases at your funeral home, crematory, prep room, etc. These preventative measures align with current best practices in the prep room or crematory (i.e. wear universal PPE, limit exposure to the disease, and clean all surfaces carefully) that protect you from everything from the common cold to tuberculosis.

Current estimates suggest that more than 500,000 people will die from COVID-19 in the US by the end of February, an average of more than 10% more deaths than previous years (CANA released a special report on states' deaths and cremation rates). But your cases are not the only potential source of infection in your businesses. Of those that contract COVID-19, 80% are estimated to be mild which means they are more likely to transmit the disease. Experts are warning that rest of 2020 will be difficult depending on our response, and likely to continue until there is a readily available and adopted vaccine.

With state and local governments setting the current restrictions and guidance, current and accurate information is important to track. Consider designating one staff member in your office as point person to monitor reports and updates from the CDC and your local jurisdictions, at least daily, to make sure your business is operating with the best information. As this post is updated, newest content will appear in gold to highlight latest information.
​
So what do you need to know to prepare your business when an outbreak hits?

Since "workers performing mortuary services, including funeral homes, crematoriums, and cemetery workers" have been officially listed as Essential Critical Infrastructure Workers, it is even more important to make sure your business is prepared for this challenge. Inform, educate, and train your staff of the CDC recommendations.

Now that this post is getting so long, we've added a Table of Contents linking to information below:

As a reminder, if there are federal and local orders/laws in conflict, follow the most restrictive to ensure that you comply with both, and ask for additional guidance and support as needed. Some resources to consider are: your state governor, local mayor, local health agency, as well as the Disaster Mortuary Operational Response Teams (D-MORT), Emergency Management Agencies (EMA) or Community Emergency Response Team (CERT) plus the Council of State and Territorial Epidemiologists (CSTE) and the National Association of County and City Health Officials (NACCHO). Be sure to check with health and government authorities any time you have questions to ensure safety and compliance for you, your staff, and your business. If you are designated an essential worker in an area under an enforced lockdown, consider carrying staff identification, state professional license, or some other information that demonstrates your status for ease of movement.

CARING FOR THE DECEASED
For any staff who handle the dead, the National Association of Funeral Directors (NFDA) and the Funeral Service Association of Canada (FSAC/ASFC) have useful resources for embalming, prep room, and removal staff in accordance with CDC guidelines (including specific guidelines for funeral homes) and OSHA guidance which clearly state recommendations for Personal Protective Equipment (PPE), transporting the deceased, and cleaning surfaces. Many authorities believe that cases and deaths are under-reported, so anyone coming in contact with the deceased should operate assuming that the case is positive.

A new study finds that the novel coronavirus remains viable long after the death of the host, continuing to replicate for more than 35 hours afterward. Thus "we recommend all work on corpses be conducted according to guidelines recently published by the World Health Organization, especially in the framework of widespread death in pandemics."

In the case of embalming, funeral homes are encouraged to follow families wishes assuming that the firm and embalmer have access to PPE and the time to embalm safely. Remember, as important as it is to wear PPE when handling the deceased, it is also important to follow the recommended sequence for putting on and removing the equipment.
​
Cremation is a sure way to destroy any contagion on a deceased body, which is why it's preferred for Creutzfeldt-Jakob Disease and Ebola, but the WHO has stated that "people who have died from COVID-19 can be buried or cremated. Confirm national and local requirements that may dictate the handling and disposition of the remains." The CDC has not released definitive information on how long the coronavirus lives in a deceased body, but they do say that "there is currently no known risk associated with being in the same room at a funeral or visitation service with the body of someone who died of COVID-19." As always, families should do what's right for them, which can include caring for the deceased themselves. They can have funerals and burials as long as they follow their state and local mandates regarding the number of people and social distancing guidelines.

