August 11, 1999

Federal Trade Commission
Public Comment
The Funeral Rule
16 CFR Part 453

Submitted by:

Funeral and Memorial Society of Greater Kansas City
Annual Survey Committee
Chair: Mercedes Bern-Klug.

These comments are grounded in our chapter's experience of collecting and tabulating General Price Lists (GPLs) from about 60 funeral homes in the Kansas City market in 1995 and again in 1998. Volunteers also attempted to collect price and option information from all local cemeteries in 1997.

As a consumer-oriented Funeral and Memorial Society, we submit these comments in the spirit of helping families better understand their options and costs when it comes to making final arrangements. Our comments are in keeping with the original intention of the Funeral Rule:

The essential purpose of the rule: to ensure that consumers receive information necessary to make informed purchasing decisions, and to lower existing barriers to price competition in the market for funeral goods and services.

1999 FTC web page regarding The Funeral Rule

Comments follow the outline in the FTC's Request for Comments

C. REQUEST FOR COMMENTS

1. Is there a continuing need for the funeral rule?

Yes.

The Funeral and Memorial Society of Greater Kansas City strongly supports continuation of the Funeral Rule. The biggest weakness of the Funeral Rule is that families have no idea that it exists.

Individuals and families have no idea that they are entitled to a written copy of a General Price List. Although efforts have been made by the Federal Trade Commission to educate funeral directors about The Funeral Rule, no governmental group has assumed the responsibility of notifying families. We ask that 10% of the funds that go to educating funeral directors about the Rule, be set aside to inform the public of their rights.

Empirical data supporting the need for the availability of the General Price List:

Funeral Information Project (FIP) Results

Study of 163 deaths of persons age 50+ who died in June and July of 1995 and whose obituary was published in The Kansas City Star. Surveys were mailed to the person who signed the funeral home bill.

FIP Survey Question: When making funeral home arrangements, how helpful would it be for families to have a price list from several funeral homes to compare merchandise and services available, and costs?

Answers:

12% not helpful
34% somewhat helpful
49% very helpful
4% no answer

Therefore, 83% of the people who were responsible for making or overseeing funeral arrangements of a loved one within the previous three months reported that a funeral home price list would be helpful.

Another question in the FIP survey people asked:

FIP Survey Question: Before meeting with the funeral director did you have any idea of what the costs listed below would be?

Percent indicating they had NO IDEA of costs:

Caskets: 46%
Vaults: 59%
Flowers: 45%
Cemetery space: 44%
Grave open/closing: 63%
Grave marker: 56%
Body transportation: 69%
Total arrangements: 52%


Half the people responsible for making or overseeing funeral arrangements reported that they had no idea what to expect in terms of final costs before they met with the funeral director. Thegeneral public is not well informed on funeral home prices, and we also found that many peoplehave no idea what their options are (i.e. rental, refrigeration, direct cremation, etc.).

There are at least seven factors that contribute to the uniqueness of making final arrangements. These factors distinguish final arrangements from other retail experiences and from other family rituals such as weddings, first communions, or bar mitzvah ceremonies.

1. The persons responsible for making final arrangements, or for overseeing the arrangements in the event that arrangements were made before the death, are typically in crisis and overwhelmed by grief. It is difficult to think clearly on what may be the saddestday of one=s life.

2. Final arrangements can be expensive. Norrgard and DeMars (1992) report that the national average costs for an open casket service followed by earth burial runs between $5,000 - $6,000. Lino (1990) reports that following the cost of a house and a car, final arrangements are typically the third most expensive consumer purchase of a life time.

3. The finality of the decisions contributes to the uniqueness of making final arrangements. While returns or exchanges are common when purchasing other merchandise, the same is not true of caskets, vaults, and grave markers.

