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Indiana’s trauma care system falls short in rural counties; will money in the budget be enough?
Pulaski County EMS, which typically runs two ambulances across the county's 435 square miles of mostly farmland, is headquartered in Winamac, Indiana, Feb. 7, 2023. (Credit: Ryan Martin)
WINAMAC, Ind. — When it’s time to move a patient from this town’s six-bed emergency room to a larger hospital specializing in trauma care, Brandon DeLorenzo sometimes has to wait.
The Pulaski County emergency medical services director can typically spare one of his two ambulances to make the 1 hour and 15-minute drive to the nearest trauma centers in Lafayette or South Bend.
But occasionally when a medic takes a vacation, DeLorenzo is down to one truck — and he’s forced to keep it available for a potential vehicle crash or other emergency somewhere across the 435 square miles of mostly farmland.
So trauma patients wait at Pulaski Memorial Hospital for sometimes hours.
“Our primary focus is 911. We can’t take that truck out of the county,” said DeLorenzo, who serves as a paramedic on one of the ambulances when he is on the clock. “There’s really nothing we can do.”
While hospitals across Indiana handle many types of injuries just fine each day, severe injuries require greater attention from doctors and staff at a trauma center.
In trauma care, time is everything. Minutes matter.
The problem? Indiana’s 24 trauma centers are primarily clumped around big cities while nearly 1 in 10 Hoosiers live more than 45 minutes away from one.
Complicating matters further, rural communities like 12,500-person Pulaski County struggle to obtain the equipment and hire the people necessary to run ambulances that they’ve already bought.
That can have consequences. Greater shares of Hoosiers are dying because of injuries compared to the U.S. average, according to Centers for Disease Control age-adjusted data from 2016-2020. That signals a trauma care problem in a state that already struggles with low life expectancy. The leading causes of death for Hoosiers aged 1 year to 44 are preventable injuries.
Anyone can experience a traumatic injury, but the problem can be exacerbated in Indiana’s less-populated areas, where a higher percentage of crashes are fatal. Pulaski County, for example, had the highest rate of fatal automobile collisions per person in 2020, and similarly high injury fatality rates over the past five years.
“We just need to fill in the gaps, so that it doesn’t matter whether you live in Indianapolis or Bath, Indiana,” said Dr. David Welsh, a general surgeon in rural southeast Indiana who is on the Indiana State Trauma Care Committee. “You deserve to get good treatment, and good treatment in trauma care makes a difference.”
Unlike other states, Indiana does not possess a statewide trauma plan to coordinate trauma centers, community hospitals and EMS providers. Nor does the state consistently fund trauma care. In a recently released report, the American College of Surgeons (ACS) criticized the system as “generally fragmented and not well coordinated.”
The problems have grown so urgent that they’ve drawn the attention of Gov. Eric Holcomb and leading lawmakers. His administration is attempting to revamp the system and is seeking more money for the state’s trauma system, but it’s not yet clear if it amounts to a Band-Aid when the system needs open heart surgery.
The disparity is evident
One thing Holcomb’s administration wants to do is reduce the number of Hoosiers who live more than 45 minutes away from a trauma center.
That’s because receiving care at a trauma center lowers an injured patient’s risk of death by 25%, according to a 2006 study.
“If you get to a trauma center within the first hour after your injury, then your risk of death or significant comorbidity is significantly reduced,” said Dr. Lindsay Weaver, an emergency medicine physician who serves as Indiana’s chief medical officer.
(Credit: Provided by the Indiana Department of Health)
In Indiana, the age-adjusted injury mortality rate is significantly higher in those regions of the state with no trauma centers, according to the ACS report.
That disparity is evident in the state’s motor vehicle fatality statistics.
Marion County, home to the most trauma centers, had by far the highest total number of collisions in 2020, but it ranked in the bottom half of counties in terms of the percent of crashes that were fatal.
Switzerland County, which is more than 45 minutes away from a trauma center and has no hospital, consistently has a higher percentage of collisions that are fatal than other counties.
