Advisory council flags DNR regulation complexity and CCEP’s historical role as DPH weighs rewrite
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Summary
Councilors noted the Connecticut College of Emergency Physicians’ historic role in the community DNR program and debated whether DPH should centralize or otherwise revise DNR oversight as part of a regulatory rewrite to avoid conflicts between DNR and MOLST processes.
The council shifted part of the meeting to discuss how community DNR processes and MOLST intersect. Rich Kainen outlined the historical role of the Connecticut College of Emergency Physicians (CCEP) in organizing delivery of DNR orders and distributing orange and metal bracelets that EMS recognizes to uphold DNR orders. "The current DNR process holds integral to it the Connecticut College of Emergency Physicians," Kainen said, noting the relationship was crafted between the department and the organization decades ago.
Participants debated whether the DNR program should be administratively centered under DPH rather than relying on an external professional organization. Dr. Shapiro suggested creating a DNR working group under DPH to simplify program administration and statutory/regulatory relationships; others noted that CCEP’s long-standing involvement and practical delivery role would still be useful. Jim flagged a potential operational gap: if someone with a DNR later executes a MOLST indicating they want CPR, the paperwork could amount to a written revocation and the system needs a mechanism to close the loop back to the original signer.
Barbara Cass said DPH has an internal regulatory-rewrite group and that DPH will include EMS, practitioners and facilities subject-matter experts as it drafts revisions; she proposed adding Dr. Shapiro’s document to the May meeting agenda for group review. "We will establish the subject matter experts at DPH internally who will be part of the internal working group," she said.
No formal votes or regulatory changes were adopted during the meeting; members agreed to continue discussions, circulate background materials that capture the program’s history, and review a draft at the next meeting.
