DIVERSITY GROWING: Leadership programs for Republicans and Democrats show success in Indiana elections

By Marilyn Odendahl

The Indiana Citizen

January 15, 2024

Tiffanie Ditlevson knew how to reassure her constituent.

Ditlevson had knocked on a front door as part of her campaign for Fishers City Council in 2023 and when the man inside said, “hello” – but kept the door closed – she began her spiel anyway, greeting him and announcing she was running for office. The man then interrupted with a forceful, “no.”

“I said, ‘I’m a Republican,’” Ditlevson recalled. “And we both laughed and he opened the door.”

Although Ditlevson describes herself as a conservative Republican, she realizes, as a Black woman, that she does not look like the GOP stereotype. She is a veteran of the U.S. Air Force, a business professional and single mother, who, she said, ran for office so she could share ideas with others about how to make their community better.

“At the end of the day, that’s what politics is supposed to be. It’s supposed to be the competition of ideas,” Ditlevson said. “It’s not supposed to be the most likes, the loudest who’s on TV. It’s, ‘Are we having conversations that are going to improve the world around us?’”

However, despite her success in the military and the corporate world, Ditlevson did not know how to politic. She was unversed in the etiquette and protocols of building relationships and running for office.

One program that helped her is the Indiana Republican Diversity Leadership Series, operated by the Indiana Republican Party. Ditlevson said the program gave her the opportunity to build relationships with elected officials and leaders in the state and learn from them.

“That’s the thing about the diversity series is that there are a lot of wonderful, conservative people of color, from many different backgrounds, but often the path is unclear because sometimes, even in 2023, we could be the first to do something,” Ditlevson said. “(The leadership of the Indiana Republican Party) did a really great job of building a program that exposed us to a lot of things to help us become more successful.”

Both the Indiana Republican Diversity Leadership Series and Hoosier Women Forward, a leadership training program for Democratic women, are celebrating historic firsts tallied in 2023, while they are also focusing on 2024 and a goal of accomplishing more.

The Indiana Republican Party championed the female mayor of Greencastle, who also was the first Republican mayor elected in that community in 38 years. In addition, the IRDLS saw six of its graduates on the ballot and wins by alumni Ditlevson and Ronald Morrell, the first Black mayor of Marion.

Hoosier Women Forward, not affiliated with the Democratic Party, noted 18 of its alumnae were on the ballot in 2023 and 12 won their races. The Indiana Democratic Party also commended three women who won mayoral races and became the first Black leaders in Evansville, Michigan City and Lawrence.

“Hoosiers are facing a lot of struggles right now,” Elise Shrock, Hoosier Women Forward board of directors’ chair, said. “It’s important that we have the best minds and the hardest workers at the take to make sure we can fix some of those problems and our women are a huge part of how those conversations will be successful.”

Making a bigger tent

According to the biographies on the websites, the past and current participants of either program are already leaders in their professional careers and their communities, building businesses, founding nonprofits, and, as Ditlevson noted, often creating paths for others to follow.

The Diversity Leadership Series and Hoosier Women Forward are months-long programs that teach the participants about their respective parties’ platforms and policies as well as how the political party structure functions. Throughout the course, the participants routinely meet and interact with elected officials and community leaders.

Whitley Yates, director of diversity and engagement for the Indiana Republican Party, described the IRDLS as teaching “politics from the grassroots to the grass tops.” She said the program’s goal is simple: to create a bigger tent, so more people, especially those from underrepresented communities and marginalized groups, can find a place within the Republican Party.

However, Yates noted, some minorities are ostracized by their communities when they align with the GOP.

“Being Black and Republican, being Latino and Republican, is almost seen as a traitor to some people, because there is a common misconception that you can tell how someone votes by the color of their skin and we simply don’t believe that to be true,” Yates said. “It’s the character, the morals, and the principles that really guide who you are politically.”

Ronald Morrell, a graduate of the leadership program, won the November election to become the first Black Republican mayor of Marion. Growing up in Marion and attending a Pentecostal church, Morrell said he was raised in a conservative home that believed in “faith, family and hard work.” The Republican label did not come until he developed his political aspirations.

Since his success at the ballot box, Morrell said he has been surprised by the number of people who have messaged him on social media, saying they wanted to join the GOP.  He is witnessing a new hope and a new light in the Republican Party that, he said, he had not seen before.

The GOP will prosper, he said, by welcoming all who agree with the fundamental philosophy of the party.

“Diversity for just diversity’s sake, to meet a quota, is a terrible idea. You’ll never be authentically diverse,” Morrell said. “So I think the benefit of any organization becoming authentically diverse and organically diverse, is you become a reflection of what the United States is supposed to be. … The United States to me is a melting pot, all these people coming together are supposed to function together.”

The Indiana Republican Party’s push to expand its tent comes as minority populations are growing across the state. According to 2020 U.S. Census data, the number of Hoosiers identifying as white declined by 3.1%, while the number identifying as Asian, Black and Hispanic increased by 64.3%, 9.5% and 42.2%, respectively.