“An effective trauma system saves lives, reduces irreversible disabilities and increases quality of life,” said Dr. Paul Halverson, dean of the Indiana University Richard M. Fairbanks School of Public Health. “If you can help save the lives of a young person or reduce their disability but keep them working and productive, it’s not only a good thing for the individual, but it’s a wise investment because they go on to be a productive part of society.”
Helicopters are able to dramatically cut transport times, but they’re usually reserved for the most extreme injuries and can’t fly when the weather is bad.
The number of trauma centers in Indiana has increased substantially since 2008 when there were only seven, Weaver points out. But even today, only Marion County is home to the highest-level trauma center. It’s also the only county with a pediatric trauma center.
Meanwhile, all of Indiana’s neighbors have the highest level of trauma centers scattered in multiple counties across the state.
To start, the Indiana Department of Health is examining hospitals located in Indiana’s dead zones and hoping to transition three into trauma centers.
Closing the gap
Becoming a trauma center, though, would be a tall order for many rural hospitals.
For one, hospitals would have to increase staffing. Even at a Level III trauma center, such as the ones in Elkhart or Bloomington, an orthopedic surgeon must be on site 24 hours a day, and patients must have access to anesthesia and radiology services within 30 minutes. Trauma centers also are required to have a designated injury prevention professional.
Rural hospitals can struggle to keep their doors open and recruit physicians. A report from the Center for Healthcare Quality and Payment Reform found that six unnamed rural hospitals in Indiana are at immediate risk of closing. Further complicating the matter, Indiana lawmakers are pursuing multiple bills intended to lower the cost of health care. Hospitals warn that could have unintended consequences: the closure of hospitals.
Already, more than a dozen rural counties don’t have a single hospital.
Other states provide grants to encourage hospitals to transition to trauma centers, but not Indiana. Arkansas, for example, even provided incentives to hospitals in neighboring states that were closer to many Arkansas residents, said Halverson, the IU dean.
He previously worked as director of the Arkansas Department of Health, where he helped establish the state’s trauma and centralized dispatch systems.
But even if the state provided more funding, multiple rural emergency room leaders told State Affairs it doesn’t make sense for them to transition to a trauma center.
They don’t see the volume of patients necessary to justify buying new equipment or hiring specialized doctors, such as trauma surgeons or neurologists. On top of that, doctors need patients to remain updated on their skills and training.
“To be an expert, you’ve got to do something at least 10,000 times,” said Dr. Ted Seall, Pulaski Memorial Hospital’s emergency department medical director. “For us to get 10,000 gunshot wounds here in Winamac, that would take forever.”
Right now, his emergency room sees about 15 patients a day.
In addition, smaller hospitals typically do not stock the large volumes of blood needed for some trauma patients.
Some states, such as Arkansas, have created a fourth trauma center tier in an effort to bring more hospitals into the system without expecting them to have the same resources as big-city hospitals. But Indiana doesn’t have that option for hospitals.
It’s not that Indiana needs a bunch of Level I hospitals; Indiana needs a functioning and coordinated system, Halverson said.
Lack of EMS providers
If Indiana state government wants to help by creating new trauma centers, rural communities have another idea: Help the EMS.
Hospital administrators say they regularly struggle to transport someone, whether it’s because they can’t find a hospital to admit the patient or there simply isn’t an ambulance available. Hospitals are required to admit patients that arrive directly from a scene. That’s not the case for those coming from another hospital. The delays can last 12 hours or more.
It’s a problem across the state. From 2019 until the third quarter of 2022, at least 29% of trauma patient transfers were delayed, with the most common known reason for delay being an EMS issue.
In Madison, driving to Louisville takes about an hour each way. Occasionally the local hospital’s EMS needs to drive further for certain specialized care, such as behavioral health. When the ambulances are on the road and unavailable, it creates a backup in the Norton King’s Daughters’ Health emergency room while patients wait for their turns to be transferred.