4. Survivors are often pressed for time when it comes to making final arrangements. After a death there is a short window of time for making final arrangements. In general survivors are faced with making the decisions during a one or two-hour meeting with a funeral director within 24 hours of the death. One local cemeterian estimates that there are over 70 tasks to be completed after a family death and about half are time pressured issues that must be dealt with before the final disposition of the body can take place (William Riley, Kansas City Catholic Cemeteries, personal communication, May 1997).

5. Confusion regarding the primary purpose of the funeral may exist. Dawson, Santos, and Burdick (1990) report that the functions served by a funeral include providing public recognition that a death has occurred, providing a framework in which to support those most affected by the death, and a means of disposing of the body. In addition, funerals can also serve as a way to pay respect for a deceased loved one. The purchase of merchandise and services may vary depending upon what the arranger perceives as the primary purpose of the funeral.

6. The person buying the merchandise and services usually has much less experience and knowledge about options and costs than does the person selling:

"In many cases a bereaved and less-than-clearheaded consumer is faced with purchasing services and merchandise from a funeral director who is thoroughly familiar with the situation and well prepared to meet its demands. This creates a serious imbalance in what might have been, with preplanning, a more normal purchasing situation."

(Nelson, 1983, p. 1).

7. There seems to be a lack of clarity in our society about the "etiquette" of final arrangements. Is it in poor taste to compare funeral home costs? Can one bargain with a funeral director over the price of a casket? Is it acceptable to decline permission to have a loved one embalmed? With whom, besides the funeral director, can one discuss the needfor a sealed vault?

These same seven factors that contribute to the uniqueness of making final arrangements can also contribute to the stressfulness of the task. Even in those situations in which the decedent hadpreplanned final arrangements, someone--usually a grief-stricken family member--must overseethe arrangements.

Therefore, especially in light of the nature of the experience of purchasing final arrangements, as described above, we do not feel that the cost of providing a GPL to families is a burden on funeral directors. Providing a general price list for families facing final arrangements is no moreburdensome to funeral directors than providing a menu to families is to restauranteurs.

Presumably funeral homes need to have a written list of what they offer and what they charge so the staff can be consistent when they work with families. Making such a list available to families does not represent a large investment we figure about 20 cents per copy (most of the GPLs we collected in 1998 appear to from a copy machine).

FTC question 2. What changes to increase benefits to purchasers?

With a group of volunteers all helping to collect and decipher GPLs, we still find ourselves confused about what is meant on many of the GPLs. There are two reasons for a GPL. The first is for the family to have a written list of the options available at the funeral home, and the costs.

The second reason is for families to be able to compare options and prices across funeral homes.

The current GPLs fall short on both accounts. Due in part to a lack of definitions, GPLs do not fully describe options within a funeral home. This lack of definition makes it difficult and in some cases impossible to compare options and prices across funeral homes. In fact, we challenge the FTC to randomly select any 10 GPLs in the country and any 10 funeral directors, and ask the funeral directors to state the price that would be charged according to each of the GPLs --for three or four examples of funeral arrangements. For instance, one example might be:

Sample Scenario 1: Mrs Vargas wants to have her husband cremated and have the cremated remains buried in their joint plot. Prior to the cremation, she would like a rosary and visitation at the church in the evening and then a funeral mass with the body present-- at the Church the following morning. After the cremation, she would like a grave side service at the cemetery. She would like to rent a casket for the church service, and would like her husband cremated in a plain pine box. What is the cost? (Not including the cemetery.)

he Funeral and Memorial Society of Greater Kansas City believes the FTC should require that funeral homes (and others if The Rule is expanded) follow a standard format for listing servicesand merchandise. In our experience, it is difficult to compare prices and options between funeral homes because of the lack of standardization, specifically:

A. Items be listed in the same order on all GPLs: We ask that the FTC require standard formatting. It is extremely difficult to compare prices if they are not listed in similar ways or in similar places on the GPL.

B. All items must be listed on all GPLs. If a funeral home does not offer that option (i.e. casket rental, refrigeration, etc.) then this must be plainly stated on the GPL. Familiesmay not realize that their options are limited by what the funeral home decides to offer.

