1. Electronic Birth Registration
2012 VSU Regional Conference
Tara Carmean
&
Susanna Sparkman

2. Agenda Background TER Basic Reminders Selected Fields
Certifying and Releasing the Record
Interesting Scenarios

3. Abbreviations TAC = Texas Administrative Code
HSC = Health and Safety Code

4. Background Statutes and History
Before discussing technical aspects of birth registration we’re going to briefly discuss some of the statutes and history of birth registration.
Purpose: understand why birth registration is required/important

5. Important Statutes Birth registration is required HSC 192.001
Births should be registered within 5 days
Exceptions made for parent’s religious beliefs
Parents must provide notification to birth registrar
Must be filed by 15th day after birth
HSC (d)(e)
HSC Sec.    REGISTRATION REQUIRED. The birth of each child born in this state shall be registered.
HSC Sec.    BIRTH CERTIFICATE FILED OR BIRTH REPORTED
(d)  Except as provided by Subsection (e), a person required to file a birth certificate or report a birth shall file the certificate or make the report not later than the fifth day after the date of the birth.
(e)  Based on a parent's religious beliefs, a parent may request that a person required to file a birth certificate or report a birth delay filing the certificate or making the report until the parent contacts the person with the child's name.  If a parent does not name the child before the fifth day after the date of the birth due to the parent's religious beliefs, the parent must contact the person required to file the birth certificate or report the birth with the name of the child as soon as the child is named.  A person required to file the birth certificate or report the birth who delays filing the certificate or making the report in accordance with the parent's request shall file the certificate or make the report not later than the 15th day after the date of the child's birth.

6. BRIEF HISTORY: Registration was not always required!
Birth registration laws not always enforced
Demand for birth certificates grew in 1930’s and 1040’s
States had record numbers of requests for delayed birth records
Medical community promoted vital registration
Growing need for infant and maternal health statistics

7. A Foundational Document
Birth Certificates are used for:
Social Security Cards
Drivers Licenses
Passport
School enrollment
Little league

8. Birth data is important for public health:
Regional health issues
Public health trends
Recommendations for medical procedures
and more….
Birth records are also an important source of statistical information, used for public health purposes
REMINDER! Discuss the statistical portion of the birth record is confidential. When it is released to the state it is not part of the legal birth certificate, and completely confidential. It can not be obtain by court order, etc…
HSC Sec.    FORM OF BIRTH CERTIFICATE
(b)  The section of the birth certificate entitled "For Medical and Health Use Only" is not part of the legal birth certificate. Information held by the department under that section of the certificate is confidential. That information may not be released or made public on subpoena or otherwise, except that release may be made for statistical purposes only so that no person, patient, or facility is identified, or to medical personnel of a health care entity, as that term is defined in Subtitle B, Title 3, Occupations Code, or appropriate state or federal agencies for statistical research. The board may adopt rules to implement this subsection.
REMEMBER! The statistical portion is strictly confidential! HSC (b)

9. TER BASIC Reminders
Texas Vital Statistics TER Birth Registration User-Guide

10. Passwords All users should have: Unique User ID
Passwords are confidential
Talking Points:
For security purposes, it’s important to make sure that every person accessing and using TER has their own User ID.
Multiple staff should not log in using the same User ID.
Sharing user ID’s, passwords and pin numbers is a violation of the TER User Agreement and may result in the termination of your use of the system. Per Texas Administrative Code §181.13
Title 25 Texas Administrative Code §181.13:
The State Registrar shall prescribe a User Agreement for the orderly implementation of electronic birth registration.
Hospitals, licensed birthing centers, midwives, and local registration officials must comply with the User Agreement in order to participate in electronic birth registration.
The bureau may discontinue any institution or individual's participation in electronic birth registration for failure to comply with the User Agreement.