OPERATING THE CREMATORY
Most guidelines that have been released do not specifically mention the crematory or operator. The following assumes that the crematory operator does not come into direct contact with the deceased, rather handles the container. If the operator in your business handles the deceased, see above.
​
CANA recommends the following:

Generally, viruses are killed above 200 degrees Fahrenheit, so the cremation process kills the coronavirus in fewer than three minutes. There is no concern about virus exiting the building via emissions through the stack or remaining in cremated remains, however the operator should wear PPE to ensure transmission from operator to urn does not occur.

When releasing cremated remains to the family, limit the size of groups to ten or fewer, but also consider bringing the urn and paperwork to the client waiting in the car. Try to minimize physical paperwork with electronic documents and signatures, or providing gloves, to cut back on touching paper. Similarly, keeping clearly marked sanitized and used pens to take and return for cleaning will cut back on multiple use.
​
In this pandemic situation, some crematories are concerned about regulations which limit the cremations a business can perform. CANA is supporting state associations who are working with these regulators to address these permits in the hardest hit areas.
​

BUSINESS SUPPORT
With the Families First Coronavirus Response Act (FFCRA), passed March 18 and effective April 1 through December 31, 2020, businesses have new requirements for managing staff. All employers with 500 or fewer employees must provide paid Family Medical Leave Act (FMLA) leave and paid sick leave – this is new for those who manage companies with fewer than 50 employees who were previously exempt from such requirements. The Department of Labor, Wage and Hour Division has required posters and useful information to communicate with your staff.

Once the FFCRA-mandated leave expires on December 31, 2020, employers with 500 or less employees are no longer compelled to provide emergency paid sick leave (EPSL) or expanded FMLA (EFMLA) to eligible employees. Instead, a covered employer may voluntarily continue to provide EPSL or EFMLA leave and receive the tax credit. The tax credit availability for those employers that choose to continue to provide FFCRA leaves is now set to expire on March 31, 2021.

As an employer who was previously exempt, this could be overwhelming, so it’s important to open lines of communication with your staff and establish a clear chain of command to address rapidly developing information. Don’t assume that all staff will immediately take advantage of these benefits and leave the business in a time of crises. Provide guidance and support in addition to addressing their concerns about what to do if they or a family member get sick. Don’t be afraid of questions or to admit that you don’t know. Importantly, communicate often to make sure staff are okay and keep lines of communication open.

The Coronavirus Aid, Relief, and Economic Security (CARES) Act, passed March 27 and retroactively effective to February 15, 2020, offers financial assistance to small businesses and large corporations alike. The US Senate Committee on Small Business & Entrepreneurship has provided the Small Business Owner’s Guide to the CARES Act resource. If your business is having financial difficulty, you can apply for relief through the Payment Protection Program (PPP) with the US Small Business Administration (SBA) and your current bank. Alternately, you can seek support from the Employee Retention Credit (ERC), however a business cannot receive both the PPP and the ERC.

To better understand how both resources effect your business, CANA recommends contacting services who manage and administer your payroll, business insurance, health insurance, preneed providers, and bank. These are groups carefully monitoring how these regulations and opportunities impact your work in your area, and know your business best.
​
For those in need of extra staff support, state associations in hard-hit areas and the NFDA have organized volunteer programs to help. Reach out to these associations with your need or availability.

SERVING THE LIVING
But don’t forget that the living are actually your primary audience, and the ones your staff come into contact with every day. The CDC has special recommendations for the workplace in “Guidance for Businesses and Workplaces to Plan, Prepare, and Respond.”

Many of the roles at a funeral home, like funeral directors, embalmers, crematory operators, don’t do the kind of jobs that let you work from home. We cannot access the prep room from our living room, or arrange with families from our beds. So encouraging proactive measures to keep employees well, then being flexible when people are ill, is key to keeping your staff and the community safe in any outbreak.
​
By now, everyone knows the top four guidelines on personal safety:

When making arrangements or directing a funeral, these measures are important. The CDC provides guidance on the risk of different types of funeral services to help families make the right decision for themselves. Included in the list of protective steps, the CDC now recommends, and many states mandate, "covering your mouth and nose with a cloth face cover when around others." With the spread of new, aggressive variants, the CDC also recommends some masks be doubled for extra protection. As of January 20, 2021, masking, social distancing, and other precautions are required on federal land including Veterans Cemeteries.