“Transfers are a big part of what we do because we’re all rural,” said Carol Dozier, the CEO of the hospital. “Sometimes we have to go a pretty long distance to get someone to the right facilities.”
Roughly half of Indiana counties have only one ambulance provider, according to Indiana Department of Homeland Security data, and 16 counties reported having as few as four ambulances or less. A handful of counties rely entirely on EMS providers in neighboring counties.
And those numbers appear rosier than reality. Not all of the ambulances are in use due to a lack of staffing. Similarly, some ambulance crews are able to treat only basic injuries.
A staffing shortage, caused in part by low wages, is driving the disparities in care. Rural EMS providers are competing with other health care industries that simply pay better, as well as providers in larger cities, to attract talent.
EMS providers say they struggle to afford the costs associated with training paramedics, let alone attracting enough people into the field in the first place.
The Medicare reimbursement rate isn’t enough to cover the cost to transport patients, and there is no separate funding from the state to run these programs. That means it often falls to local governments or hospitals to eat the costs associated with running EMS.
And the cost of new ambulances is skyrocketing. In a typical year, the cost of a new truck grows about 5% every year; last year, though, it jumped by 35%, said Dr. Scott Smith, a longtime emergency room doctor who runs Adams Memorial Hospital in Decatur.
“Our EMS operates at a loss,” Smith told State Affairs, “and has for as long as I can remember.”
That leaves little left over for salaries and training in some communities with small populations and budgets.
(Credit: Brittney Phan for State Affairs)
In Harrison County, a 40,000-person county near Louisville, the hospital EMS was so understaffed until recently that it operated with three trucks, instead of the usual five, said Jeremy McKim, the EMS manager.
But the situation is worse in neighboring Crawford County, which does not have a hospital and at times runs only one ambulance. Sometimes Harrison County EMS has to chip in, McKim said.
“We’ve got to figure something out to get people into our industry,” McKim said. “The staff is aging and they’re not going to continue to do this. The rate of people coming into this industry is not meeting the numbers of people leaving.”
Indiana lost 233 ambulances and 1,075 EMS clinicians between 2018 and 2021, according to the ACS. The staffing problems have been exacerbated by a 66% increase in ambulance runs from 2018-2021, said Kraig Kinney, Indiana EMS state director, during a State Trauma Care Committee meeting last year.
“It’s a nationwide trend,” Kinney told State Affairs. “That’s part of the reason the workforce shortage is showing up right now, because not only are we tighter on number of people available, but we have more needs, so everyone is busy.”
How Indiana hopes to fix the problem
State health leaders realize the trauma system has gaps. In fact, it was the state that invited the ACS to evaluate Indiana’s system in November.
But the list of recommendations from the ACS is lengthy, and ranges from creating a trauma system performance improvement plan, to completing an EMS workforce assessment, to securing ongoing funding. The ACS, though, did not recommend a specific dollar amount needed to rightsize the system.
The two-year proposed budget contains $9 million over two years for “trauma system quality improvement,” which Weaver said can be used to better coordinate trauma care across the system, identify current problems using data analysis and focus on prevention. Ultimately, the Trauma Care Commission — which would be codified under the public health bill, Senate Bill 4 — would provide oversight on how to best use that money, she said.
Is the money enough? “I think you have to start somewhere,” Weaver told State Affairs.
There’s no guarantee that funding will go toward encouraging more hospitals to become trauma centers or current trauma centers, despite the recent recommendation from the ACS to provide financial incentives encouraging participation in the state trauma system in both its 2008 and recent report.
An additional $14.6 million would be set aside for EMS under the budget that can be used for recruitment, training and new ambulances. It also can be used to ensure the closest emergency departments are responding when dispatched.
The state is also already undergoing the recommended EMS workforce assessment. Plus, if SB 4 passes as is, the Trauma Care Commission would be tasked with developing a statewide trauma plan. Some changes might also have to come in future years.
The House passed the budget Thursday and the bill now moves to the Senate, where Senate President Pro Tempore Rodric Bray, R-Martinsville, and other senators have signaled a willingness to fund the trauma care proposal.
