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Hospital general counsel enjoys diverse workload

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In-House Counsel

After spending 12 years in the health-care field as an X-ray technician, an in-house counsel for a hospital network in Indianapolis seems to be in the right place.

Shelley Fraser has been at Community Health Network for almost two years after hearing about the job from a neighbor of someone who worked in Community’s legal department. At that time, she’d been working for the firm now known as Taft Stettinius & Hollister for about five years, where she practiced health-care law.

shelley fraser Shelley Fraser, in-house counsel for Community Health Network in Indianapolis, went to law school to pursue a practice in health-care law after being an X-ray technician for 12 years. (IBJ Photo/ Perry Reichanadter)

Her main interest in going to law school was to practice something in the field of health care, so she enjoyed that job where she had experience with transactional and regulatory work in the health-care field.

But she was also excited for a new opportunity and ready for a change where she could focus on just one client. She also saw potential of being able to spend more time with her family – she was pregnant at the time – and spend less time worrying about billable hours and business development. She added this doesn’t mean she has any less work – if anything she might have more work – but it’s also faster paced and more focused because she only has the one client.

Today, as assistant general counsel to Community Health Network, she splits her time between an office at Community Hospital East and another office at Visionary Enterprises Inc.

“VEI is essentially the innovative development arm of the network – it owns and manages numerous ambulatory surgery centers, manages physician practices, and owns and manages real estate in addition to many other business ventures,” she said.

Each of those offices also has a member of the legal department who is there full time – Karen Ann Lloyd is at Community Hospital East, and Karen Turner is at VEI. The three of them oversee the legal issues of the network that includes 11,000 employees around central Indiana. She also said the three attorneys work well together, and she never feels isolated.

“It’s more of a team environment,” she said. “We don’t collaborate on everything, but we always support each other.”

There are five hospitals, plus more than 90 sites of care, which have a wide range of legal issues, she said.

In her role, she continues to work on transactional and regulatory compliance, but she and other general counsels also address tax, employment, mental health issues, and even criminal questions. She said the work is diverse and no two days are ever alike.

While she doesn’t often use her clinical background in her day-to-day work, she said it does help her understand how a hospital works, including the importance of focusing on the needs of patients.

She also said as a member of the risk-management team for the hospital network, even though things have changed since she was in the field, when she works with nurses she at least has an understanding of what they do because of her background.

While it doesn’t happen every day, from time to time she is able to affect patients’ lives directly – something she misses from her time as an X-ray technician. This usually only happens when she receives a call from the intensive care unit regarding a patient who is incapacitated and a decision needs to be made about the patient’s treatment, even if there’s no clearly defined person who can speak on behalf of the patient.

They’re never easy choices to make, she said. She can tell the physician the ethical or legal ways to handle the situation, but there isn’t always a clear answer one way or the other.

She has also learned about mental-health legal issues as the network has a number of patients with these concerns. For instance, the legal aspects of the commitment process, such as when someone can be constrained; what happens if the person needs medication but cannot give consent and who can give that consent; guardianship and power of attorney issues; the network’s role in cases involving child protective services and adult protective services; when mental-health records can be released; what records can be released when it comes to alcohol and substance abuse; duty to warn issues when it comes to issues like HIV reporting; and what can or can’t be shared in therapy sessions involving support groups.

While most of the physicians and others in the network have seen a lot of these firsthand and know many of the answers themselves, she said, “They already know the easy answers. By the time the question gets to me, there’s some kind of twist to it that’s unusual from what they usually see.”

She said among the issues she’s seen, some of the harder ones to address involve forced medication and consent issues, including controversial procedures or even when the issue of patient sterilization arises.

The hospital network has also worked with court programs. While those programs run on their own, she said the legal department has reviewed some of the forms to make them in compliance with what can and can’t be disclosed to the court regarding mental-health issues.

She added a number of people who work for the hospital have been there 20 or 30 years, and can also provide institutional knowledge when needed. Or when changes need to take place – as they have under health-care reform over the past couple years since Fraser started – others in the hospital can serve as a good reference when it comes to what has or hasn’t worked in the past.

“As the health-care industry is being revamped and redesigned, it’s a great opportunity to improve processes,” she said. “Our goal is to have better patient care and better access, and we’re analyzing how to make those changes over the next couple years.”

Among those changes are how to make records more high tech and in compliance with the Health Insurance Portability and Accountability Act, but because the hospital network is already connected, one concern is if the requirements are somehow different from what the network already does.

Fraser remains in touch with her mentor, Dave Bromund, a partner at Taft Stettinius & Hollister.

“Shelley was an important member of our health and life sciences group,” he said via e-mail. “We were sorry to see her move on, but understood that she was getting a great opportunity at Community. While she was here, she had a quiet confidence and maturity beyond her years in practice that clients loved. Some of that was due to her background in the health-care industry, but much of it was her great personality. She was a great problem-solver and saw issues from the client’s perspective. Again, this may be due, in part, to her prior industry experience. Her success and rapid progress to more significant and complex work came from her own hard work, solid critical thinking skills and good sense to ask the right questions.

“Shelley also showed her own initiative to get involved in the leadership of the American Bar Association’s task force on women’s issues,” he added. “She was passionate about helping women with breast cancer and focused her pro bono efforts on this cause.”•

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  1. Yes diversity is so very important. With justice Rucker off ... the court is too white. Still too male. No Hispanic justice. No LGBT justice. And there are other checkboxes missing as well. This will not do. I say hold the seat until a physically handicapped Black Lesbian of Hispanic heritage and eastern religious creed with bipolar issues can be located. Perhaps an international search, with a preference for third world candidates, is indicated. A non English speaker would surely increase our diversity quotient!!!

