By Phil Demers | MassLive

Part 1 in a MassLive series on what happens to Massachusetts' poor and unwanted when they die and the few people who take on the task of burying them.

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Stephen Ledoux had a physician's order to remain on oxygen "at all times."



The homeless Brocktonite, a 53-year-old opioid addict, suffered chronic obstructive pulmonary disease and assorted other ailments typically seen in people decades his senior, consequences of hard living. He was receiving methadone treatment at a local clinic.



And so when police, in August 2016, found Ledoux dead at a friend's apartment on Green Street in Brockton amid unused oxygen tanks, the cause did not seem suspicious.



Upon learning of Ledoux's recent hospital diagnosis, the Office of the Chief Medical Examiner subsequently refused his body when police came calling. Already under the strain of a backlog, the overloaded agency — which need only investigate deaths that occur under violent, suspicious, or unexplained circumstances — will naturally avoid coming into possession of extra bodies when possible.



That refusal kicked off a chain of events many police, especially in Eastern Massachusetts, are all too familiar with. With the state out and no family to claim him, what was to be done? The waiting game began. Some funeral directors describe these as abandoned bodies.



It wasn't that Ledoux didn't have anybody. After all, he died in the apartment of a friend -- a woman in her 30s who was also a new mother. She would let Ledoux stay in her apartment on weekends, according to Brockton police report. This woman told police another homeless man, Tim Reed, whom police later located and informed of Ledoux's death, was also a "very close friend."



What Ledoux lacked was surviving family to claim his body. Police located an ex-wife in Saugus hours into the search, and that's the best they could do.

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Brockton police incident report detailing the circumstances of Ledoux's death and the 9-hour struggle to find a funeral home willing to take his body. (Courtesy Brockton police)

The scenario happens a lot more than one might expect, and when it does, the responsibility of finding a funeral home to take care of the body falls on the municipality.



Meaning, inevitably, it's up to police.



"It's incredibly unfair to police. I've had guys plead with me," says Bob Lawler, longtime co-director with his brother, Bill, of Robert J. Lawler & Crosby Funeral and Cremation Services in West Roxbury. The business is one of the few among Massachusetts' 500-plus funeral homes still willing to bury abandoned bodies anymore.



"Nobody is willing to do it," Lawler said. "There's like three (funeral homes that do) in the whole state."



Paraphrasing the regular calls he gets from police, Lawler said, "'I've called 10 funeral homes, I've been here 8 hours.' I can't say no. Usually, it's, 'Alright, I can do it.'"



He added, "Sometimes, we're talking about 2 or 3 o'clock in the morning to go get a 300-pound guy who died on the top floor of a triple-decker in Cambridge or Somerville."

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Robert J. Lawler Jr. and his brother William Lawler, who together co-direct Robert J. Lawler and Crosby Funeral and Cremation Service in West Roxbury. The funeral home is one of the few still willing to bury the indigent and unclaimed in Massachusetts. (Courtesy)

Brockton police wound up waiting alongside Ledoux's corpse on that August day in Brockton for more than nine hours.



"We got there at 9 in the morning and stayed all day through late afternoon," Lt. William Hallisey said. "It doesn't happen often, but it can be a huge issue."



The two city officers waiting alongside Ledoux's body in the Green Street apartment made call after call, first to local, then increasingly distant funeral homes, getting rejected time and again. They spoke to more than a half-dozen funeral homes to no result.



Three increasingly desperate calls to the medical examiner later, the restless officers were finally connected with Worcester's Graham Putnam & Mahoney Funeral Parlor, run by Director Peter Stefan, who is, alongside the Lawlers and Casper Funeral & Cremation Services in Boston, another of the state's voluntary undertakers of the poor.



"The cops there practically hugged our people when they showed up," Stefan said.

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Peter Stefan at Hope Cemetery in Worcester where a man's body that had been unclaimed by anyone was being buried five months after his death. (Kristin LaFratta)

Stefan is known for speaking out on issues of the dead and for making a few waves. He famously buried Boston Marathon bomber Tamerlan Tsarnaev in 2013 when no one else would. Protesters picketed the funeral home for days. Stefan said he received threats. But Stefan insisted that his job was to bury bodies -- anyone's.



"It was the right thing to do," Lawler says of burying Tsarnaev.

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Ruslan Tsarni, left, uncle of killed Boston Marathon bombing suspect Tamerlan Tsarnaev, departs the Graham, Putnam, and Mahoney Funeral Parlors, in Worcester on May 5, 2013. Funeral director and owner Peter Stefan, right, walks him to his car. (AP Photo/Steven Senne)

Bodies stacking up

First a headache for police, Stephen Ledoux's remains then ended up going unburied another six months — and not before changing hands several more times.