"We live in a state where a significant impact on how long you live, is where you live,” Sen. Ed Charbonneau, R-Valparaiso, said when discussing SB 4 on Thursday.
But perhaps nothing shows the need for trauma care system changes more than an anecdote DeLorenzo shared of a patient who fell off the roof of his home. Because of the winter weather, no emergency helicopter could fly, which meant the man had to be transported to the local, non-trauma center hospital to be stabilized.
After he arrived at the local hospital, though, staff struggled to find a trauma center that could accept the patient, he said. The only option: a Level III center, when in reality, DeLorenzo said the man’s injury would usually need a higher caliber trauma center.
On top of that, icy roads slowed the drive to two hours.
“That was not good for that patient,” DeLorenzo said. “We’re in the middle of nowhere, so when you’re max speed of 30 miles per hour, trying to stay on the road and go 20 miles to a call, it takes a long time.”
While DeLorenzo is not certain whether the patient survived his injuries, he still wonders if he had been transported more quickly, or had been moved to a higher level trauma center, whether the man’s chances of survival would be greater.
Contact Kaitlin Lange on Twitter @kaitlin_lange or email her at [email protected].
Contact Ryan Martin on Twitter, Facebook, Instagram, LinkedIn, or at [email protected].
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Header image: Pulaski County EMS, which typically runs two ambulances across the county's 435 square miles of mostly farmland, is headquartered in Winamac, Indiana, Feb. 7, 2023. (Credit: Ryan Martin)
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New EPA rules would force Indiana to hasten its energy transition
Indiana is probably the type of state that the Environmental Protection Agency had in mind when it proposed a new set of rules that target fossil fuel-fired power plants.
Not only is the state still reliant on fossil fuels for most electricity — more than two-thirds is generated by coal (47%) and gas (29%), data show — Indiana has some of the worst air quality and is one of the most polluted states in the country. The primary focus of the new EPA rules, though, is an attempt to significantly reduce the amount of carbon dioxide released by those plants. Fossil fuel-fired power plants are responsible for about a quarter of all greenhouse gas emissions, according to the EPA, and for about a third of the nation’s carbon dioxide emissions that are heating the planet.
Yet while Indiana has been slow to adopt renewable energy sources, the pace of the state’s transition away from fossil fuels has been picking up steam in recent years.
But not fast enough for the EPA.
President Joe Biden’s aggressive climate agenda would require states like Indiana to hasten their energy transitions considerably. The draft power plant rules, released in May, would broadly require utility companies to cut their dependence on coal and gas, and to adopt emerging technologies that would enable the use of carbon storage and hydrogen.
Now Indiana government leaders and electric utility companies are raising concerns. They say the plans would force Indiana power plants to retire early, which could substantially increase the cost of electricity for Hoosiers while risking the reliability of the electric grid. And they say the technology cited by the EPA is not ready for widespread adoption.
“For carbon capture, while this is a technology that the state is invested in, it is not yet at the scale needed to accommodate all the utilities in the state,” Brian C. Rockensuess, commissioner of the Indiana Department of Environmental Management, told lawmakers during a committee meeting this month.
Environmental advocates, however, are characterizing the concerns as overblown. They point to two federal bills — the Inflation Reduction Act and the Bipartisan Infrastructure Law — that contain grants and incentives for power plants to transition away from coal and gas. And they say the power industry always raises concerns about any new regulations but always finds a way to comply.
“They are like the boy who cried wolf,” said David Doniger, a former EPA official and current senior strategic director at the nonprofit Natural Resources Defense Council. “If you look at the track record, they say this every time and then, if the regulations are in fact adopted, the compliance goes smoothly.”
Indiana agency head raises concerns
Rockensuess voiced his concerns about the new EPA rules to Indiana lawmakers during an Interim Study Committee on Energy, Utilities, and Telecommunications meeting this month.