11. Mandatory vs. Non-Mandatory Fields
Must be answered to resolve the record
Example: last name
Non-Mandatory Fields
Can be left blank
Example: middle name
The best way to enter information in TER is by using the Tab feature.
More accurate and complete
Prevents skipping
MANDATORY fields –
Cannot be left blank
The record will remain unresolved until information is filled in. Example – the last name
Note: for mandatory fields that information is n/a, enter “?” for numeric fields and “unknown” for alphabetic.
NON-MANDATORY fields -
TAB through the field. A pop-up box will ask “…will you need to answer this later?” Then answer NO if you intent to leave it blank, and it will be resolved.
Example: middle name
Note: If there is no middle name leave the item blank. Do not enter NMI, NMN, none, etc. because what ever is typed in the field will go on the b/c
Selecting No will leave this field blank and resolved.

12. Visual Reminders
Visual Reminders help determine if a field is resolved
All fields must be resolved to release the record

13. Selected Fields

14. General Tab
Reminder: Complete each item by tabbing from field to field

15. General Tab 1 – Record Type
One must be selected
Born at Facility
Born En Route to facility
Foundling
Home Birth
Hospital/birth center may not file a home birth
Definitions:
BORN AT FACILITY: when a child is born in a hospital or birthing facility
BORN EN ROUTE: If the mother is en route to the hospital when the child is born and the hospital is the first place where the child is removed from the conveyance, “En route” should be indicated. In this case the Hospital should complete the birth record to show the name of the city or town in which the facility of destination is located.
If it has been determined that the child was not first removed from conveyance at the hospital, the birth record should be filed by the parent(s) with the local registrar of the city, town, village, or location where the child was first removed from the conveyance (car, truck, airplane, etc).
FOUNDLING: Texas Family Code § allows for hospitals to take possession of a child who appears to be 60 days old or younger if the child is voluntarily delivered to the hospital by the child's parent and the parent did not express an intent to return for the child. VSU facilitates this process by setting up the TER "Foundling" record type. 
HOME BIRTH: When a birth occurs at home, or in a non-institutional setting. Can be planned, or unplanned. For example, the mother went into birth and had the baby at home before getting to the hospital. If this happens, the parents will have to register the birth with the local registrars office. Note to Hospitals: birth registrars can assist mothers by helping complete the Mother’s Worksheets and Medical Worksheet so the parent(s) can bring it with them to register the birth, etc.) ***** STRESS THIS POINT : STRESS THAT THE HOSPITAL CAN’T FILE A HOME BIRTH EVEN THOUGH IT’S LISTED AS AN OPTION. DESIGNED FOR MIDWIVES TO USE. NOT HOSPITALS.
Might be useful to cite definitions, they may be more inclined to follow along and use codes book

16. General Tab 1 – Child’s name
Parents can name the infant anything, except:
No obscenities
No numeric, non alphabetic or special characters
Hyphenated names are acceptable
The name must fit the space provided
First and last name are required fields
Middle names can be left blank
The last name doesn’t have to be same as either parent
First Name:
Enter the infant’s first name. If the parents have not selected a given name for the infant, enter “Infant.” Do not enter the last name of the mother as the child’s first name. Do not leave this item blank.
Middle Name:
Enter the infant’s middle name and any names other than First and Last. If there is no middle name, leave this item blank; do not enter NMI, NMN, etc.
Last Name:
Enter the infant’s last name. The child’s last name does not have to be the same as either parent. Also enter any suffixes following the last name.
No numerical characters can be used in names [Example: ], but you may spell out a number in a name. [Example: One, Two, Three, etc.]
No obscenities, or non alphabetic characters are permitted.
Special Characters that are used in languages other than English are not permitted. [Examples: á, é, ó, ý, ø, ä, etc.]
Parents may name the infant any name they desire as long as it will fit in the space provided on the certificate.
The parent(s) do not have to give the child their surname; for instance John Jones and Mary Brown, husband and wife, may name their child Tommy Green, Jr.
A mother may give her child a supposed father’s name without his name appearing on the birth certificate as the father.
A last name may be hyphenated, as in Jones-Brown.
Note: Generational suffixes are used to distinguish persons who would otherwise share the same name within a family.   The most common name suffixes are SR for “Senior” and JR for “Junior”. 
MR., MRS, or MS. Should not be used in this field. MR and MS are considered an Honorific, a word or expression with connotations conveying esteem or respect when used in addressing or referring to a person.  MR and MS should not be entered into the suffix field of the mother, father, or child’s name.
In addition, Academic suffixes and names should also not be entered into the Suffix field.  Academic suffixes, such as “PH.D.”, “M.D.”, “M.F.A.”, should not be entered into the suffix field of the mother, father, or child’s name.
Maybe talk about consequences of comitting some of these mistakes, diacritical marks and SSA, ppl are better able to remember and understand if they know why