Of course, the most vulnerable populations are typically older generations and those with pre-existing conditions (including smokers). If a staff member is concerned that they have been exposed, the CDC has issued guidelines for Safety Practices for Critical Workers which include frequent temperature readings, mask wearing, and frequent disinfecting of work spaces. The CDC and Environmental Protection Agency (EPA) have released joint guidance on appropriate disinfectants and cleaners. Shared work spaces include break rooms, vehicles, and any shared equipment. The CDC has developed a toolkit with language and posters you can use to communicate with your staff.
And don't forget your four-legged co-workers. Some animals have tested positive for the coronavirus, though it's unclear whether the virus can spread from pets to humans. To protect your pets, service animals, and your community, the CDC recommends limiting their interactions as well.

COVID-19 FUNERAL ASSISTANCE
Starting Monday, April 12, 2021, the Federal Emergency Management Agency (FEMA) will accept applications for financial assistance to families who have lost loved ones to COVID-19 since January 20, 2020. Families must meet the eligibility requirements and must have appropriate documentation to make a claim. Some of this documentation comes from the funeral home, crematory, cemetery, or supplier that served them, so be prepared for requests for duplicate invoices, death certificates, and other support from your families.

This program is a fantastic resource to US citizens and other qualified residents who were faced with the unexpected expense of the death of a loved one. You may choose to be proactive and reach out to the families you have served since January 20, 2020 to offer help in determining eligibility or offer receipts and paperwork. The FEMA COVID-19 Funeral Assistance webpage provides detailed instructions, FAQ, and requirements to help in addition to guidance on spotting fraudulent scams claiming to offer assistance.

For those families who delayed services or interments, it is advisable they make those plans and purchases prior to submitting their application, since they are eligible for one reimbursement only.

This is the largest scale death benefit program FEMA has administered so patience and persistence will be helpful. FEMA will release more information in the coming days and weeks and CANA will report to you as the details become available.

MANAGING STAFF
In the event that someone does get sick, encourage them to stay home. This is a difficult argument to make with the existing workforce shortage on top of a potentially growing caseload, because these jobs rely on you being in person to serve your families. But with the COVID-19 pandemics, you cannot serve your community while being sick yourself. Sick employees need to stay home to recuperate and be well, but also to prevent the spread of disease in the community. As the disease continues to spread, you may encounter employee shortages from illness, school closures, and caring for loved ones. Your business must have a plan for what you will do if you have too few staff.

Death Care Services are deemed as a low risk sector, and typically exempt from reporting to OSHA, the Bureau of Labor Statistics (BLS), or state agency incidents of illness, however CANA Member Regulatory Support Services recommends making a record of all work-related illnesses and injuries and placing that record in the affected employee’s file. For confirmed cases of COVID-19 or an employee that shows symptoms of COVID-19, this would include the employer’s directive to an ill employee that he or she does not return to work until cleared to do so by health care professional.

The challenge with COVID-19, or any infectious disease for that matter, is knowing with absolute certainty that an illness is a result of exposure in the workplace. Especially with the high communicability of the coronavirus, sources of exposure outside the workplace must be considered when assessing whether to report any fatality or hospitalization of an employee as a result of contracting COVID-19. However, some states are presuming that any essential worker who contracts the disease to have become infected at work thus making them eligible for worker compensation. Check your state's department of labor for any specific requirements.

The federal, state, and local health authorities have recommendations on reducing spread in the workplace including isolation and quarantine periods. In some cases, this could mean a note from a doctor about when it's safe for an infected employee to return to work. Plus, recommendations vary between health agencies with frequent changes. Stay informed on these protocols and update policies. Then, once expectations are set, you need to follow them while maintaining privacy. Remember that it can be obvious who is sick when they need shifts covered, but you can never explicitly confirm a diagnosis of an employee. If you have concerns that staff may take advantage of policies, reach out to a labor attorney to discuss options and risks.