C. The FTC should establish definitions for key terms. At prior FTC hearings, the funeral industry claimed that it would not be practical to include definitions because terms were used differently in different parts of the country. This is another reason why funeral home should have to use definitions. The buyer may be from another part of the country, or may have been raised elsewhere. General Price Lists will not achieve their intended purpose until clear and complete definitions are provided. The GPL may be the only thing in writing that a family member ever sees describing final arrangement options and costs.

It needs to be complete. Families will not be able to compare prices and options if funeral homes use the same term to mean different things.

Even when the family knows which funeral home it intends to use, an explanation of key terms would facilitate a more complete understanding of options available at that one funeral home.

Terms that are often not explained in the General Price List, and that lead to consumer confusion include:

Grave side service: A 1998 Funeral and Memorial Society of Greater Kansas City GPL price survey found that the cost of a grave side service in Kansas City ranges from $65 to $2,770. What accounts for this $2,700 difference? Is one funeral home charging $65 and another over $2,000 for the exact same service? It was not typical for the GPL to explainwhat was included. Some GPLs seemed to suggest that a grave side service was availableonly after a full funeral service was held. Others made it sound like a grave side service was in lieu of a formal inside service. Most did not provide any explanation at all. It is impossible for families to look through the set of Kansas City GPLs and determine the cost of a grave side service.

Examples of other terms that should be clearly defined:

Basic services.
Minimum container.
Alternative container.
Alternative container interior.
Viewing.
Visitation.

D. Font size. One hates to see government have to regulate the size of the font used on GPLs, but our 1998 Kansas City area GPL review found that about one quarter of the GPLs used a 10 point or smaller font size. Independently owned funeral homes and members of large chains can be found among the small font culprits. A large percentage of older adults have vision problems that make a piece of paper with size 10 font useless. What good is a price list if you can not read it? Small font GPLs defeat the intention of providing information to families.

FTC 11. D Requiring authorization prior to embalming?

The current FTC regulations require funeral homes to ask permission before they embalm for a charge. Whether or not the funeral home intends to charge for embalming, the family should have the right to agree or deny the request to embalm. Funeral homes should not be allowed to embalm bodies (for a charge or not for a charge) without the explicit and written permission of the next of kin.

FTC 20. Do consumers who make pre-need arrangements spend less on funerals than those who do not?

Empirical data:

Funeral Information Project results ( in Bern-Klug, DeViney, & Ekerdt)

Families reported that preneed burials had an average (mean) cost of $5,316 compared to a mean of $7,036 for non preneed burials. Preneed cremations had a mean cost of $1,600 compared to $2,470 for non preneed cremations.

We do not know why preneed costs are less. It could be that when people select final arrangements for themselves, they are more frugal than when other people buy for them. It could be that the people most concerned about final arrangement costs buy preneed plans. It could be that preneed purchasers are more likely to comparison shop. Research is needed to answer this question.

Despite the lower cost for preneed final arrangements, these arrangements may be costing more than the purchaser had intended. Although we did not ask the question, some FIP respondents wrote on their survey that they were told by their loved one that all costs were covered with apreneed plan, only to find out after the death that the casket selected was no longer available, and the closest thing available would cost the family another $700.

It is assumed that most preneed plans are purchased by the person who intends to use it upon his/her death. Therefore the person "most invested is not around to determine if he or she really got what was paid for" ( Bern-Klug, DeViney, Ekerdt, in press). We have also noticed that if a family wants to up-grade what was prepurchased, the funeral home has no problem with that.

The wishes of the deceased are up-graded. However, if the family chooses less expensive services or merchandise, the funeral home is likely to insist that the plans of the deceased must be honored.

FTC 22. Should the Commission expand the definition of "funeral provider" in order to bring non-traditional members of the funeral industry within the scope of the Funeral Rule's coverage?

