LOUISVILLE, Ky. (AP) -- Kate Hopkins didn't know the man in the casket, never met him or his family. Yet, Hopkins stood watch over 48-year-old Francisco Carmona's funeral on a gray, cold day at a county-owned cemetery in south Louisville.
Hopkins joined a group of high school students, a few county employees and a deputy coroner Feb. 6 to ensure Carmona, who died in January in a Louisville hospital with no family or friends, had a service -- the 91st service for the poor in Louisville since Nov. 1.
"We don't come into the world alone. We shouldn't leave it alone," Hopkins said of her practice of attending funerals for paupers since her son first volunteered six years ago.
Counties across Kentucky, like much of the country, are seeing more cases of unclaimed bodies and families who can't afford to bury or cremate a loved one. Every situation is unique, but coroners and local government officials tell a similar story: The economic downturn has left many people without the money to pay for funeral services that can cost thousands of dollars, and it's falling on cities and states to cover the bills.
"You see them more and more because of the economy and people in dire states with financial problems," said Kevin Kirby, a funeral home owner who doubles as the Warren County Coroner in Bowling Green.
No organization or state tracks the number of indigent burials. For this story, The Associated Press interviewed coroners, medical examiners, and experts from professional associations in states and counties across the country.
How unclaimed remains are handled varies by state, and in many cases, in which county the person dies. Sixteen states now subsidize the burial or cremation of unclaimed bodies, including Illinois, Massachusetts, West Virginia and Wisconsin. Most of the state programs provide disposition services to people on Medicaid, a cost that has grown along with Medicaid rolls. Chicago has used mass graves and in Los Angeles, bodies are routinely cremated. Kentucky gives counties an option of burying the deceased or obtaining a court order to have the remains cremated.
In Tennessee, medical examiner and coroners' offices donate unclaimed remains to the Forensic Anthropological Research Center, known as the "Body Farm," where students study decomposition at the University of Tennessee. The facility has had to stop accepting the donations at times in recent years because it received so many. In South Dakota, indigent burial costs rose to a point that the governor signed a bill in March allowing counties to have remains cremated, in part to help control costs that were busting the budgets of some counties.
All the costs "can be a problem for medical examiners around the country," Dr. Gregory A. Schmunk, the Polk County Medical Examiner in Des Moines, Iowa, and president of the National Association of Medical Examiners.
The U.S. economy fell into a deep recession in 2008 -- a dip it has slowly been pulling out of. Nationally, the unemployment rate is 7.9 percent.
The cost of a regular adult funeral is about $6,500, according to the National Funeral Directors Association. This includes everything but cemetery, monument or marker costs and miscellaneous charges such as flowers or obituaries. Monuments or markers sell for anywhere from $300 for a small marker to several thousand dollars for a larger headstone, while flowers cost anywhere from $50 to $250.
Funeral homes are generally cooperative in setting up a burial if the body goes unclaimed, but balk at the expense, Kirby said.
"Some will not do them," Kirby said. "We feel like we should. They deserve a burial like everyone else."
In Kentucky, counties are required to pick up the bill for indigent funerals, something that causes occasional budget busting.
Buddy Dumeyer, a Louisville deputy coroner who runs the indigent burial program, has seen the annual number of pauper burials in Jefferson County jump from 65 in 2005 to 300 in 2012. The deaths cover everything from families who cannot afford a funeral to people with no one to claim their remains.
In Kentucky, many coroners will advertise in a local newspaper that they are looking for the next of kin for a deceased person whose remains have not been claimed. In Carmona's case, no one related to him or who knew him came forward, Dumeyer said.
"We didn't get a single call on him, not one," Dumeyer said.
Carmona's hospital records indicate he had no social security number and did not speak English, Dumeyer said. The records said Carmona had arrived at an emergency room on Jan. 8 complaining of abdominal pain, but did not indicate how he had traveled there. He was admitted, and, two weeks later, he was dead.