The Need for Reform to Address Massachusetts’ Indigent Burial Crisis

In Massachusetts, morgues, funeral homes, and hospitals are overwhelmed. This crisis mirrors the broader neglect of the Commonwealth’s most vulnerable citizens. Every year, residents die without family or financial resources, and no one is left to oversee their final arrangements. The burden often falls on hospitals and police departments, or on funeral homes and municipalities, many of which lack the resources to address it.
The Black Tie Coalition (BTC), founded by Massachusetts funeral director and decedent affairs coordinator Matt Mazzuchelli, works tirelessly to address this gap.
“My team and I have worked tirelessly to spread awareness of our mission - there’s just so much wrong with how our state handles this issue,” Mazzuchelli said.
Through advocacy and financial assistance, the nonprofit works to make certain that everyone receives humane disposition after death. The BTC is doing the work the Department of Transitional Assistance (DTA) is failing to do alone, which makes legislative support all the more critical.
“The main issue is it [the DTA’s program] isn’t enough, and I don’t think money and bureaucratic hurdles should stand in the way of dignified burials, ” Mazzuchelli said when asked about the DTA’s currently implemented program.

The Scope of the Crisis
The issue of unclaimed and abandoned bodies is prevalent. The Office of the Chief Medical Examiner (OCME) has over 686 unclaimed individuals listed in the National Missing and Unidentified Persons System (NamUs) as of February 2025, yet this figure excludes thousands of unrecorded cases in hospitals, nursing homes, and police departments. For the majority of individuals that die without OCME intervention, the burden is placed on the unassuming public.
The most affordable burial solutions in Massachusetts start at approximately $3,000; cemetery fees alone often fall in the $1,500 to $4,000 range. With only $1,100 per case available from the state’s burial assistance program, funeral homes must cover the remaining expenses or refuse cases entirely. To further complicate this, total funeral expenses must not exceed $3,500 in order to be eligible for the $1,100.
The Burden on Hospitals and Funeral Homes