17. Which name is acceptable?
Resúme Smith
Puppy Dog Taylor
Lúis Hernandez
8 Ball Harris
(aka: the artist formerly known as Prince)

18. Mother 1 Tab
Reminder: Click on each “button” to reveal additional information to be completed

19. Mother 1 (Tab 2)- SSN for baby
Select if parent(s) want Social Security Number
If “yes” is selected” it enables the ability to print Social Security Letter
Parents will receive the Social Security Card from the SSA in approximately two weeks
If “no” is selected, a SSN will not be issued by the SSA through the birth registration process
Child’s Social Security Number – Mark the “Yes” box if the parent wants a Social Security number issued for the baby; mark “No” if the parent does not. Answering “yes” to this question will enable the Social Security Letter and will make the record eligible to be included in the SSA Extract.
If the “Yes” block is not checked or the child does not have a name, no social security number will be issued by the Social Security Administration through the birth registration process. The parent(s) will have to go to the SSA office to obtain a SSN for their childe.
It will take approximately two weeks from the time of electronic transmission for the parent to receive the social security card from the Social Security Administration.
Reminder: Assuming that the b/c was entered correctly, etc.
To Print the Social Security Letter
Save the Record.
Access the Print menu by one of the following methods:
Use Icon
From the Registration pull-down menu
On the print preview toolbar, click the print icon.
In the Print window, click OK.

20. Mother 1 (Tab 2)- Hispanic Origin
Report what the mother considers herself to be
Only one choice can be selected
If more than one origin apply:
Select “Yes – Other”
Specify in the next field
If mother did not complete:
Select “Unknown if Spanish/Hispanic/Latina”
Note: Also applies to Father 1 Tab
Mother of Hispanic Origin? - For the purposes of this item, “Hispanic” refers to those people whose origins are from Spain, Mexico, or the Spanish-speaking countries of Central or South America. Origin can be viewed as the ancestry, nationality, lineage, or country in which the person or his or her ancestors were born.
Report what the mother considers herself to be.
Only one choice can be selected.
If specific origin is not listed (eg. Salvadorean, Nicaraguan, etc.) or if more than one origin apply (eg. Mexican and Cuban), select ‘Yes – Other Spanish/Hispanic/Latina Origin’ and specify in the next field.
If the mother has not completed this section on the Mother’s Worksheet, select ‘Unknown if Spanish/Hispanic/Latina origin.’
STATISTICAL PURPOSE: Hispanics comprise the second largest ethnic minority in this country. This item provides data to measure differences in fertility and pregnancy outcomes as well as variations in health care for people of Hispanic and non-Hispanic origin. Without collection of data on persons of Hispanic origin, it is impossible to obtain valid demographic and health information on this important group.

21. Mother 1 (Tab 2)- Mother’s Race
A Self- Report measure
Select what the mother considers herself to be
More than one race can be selected
***SELF REPORT. Don’t change their answers.
Check one or more races to indicate what the mother considers herself to be. If a race indicated by the mother is not included in the checklist, check the “Other (Specify)” box and enter the race indicated.
Reminder: Father Tabs answered the same way
STATISTICAL USE: Race is used to study racial variations in childbearing, access to health care, and pregnancy outcomes (infant mortality and birth weight). Race
is an important variable in planning for programs and preparing population estimates.