The story, detailed here, of their final disposition highlights the legal and financial flaws in the way Massachusetts oversees the burial of not just its abandoned and unclaimed people, but increasingly, the poor in general.



Stefan would hold Ledoux's body more than two months before the medical examiner's office, after initially saying 'No,' then decided to take the remains, ultimately transferring them to Lawler, in West Roxbury. Finally, Ledoux was buried, in January 2017.



Some might wonder: Why not cremate these bodies? That's illegal under current Massachusetts law, because a family member could sometime later pop up, and reveal the person was a member of a faith with restrictions against the cremation, leaving the funeral director legally liable.



Abandoned bodies, then, must be buried.



Former Chief Medical Examiner Henry M. Nields, in a recent report, aptly described the reasons why the burial of Ledoux and many others like him are subject to major delays.



His report says the OCME was "becoming increasingly concerned" by the amount of time it takes to find funeral homes willing to accept their abandoned bodies, or as they referred to them, "unclaimed decedents."



Abandoned bodies were, at Nields' time of writing and for years before, having a disproportionately large impact on the OCME morgue and other facilities around the state as a result of these issues.

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Republican file photo

Data the state provided to MassLive highlights the problem. Between January 2014 and January 2016, the OCME came into possession of 186 abandoned bodies, each of which it held in its morgue coolers an average of 44 days, the data show.



This means, at any time during that period, the morgue was holding on to a dozen or more of yesterday's bodies, because of troubles the state Department of Transitional Assistance was experiencing in trying to find funeral directors willing to bury them. These numbers do not include abandoned and unwanted bodies the medical examiner's office did not claim, of which there are many.



The primary reason? It doesn't pay.



The welfare payout in Massachusetts on burying the penniless and abandoned remains $1,100 — the same as in the late '70s, according to multiple funeral directors MassLive spoke to — hardly enough to cover the cost of even the most threadbare burial nowadays.



Consequently, nursing homes and hospitals all over the state, too, are struggling with the same issue, and are also finding themselves holding onto abandoned bodies months at a time, occasionally even taking the extraordinary step of going to court to rid themselves of the dead.



Worcester's UMass Memorial Medical Center, located on Belmont Street, says it comes into possession of, on average, 30 abandoned bodies a year, hospital spokesman Tony Berry said in response to a MassLive inquiry.



"The specific issue of hospital possession of unclaimed remains is a significant challenge," Berry said. "It's a problem that cries out for a state legislative solution."



Compounding the problem, under current Massachusetts law, funeral directors can't collect the $1,100 state welfare payment for their work unless "the total cost of (the subsequent) funeral service" does not exceed $3,500.



The state counts a family's assets against that $3,500 cap, and months after someone is in the ground, retroactively pays the $1,100 to the funeral home responsible for burying the individual, if the cost of the burial stayed under the cap.



In response to a MassLive records request, Massachusetts provided welfare assistance in this fashion in more than 4,000 funerals in 2017.

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Paul St. Germaine of Graham Putnam & Mahoney Funeral reads a verse as workers quickly bury Anibal Velez, an 88-year-old man with a string of domestic assault convictions who died six months earlier, but whose body went unclaimed. (Kristin LaFratta)

As if the finances weren't already barely feasible, funeral directors tell MassLive there has been an, additional, annoying increase in number of deductions from and outright denials of this payout by state welfare — the Department of Transitional Assistance — further disincentivizing work that's already beyond consideration for the majority.



Especially when, in addition to the normal work a burial involves, the unclaimed sometimes require receiving funeral directors to spend hours of time spread across days attempting to track down potential relatives, often to no avail. Some of these relatives, funeral directors say, actively want to avoid contact out of fear of incurring burial costs. Only if they're having a lucky day will a funeral director be able to reach a family member, in which case they can ask them to sign off on the cheaper option: cremation.



All the while, though, the few willing funeral directors must keep a body for extended period inside their place of business.



"I don't have a cooler at my facility," said Robert Graham of Easthampton's Graham Funeral Home, another funeral director who tries to play a helpful role in burying abandoned bodies and the less fortunate. "That's one smell you will never, ever forget."



Graham, Stefan and the Lawlers told MassLive they've buried people on their own time and dime on occasion. The Department of Transitional Assistance will, over a month later, sometimes deny their $1,100 claims. They say sometimes this is done by the department itself artificially inflating the cost of funerals to bump them above the $3,500 cap, disqualifying the funeral director's claim.



One way it's done, said Graham, is by having state workers call surviving family to inquire over the cost of expenses related to the death but unrelated to the funeral — like newspaper and online obituaries — which can be quite expensive, amounts between $300 and $700 being common, and adding these dollars to the total cost of the funeral.



