Remarks
Richard M. Campanelli, Director, Office for Civil Rights
United States Department of Health and Human Services' Commemoration of the
40th Anniversary of the Civil Rights Act of 1964
July 13, 2004
Washington, DC
Thank you, Deputy Secretary Allen. It is a great honor and privilege to be serving as the
Director of the Department's Office for Civil Rights and to have the opportunity to work with
Secretary Thompson and Deputy Secretary Allen, and with the Office for Civil Rights staff all
across the country, on issues that are important to all of us, and especially to the most vulnerable
in our society; and that really comes home today as I have the privilege of joining with you as
we recall, celebrate and focus on moving forward with the legacy of the Civil Rights Act of
1964. The Act was passed 40 years ago this month, and although that is a long time, for many in
this room it doesn't seem so long ago.
We have in our audience today employees of the Office for Civil Rights, and I am sure other
Department employees, that were in federal service 40 years ago when this Act became law.
And a little later on, we are going to introduce to you some employees who were early
champions in ensuring that health care facilities that received federal funds were not segregated.
We also have with us a number of the former directors of the Office for Civil Rights who have
played an important role in implementing the Department's commitment to ensure that no person
is denied access to services in federally funded programs on the basis of their race, color or
national origin. Let me recognize them now: Stanley Pottinger, Peter Holmes, and Audrey
Morton.
To all these I've mentioned, and to many others in this room, the reality of the 1964 Civil Rights
Act has been an abiding presence and commitment for these four decades.
It's a classic, steamy hot day in Washington. These days remind me, as I am sure it does many
of you - of another hot summer - just 4 years shy of 40 years ago: 1968 - the summer after
Martin Luther King was assassinated. At the time, I was volunteering in a housing project of
Jersey City, New Jersey, in a little storefront ministry providing summer activities for kids. But
the real purpose for that little program was to bring African-Americans and whites together
when tensions were so high just a few months after Martin Luther King died.
One evening we got lost driving home, and ended up in Newark the second night that riots had
erupted: We turned a corner and found ourselves face to face with the muzzle of a National
Guard tank - manned by kids who seemed as young as we were, pointing their guns right at us,
worried that a car of mostly white kids in that area of town at night could only be up to no good.
We were scared, and I'll tell you we had a clearer sense for what life must feel like to people
who lived, worked and slept in that neighborhood all the time.
But another feeling - a feeling of hope and belief - compelled the people of every race that met
together in those times at that little storefront location: Martin Luther King gave voice to that
hope in so many ways. One thing, that he said - when he received the Nobel Peace Prize in
1964 - particularly stayed with me since:
"I believe that unarmed truth and unconditional love will have the final word in reality.
This is why right, temporarily defeated, is stronger than evil triumphant."
We didn't see the road ahead that night when we faced that tank, lost in Newark; and we didn't
know what might come from those small efforts at reconciliation, but all who met at the
storefront church just believed Dr. King's statement, and the promise of efforts all across the
nation, that we should keep trying, because hope would be justified.
Those words - that right is stronger than evil, even when evil appears triumphant - rang true to
all of us that summer; and they are good words for us to remember today, as we face other
dangers around the world. And those words exemplified the spirit that drove Congress to stay on
the historic road that led to passing the Civil Rights Act of 1964.
Most of us know that with the passage of the 64 Act, the nation was clearly set on a path of
rejecting "separate but equal" policies in the areas of education, employment, housing and the
administration of justice. But what many may not know, and what needs to be known, is the
profound impact of the Act on the desegregation of healthcare. In fact, Medicare was the first
new major federal program in which the promise of the Civil Rights Act proved its importance
and demonstrated its power.
In the late 50s and early 60s, much of America still clung to the notion that "separate but equal"
facilities were justified. As important as Brown v. Board of Education had been, - and I might
mention, today is the birthday of Thurgood Marshall, one of the Key players who brought about
that important victory - it was not self-effectuating - either in the context of education, or
otherwise across the American landscape. And in the healthcare arena, "separate but equal"
meant the same thing it meant where education was concerned: "inherently unequal."
In 1963, there were still segregated healthcare facilities spread across the nation. At hospitals
and other facilities, people of color often were treated in separate buildings from the main
facility, where they were served by medical staff with inferior equipment, did not have access to
basic medicines, and otherwise received inadequate care. I was looking over an article from a
1965 Georgia newspaper, remarkably reporting the story of three doctors who said they would
rather lose their ability to participate in federally funded programs than discontinue their practice
of having one waiting room for whites, and another for African-Americans. Even in my
generation, on the early side of the baby boom generation, many were born in segregated
institutions.
The sad truth is that segregation in our healthcare system was legally authorized in law: the Hill-Burton Act, which increased the number of hospital beds available, also allowed those beds to be
placed in "separate but equal" facilities.