22. QUESTION? Can you tell which man was born in Canada and which was born in the US just from appearance?

23. Mother 2 Tab

24. Mother (Tab 2) - AOP Marital Status Choices: Never married Widowed
Divorced
Currently married
Married but refusing husband information
The Acknowledgement of Paternity (AOP) process provides a way to establish the biological father as the legal father of the child. Depending on the Marital Status is entered, you may need to Answer the AOP question
Marital Status Choices:
Never married – if selected, focus will automatically advance to the AOP” field.
Widowed – if selected, focus will automatically advance to the “Married within 300 days” field
Divorced – if selected, focus will automatically advance to the “Married within 300 days” field
Currently Married – This includes Separated but not divorced and Common Law marriage. If selected, focus will automatically advance to the “AOP” field
Married but Refusing Husband Information – If selected, TER will assume there is not Paternity info and will disable the Fathers information
STATISTICAL USE
This information is used to monitor the substantial differences in health and fertility between married and unmarried women. It enables the study of health problems
encountered during and after pregnancies. This information allows researchers to measure medical risk factors of out-of-wedlock children and their mothers.
Studies have found that children born to unwed mothers tend to have lower birth weight and higher infant mortality, and they may be born to mothers with less prenatal care. Understanding these differences helps to recognize that unmarried women and their babies may need additional health services.

25. Father Tab 1
If mother is not married or refusing AOP information the tabs will be greyed out and no information can be entered

26. Father 2 Tab
If mother is married, but her husband is not the father of the baby, and the biological father is listed on the Father 1 tab – enter her husband’s information on ‘Father 2.’ under “presumed father”. This information wont’ appear on the birth record! It is for the AOP only. Only enter if he’s able to be there and sign the AOP

27. Father 1 and Father 2 tabs
No signatures or AOP required to add father, if:
Mother is married at time of birth
If marriage ended not more than 300 days before birth
Common law marriage
However, the OAG recommends obtaining a signed AOP
AOP required to add father, if:
Parents not married
If mother is married to someone other than the father
If the mother is married at the time of birth, (or was married and the marriage ended not more than 300 days before the birth), the husband or former husband of the mother is presumed to be the father of the child. [FC § (b), FC § ] If the husband or former husband actually is the father of the child, his information can be added to the birth certificate, and no signatures or Acknowledgment of Paternity are required.
If the parents state that they are married by common law, VSU will accept the birth certificate without an AOP as long as “Mother Married” is checked “Yes”. However; the Office of the Attorney General recommends that an AOP be signed in cases involving common-law marriage because of the difficulty of proving a common-law marriage if it is ever challenged.
When the parents are not married, or the mother is married to someone other than the father (or was married and the marriage ended within 300 days before the birth of the child), paternity may be voluntarily established by using a witnessed Acknowledge of Paternity, Form VS (AOP). If the form is properly completed and attached to the birth certificate, the father’s information can be included on the birth certificate.
NOTE: If you have a question about whether to add the father’s name to the birth certificate, please contact your Paternity Opportunity Program Specialist in your area. Also there is AOP Re/Certification this afternoon!!

28. Medical 1 Tab
Reminder: Use information from the Mother’s Worksheet Medical Worksheets to complete the Medical 1 Tab (And Medical 2 Tab)

29. Medical 1 Tab -Pregnancy History
Live Births Now living
Do not include current birth or adopted children
For plural delivery, the certificate of the 1st born should not include other births. The certificate of the 2nd born should include the 1st. Etc…
Live Births Now Dead
Don’t include this birth or adopted children
Other Pregnancy Outcomes
Enter number of fetuses delivered dead regardless of gestation, or cause of death
If mother refused to answer these questions enter one question mark(?)
Pregnancy History – This section only pertains to births prior to this birth event. Enter birth history prior to this birth
LIVE BIRTHS NOW LIVING
Enter the number of prior children born alive to this mother. Do not include this birth or any children by adoption.
When certificates are prepared for a plural delivery, the certificate of the first-born should not include any of the other deliveries. On the certificate of the second-born, these items should include information about the first-born of the plural delivery. Similarly, for the third-born, these items should include information about the first- and second-born, and so on.
LIVE BIRTHS NOW DEAD
Enter the number of prior children born alive to this mother who are no longer living. Do not include this birth or any children by adoption.
OTHER PREGNANCY OUTCOMES
Enter the number of fetuses that were delivered dead regardless of the length of gestation. These deliveries include miscarriage, fetal death, ectopic pregnancy and spontaneous or induced abortions
STATISTICAL USE:
Pregnancy History: These items are used to determine live-birth order and total-birth order, which are important in studying trends in childbearing and child spacing. They are also useful in studying health problems associated with birth order (for example, first births to older women) and determining the relationship of birth order to infant and perinatal mortality.
In studying child spacing, the dates of last live birth and other terminations are used to compute the intervals between live births and fetal deaths and between pregnancies. This information allows researchers to measure known risk factors associated with the mother’s previous pregnancies, such as prior fetal loss, short inter-pregnancy interval, and high parity.