The Indiana Business Research Center at Indiana University Kelley School of Businesses reviewed the census data and drew two conclusions:  “Indiana continues to grow more diverse” and “the state has long been more diverse than we previously understood.”

Better policymaking through diverse viewpoints

For Hoosier Women Forward, the focus comes from what Shrock said was the need to create a support network for Democratic women. Women in the program are already leaders in their communities, she said, but they are given an opportunity to sharpen their skills through HWF and create an infrastructure to assist them as they move higher whether in public office or in the boardroom.

Creating space in the Democratic Party for more women, Shrock said, will bring more diversity in viewpoints and experiences that will ultimately strengthen the party.

“We have women from so many different parts of the state, so many different perspectives and we know that our communities receive better policymaking when we have those different types of women at the table,” Shrock said.

Arielle Brandy, deputy director of the Indiana Democracy Collective/Indiana Progress, is a graduate of the HWF class of 2018-19. She has used the skills and knowledge she learned in the program to help others, especially people of diversity, run for office.

Most recently, she worked on the successful 2023 campaign of Bianca Tirado, who is now the first openly gay woman – and Afro-Latino – to serve as South Bend’s city clerk. Brandy was also part of the campaigns of ZeNai Brooks, the Democratic nominee for Indiana auditor in 2022, and of former South Bend mayor Pete Buttigieg, who, in 2020, became the first openly gay man to launch a major campaign for president.

Asked if the victories of diverse candidates in 2023 indicate that programs like Hoosier Women Forward and the Indiana Republican Diversity Leadership Series are now not needed as much, Brandy smiled. The hard work, she said, is not done.

“We are making a lot of great, impacting success, but the fact that we have to say ‘the first’ in so many of these roles, we’re like ‘Ugh, what are we not doing,’” Brandy said, adding that Hoosier Women Forward wants women in minority communities all over Indiana to realize that they can run for office. “And then it becomes so normal for us to see people from all of these backgrounds in these positions and that’s just what our state is.”

Bright ideas, hard work

Hoosier Women Forward and the Indiana Republican Diversity Leadership Series are each intent on preparing its participants for the hard knocks and high stress of being leaders, Shrock and Yates said. The programs teach their graduates to become substantive leaders who help communities advance rather than just bei

ng symbols of diversity.

Now that they are in office, both Ditlevson and Morrell acknowledged they are under more pressure since they are trailblazers. The leadership programs, they said, gave them the skills to be not only successful candidates but also elected officials who can build coalitions to tackle their communities’ challenges.

As they start their terms, Ditlevson and Morrell are motivated by energy and ideas.

Ditlevson has been developing a concept for “family zones,” which would steer tax credits to neighborhoods where many households are led by single parents and struggling with low income and low literacy rates. Morrell is launching an initiative to restore his community’s pride by cleaning up blight through tearing down dilapidated homes and picking up cigarette butts and plastic bottles in the streets.

“I was just telling somebody, ‘What does all this press matter and all these folks and accomplishments matter, if I get into the office and we don’t do anything for this community,’” Morrell said. “So our main goal is to take the energy that’s coming, both positive and negative, from local, state and national (sources), and turn it into a success story for our citizens.”

FOOTNOTE: Dwight Adams, a freelance editor and writer based in Indianapolis, edited this article. He is a former content editor, copy editor and digital producer at The Indianapolis Star and IndyStar.com, and worked as a planner for other newspapers, including the Louisville Courier Journal.

STARK LAW: Community Health Network agrees to multi-million settlement linked to alleged ‘fraudulent scheme

JANUARY 16, 2024

Community Health Network, headquartered in Indianapolis, has agreed to pay $345 million to settle allegations that it violated the False Claims Act by knowingly submitting claims to Medicare for services that were referred to its facilities in violation of the Stark Law.

The U.S. Attorney’s office for the Southern District of Indiana announced the settlement Tuesday.

Not only is this the second False Claims Act Community has settled with the government, after paying $20.3 million to settle allegations of misconduct  in 2015, this is believed to be the largest Stark Law False Claims Act settlement. The $345 million is nearly triple the largest prior settlement of $115 million with Adventist Health System in North Carolina, according to a news release from DeLaney & DeLaney, an Indianapolis law firm that assisted the whistleblower in this case.

“When doctors refer patients for CT scans, mammograms, or any other medical service, those patients should know the doctor is putting their medical interests first and not their profit margins,” said Zachary A. Myers, U.S. Attorney for the Southern District of Indiana. “The United States alleged that Community Health Network overpaid its doctors, and that it paid doctors bonuses based on the amount of extra money the hospital was able to bill Medicare through doctor referrals. Such compensation arrangements erode patient trust and incentivize unnecessary medical services that waste taxpayer dollars.”

The government did not disclose how much CHN received from its alleged “fraudulent scheme.” However, the government’s intervening complaint said “CHN received millions of dollars in Medicare reimbursement to which it was not entitled.”

Community Health Network has 10 hospitals in its organization, according to its website. Six are in Indianapolis with others in Anderson, Kokomo, Anderson and Brownsburg.