In 1997, The Funeral and Memorial Society of Greater Kansas City attempted to conduct a price and options survey of all local cemeteries. Volunteers were frustrated by the lack of written information describing cemetery goods and services. In many cases, our volunteers had to visit the cemetery and sit down and look at three-ring binders full of photos of options, and then take their own notes. Nothing was provided in writing. The terms used by cemeteries are not standard. It is next to impossible for the average family to fully understand their options and the costs at cemeteries. Our Society is particularly concerned about the lack of information in writing specifying the right to bury cremated remains in a grave plot. It is not at all clear, how many cremains can be buried in one plot or as one cemeterian answered, "You can bury all the cremains there that you want, but you can only have one marker."

Cemeteries should be required to put prices for services and merchandise (and all definitions of such) in writing. They should have to clearly list the opening and closing costs (including any "extra" costs for evening, week-end or holiday services), and when these costs must be paid.

(Many of the FIP respondents were surprised and irked--to learn that they had to pay opening and closing costs, up-front and in-cash before the cemetery would dig the grave.)

Cemeteries should also have to put in writing the conditions of payment and of re-sale. The consumer needs this information BEFORE deciding to purchase. Having the information in tiny print in a contract is not sufficient. Cemeteries should not represent their preference for vaults as state law. Cemeteries should clarify in writing the requirement for a vault for cremated remains.

Also, it should be very clearly stated in writing that the consumer is allowed to purchase outer burial containers, and/or markers elsewhere.

We have heard from families including families in rural areas that the local cemetery refused to sell a single plot, and required instead that two, three or in some cases four plots be purchased, even though the family was in need of only one. A written price and option list for cemeteries should clarify that families can not be required to purchase services or merchandise they do not want.

We occasionally have a family member comment that the cemetery required that the family leave the grave site before the casket was lowered into the grave. This "requirement" disturbs many families who wish to remain until the casket is lowered and the grave is covered. Families do not know if they have the right to remain.

Funeral Information Project Survey Question: When making cemetery arrangements, how helpful would it be for families to have a price list from several cemeteries, to compare the merchandise and services available, and the costs?

15% Not helpful
33% Somewhat helpful
44% Very helpful
  8% No answer

Three-quarters of this sample stated that having a cemetery price list would be helpful to families.

FTC #28 Should GPL be modified

(a) 1. Should the Rule require that the price of private viewing without embalming be included on the General Price List?

The Funeral and Memorial Society of Greater Kansas City supports this requirement. Familiesshould not be forced into approving and/or paying for embalming. It does not benefit families tohave this information excluded from the price list.

(a) 2. Should the Rule require that the price of donating a body to a medical school be included on the General Price List?

The Funeral and Memorial Society of Greater Kansas City supports this requirement. The GPL is not only a price list, it is also a listing of options. Families deserve to be informed of all theiroptions and the prices of those options. It does not benefit families to exclude this information from the GPL.

(a) 3. Direct cremation

The Funeral and Memorial Society of Greater Kansas City supports the requirement that GPLs include the price of the actual cremation in the quoted price for a "direct cremation." It is misleading to not include the price of cremation in a direct cremation. In our 1998 GPL survey we found that 13 of the 60 GPLs in the Kansas City market did not indicate that the cremation fee was included in the price of direct cremation.

In response to the changes suggested by the Funeral and Memorial Society of America (FAMSA).

1). Elimination of the non-declinable fee

In our society's experience this is the single most confusing part of the General Price List (GPL).

It is also among the most expensive items on many GPLs. It is a wild card that most families know nothing about. If they are inquiring by phone, the cost may not even be mentioned, andwho would think to ask, "will there be a non-declinable fee for buying services and merchandise atyour funeral home?" In 1998, we found that Basic Services fees ranged from $690 to $2,770.

We strongly support the complete elimination of this item from the General Price List.

The nondeclineable fee thwarts the family's attempt to compare prices across funeral homes.