30. Medical 2 Tab

31. Medical 2 Tab – Child’s Health
Birth Weight
Enter weight as it is recorded in the hospital record
Can be grams OR pounds and ounces
Do not convert from one measure to the other
Enter the birth weight of the child as it is recorded in the hospital record. Enter the weight as shown in either grams OR pounds and ounces. Do not convert from one measure to the other.
** If the child is under 225 grams and TER wouldn’t accept it, enter the minimum weight and send TER Help Desk with “Statistical Correction” in subject line. Give name, DOB and record has to be released and filed already. Once release and we file it then they can send and give the correct weight and VSU will go in and correct the weight. (lower than the average range)
STATISTICAL USE:
Birth Weight is the single most important characteristic associated with infant mortality. It is also related to prenatal care, socioeconomic status, marital status and other factors surrounding the birth. Consequently, it is used with other information to plan for and evaluate the effectiveness of health care.

32. Certifier Tab

33. Attendant vs. Certifier
the person present at the time of birth
can attest to the facts of birth
Certifier:
certifying that the infant was born alive at place, time and date stated on the birth certificate
ATTENDANT:
A person that was present at the time of birth and can attest to the facts of birth.
An attendant can be the mother, physician, paramedic, midwife or another person who was present at the time of the birth.
Note: if the mother was alone when the baby was born, she should be listed as the attendant. However, she must file the birth certificate as a non-institutional birth with the LR
CERTIFIER:
The certifier is the individual accepting the responsibility of certifying that the infant was born alive at the place and time and date stated on the birth certificate.
The certifier may be the attending physician, the hospital administrator, or the administrator’s designee.
If a local registrar is entering the record in TER the certifier is going to be the Local Registrar.
(Note from VR: If the LR is not entering the record in TER it is generally the attendant. So if the parents are completing a paper record and the father attended the birth, he will generally be the certifier too. This is not set in stone. The local registrar can also be the certifier on a paper record too.)
Note: The names of individuals who either deliver babies or certify the birth record can be added either directly through Library Maintenance or through the Adding On the Fly (AOF) Process.
If the attendant is not on the list the attendant’s name and mailing address may be entered by the “Add on the Fly” process. To add on the fly, select “Add New” at the bottom of the list. Type the full name and address of the person who delivered the baby (the person who was with the mother when the baby emerged from the birth canal – regardless of who cut the umbilical cord.)
Attendant
Select an attendant from the list. If the attendant is not on the list, the attendant may be entered via “Add On the Fly” (AOF) process.
Is Certifier Same as Attendant?
If ‘Yes’ is selected, the remaining fields will populate under Attendant Information.
Certifier
Select a certifier from the list. If a certifier is not on the list, the certifier may be entered via “Add On the Fly” (AOF) process.

34. Certifying & Releasing

35. Certification Definition:
Verifies the child was born at the facility on the date and at the time indicated
Reminders:
Review the information for completeness and accuracy before certifying
The individual certifying the birth cannot be the same individual who entered the record in TER
Once the data has been entered into the record, the record will need to be certified then released. The following processes must be completed.
Definition of Certification
Certification stipulates the fact that the child represented was born at the facility on the date and time indicated.
Certifying the record
As stipulated in the TER User Agreement, the person certifying the record should be a different individual than the one who entered the data into the record.
The TER User Agreement states: All births must be certified by an individual approved by DSHS to certify births.
The individual certifying the birth cannot be the same individual who completes the birth registration process in TER.
*All records will require electronic certification in order to be legally released from the facility.
Remember to print the Verification of Birth Facts and have it signed by parents.
Verify the accuracy and completeness of the information entered in the TER system by reviewing the Verification of Birth Facts form.
To Print the Verification of Birth Facts
Save the Record.
Access the Print menu by one of the following methods:
Use Icon
From the Registration pull-down menu
On the print preview toolbar, click the print icon.
In the Print window, click OK.