Staff morale suffers when colleagues become ill or need to quarantine: fear for their colleague's and their own health, resentment of working to cover extra shifts, stress and exhaustion from a long pandemic, and more. Team-building is never more important than in a crisis. Like the military, we're not protecting ourselves for us, but also for the person working beside you, and the people at home. Whatever you can do to build team cohesion will benefit everyone in the short- and long-term.
​
A Note about Vaccines: The federal government can mandate vaccination, but is unlikely to do so. Individual states/provinces are allowed to mandate vaccination, especially for specific licenses, but this will be determined on their own timelines and dependent on availability of the vaccine. It's currently unknown if employers can require staff be vaccinated, but it's unlikely, particularly since the experimental COVID-19 vaccines are initially approved for emergency, not widespread, use. If you are considering requiring staff get the vaccine, contact a labor attorney to discuss feasibility and risk-benefit analysis.
​

VACCINE AVAILABILITY
​At the end of 2020, vaccines to protect people against the novel coronavirus began to receive authorizations by governments around the world. The rollout and availability of the vaccines has left many confused on who is eligible, how to get vaccinated, and where to get the shot.

Your state and local associations are great resources for information on when funeral home, cemetery, and crematory employees (licensees and also those who coordinate the proper recovery, handling, identification, transportation, tracking, storage, and disposal of human remains) are eligible to get vaccinated. In many cases, vaccinations are distributed by county governments under direction from state governments. The federal government has designated all mortuary staff as essential workers as part of the critical infrastructure of public health.

For US practitioners, one CANA member shared this list of Statewide Vaccination Plans with details on vaccination phases and registration enrollment websites for each state. This list provides links to state's government websites to see the latest information. Your state and local associations are additional great resources since they have connections to state and local governments to learn the latest information and advocate on your behalf.

Unfortunately, CANA Members report that staff have been turned away from vaccination centers, despite being eligible. In some cases, one facility will refuse but another will administer the shot. In one area, we learned that mortuary workers are eligible, but were instructed to register as another licensee since "funeral director" was left off the list. In addition to registering for the vaccination, bringing your government-issued identification and health insurance card, CANA also recommends bringing proof of employment at a death care facility. Let us know about your perspective on the vaccination process and experience in our pulse poll.

If you and your colleagues have questions about the vaccines themselves, you can read more about the program, the testing, and possible side effects on the CDC's website. CANA Members who have received the vaccine, report typical vaccination side effects like soreness in the arm and fatigue.

Remember: when you and your team have all been vaccinated, PPE is still an important part of keeping your loved ones and your entire community safe. Current vaccines require two doses given several weeks apart to reach full protection, and neither dose is immediately effective but require time to build up in your system. After which, the CDC has stated that the long-term efficacy of the vaccine is still unknown and that the vaccinated or "naturally immune" from previous infections may still carry live virus. Not to mention that standard PPE will always be recommended for backroom positions handling the dead. Please continue to wear PPE.
​

DIRECTING THE FUNERAL
And don’t forget that you also host community events and services with their own considerations. The CDC has special, updated guidelines for “Mass Gatherings or Large Community Events” to help you plan and host safe services. Primarily, they recommend having posters and signs in addition to supplies on hand to keep everyone healthy, namely hand sanitizer, soap, tissues, and face coverings. Keep surfaces like door handles and light switches clean, and remember to talk to your community volunteers about being safe, too. The CDC even has a toolkit with posters and language you can use to  communicate safe practices to your attendees.