He didn’t dive into the pros and cons of the environmental impacts; rather, he focused on the difficulty for policymakers and regulators in Indiana who will be tasked with enforcing the final rules adopted by the federal government.
Among the difficulties, he said, are requirements for some power plants to use hydrogen to generate electricity or rely on carbon capture and storage to reduce emissions. Both technologies, he said, are not ready for wide use, yet the federal government would require Indiana to explain how the state would implement the new federal rules within 24 months.
“Bottom line is they are asking for a lot in too short of a time,” he said. “Indiana and other states are being set up to run afoul of that timeframe from the start.”
Those concerns were echoed in a joint letter sent to the EPA by his department, the Indiana Utility Regulatory Commission and the Indiana Office of Utility Consumer Counselor.
The study committee also featured an out-of-state speaker who shared fiery testimony in opposition to the EPA proposal. By the end of the presentation, Rep. Matt Pierce, D-Bloomington, questioned whether the Republican leaders considered inviting anyone with a different viewpoint.
“I was just kind of curious as to whether the chairman attempted to invite testimony from anyone in support of the rules, such as the Clean Air Task Force or the Natural Resources Defense Council, people along those lines?” Piece asked.
Committee chair Sen. Eric Koch, R-Bedford, said that such viewpoints were already well-known because of the EPA’s plans, but he would consider Pierce’s request if lawmakers take up legislation on the matter when the legislative session begins in January.
Koch, who also leads the Senate utilities committee, later confirmed to State Affairs that he was unsure what actions the Indiana General Assembly might take in response to the federal rule, but he does not plan to file legislation this year.
The chair for the House utilities committee — Rep. Ed Soliday, R-Valparaiso — told State Affairs he did not yet know if he would file anything.
Environmental advocates push back
While they were not invited to speak at the public meeting, many environmental advocates in Indiana are supportive of the president’s efforts to curb carbon emissions.
“Probably what you didn’t hear in the testimony at the Statehouse was the cost of mitigating and addressing issues related to climate change. And you probably didn’t hear the effects of air pollution and how that contributes to asthma and other diseases,” said Sam Carpenter, executive director of the nonprofit Hoosier Environmental Council. “In the big picture, all those things need to be considered.”
The Biden administration estimates up to $85 billion in environmental and public health benefits over the next 20 years.
Indiana once relied almost exclusively on coal for electricity. And while the state continues to be a top-five consumer of coal for electricity, the major utility companies have started shifting away from coal in recent years. They’ve largely replaced that fuel source, though, not with renewables but with natural gas. That’s because gas is relatively affordable, and it easily enables utility companies to both meet the daily electricity demands but also rapidly ramp up production during cold snaps and heat waves.
Some utilities are seeking state approval to build new gas plants even now. Indiana customers will be on the hook for whatever is constructed now — such as a gas plant — even if those plants are rarely used or even shut down because of federal regulations. And then Hoosiers will also have to pay for whatever the utility companies build next.
“This continued investment into fossil fuels is going to be a stranded investment,” Carpenter said. “Down the road that’s not going to be paying off. That’s just a bad path to take.”
Future battles
If enacted, the new EPA rules are sure to draw litigation from Republican officials.
Attorney General Todd Rokita has already promised Indiana’s involvement: “Fortunately, the courts will almost certainly strike down these new EPA mandates — and on behalf of Hoosiers, I’ll do everything in my power to ensure that happens,” Rokita said in a statement about the proposed rules.
His comments align with those made by Indiana’s major utility companies. They accuse the EPA of overstepping — arguments that were at the center of a U.S. Supreme Court decision in 2021 that said the EPA lacked the authority under the Clean Air Act to regulate carbon emissions.
Others aren’t as confident as Rokita and utility companies.
Rockensuess, the state environmental management department commissioner, noted in his testimony that the EPA does have the authority because of new language contained in the Inflation Reduction Act, which Congress passed after the Supreme Court decision.
“It clarified and granted them the authority to regulate greenhouse gasses,” Rockensuess told lawmakers.
Rockensuess said he expected to see the final EPA rule by next May.