36. Release Record Definition:
The act of submitting the record to the state
Reminders:
Releasing the record implies it is complete
Don’t expect to make changes after releasing
Amendments are required after filing
Releasing the record is the act of submitting the record to the state. Once the record has been released, changes to the record are not possible without an amendment. Releasing the record implies that there are no remaining questions regarding any of the data fields in the category being released.
Remember to print the Verification of Birth Facts and have it signed by parents.
Verify the accuracy and completeness of the information entered in the TER system by reviewing the Verification of Birth Facts form.
To Print the Verification of Birth Facts
Save the Record.
Access the Print menu by one of the following methods:
Use Icon
From the Registration pull-down menu
On the print preview toolbar, click the print icon.
In the Print window, click OK.

37. Resolve all Fields before Releasing
REMINDER!! After Certifying records, it’s important to double check for any unresolved items, before you attempt to release them. All unresolved fields must be resolved before releasing the record.
Check for unresolvFix any unresolved items
Unresolved Fields : You may view a list of birth fields that are unresolved for a particular record and jump to that field to complete the information.
For the unresolved fields list, click on the Status Bar in the bottom right hand corner of the screen ed items
Identifies fields and issues on the current record.

38. Adding a Certifier Click ‘Library Maintenance’
Click ‘Attendant/Certifier/Infant Attendant’ from the pull-down
NOTE: Only users that have been assigned the ‘Attendant Maintenance’ functioby their Local Administrator will have access to the Library Maintenance menu
item.
1. From the Birth screen, select Library Maintenance from the menu bar.
NOTE: Only users that have been assigned the ‘Attendant Maintenance’ function by their Local Administrator will have access to the Library Maintenance menu item.
2. Select Attendant/Certifier/Infant Attendant. - You will be taken to the ‘Attendant/Certifier’ screen NEXT SLIDE

39. Click the ‘New’ icon to create a new certifier
3. Click the ‘New’ icon to create a new entry.

40. Enter the information requested, tabbing from field to field.
Select ‘Certifier Only’ from the Role pull-down
4. Enter the info requested, including enter the name of the person being added and select their Role and Type from the dropdown menus.

41. Enter 999 for the license number
Select the “Facility Administrator or Designee” as the Certifier Type from the ‘Type’ pull-down.
6. Enter the License number.- Enter 999
7. Enter the Texas Provider Indicator (TPI) number if known, otherwise tab past the TPI number field.
Enter 999 for the license number
Enter TPI number if known otherwise tab past the TPI number

42. Be sure the ‘Display in Lists?’ box is checked
Enter address
Be sure the ‘Display in Lists?’ box is checked
8. Complete the address information.
9. Be sure the ‘Display in Lists?’ box is checked.
NOTE: Deselect the ‘Display in Lists?’ box for all Attendants and/or Certifiers no longer practicing at the facility.

43. Enter a temporary PIN number
10. If the new entry is a Certifier, enter a temporary pin number. This will be used when electronically “signing” the birth records
NOTE: The Certifier will be prompted to reset their pin number when certifying their first record(s).
11. Click the ‘Save’ icon and the new entry will then appear in the Attendants/Certifiers table below.
Add an Attendant On-the-Fly
TER has the ability to ‘AOF’ (Add-On-the-Fly). Add-On-the-Fly function gives all users the ability to add entries to a library table during birth record data entry.
To add an Attendant On-the-Fly, select the dropdown arrow in the Attendant field and select ‘(Add New)’ from the bottom of the list. Follow steps 5 through 9 to Add-
On-the-Fly. Make sure to save your entry by clicking on the ‘Save” icon.
Click ‘Save’

44. Certification Select the electronic certification icon
Choose Certifier
Enter PIN number
Check the box for each record to be certified
Select the “certify” icon
DETAILED STEPS:
Select the Electronic Certification Icon or select “Electronic Registration” from the “functions” menu
Choose the Certifier from the Certifier login window and enter PIN number. Only the certifiers that are designated on the certifier tab will appear in the certifier login window.
The list of records ready to be certified for the selected Certifier will display. Place a check in the box next to each record to be certified.
Select the “certify” icon from the toolbar or select “certify Record from the “Certification” menu
 NEXT SLIDE for step 6