Enforcing best practices can be challenging with frequently changing information and fear of the unknown. Set a policy to protect your staff and visitors that includes your federal, state/provincial, and local requirements for safety of gatherings. Then, since there is nothing worse than having something in writing that sounds great but is not followed in practice, you must implement the plan, communicate it, train staff on it, and enforce it. Once you've set a standard, you don’t want to have to play funeral cop — but you also don’t want to let expectations slip. But scenarios are never simple—you can be reasonable and sensitive to the situation. Visitors are not employees, so you don’t have the same ability to enforce rules, but posting signs and agreements prove to the government agency(ies) that you are encouraging compliance, along with your documented protocols for family interactions. Consider investing in conflict resolution and de-escalation training for staff to make these conversations easier.

Depending on your location, you have state and local restrictions, and your business can be held legally responsible for violations, not the individual or family who is violating the order. But more than legal repercussions, ask yourself: Do I want to be in the news for hosting a superspreader event? Given how readily this virus spreads, it can happen too easily and then you're facing two crises—the increased calls from the pandemic and a public relations battle. Consider your community's trust and develop policies to comply.

With increasing emphasis on mitigating the spread of COVID-19, in areas with active outbreaks, the CDC recommends community-based interventions including "event cancellations, social distancing, and creating employee plans to work remotely," careful planning and communications with your families is important. Social distancing, in particular, runs counter to the spirit of the funeral by discouraging gatherings of more than 10 people, encouraging vulnerable populations to stay away, and avoiding direct contact with others. Fortunately, you are professionals trained in talking to families with compassion and understanding. For ideas on making your communications meaningful, watch a free, on-demand webinar from Lacy Robinson with " Practical Ways to Serve Families During COVID-19."

Now that federal guidelines from the White House have sunset, state governors' and state and local health authorities are determining how businesses and communities can operate — you can find this list of resources above. In some areas, any visitation or service has been prohibited. White House guidelines to reopen businesses and services is recommended in multiple phases to keep employees healthy, prevent spread, and moderate hospital cases and is helping states set their own reopening procedures. These recommendations will require your business to develop plans and policies to accommodate your families' preference for service while maintaining the health of your community.

Guidance from the CDC for consumers is written to help you educate your families on ways to hold services safely and the importance of taking social distance guidelines safely. Ceremony expert Glenda Stansbury provided a free resource to help you and your families find creative solutions, such as livestreamed services, to protect your business and the communities you serve. Grief expert Dr. Alan Wolfelt shared his suggestions on holding some form of ceremony at the Center for Loss blog.

Develop a plan with recommendations from the CDC including how to communicate with relevant parties. Mostly, be in touch with state and community partners to help respond to changing needs of your community. Working together facilitates communications, response planning, and organizing when the need arises. The Council of State and Territorial Epidemiologists (CSTE) has a list of who to contact at the state-level and the National Association of County and City Health Officials (NACCHO) is a good resource for local-level needs. These are great new additions to your connections with first responders, hospices, and other community leaders.
​

KEEP SUPPLIES STOCKED
PPE and other safety materials have been difficult to source, so it’s a good idea to take stock of the goods you use frequently and make sure you have supplies. For those that are concerned about PPE supplies, the CDC has recommendations for Optimizing the Supply of PPE and and OSHA has issued interim guidance which brings their enforcement more in line with CDC recommendations.

The CDC has also provided a PPE Burn Rate Calculator to help facilities to plan and optimize the use of PPE. Also, reach out to suppliers, even those outside of mortuary supply, if your need is severe. As a final resort, reach out to your local health authority, coroner, or medical examiner to explain your need and ask for recommendations. One CANA Member suggested ordering smaller quantities to prevent large orders being flagged and redirected.
​
CANA Member Bass-Mollett shared their hard work finding the answer on how to request N95 masks as it was explained to John Flowers, CEO of Bass-Mollett:

The National Institute for Occupational Safety and Health (NIOSH) has issued recommended Guidance for Extended Use and Limited Reuse of N95 Filtering Facepiece Respirators which suggests that equipment be alternated and discarded when damaged or dirtied. Some recommendations suggest to avoid wearing cosmetics, which could dirty the mask and reduce its effectiveness faster.
​
Review the OSHA Standards on N95 respirators to ensure safety for staff and compliance for the business. Complaints about lax compliance have risen against health care facilities recently with fines in the millions of dollars, so review your policies and make sure staff are following them before a complaint can be made against your business.