We quote a story in the Kansas City Star (April 25, 1998) based in part on our 1998 survey. The range in costs for "Basic Services" in 1998 in Kansas City was $690 to $2,770. Rick Alm, the Kansas City Star reporter interviewed the manager of the funeral home with the $2,770 fee.

When asked to justify the high fee, the reply was "One of the reasons we're high is there is not another funeral home that is as beautiful in the state of Missouri."

Why should the family who has their loved one embalmed there but has the service in the church, pay the same overhead costs as a family who has the funeral in the most beautiful little funeralhome in Missouri? Why should the family who holds a funeral service outside the most beautiful funeral home incur a nondeclinable fee that helps to cover chandeliers?

If the FTC insists on maintaining the non-declinable fee, there needs to be changes.

First of all the FTC needs to clarify what exactly is the set of services that is common to all finalarrangements. Absent a basic set of services, there should be no nondeclinable fee.

It will likely turn out that the actual basic set of like services is the filing of permits and paperwork. But even these vary from customer to customer. All costs associated with other services or merchandise should be priced with those services and merchandise, otherwise familiesare being forced to subsidize services and merchandise they do not necessarily use.

Second, when the federal government provides funeral homes with the right to charge a "non-declinable fee" there ought to be a reciprocal obligation on the part of the funeral home. If families are obligated to pay this fee, funeral homes ought to be required to clarify just what they are obligated to provide. As it is now written, funeral homes are allowed to charge the non-declinable fee but it is not clear to what the family is entitled for paying this fee.

There appears to be some confusion among funeral homes about the nondeclineable fee as well.

Many Kansas City funeral homes charged more on their nondeclineable fee than they did for forwarding a body although they report, "this fee is already included in our charges." How couldthis bigger fee be included in a forwarding charge that is smaller? Lisa Carlson, executive Director of the Funeral and Memorial Society of America (FAMSA) calls this "magic math" and such instances can be found all over Kansas City GPLs.

Our advice? Stop the confusion and drop the nondeclineable fee.

2). Addition of 4 items to the GPL: Items 1-3 are discussed earlier #4 is below:

4. Rental Caskets: We strongly support the inclusion of the full price of renting a casket. If the facility does not offer this option, they should state this in the GPL. There is much potential for confusion. Our 1998 GPL survey found that some funeral homes listed the rental cost and then a separate cost for "casket liners." If one can not rent a casket without purchasing a casket liner, the consumer needs to know this in writing and the costs should appear next to each other.

Those funeral homes that do offer casket rental like to offer this option only when the body will be cremated after the service. Families ought to be able to rent a casket for a funeral service regardless of the final disposition. In other words a family may want to rent a cherry wood casket for a service and then bury in a pine box. This should be an option. Funeral directors do not seem to "allow" casket rentals when the body will later be buried in a less expensive box. The FTC should protect the rights of families to do so.

3). Include cremation charge in cost for direct cremation (addressed earlier)

4). Mark up on cash advances.

Our Funeral and Memorial Society believes that families should be informed of the mark-up that the funeral home intends to charge on cash advances. This is part of being honest with familiesabout the costs they can expect when they do business with a particular funeral home. It comes a s surprise to us that this is controversial.

5). Scope of the Funeral Rule be expanded to include cemeteries, monument dealers, and casket sellers.

Yes. Of course. Why deprive families of the right to understand their options and the costs?

Other interesting things we noticed when reviewing the 60 GPLs in the Kansas City market:

Aside from the Basic Services confusion, a review of the Kansas City GPLs revealed other areas for clarification:

At least five GPLs contained evidence for casket handling fee charges, in that families were charged more to use their own casket than to buy one from the funeral home (particularly concerning immediate burial).

Refrigeration. Some funeral homes seem to be putting pressure on families to embalm, we saw quite a few GPLs from chain funeral homes that state: "It is our policy to refrigerate an unembalmed body after 6 hours" $465. Six hours seems rushed. Others said 24 hours. Neither clarified how long the body would be refrigerated at that price.