"We've helped out, basically for free, and now we're often finding out we're actually going to take one on the chin, financially," Graham said. "Not many people are willing to keep working at a loss."



"If (welfare) doesn't have the money, fine, I'll do it for the lousy $1,100. There aren't that many," Stefan said. "But I want an explanation on why welfare is bending over backwards to penalize us and deduct money from the $1,100 we get."



Although a great many funeral directors seem to believe burying the poor is the right thing to do, and some of these will help out where possible, they remain businesses, which can go so far before the rules of the market take over.



"We've had to go begging to cemeteries, asking them to donate graves" to keep down costs, Lawler said.



Nields, in his 2016 assessment of the problem, corroborated the struggles of the funeral directors trying to do a bit of good.



"There are two issues adversely impacting (abandoned body) releases though DTA: one is a lack of cemetery space for (welfare) cases and the second is the current fee of $1,100 per (body) funeral homes receive from (welfare) for handling these cases does not cover the expenses associated with the transportation, preparation and burial," he wrote.



As did Berry, the spokesman of UMass Memorial in Worcester.



"The reimbursement available to families and funeral homes is woefully inadequate to cover the time and expense most funeral homes incur for such a burial," he said.



Boston is also the only place currently living up to what remains the technical law of the state, codified in older tombs, which says cities and towns are responsible of providing cemetery space for the burial of their own, regardless of whether, as Stefan says, "They don't have two nickels to rub together."



Which is frequently the case.

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Aerial view of Fairview Cemetery in Boston, one of the few places where funeral directors can still affordably bury indigent and unclaimed people. (Courtesy Google Earth)

There's a catch. Only those who were residents of the city itself qualify for burial the City Poor Lot at Fairview, and the cemetery can get tricky about residency.



According to Stefan and Lawler, Fairview won't provide plots if the late homeless person's place of residence was, say, a shelter in Somerville or Charlestown.



Other Massachusetts municipalities don't have the budget of Boston, to be sure, and there's consequently little room to negotiate plot prices.



Private and municipal cemeteries (most are private) all have their own budgets to balance. There's only a moral incentive, no formal mechanism, encouraging cemeteries to receive less compensation on a cemetery plot by taking a welfare case.



The majority of cemeteries thus won't, or can't, lower their cost, leaving Stefan and other funeral directors involved in such work to rely almost entirely on the generosity of church cemeteries.



"The law says every city and town must provide space for indigents, but there's nothing in there about the price, and that doesn't mean it's free," Stefan said.



Added Lawler, "They can say a cemetery plot is $1,500. I'll say, 'Well, I only have $1,100 to work with.' They say, 'I'm sorry, that's our price.'"



Stefan buries his unclaimed, sometimes two bodies to each unmarked grave, at St. John's Cemetery in Worcester at a cost of $700 per, the best he can do. At Hope Cemetery, also in Wocester, Stefan can bury one body per grave at a cost of $750. That's option number two.



West of Worcester, the situation is basically hopeless, with funeral plots costing mostly over $1,000.

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St. John's Cemetery in Worcester (Phil Demers | pdemers@masslive.com)

Faced with such a thin margin to break even somewhat even, Stefan says the Department of Transitional Assistance rejections become extra vexing.



Dozens of invoices he turned over to MassLive show welfare deducting sometimes large, sometimes comically small, amounts of money from his $1,100 reimbursement, because their people had tracked down some money belonging to the deceased.



In his favorite example, the department identified $4.52 belonging to a welfare case Stefan buried in September, an amount which was summarily deducted from his compensation, leaving it at $1,095.48.

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The Department of Transitional Assistance apparently located $4.52 in assets this late person possessed, and -- ridiculously, he thinks -- knocked that amount off funeral director Peter Stefan's welfare reimbursement. Only a handful of funeral directors are burying the poor already in Massachusetts, and a recent increase in DTA scrutiny has resulted in full or partial denials of burial reimbursement claims, even though the amount that's given already fails to cover the cost in most cases.

Other times, Stefan has taken state welfare to court, and won, for instance, by arguing that an automobile they sent him chasing after in lieu of compensation was an "inaccessible asset."



In an era of routinized online fundraising campaigns to raise money to help defray funeral expenses, multiple funeral directors recounted being directed by the Department of Transitional Assistance to plunder GoFundMe contributions for their $1,100 reimbursement.



"I'm going to take them to court and subpoena the policy people," Stefan said. "They don't have a leg to stand on."



Which brings the whole story back to the illustrative case of Stephen Ledoux, of Brockton.



After two months of unsuccessfully searching for surviving family, Stefan said he was intending to take the city of Brockton to court to initiate a discussion of the issues detailed in this report.