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Header image: A row of solar panels sits outside AES Indiana’s Harding Street power plant. (Credit: Ryan Martin)
Eric Doden says school district consolidation is ‘death knell’ for rural Indiana
Republican gubernatorial candidate Eric Doden is calling on the Indiana Chamber of Commerce to end its support for school district consolidation in rural Indiana.
In a letter sent today, the Fort Wayne businessman labeled the business group’s position as “damaging.”
“While the stated aims of this position are laudable, the message sent to our small towns and rural communities is damaging,” Doden wrote. “Proposing to do away with small public school districts through consolidation will be seen as a death knell for the millions of Hoosiers who live in small towns and rural communities.”
For years, the Indiana Chamber has advocated for fewer school districts across Indiana. A 2017 study commissioned through Ball State University identified worse educational outcomes for students in smaller districts in several categories, including scores for state standardized testing and the SAT, as well as the pass rates for Advanced Placement classes.
The Indiana Chamber re-upped its position last month when it released its long term economic development plan. Among the listed policies was a goal to “reduce by half the number of very small school districts with enrollments below 2,000 students to provide much stronger educational opportunities for rural students and communities.”
More than half of Indiana’s school districts have fewer than 2,000 students.
In a statement to State Affairs, Indiana Chamber President and CEO Kevin Brinegar said the state is providing a “two-tiered educational system” depending on income and ZIP code.
“Hoosier students should not be limited academically solely due to where they live. And that’s the case now in some of the smaller school districts where students are not afforded the opportunity to take a full array of STEM, Advanced Placement or college preparation courses,” Brinegar said in the statement. “The Chamber’s stance on smaller school district consolidation is rooted in wanting to lift up young Hoosiers in these rural communities, so they have a better chance at prosperity by properly preparing them for the state’s current and future job opportunities.”
The statement also contained a specific response to Doden’s criticism.
“We would be happy to sit down with Mr. Doden and go through the research and show him why we have adopted this position for the betterment of the academic and economic opportunities for our young people,” Brinegar said in the statement. “The status quo that Mr. Doden is championing has and will continue to leave small communities, schools and students behind. That’s not acceptable.”
But whereas the business group sees consolidation as one way to improve life in rural Indiana, Doden sees the opposite.
“Across our state it’s easy to see the remnants of a school consolidation push that began in the 1950s,” Doden wrote in his letter. “Too many towns that lost their local school to consolidation dried up and were virtually swept from the maps while other towns kept their schools and their identities. These communities had a better opportunity to survive.”
Doden also cited one of his policy proposals, which would redirect $100 million in state money toward small towns — in an effort to address declines in populations and quality of life.
“With local leadership and local control, we can revitalize our small towns and hometowns with a fraction of the investment we give away in the form of incentives,” Doden wrote.
Doden addressed the letter to Vanessa Green Sinders, who will replace Brinegar as the Indiana Chamber’s leader. Her tenure will begin in January, so she was unavailable to provide comment to State Affairs. Either way, the Indiana Chamber’s members are the ones who suggest policy positions for the board of directors to approve before each legislative session.
In addition to Doden, the crowded Republican field for governor includes U.S. Sen. Mike Braun, former Commerce Secretary Brad Chambers, Lt. Gov. Suzanne Crouch and former Attorney General Curtis Hill.
Jennifer McCormick, the former state superintendent of public education, has emerged as the leading Democratic candidate. Instead of school district consolidation, the state should reevaluate its expansion of school choice vouchers, McCormick has previously said.
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Header image: Eric Doden, 2024 Republican candidate for governor of Indiana (Credit: Eric Doden for Indiana Governor/Facebook)
Attorney general faces misconduct allegations in handling of high-profile abortion case
The Indiana Supreme Court Disciplinary Commission today filed a formal complaint against state Attorney General Todd Rokita that alleges three violations of attorney professional conduct rules.
Rokita faces official allegations that he committed professional misconduct with his public comments about Dr. Caitlin Bernard after she provided an abortion to a 10-year-old Ohio rape victim last summer.