As part of the settlement, CHN will enter into a five-year corporate integrity agreement with the Office of the Inspector General for the Department of Health and Human Services. Terms of the agreement include the appointment of a compliance officer, creation of procedures to ensure compliance with the Anti-Kickback Statute and Stark Law, and hiring a law firm or consulting firm to perform claims review.

“HHS-OIG remains steadfast in our efforts to protect our health care programs and the people they serve, including holding those accountable who violate the Stark Law,” said Deputy Inspector General for Investigations Christian J. Schrank of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). “Our work will not cease here.”

Under the Stark Law, hospitals are prohibited from billing Medicare for certain services to patients who were referred by physicians who, in turn, have a “financial relationship” with the hospitals. The U.S. alleged that Community was paying some physicians – including cardiologists, cardiothoracic surgeons, vascular surgeons, neurosurgeons, and breast surgeons – well above fair market value, awarding bonuses to physicians based on the number of patient referrals and submitting claims to Medicare for services that resulted from the unlawful referrals.

Community Health Network issued statement, saying the matter involved “alleged technical violations” and the settlement resolves the government’s claims with “no finding of wrongdoing.” The health-care provider also emphasized it is committed to patient care.

“This is completely unrelated to the quality and appropriateness of the care Community provided to patients,” said Community spokesperson Kris Kirschner. “This settlement, like those involving other health systems and hospitals, relates to the complex, highly regulated area of physician compensation. Community has consistently prioritized the highest regulatory and ethical standards in all our business processes.”

Whistleblower case

The settlement follows the False Claims Act lawsuit Thomas Fischer, former Community chief financial officer, filed against the health-care provider in 2014. Fischer is a whistleblower who filed the complaint against his former employer on behalf of the U.S. government. In his compliant, he alleged Community Health Network defrauded the federal government and the state of Indiana by improperly compensating physicians to get them to refer patients, including Medicare and Medicaid patients, to its hospitals and associated medical facilities for medical services.

The U.S. Department of Justice intervened in Fischer’s case in 2019 and filed its own complaint. The settlement resolves the government’s complaint. Fischer’s case against Community is continuing over similar allegations of fraud, as well as his individual employment and retaliation claims.

Fischer disputed Community’s characterization of the violations.

“I am grateful for this recovery,” Fischer said in a press release. “These claims are not mere technicalities; they directly affect patients, hospital employees and the high cost of healthcare. This puts money back into the healthcare system and is a victory for the Indiana taxpayer.”

Fischer is represented by attorneys from Joseph Greenwald & Laake, Preti Flaherty Beliveau & Pachios, Lite DePalma and local employment counsel Kathleen DeLaney of DeLaney & DeLaney, in Indianapolis.

Compensating for referrals

According to the government’s intervening complaint, CHN began an “aggressive campaign to recruit physicians for employment” starting in 2008 and 2009 and particularly after Bryan Mills became the hospital’s CEO.

Many of the physicians already had staff privileges or practiced at CHN and were referring patients there, but the government alleged, they were recruited and employed by CHN to prevent them from making referrals to local competing hospitals. CHN lured “hundreds of physicians” by paying salaries that were significantly higher than both what they were receiving through their own practices and the fair market value.

Valuations of the compensation by outside accounting firms put the amounts at or above the 90^th percentile of the market data, the government stated in its complaint. In an analysis of CHN payments to physicians in 2012 and part of 2013, Indianapolis accounting firm Katz Sapper & Miller described the compensation as “staggering.”

CHN boosted its employment rolls to capture more Medicare reimbursements, according to the government. The Medicare reimbursements to hospitals are higher when the medical services are provided in the hospital, instead of at a physician’s office, the government said.

Consequently, CHN stood to receive more Medicare dollars for the same services, because the employee-physicians would instead be referring patients directly to the hospital for medical services, the government said.

Along with paying high salaries, CHN also awarded “incentive compensation” to physicians based on the “volume or value of referrals,” according to the government.

“Compliance with the Stark Law goes to the essence of Medicare’s bargain with participating healthcare providers,” the government stated in its intervening complaint. “The Stark Law plays a key role in ensuring that services are reasonable and necessary, and not provided merely to enrich the parties in a financial relationship at the expense of federal health programs and their beneficiaries.”

Among the causes of action, the government alleged three violations of the False Claims Act. The government alleges, in particular, CHN submitted false claims for payments and made and used false records or statements “with reckless disregard or deliberate ignorance of whether or not they were false.”

Fischer’s co-counsel, Tim McCormack from Preti Flaherty Beliveau & Pachios, credited his client with stopping CHN’s alleged unlawful actions.

“I could not be prouder of Mr. Fischer’s tenacity,” McCormack said. “Cases like this are vital to keeping financial incentives away from medical judgment. Without a brave insider like Mr. Fischer, willing to speak up, speak out, and then blow the whistle, Community likely would have continued to get away with its fraud.”

The case is United States and the State of Indiana ex rel. Thomas Fischer v. Community Health Network, Inc., et al., 1:14-cv-1215.

Dwight Adams, a freelance editor and writer based in Indianapolis, edited this article. He is a former content editor, copy editor and digital producer at The Indianapolis Star and IndyStar.com, and worked as a pla