"I wanted to hold the guy's body over the city of Brockton and say, 'What would you have done if I didn't come from 75 miles away to get him?'" Stefan said. "The answer would have been, 'We don't know.' End of story."



That's when — more than 60 days after Ledoux's death and after having earlier rejected his body because his cause of death was self-evident — Stefen received a call from the medical examiner's office, which now wanted Ledoux back for unknown reasons.

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(Kristin LaFratta)

A partial fix

Since its earlier rejection of Ledoux, MassLive has learned, the medical examiner's office had been experimenting with a simple fix, first suggested by Nields: to increase the $1,100 payout on its own unclaimed bodies by $1,000. Bumping up the total reimbursement to $2,100.



Data obtained from the Medical Examiner's office by MassLive suggest the solution worked.



As stated earlier, when the payout was still at $1,100, between January 2014 and January 2016, a total of 186 unclaimed bodies it had remained in the morgue 44 days apiece while the Department of Transitional Assistance attempted to find a funeral director to bury them.



Since the reimbursement on abandoned bodies in the OCME's possession was increased to $2,100, the average stay in the morgue for each of the 150 abandoned bodies it has since received has been cut down to just 8.8 days.



It's only a partial fix. The additional payout does not cover bodies that the examiner has not claimed. Bodies picked up by Stefan and the Lawlers (all those non-suspicious deaths) still receive that same $1,100 payout. Stefan says his funeral home alone handles about 50 abandoned bodies a year.

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Data courtesy OCME

Phil Demers | pdemers@masslive.com

In an interview, Lawler said he and Gov. Charlie Baker spoke in person about the matter.



"He actually thanked us for burying the homeless people," Lawler said. "I explained to him the problem. Within a month, the change had been made."



Other funeral directors interviewed by MassLive were less satisfied with the solution. Notably Stefan, who called the policy "discriminatory."



The Office of the Chief Medical Examiner, he points out, has effectively given preferential treatment to the abandoned bodies it receives, even though the others that the agency rejects, like Ledoux, create problems elsewhere, for other people, who don't have the same access to tax dollars to throw at the problem.



"What's the difference between an abandoned body the medical examiner has versus one I pick up off the street in Worcester?" he said. "They deserve the space more than I do? It's not fair, and I'm not even sure it's legal."



He added, "The fact of the matter is, it's getting impossible to do this anymore at $1,100. What happens if the cemeteries raise their (plot) prices $100, $200?"



Stefan doesn't necessarily propose increasing it.



Instead, he wants state lawmakers to propose new legislation empowering municipal boards of health to deal with future Ledoux scenarios as matters of public health, and have the authority to issue permits to funeral directors allowing them to cremate rather than bury unclaimed cremains after a month, without facing legal liability.



Cremation costs much less than the cheapest cemetery plots available in anywhere in Massachusetts but Fairview Cemetery in Boston.



"This way it forces people to meet the issue head-on, because I can say, 'I'm not looking for a dime out of this,'" Stefan said.

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Workers at Hope Cemetery in Worcester lower the body of a man whose body went unclaimed until Peter Stefan accepted and agreed to bury it, five months after the death. (Kristin LaFratta)

Stefan, who had expected to receive Ledoux's body back from the medical examiner eventually, said he was surprised to find the office never contacted him again about the matter.



In response to a MassLive inquiry about what ever happened to Ledoux, Office of the Chief Medical Examiner spokesman Felix Browne said after the office dispossessed Stefan of his body, the department of Transitional Assistance ended up transferring the remains to Lawler.



Almost six months after his death, on Jan. 23, 2017, Stephen Ledoux was finally laid to rest in West Roxbury, a place that was not his home, because The Society of St. Vincent de Paul Boston had donated a cemetery plot to Lawler.



Of the burial, Lawler said he never knew Stefan had Ledoux's body before he did, adding that he had never heard of another example of the medical examiner taking back a body it had initially refused from a funeral director, if there were no intentions of performing an autopsy.



Stefan maintains it was done because the medical examiner's office had become aware of his intentions to raise issues related to state policy on unclaimed bodies, in court.



"They have no answer," Stefan said. "There's a lot of Stephen Ledouxs."



Reading the ledger details of Ledoux's burial, Lawler said, "he had a small graveside service attended by kids from the Roxbury Latin School, with some prayers and hymns."



He said, "I'm trying to buy my way into heaven, I guess. My father started burying indigent people 70 years ago, and before he passed the business on to my brother and I, he asked us to always keep it going."

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(Kristin LaFratta)

Coming next, Part 2 -- Who buries Massachusetts' poor? State pays so little only a couple of funeral homes will take them

Tomorrow MassLive continues its look at burying the poor with a close examination of what the state pays funeral homes who take abandoned bodies.

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