Also in regard to refrigeration...suppose a family does not want their loved one embalmed and would like a viewing. If the body can be refrigerated and then puton dry ice, the family should be allowed to have these arrangements. None of the GPLs alluded to this option. From the GPLs it looks as though the only arrangements possible for people who dislike the idea of embalming are direct cremation and immediate burial. For some people, viewing their loved one unembalmed and un made-up makes it easier to accept the fact that they are dead.

Some families don't want to see dad with make-up on, but do want to see him before burial or cremation. These families are being pressured into embalming or direct cremation/burial.

Sanitizing fee

"This charge applies only to cases where embalming is not required $195."

Go figure.

Cost for preparing a body for identification (generally referred to in cremation situations). Five local funeral homes are charging families around $100 for this.

This seems wrong.

Embalming charges higher for organ donation cases. Six GPLs listed anywhere from $110 to $490 extra for embalming in the case of organ donation.

This seems wrong.

Telling consumers that if they buy a casket elsewhere (or make one) the casket has to comply with "any applicable state or cemetery requirements." There are none.

But how would a consumer know this?

GPLs appear to be insinuating that alternative containers or minimum containers can only be purchased and used with immediate burials and direct cremations. The family should have the right to use such a container for any arrangements.

If the family wants to use a minimum container as the casket for the open-casket service and then bury/cremate in that container, that should be "permitted." Why should the family be limited to buying low-cost containers only when direct cremation and immediate burial are used? The FTC should clarify that families can select any casket type for any service and disposition choice.

In short, the Funeral Rule as it now stands is a good beginning, but does not fulfill its potential.

Families still are not able to fully understand the options and prices within one funeral home and certainly are not able to easily compare options and prices between funeral homes. Much of the confusion could be eliminated by requiring definitions and listing all basic options, even if the funeral home elects to not offer that service.

The purchase of final arrangements is unlike any other consumer purchase. Added to the emotional burden of the day, is the fact that on average final arrangements cost between $5,000 and $6,000. This is a large expense considering that half the widowed women over the age of 65 live on less than $10,000 per year (Hooyman & Kiyak, 1996, p. 471).

References

Alm, R. (1998). The price of dying. Kansas City Star, April 25, Business section, page 1.

Bern-Klug, M. , DeViney, S., and Ekerdt, D. Variations in funeral-related costs of older adults and the role of preneed funeral contracts and type of disposition. Manuscript accepted by Omega: Journal of Death and Dying.

Bern-Klug, M., Ekerdt, D., and Wilkinson, D.S. (1999). What families know about funeral-related costs: Implications for social work practice. Health and Social Work, 24(2), 128-137.

Dawson, G. D., Santos, J.F., & Burdick, D.C. (1990). Differences in final arrangements between burial and cremation as the method of body disposition. Omega, 21 (2), 129-146.

Funeral and Memorial Society of Greater Kansas City. (1997). Making Sense of Cemetery Services. The Report, Spring. Cover story.

Funeral and Memorial Society of Greater Kansas City. (1998). Kansas City Area Funeral Home Price Survey. May 6.

Hooyman, N., & Kiyak, H.A. (1996). Social Gerontology: A Multi-Disciplinary Perspective.Boston: Allyn and Bacon.

Lino, M. (1990). The $3,000 farewell. American Demographics. July, p.8.

Nelson, T.C. (1983). It=s Your Choice: The Practical Guide to Planning a Funeral. Glenville, Ill.:American Association of Retired Persons/Scott Foresman and Company.

Norrgard, L., & DeMars, J. (1992). Final Choices: Making End-of-Life Decisions. ABC-CLIO: Santa Barbara, CA.

The Funeral and Memorial Society of Greater Kansas City
c/o 4501 Walnut Str.
Kansas City, MO 64111
Phone 816 561-6322