Hospitals Strained by Overcrowded Morgues
Many hospitals now find their morgue facilities pushed to capacity due to delayed burials of unclaimed decedents. In some cases, the deceased remain in morgues for extended periods of time. This practice far exceeds the space and resources available for standard operations.
Current options are limited. When a hospital identifies an unclaimed body, staff must go through a process of locating family members and securing financial assistance. Subsequently, when it comes time to coordinate with funeral homes, many facilities are unwilling or unable to take the case. For funeral
homes, working without a next of kin is both a liability and costly. In some cases, funeral directors pay out of pocket just to get the individual laid to rest. This creates an inefficient, costly cycle that diverts hospital resources away from patient care.
Funeral Homes Caught in a Financial Dilemma
For funeral directors, handling indigent cases has become nearly impossible under Massachusetts’ current funding model. The $1,100 reimbursement falls short of covering actual costs and may be reduced based on any assets the deceased might have had, no matter how small.
As a consequence, fewer than four funeral homes in Massachusetts still accept indigent burials. Funeral directors like the late Peter Stefan of Worcester’s Graham Putnam & Mahoney Funeral Home have voiced concerns about the issue; many are forced to store unclaimed bodies for extended periods of time and, when necessary, pay burial costs out of their own pockets.
The Role of The Black Tie Coalition
The BTC has stepped in where the Massachusetts DTA has fallen short. The nonprofit organization works to:
● Fund unclaimed burials by providing financial assistance to funeral homes willing to take on these cases.
● Support families and non-familial guardians who cannot afford funeral costs but want to provide their loved ones with a dignified burial.
● Advocate for systemic change, by increasing state burial assistance and promoting alternative solutions like publicly funded cremation options.
Since its inception in 2024, the BTC has raised over $17,000 yet spent $16,400 covering burial expenses for those most in need. Without legislative reform, the current crisis will increase substantially.
“It’s been a tough journey so far, but even the moderate amount of money we’ve raised has made an incredible impact. Sometimes it feels like a slow process, but I’m determined to help however I can, no matter how long that takes,” said Mazzuchelli, when asked about the organization’s one year anniversary.
The Black Tie Coalition’s services are typically engaged via contact from social workers, religious organizations, hospitals, and sometimes even funeral home’s caught in difficult situations. From there, the organization provides financial assistance, offers guidance, and sees that the individual in need is laid to rest.
When asked what the future goals of the organization are, Mazzuchelli responded,
“My plan right now is to just keep plowing ahead - spread awareness, fundraise as much as possible, and maybe eventually raise enough money for a public, no-cost cemetery. For now, we will just keep doing whatever it takes to give people dignified burials”
Legislative and Policy Solutions
To address the problem, stakeholders must implement both legislative and community-driven solutions. The BTC and other advocates propose the following reforms:
● Increase state burial assistance
The $1,100 burial stipend is grossly inadequate. Adjusting this amount to reflect current burial costs (at least $3,000 to $5,000) would allow funeral homes to take indigent cases without financial hardship.
● Allow for publicly funded cremation
State law currently prohibits cremation without next-of-kin authorization, even for unclaimed decedents. By revising Chapter 114, Section 43M, Massachusetts could allow local Boards of Health to authorize cremation after a reasonable waiting period.
● Create an emergency burial fund for hospitals
A dedicated fund for hospitals handling unclaimed decedents would ease financial strain and make burials more efficient. These changes could significantly ease the overcrowding problem in local morgues.
● Improve funeral home incentives
Tax incentives or subsidies for funeral homes that manage indigent cases could alleviate the bottleneck of unclaimed burials.
● Expand public-private partnerships
Partnerships among the Commonwealth, funeral homes, hospitals, and nonprofit organizations like the BTC could prevent the deceased from being abandoned.
Massachusetts Lives Impacted by the Crisis
While statistics may highlight the scale of Massachusetts’ unclaimed burial crisis, the scope of the issue comes through in the real, human stories of those affected. These case studies, sourced from press materials and a letter to former Governor Charlie Baker, demonstrate where the current system falls short.
A Hospital Morgue Overcrowded with Unclaimed Bodies
Between April 1, 2023, and January 1, 2024, one Massachusetts community hospital documented 909 decedents moving through its morgue, with some bodies staying over 90 days because no funeral home would accept them. The longest stay recorded was 108 days. On two occasions, the emergency morgue was activated due to lack of space.
Due to the Commonwealth’s strict cremation laws under (see Section 13 of Chapter 38), bodies accumulated far past the morgue’s capacity, which forced the hospital to rely on facilities usually reserved for emergency surges. Hospital staff found themselves diverted from patient care to managing an overflow of decedents.
The Man No One Would Claim
In Brockton, a 53-year-old unhoused man named Stephen Ledoux died at a friend’s apartment. His history of opioid addiction and COPD made his death, while tragic, not unexpected.
It also drew attention to serious gaps in the system. When police tried to arrange transport for Ledoux’s body, the Office of the Chief Medical Examiner refused, citing the policy of only investigating violent deaths. Meanwhile, funeral homes turned them away because of inadequate reimbursement rates. As a result, police officers waited more than nine hours with Ledoux’s body before they found someone willing to take him.
The Veteran Whose Family Refused Him
James, an unhoused veteran living near Boston’s infamous “Mass and Cass”, wanted to be cremated — to have his ashes scattered on Cape Cod. His friends Jane and Bill hoped to honor his request, but because James had living relatives who refused to claim him, his friends could not legally authorize his cremation.
In the end, James was buried in a low-cost grave paid for by the hospital. Jane and Bill watched helplessly as bureaucracy overrode this veteran’s final wishes.
The Nursing Home Director’s Plea for Help
At Heritage Hall Nursing Home in Agawam, a resident named Thomas Colligan died. Without family or money, there was no one to claim his body. Nursing home staff made call after call to local funeral homes, but one after another turned them down.
After days of calls, the late Peter Stefan agreed to take Colligan. Stefan, who had gained a reputation as the “funeral director of last resort,” accepted cases that no one else would until his own death in 2022. Even so, he spoke out about how the system places an unfair burden on funeral homes.
A Multigenerational Perspective
In March 2021, William F. Spencer wrote directly to then Governor Charlie Baker about the indigent burial crisis. Spencer’s family has run their funeral home since 1896, starting “in a store front with a horse and hearse.”
“I have been in the funeral business for over forty years and am struggling to understand the Commonwealth's response to those of low socioeconomic class, or lack thereof,” Spencer wrote in the unpublished letter, which the BTC has permission to share. “DTA continuously denies cases, cases that should never be denied, the 50-year-old homeless, struggling addict, and mom of three who overdoses in a Stop and Shop bathroom; the 35-year-old returning citizen who overdoses a month out of prison; the veteran who dies alone in their 1-bedroom apartment.”
Throughout the pandemic, Spencer visited “houses, nursing homes, tent cities, hospital morgues and everywhere in between,” and saw firsthand how under-resourced families struggled with burial costs.
Each of these stories represents a larger crisis. These cases are not isolated incidents. They are happening in rising numbers throughout the Commonwealth, from Boston to Worcester to Brockton.

A Call for Urgent Action
The BTC provides direct financial assistance to those left behind in Massachusetts. However, it can only do so much without legislative intervention and support from the DTA. Without immediate policy change, hospitals, funeral homes, and law enforcement will continue to struggle.
Ultimately, the crisis of unclaimed and indigent burials in Massachusetts is a moral failing on the part of the DTA. The current system leaves the most vulnerable without dignity in death; it forces hospitals and funeral homes into impossible financial decisions. Meanwhile, grieving families are left to grapple with unnecessary burdens as they process their losses.
The Massachusetts House of Representatives must take action. Legislative action is necessary to:
● Increase state burial assistance so funeral homes can take on indigent cases.
● Allow for publicly funded cremation to prevent unnecessary delays.
● Provide financial relief for hospitals overwhelmed by unclaimed bodies.
Until these changes occur, the BTC will continue to fight for those who have no one else to fight for them. For more information, visit www.BlackTieMA.org.