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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. I have been on this program while on parole from 2011-2013. No person should be forced mentally to share private details of their personal life with total strangers. Also giving permission for a mental therapist to report to your parole agent that your not participating in group therapy because you don't have the financial mean to be in the group therapy. I was personally singled out and sent back three times for not having money and also sent back within the six month when you aren't to be sent according to state law. I will work to het this INSOMM's removed from this state. I also had twelve or thirteen parole agents with a fifteen month period. Thanks for your time.

  2. Our nation produces very few jurists of the caliber of Justice DOUGLAS and his peers these days. Here is that great civil libertarian, who recognized government as both a blessing and, when corrupted by ideological interests, a curse: "Once the investigator has only the conscience of government as a guide, the conscience can become ‘ravenous,’ as Cromwell, bent on destroying Thomas More, said in Bolt, A Man For All Seasons (1960), p. 120. The First Amendment mirrors many episodes where men, harried and harassed by government, sought refuge in their conscience, as these lines of Thomas More show: ‘MORE: And when we stand before God, and you are sent to Paradise for doing according to your conscience, *575 and I am damned for not doing according to mine, will you come with me, for fellowship? ‘CRANMER: So those of us whose names are there are damned, Sir Thomas? ‘MORE: I don't know, Your Grace. I have no window to look into another man's conscience. I condemn no one. ‘CRANMER: Then the matter is capable of question? ‘MORE: Certainly. ‘CRANMER: But that you owe obedience to your King is not capable of question. So weigh a doubt against a certainty—and sign. ‘MORE: Some men think the Earth is round, others think it flat; it is a matter capable of question. But if it is flat, will the King's command make it round? And if it is round, will the King's command flatten it? No, I will not sign.’ Id., pp. 132—133. DOUGLAS THEN WROTE: Where government is the Big Brother,11 privacy gives way to surveillance. **909 But our commitment is otherwise. *576 By the First Amendment we have staked our security on freedom to promote a multiplicity of ideas, to associate at will with kindred spirits, and to defy governmental intrusion into these precincts" Gibson v. Florida Legislative Investigation Comm., 372 U.S. 539, 574-76, 83 S. Ct. 889, 908-09, 9 L. Ed. 2d 929 (1963) Mr. Justice DOUGLAS, concurring. I write: Happy Memorial Day to all -- God please bless our fallen who lived and died to preserve constitutional governance in our wonderful series of Republics. And God open the eyes of those government officials who denounce the constitutions of these Republics by arbitrary actions arising out capricious motives.

  3. From back in the day before secularism got a stranglehold on Hoosier jurists comes this great excerpt via Indiana federal court judge Allan Sharp, dedicated to those many Indiana government attorneys (with whom I have dealt) who count the law as a mere tool, an optional tool that is not to be used when political correctness compels a more acceptable result than merely following the path that the law directs: ALLEN SHARP, District Judge. I. In a scene following a visit by Henry VIII to the home of Sir Thomas More, playwriter Robert Bolt puts the following words into the mouths of his characters: Margaret: Father, that man's bad. MORE: There is no law against that. ROPER: There is! God's law! MORE: Then God can arrest him. ROPER: Sophistication upon sophistication! MORE: No, sheer simplicity. The law, Roper, the law. I know what's legal not what's right. And I'll stick to what's legal. ROPER: Then you set man's law above God's! MORE: No, far below; but let me draw your attention to a fact I'm not God. The currents and eddies of right and wrong, which you find such plain sailing, I can't navigate. I'm no voyager. But in the thickets of law, oh, there I'm a forester. I doubt if there's a man alive who could follow me there, thank God... ALICE: (Exasperated, pointing after Rich) While you talk, he's gone! MORE: And go he should, if he was the Devil himself, until he broke the law! ROPER: So now you'd give the Devil benefit of law! MORE: Yes. What would you do? Cut a great road through the law to get after the Devil? ROPER: I'd cut down every law in England to do that! MORE: (Roused and excited) Oh? (Advances on Roper) And when the last law was down, and the Devil turned round on you where would you hide, Roper, the laws being flat? (He leaves *1257 him) This country's planted thick with laws from coast to coast man's laws, not God's and if you cut them down and you're just the man to do it d'you really think you would stand upright in the winds that would blow then? (Quietly) Yes, I'd give the Devil benefit of law, for my own safety's sake. ROPER: I have long suspected this; this is the golden calf; the law's your god. MORE: (Wearily) Oh, Roper, you're a fool, God's my god... (Rather bitterly) But I find him rather too (Very bitterly) subtle... I don't know where he is nor what he wants. ROPER: My God wants service, to the end and unremitting; nothing else! MORE: (Dryly) Are you sure that's God! He sounds like Moloch. But indeed it may be God And whoever hunts for me, Roper, God or Devil, will find me hiding in the thickets of the law! And I'll hide my daughter with me! Not hoist her up the mainmast of your seagoing principles! They put about too nimbly! (Exit More. They all look after him). Pgs. 65-67, A MAN FOR ALL SEASONS A Play in Two Acts, Robert Bolt, Random House, New York, 1960. Linley E. Pearson, Atty. Gen. of Indiana, Indianapolis, for defendants. Childs v. Duckworth, 509 F. Supp. 1254, 1256 (N.D. Ind. 1981) aff'd, 705 F.2d 915 (7th Cir. 1983)

  4. "Meanwhile small- and mid-size firms are getting squeezed and likely will not survive unless they become a boutique firm." I've been a business attorney in small, and now mid-size firm for over 30 years, and for over 30 years legal consultants have been preaching this exact same mantra of impending doom for small and mid-sized firms -- verbatim. This claim apparently helps them gin up merger opportunities from smaller firms who become convinced that they need to become larger overnight. The claim that large corporations are interested in cost-saving and efficiency has likewise been preached for decades, and is likewise bunk. If large corporations had any real interest in saving money they wouldn't use large law firms whose rates are substantially higher than those of high-quality mid-sized firms.

  5. The family is the foundation of all human government. That is the Grand Design. Modern governments throw off this Design and make bureaucratic war against the family, as does Hollywood and cultural elitists such as third wave feminists. Since WWII we have been on a ship of fools that way, with both the elite and government and their social engineering hacks relentlessly attacking the very foundation of social order. And their success? See it in the streets of Fergusson, on the food stamp doles (mostly broken families)and in the above article. Reject the Grand Design for true social function, enter the Glorious State to manage social dysfunction. Our Brave New World will be a prison camp, and we will welcome it as the only way to manage given the anarchy without it.

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