Rokita is defending his actions, saying that state confidentiality laws shouldn’t apply to him because Bernard was the first to talk in the news media about the girl’s treatment. It could take months before the state Supreme Court decides whether Rokita will face any punishment.
What’s Happening
The commission didn’t ask for a specific punishment against Rokita, asking simply that he be “disciplined as warranted for professional misconduct” by the state Supreme Court.
Commission Executive Director Adrienne Meiring filed the complaint that focuses on actions by Rokita and his office between early July 2022 and Nov. 30, 2022, when the attorney general’s office filed a misconduct complaint against Bernard with the state Medical Licensing Board.
Bernard drew national attention in the days after a July 1, 2022, story by The Indianapolis Star quoting her about the young girl’s abortion just days after the U.S. Supreme Court’s overturning of Roe v. Wade.
The complaint against Rokita highlights his July 13 appearance on a Fox News program, during which he said he would investigate Bernard’s actions and called her an “abortion activist acting as a doctor — with a history of failing to report.”
It also points to his office’s unusual action of publicly releasing on July 13 a letter to Gov. Eric Holcomb that named Bernard in seeking records from two state agencies and a July 14 press release from his office about the investigation.
The complaint alleges Rokita’s actions violated confidentiality requirements of pending medical licensing investigations under state law and by doing so Rokita “caused irreparable harm to Dr. Bernard’s reputational and professional image.”
Rokita responded Monday with a legal filing saying that the confidentiality requirements shouldn’t apply to him because Bernard had already gone public about the girl’s medical treatment.
Rokita also argued that “The Attorney General, an elected official who answers to the public, has a duty to keep the public informed of the Office’s actions and decisions.”
The state Medical Licensing Board voted 5-1 in May to reprimand Bernard and fine her $3,000 for violating patient privacy laws. The board, however, voted unanimously to reject allegations from the attorney general’s office that Bernard violated state law by not reporting the child abuse that led to the girl’s pregnancy to Indiana authorities and did not issue any restrictions on Bernard’s medical license.
Why It Matters
The Disciplinary Commission’s complaint carries the potential of forcing the Republican attorney general from office.
State law requires that the attorney general be “duly licensed to practice law in Indiana.” The state Supreme Court, which has the final say over attorney disciplinary matters, has wide discretion, with options all the way up to permanently stripping an attorney of his law license.
Rokita won the Republican nomination for attorney general in 2020 over then-Attorney General Curtis Hill after Hill faced allegations that he drunkenly groped four women at a party celebrating the end of the 2018 legislative session.
The Supreme Court suspended Hill’s law license for 30 days, saying that “by clear and convincing evidence that [Hill] committed the criminal act of battery.” The court rejected the hearing officer’s recommendation of a longer suspension that could have forced him from office. Hill is now seeking the Republican 2024 nomination for governor.
Rokita has sought to burnish his anti-abortion and national profile with the Bernard case. Besides challenging Bernard’s medical license, his office last week filed a lawsuit against the doctor’s employer, Indiana University Health, alleging it violated federal law by allowing Bernard to disclose information about the Ohio girl’s treatment. The girl’s mother brought her to Indiana to receive abortion drugs because an Ohio ban on abortions after six weeks had taken effect after the U.S. Supreme Court’s ruling last summer.
What’s Next?
Rokita is entitled to defend himself with a hearing before a judicial officer appointed by the Supreme Court, who would then submit a recommended punishment to the court.
In Hill’s case, it took about 14 months from the time that the disciplinary complaint was filed against him for the court’s five justices to receive the case and make their decision.
Rokita’s defense lawyers include two from the Washington, D.C., firm Schaerr-Jaffe. The firm also assisted the attorney general’s office with the case against Bernard under a contract allowing it to bill the state $550 an hour for work by the firm’s attorneys.
“This is a complaint against the official duties of the Attorney General and is an attack against his official capacity, so this is paid by the office,” Rokita’s office said.