45. Certification Enter the PIN Exit the record Save Changes
6. Enter pin number when prompted (remember, the certifiers PIN number must be kept confidential and used only by the Certifier)

46. Releasing Records Click “yes” to release the legal portion
Click “yes” to release the statistical portion
Once you certify records you will have an option to release the record, or records that are complete.
After all Unresolved Fields are resolved and you SAVE the record, TER will reveal a prompt, letting you know all legal fields are complete
8. Click ‘Yes’ to release the “legal” portion of the birth record to the State office for processing. The birth record cannot be filed until it has been Legally Released.
9. Click ‘Yes’ to release the statistical information to the state. Statistical processing and analysis cannot be done until this release point has been completed.
These are not optional steps
Each step must each be completed

47. Check for Unresolved Records
Remember to periodically check for unresolved records.
Quick Search/Unresolved Work Queue
This search allows the user to search for birth records that have not been filed with the State.
Within Registration, it is possible to perform a ‘quick search’ by viewing a list of birth records that are unresolved and/or not yet filed with State. This list is referred to as the Unresolved Work Queue. Once a birth record has been resolved and released to the State, it will no longer appear on this list. However, as long as a birth record is still in the Unresolved Work Queue, the hospital can select a birth record from the queue for viewing and editing.
The Quick Search/Unresolved Work Queue is located in the upper right hand corner of the Registration screen.
The Quick Search/Unresolved Work Queue contains the following filters:
• Unsent Paternity
• Uncertified Records
• All
The Quick Search/Unresolved Work Queue will list the records in date of birth order (oldest first) and are identified by the following
• Child’s Last Name
• Child’s First Name
• Child or Mother Indicator (C or M)
• Date of Birth
If the child’s information is not available, the child’s name will be replaced by the mother’s name. This will be followed by an (M) to indicate mother.

48. Next Steps… Birth Record is filed with the State
An electronic record is sent to the Local Registrar for filing
Explain what happens once the record has been released
Remind them that a birth certificate is not automatically sent to the parents. The parents have to request a certified copy of their child’s b/c from the local registrar or state
Parents can request a certified copy from the local registrar or the State office

49. Interesting Scenarios

50. The parents wants us to enter the baby’s name according to their family heritage. Why can’t we enter “José Martínez” in TER? And who came up with the rules for entering information on the Birth Certificate, anyways?

51. Diacritical Marks
Names must only use the 26 letters of alphabet without diacritical marks
Spaces, hyphens, apostrophes OK
No special characters.
Example: á, é, ó, ý, ø, ä.
Data must be compatible with other state and federal government databases (SSA, DMV, OAG, etc.)
If a diacritical mark is entered in TER, a SSN is not issued!!
According to the Health and Safety Code § (a) the Texas Department of State Health Services is responsible for prescribing the form and content of the death certificate.  The form and content that the Texas Department of State Health services uses is set by National Center for Health Statistics (NCHS) and the National Association for Public Health Statistics and Information Systems (NAPHSIS). 
Like a Social Security Card or a Texas Drivers License, all the information on a death certificate will be in all capital letters. The system automatically puts the data in all caps to ensure that the data received through the Texas Electronic Death Registration system is uniform and consistent.  It also alleviates any issues the end users may have with proper formatting.  This makes the data easily compatible with the databases used by other state and federal government stakeholders (e.g. Social Security Administration, Department of Motor Vehicles, Office of Attorney General, National Center for Health Statistics, etc) and makes it easier on the end user.
In addition to the all capital lettering, Federal Public Law , AKA the “Computer Security Act of 1987” requires that all federal databases follow the standards determined by the National Institute of Standards and Technology (NIST) and to use the 26 letters of the alphabet without diacritical marks. (note: Spaces, hyphens, and apostrophes are acceptable). 

52. A foundling was dropped off at our facility
A foundling was dropped off at our facility. A social worker from Child Protective Services is involved so the baby can be adopted, but we don’t know how to complete the record. Help!

