Page 1 of 5 STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH HEALTHCARE QUALITY AND SAFETY BRANCH In Re: Heather Alfonso, A.P.R.N. Petition No. 2012-1112 CONSENT ORDER WHEREAS, Heather Alfonso (hereinafter "respondent") of Middlebury, connecticut has been issued license number 004657 to practice as an advanced practice registered nurse by the Department of Public Health (hereinafter "the Department") pursuant to Chapter 378 of the General Statutes of A Connecticut, as amended; and, WHEREAS, the Department alleges that: 1. On seven occasions in 2012, during the course of providing opioid therapy for a chronic non- cancer pain patient, respondent failed to personally examine said patient prior to renewing the patient?s narcotic pain medication(s) and instead inappropriately relied upon a physical I examination delegated to an unlicensed medical assistant. 2. The above described facts constitute grounds for disciplinary action pursuant to the General Statutes of Connecticut, including but not limited to WHEREAS, respondent, in consideration of this Consent Order, has chosen not to contest the above allegations at a hearing front of the Board of Examiners for Nursing (hereinafter "the Board"). I i violated any statute or regulation, including but not limited to ?20?99(bj of the General Statutes of Connecticut. Respondent further agrees that this Consent Order shall have the same effect as if ordered after a ?ll hearing pursuant to ??19a~9, 19a-10, and 20?99(3) of the General Statutes of Connecticut. BOENCO Page 2 of 5 WHEREAS, respondent has successfully completed courses in Safe and Effective Opioid Prescribing for Chronic Pain, APRN Scope of Practice and Delegating to Unlicensed Assistive Personnel. NOW THEREFORE, pursuant to ?l9a?17 and ?20?99(a) of the General Statutes of Connecticut, respondent hereby stipulates and agrees to the following: 1. Respondent waives her right to a hearing on the merits of this matter. 2. Respondent shall comply with all federal and state statutes and regulations applicable to her profession. 3. Respondent's license number 004657 to-practice as an'advanced practice registered nurse in the State of Connecticut is hereby reprimanded. 4. Respondent shall pay a civil penalty of two thousand dollars by certi?ed or cashier?s check payable to ?Treasurer, State of Connecticut.? The check shall reference the Petition Number on the face of the check, and shall be payable at the time respondent submits the executed Consent Order to the Department. 5. All correspondence and reports shall be addressed to: Practitioner Compliance and Monitoring Unit Department of Public Health 410 Capitol Avenue, MS PO. Box 340308 Hartford, CT 06134-0308 deemed suf?cient if sent to respondent?s last known address the Practitioner Licensing and Investigations Section of the Healthcare Quality and Safety Branch of the Department. BOENCO .. .. . . . . . rum-7n? let?=3 Page 3 of 5 7. This Consent Order is effective on the day on which this Consent Order is approved and accepted by the Board. 8. Respondent understands this Consent Order is a matter ofpublic record. 9. The Department's allegations as contained in this Consent Order shall be deemed true in any subsequent proceeding before the Board in which (1) her compliance with this same order is at issue, or (2) her compliance with ?20-99(b) of the General Statutes of Connecticut, as if 1i amended, is at issue. Further, reSpondent understands that any discipline imposed by this Consent Order shall be reported to the National Practitioner Data Bank and the Healthcare Integrity and Practitioner Data Bank maintained by the United States Department of Health and Human Services. 10. This Consent Order and terms set forth herein are not subject to reconsideration, collateral attack or judicial review under any form or in any forum. Respondent understands that this I Consent Order shall not be subject to modi?cation as a result of any claim that the terms contained herein may result in action by third parties, including, but not limited to, healthcare facilities and/or credentialing or licensure boards. Respondent assumes all responsibility for assessing such actions prior to the execution of this document. Further, this Consent Order is not subject to appeal or review under the provisions of Chapters 54 and 368a of the General Statutes of Connecticut, provided that this stipulation shall not deprive respondent of any other rights that reSpondent-may have, under the laws of the State of Connecticut or of the United states?; I I 11. Respondent permits a representative of the Department to present this Consent Order and the factual basis for this Consent Order to the Board. The Department and respondent understand that the Board has complete and ?nal discretion as to whether an executed Consent Order is BOENCO G's 12. 13. 14. 15. Page 4 of5 approved or accepted. Respondent hereby waives any claim of error that could be raised that is related to or arises during the course of the Board?s discussions regarding whether to approve or reject this Consent Order andfor a Board member?s participation during this process, through the Board member?s review or comments, including but not limited to bias or reliance on evidence outside the administrative record if this matter proceeds to a hearing on a statement of charges resulting in a proposed decision and/or a ?nal decision by the Board. This Consent Order is a revocable offer of settlement, which may be modi?ed by mutual agreement or withdrawn by the Department at any time prior to its being executed by the last signatory. Respondent has had the opportunity to consult with an attorney prior to signing this document. The execution of this document has no bearing on any criminal liability without the written consent of the Director of the Medicaid Fraud Control Unit or the State?s Attorney?s Of?ce where the allegation occurred or Bureau Chief of the applicable unit in the Chief State?s Attorney?s Office. The purpose of this Consent Order is to resolve the pending administrative license disciplinary petition only, and is not intended to affect any civil or criminal liability or defense. This Consent Order embodies the entire agreement of the parties with respect to this case. All previous communications or agreements regarding the subject matter of this consent order, :--whether-. oral or written; between the parties are superseded unless expressly incorporated 1 herein er made a part hereof. BOENCO Aunt-1:2: Page 5 of 5 1, Heather Alfonso, have read the above Consent Order, and I agree to the terms set forth therein. I ?thher declare the execution of this Consent Order to be my free act and deed. ether lfonso Subscribed and sworn to before me this i day of Junk . 2014? ublic or person authorized by law to administer an oath or af?rmation The above Consent Order having been presented'to the duly appointed agent of the Commissioner of the Department of Public Health UUNL, hereby accepted. . 2014, it is raw - M614 Kathleen Boulware, RN, Public Health Services Manager Practitioner Licensing and Investigations Healthcare Quality and Safety Branch The above Consent Order having been presented to the duly appointed agent of the Connecticut rt? 1. . . Board of Examiners for Nursing on the m3 day of 1 ??41 2014, It is I- I ordered and accepted. BY: Connecticut Board of Ex' a. bMXa ers for Nursing S:ll?r?AlFonso BOENCO GS