Rokita isn’t backing down in the political battle, either, as he released a statement Monday calling himself “a passionate fighter” who “is beating back the culture of death, grievance and transanity being pushed by radicals in workplaces, schools, media and government.”
Democrats argue Rokita is using the Bernard case “to further his own personal political ambitions.”
“Todd Rokita’s actions toward Dr. Caitlin Bernard over the past year brought shame and ridicule upon our state,” Indiana Democratic Chairman Mike Schmuhl said in a statement. “Now, he is starting to see the consequences of making baseless claims regarding a medical professional on national television.”
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Header image: Indiana Attorney General Todd Rokita speaks during the America First Agenda Summit organized by America First Policy Institute. (Photo by Oliver Contreras/SIPA USA)(Sipa via AP Images)
Sen. Jon Ford confirms move to coal industry group upon resignation
Republican Sen. Jon Ford of Terre Haute confirmed Friday that he is resigning from the Legislature to become leader of an association that promotes the coal industry and other fossil fuel producers in Indiana.
Ford told State Affairs that he will join Reliable Energy this fall after his Senate resignation takes effect Oct. 16.
“I’ll be running the association, the business side of it,” said Ford, who faces a one-year prohibition on being a paid lobbyist after leaving the Legislature.
What is Reliable Energy?
Reliable Energy was incorporated as a nonprofit corporation by prominent lobbyist Matt Bell in 2020 with the same downtown Indianapolis address as his Catalyst Public Affairs Group.
In testimony to a legislative committee last year, Bell described the group’s members as “fossil fuel producers and the Hoosier businesses supporting the fossil fuel industry.”
“Reliable Energy advocates for policies that ensure an abundant supply of available, affordable and dependable energy in Indiana and across the country,” Bell’s testimony said.
The organization is an offshoot of the Indiana Coal Council.
“I think it really grew out of that group and is really a group made up of membership of people involved in energy in a lot of different ways,” Ford said. “Many of the members are vertically integrated power companies. Some produce coal, some produce energy. Most are involved in alternative energies, as well.”
Ford’s reasons for resignation?
Ford, who was first elected to the Senate in 2014, won reelection last November to a four-year term. His resignation will result in a new senator serving for three legislative sessions without appearing on a general election ballot.
Ford cited personal reasons for deciding to resign less than a year after winning his new Senate term.
“Some things in my life have changed that made me think, you know, the passing of friends and other life events made me rethink what I wanted to do in my life and what I had achieved in the district,” Ford said. “I just felt it was time to move on.”
Ford said the Reliable Energy position didn’t prompt his Senate resignation.
“The job really came after the decision that it was time to move on,” he said.
Ford hasn’t specialized in energy-related issues while in the Legislature and hasn’t been a member of the utilities or environmental committees that consider most such legislation.
Ford has been business development director for the economic and community development group Thrive West Central, based in Terre Haute.
Will Ford become a lobbyist?
State law prohibits members of the General Assembly from lobbying former colleagues for one year after leaving office.
Ford said that even after that time he was not sure he would become an advocate for Reliable Energy in the Statehouse hallways.
“This group has had a hired lobbyist for a while that’s worked with them, so I don’t know,” Ford said. “I would see it playing a similar role to many other associations that are out there, but, you know, main focus will be to grow it and to focus on where Indiana goes forward with energy.”
Involvement in selecting replacement?
Ford was noncommittal on whether he would endorse a candidate to replace him ahead of the caucus of Republican precinct committee leaders who will make that decision in the coming weeks.
“I don’t know at this time, it really depends, I guess, on who steps up,” Ford said. “I don’t foresee myself being at the vote, to be quite honest. I think it’s a decision of the precinct committeemen.”
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Tom Davies is a Statehouse reporter for State Affairs Pro Indiana. Reach him at [email protected] or on X at @TomDaviesIND.
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Header image: Republican Sen. Jon Ford speaks in the Indiana Senate chamber. (Credit: Indiana Senate Republicans)