Situations like this, in times of increased caseloads and illness, require flexibility, patience and planning which is why you need to have these discussions and plans now. Like the radiation case study in 2019, we want to help you plan, be safe, and prevent panic and misinformation. As information continues to change rapidly, the best resource for the most current information on your business operations is your local government and health authority.
​
Predictions say that "prolonged or intermittent social distancing may be necessary into 2022." Preparing now for the virus's resurgence in the Fall and Winter means you can protect yourself and your business with proactive plans and preventative measures.

Situations like this also require extra care for yourself and your colleagues. "Stress prevention and management is critical for responders to stay well and to continue to help in the situation." Use the support resources from the CDC available by both call and text, and work together to stay healthy. Jason Troyer, PhD., specializes in helping death care professionals serve their families better. He wrote a post for us about taking care of yourself in these ever-changing times. Additional resources unique to death care are available in his Finding Resilience program.

Thank you for the work you do.

For the next few months, CANA Members are invited to join us for monthly Open Forums to discuss how they're handling their response to COVID-19 and supporting their community. Check your inbox for instructions to join, or contact Membership Manager Brie Bingham for more information.

US CENTER FOR DISEASE CONTROL (CDC)

US OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION (OSHA)

ADDITIONAL RESOURCES

Regardless of your role in the industry, it is important to understand the current laws and regulations that govern your work. Put aside the necessary time to review the federal, state, and local laws and regulations which affect your day to day operations. Right to control final disposition and cremation authorization issues dominate legal complaints against people and businesses in this industry. If you have difficulty finding the statutes and regulations, try searching the web sites for your state association or licensing board – they often have links available.
​
CANA Members: If you need further assistance, use your legal consultation benefit and give me a call.

Employment issues are a prevalent headache across all industries and business models. Address common concerns in your employee handbook, so that everyone is on notice of the standards to which they will be held accountable. Implement clear, unambiguous policies on work hours, time off, sick leave, vacation time, and dress codes. Have appropriate sexual harassment policies in place. Communicate your expectations regarding social media use and restrictions on employee posts on business matters. Make sure employees are aware that social media is not for airing of workplace grievances or complaints.
​
CANA Members: Read up on what my office suggests for these policies as part of the Crematory Management Program.

Periodic training and review of operational and employment policies and procedures are critical. There cannot be compliance without your employees first understanding your expectations and standards to which they will be held accountable.
​
CANA Members: You can keep your standard operating procedures current and your staff informed with the Crematory Management Program and support from Cremation Strategies & Consulting.

Make sure your insurance agent or broker understands your business. Too often there are gaps in coverage discovered when you need insurance assistance or defense to a legal claim, when is too late to put the protections you need in place. Many gaps in coverage result from your agent or broker not understanding your daily work and operations sufficiently to make sure that what you actually do is covered. Just because you have “professional liability” insurance, you have no guarantee that all of your professional services are covered. Proactive insurance strategies will serve you best.
​
CANA Members: Have you looked over CANA’s newest benefit, a professional liability insurance program for crematories? Read what makes this policy different and how it covers businesses like yours.

Take some time to think about the education and assistance which will benefit you and your business most in the upcoming year. Then, search for continuing education opportunities that will assist in meeting your goals. There are in person and online resources available to address almost any concern as an industry professional or business owner. Some jurisdictions even allow you to get your crematory operator certification online. If you attend CANA’s convention in Seattle this year, please say hello. I look forward to seeing you!
​
CANA Members: Not sure how to get started developing a defined professional development plan for your employees? CANA Education Director Jennifer Werthman is here to help you achieve your goals – reach out any time.

​
​Getting your new year off to a good start can jumpstart accomplishing your business’s New Year’s Resolutions. Best wishes for your success in 2020!
​
CANA Members: Your association is here to help! If you ever need these resources or anything else offered by CANA, reach out.