  2. First, I want to thank Justice Rucker for his many years of public service, not just at the appellate court level for over 25 years, but also when he served the people of Lake County as a Deputy Prosecutor, City Attorney for Gary, IN, and in private practice in a smaller, highly diverse community with a history of serious economic challenges, ethnic tensions, and recently publicized but apparently long-standing environmental health risks to some of its poorest residents. Congratulations for having the dedication & courage to practice law in areas many in our state might have considered too dangerous or too poor at different points in time. It was also courageous to step into a prominent and highly visible position of public service & respect in the early 1990's, remaining in a position that left you open to state-wide public scrutiny (without any glitches) for over 25 years. Yes, Hoosiers of all backgrounds can take pride in your many years of public service. But people of color who watched your ascent to the highest levels of state government no doubt felt even more as you transcended some real & perhaps some perceived social, economic, academic and professional barriers. You were living proof that, with hard work, dedication & a spirit of public service, a person who shared their same skin tone or came from the same county they grew up in could achieve great success. At the same time, perhaps unknowingly, you helped fellow members of the judiciary, court staff, litigants and the public better understand that differences that are only skin-deep neither define nor limit a person's character, abilities or prospects in life. You also helped others appreciate that people of different races & backgrounds can live and work together peacefully & productively for the greater good of all. Those are truths that didn't have to be written down in court opinions. Anyone paying attention could see that truth lived out every day you devoted to public service. I believe you have been a "trailblazer" in Indiana's legal community and its judiciary. I also embrace your belief that society's needs can be better served when people in positions of governmental power reflect the many complexions of the population that they serve. Whether through greater understanding across the existing racial spectrum or through the removal of some real and some perceived color-based, hope-crushing barriers to life opportunities & success, movement toward a more reflective representation of the population being governed will lead to greater and uninterrupted respect for laws designed to protect all peoples' rights to life, liberty & the pursuit of happiness. Thanks again for a job well-done & for the inevitable positive impact your service has had - and will continue to have - on countless Hoosiers of all backgrounds & colors.

  3. Diversity is important, but with some limitations. For instance, diversity of experience is a great thing that can be very helpful in certain jobs or roles. Diversity of skin color is never important, ever, under any circumstance. To think that skin color changes one single thing about a person is patently racist and offensive. Likewise, diversity of values is useless. Some values are better than others. In the case of a supreme court justice, I actually think diversity is unimportant. The justices are not to impose their own beliefs on rulings, but need to apply the law to the facts in an objective manner.

  4. Have been seeing this wonderful physician for a few years and was one of his patients who told him about what we were being told at CVS. Multiple ones. This was a witch hunt and they shold be ashamed of how patients were treated. Most of all, CVS should be ashamed for what they put this physician through. So thankful he fought back. His office is no "pill mill'. He does drug testing multiple times a year and sees patients a minimum of four times a year.

  5. Brian W, I fear I have not been sufficiently entertaining to bring you back. Here is a real laugh track that just might do it. When one is grabbed by the scruff of his worldview and made to choose between his Confession and his profession ... it is a not a hard choice, given the Confession affects eternity. But then comes the hardship in this world. Imagine how often I hear taunts like yours ... "what, you could not even pass character and fitness after they let you sit and pass their bar exam ... dude, there must really be something wrong with you!" Even one of the Bishop's foremost courtiers said that, when explaining why the RCC refused to stand with me. You want entertaining? How about watching your personal economy crash while you have a wife and five kids to clothe and feed. And you can't because you cannot work, because those demanding you cast off your Confession to be allowed into "their" profession have all the control. And you know that they are wrong, dead wrong, and that even the professional code itself allows your Faithful stand, to wit: "A lawyer may refuse to comply with an obligation imposed by law upon a good faith belief that no valid obligation exists. The provisions of Rule 1.2(d) concerning a good faith challenge to the validity, scope, meaning or application of the law apply to challenges of legal regulation of the practice of law." YET YOU ARE A NONPERSON before the BLE, and will not be heard on your rights or their duties to the law -- you are under tyranny, not law. And so they win in this world, you lose, and you lose even your belief in the rule of law, and demoralization joins poverty, and very troubling thoughts impeaching self worth rush in to fill the void where your career once lived. Thoughts you did not think possible. You find yourself a failure ... in your profession, in your support of your family, in the mirror. And there is little to keep hope alive, because tyranny rules so firmly and none, not the church, not the NGO's, none truly give a damn. Not even a new court, who pay such lip service to justice and ancient role models. You want entertainment? Well if you are on the side of the courtiers running the system that has crushed me, as I suspect you are, then Orwell must be a real riot: "There will be no curiosity, no enjoyment of the process of life. All competing pleasures will be destroyed. But always — do not forget this, Winston — always there will be the intoxication of power, constantly increasing and constantly growing subtler. Always, at every moment, there will be the thrill of victory, the sensation of trampling on an enemy who is helpless. If you want a picture of the future, imagine a boot stamping on a human face — forever." I never thought they would win, I always thought that at the end of the day the rule of law would prevail. Yes, the rule of man's law. Instead power prevailed, so many rules broken by the system to break me. It took years, but, finally, the end that Dr Bowman predicted is upon me, the end that she advised the BLE to take to break me. Ironically, that is the one thing in her far left of center report that the BLE (after stamping, in red ink, on Jan 22) is uninterested in, as that the BLE and ADA office that used the federal statute as a sword now refuses to even dialogue on her dire prediction as to my fate. "C'est la vie" Entertaining enough for you, status quo defender?

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