53. Foundlings The hospital completes the birth certificate
Under Record Type on the General Tab, select “Foundling”
The baby’s name may be entered as “Infant Doe.”
The social worker can also provide name
Where the baby was found should be considered the place of birth
The “attendant” can be:
The ER Physician, Chief of Medical Officer, or Hospital Administrator
Or the Social Worker (as last resort)
For “SSN for baby?” and “Did mother relinquish her rights ”
Select “Unknown”
For other information that is unknown;
Enter “unknown” for required text fields
Enter a single question mark (?) for required numeric fields.
Texas Family Code § allows for hospitals to take possession of a child who appears to be 60 days old or younger if the child is voluntarily delivered to the hospital by the child's parent and the parent did not express an intent to return for the child.
This statute was enacted to give these children a chance to be adopted without consequences to the parents. 
In order for the child to be adopted, a birth certificate must be created. 
VSU facilitates this process by setting up the TER "Foundling" record type. 

54. A mother unexpectedly went into delivery at home
A mother unexpectedly went into delivery at home. When the ambulance arrived she had already given birth. She and the baby were brought to our facility because she was planning on giving birth here. Can we complete the birth certificate?

55. Non-Institutional Births not attended by registered, certified or documented health care provider
The parent(s) must file the birth certificate with the local registrar.
The following proofs must be provided:
Proof of pregnancy
Proof that the infant was born alive
Proof that the infant was born in the registration district
Proof that the infant was born on the date stated
Texas Administrative Code
STRESS hospital can’t enter home birth even though the option is in record type.
Discuss how if/when this happens, the hospitals/birth registrars can assist the parents by providing the Mothers Worksheet and helping to complete the Medical Worksheet so the parents can bring this to register the birth. Also, copies of hospital reports/the paramedics report, etc can be helpful for the parents to provide “proof” to the local registrar that the baby….

56. A mother had a baby on the side of the road when her husband realized they wouldn’t get to the hospital in time. Can we complete the birth certificate, even though the baby was born on side of the road?

57. EnRoute Birth If the hospital is the first place the child is removed
The hospital should file the birth certificate
For Record Type, Select “En Route”
The physician who first attends the mother may be considered the attendant
If the hospital was NOT the first place the child was removed
The parent(s) will need to file the birth certificate with the local registrar
Evaluate each en-route birth before entering anything into TER.
STRESS: ASK A LOT OF QUESTIONS to find out exactly what happened and to make sure the child was not removed from vehicle, etc.
Was the child born at home and then taken to the hospital either by car, ambulance, or other vehicle?
Not an en-route birth and must be filed as a non-institutional birth.
Was the child born in the vehicle while on the way to the hospital?
If yes, was there a medical attendant (EMT) there to attest to the fact birth was in the vehicle?
Was the child born in the parking lot?
If yes, the hospital would file the birth record as “Born at Facility”

58. How long do we have to hold onto the documents used to complete a birth certificate?

59. Document Retention Mother’s Worksheet = 6 years
Signed Verification of Birth Facts = 6 years
Medical Data Worksheet = until July 1st of next year
AOP and OAG Parent Surveys = Refer to AOP Training
Document Retention
The TER Mother’s Worksheet must be used to collect the information for the birth certificate. The TER Mother’s Worksheet and signed verification form must be retained by the facility for a minimum of 6 years from the date the verification is signed.
The TER Medical Data Worksheet must be retained until July 1st of the year following the completion of the Medical Data worksheet by the facility. (Example: all of 2011 can be purged on 7/1/2012. Date set up because of our statistical data cut off ends. If there is an questionable item VSU may need verification we can ask them to review the worksheet. Once the statistical cut off has passed there is nothing we can do so no reason to retain info anymore.)
Acknowledgments of Paternity and OAG Parent Surveys will be retained by the facility for a minimum of 5 years.
AOP and OAG Parent Surveys = Refer to AOP Training
Laws change. Use to be 5 years. Law recently changed and may change again.
If asked why they have to retain documents
TER User Agreement states retention rage
TAC states each facility must comply with TER User Agreement

60. Resources VSU Website VSU Handbook on Birth Registration:
VSU Handbook on Birth Registration:
Texas Electronic Registrar Birth Registration Facility User Guide
TER Help Desk
ext 3490
Texas Vital Statistics TER Birth Registration User-Guide