But Martin Luther King was right: the wall of healthcare segregation was going down: it had to.
In 1963, before passage of the 64 Act, the fourth circuit Court of Appeals issued a key ruling in
the case Simpkins v. Moses H. Cone Hospital. Simpkins was a very qualified doctor who was
refused hospital privileges in two hospitals that received significant Federal funding, just
because he was African-American. The lower court upheld these separate-but-equal facilities,
but the 4th Circuit declared these provisions unconstitutional. Mr. Simpkins won a victory for
himself, and for many others, and a big hole opened in the wall.
But voluntary desegregation of healthcare was still uneven, at best; and it became clear that, as
in so many other areas, strong, national legislation was needed to end discriminatory practices.
One year later, responding to these and many similar needs, Congress passed the Act we
celebrate today. Its mandate is direct and simple: Title VI of the Act has three key elements:
1. It established a national priority against discrimination in the use of federal funds;
2. It authorized federal agencies to establish standards of nondiscrimination; and
3. It provided for enforcement by withholding funds or "by any other means
authorized by law."
That was a great success; and today, as we respect and remember those who were responsible for
its passage, we also remember the sacrifices of those who endured generations of segregation
and substandard care. As President Bush recently reminded us:
"Generations of African-American citizens grew up, and grew old, under laws designed
to demean them. . . . The color of your skin determined where you could purchase
property, which hospital ward you could be treated in, which park or library you could
visit. . . . "
Of course, passage of the 64 Act was not the end of the story - not by a long shot. We are all
here today because we are committed to continuing to move forward to fulfill the promise of the
Act.
This Department, and its predecessor HEW, started that process by taking immediate and bold
steps to implement the promise of the Act. By 1966, Medicare was becoming a reality, and the
Department took the opportunity to launch a radical attack on separate but equal healthcare
facilities. The Department drafted new regulations forbidding hospitals and other facilities
receiving federal funds to engage in separate-but-equal practices. And many individuals -
including some we have the privilege of honoring today - stepped forward to wield this
important new lever to end these practices.
They, and hundreds of their fellow Department employees and volunteers, fanned out across the
country to ensure that hospitals were in compliance with Title VI. This was no easy task, and
predictably, hospitals creatively attempted to maintain segregated facilities.
- We have reports of one institution that removed the "colored" and "white" signs from
restrooms, but installed locks on all the doors, and gave keys only to the white staff.
- In another, a hospital claimed to have ended segregation by closing its "colored" wing,
integrating the nursery, and housing black and white patients together - but the
investigators were diligent, and discovered that when the review team left town, the
hospital had shifted everything back.
But as you will soon hear, these challenges did not stop the investigators, and their successful
efforts were a huge leap forward in ensuring equal access to healthcare. As a result, within a
short period following the enactment of the Civil Rights Act, hospitals and healthcare facilities
across the country were committed to providing services on a nondiscriminatory basis. It was a
quiet and powerful revolution.
Of course, the mission is not complete. Title VI is an essential vehicle for ensuring equal access
to HHS services, and the Office for Civil Rights' compliance activities and technical assistance
efforts are important means of effectuating the rights guaranteed by Title VI.
We at OCR continue to be diligent in our efforts to ensure that no person is denied access to
services based on race, color, national origin or any of the other protected classifications which
we are privileged to protect through our array of compliance activities - from investigations of
complaints and compliance reviews - to outreach, technical assistance and public education.
And Title VI has broader application today, ranging from ensuring that persons who are limited
English proficient have meaningful access to healthcare, to ensuring that discrimination on the
basis of race, color or national origin plays no role in adoption and foster care.
OCR staff in regional offices throughout the country and here in headquarters actively reach out
to recipients - so that they understand their obligations - and to consumers - so that they
understand their rights; and we make hundreds of presentations on Title VI to all of these
groups.
The 1964 Civil Rights Act was also a precursor to many subsequent acts that protect the rights of
individuals, paving the way for key national initiatives to protect Civil Rights, including The
Voting Rights Act, The Fair Housing Act, The Age Discrimination Act, Title IX of the
Education Amendments, and the Americans with Disabilities Act. In fact, the Office for Civil
Rights now is responsible for compliance with over 20 statutes that protect the rights of
individuals, most recently including the rights of our citizens to protection of the privacy of their
health information.
These efforts also contribute to the Secretary's priority initiative for the Department, to close the
health care gap - and I know that Secretary Thompson is looking forward to personally telling
you more about those Department-wide efforts.
I want to conclude by saying a special word of thanks to all of those in this room, and who will
be viewing this presentation at our offices across the country, in the Office for Civil Rights and
throughout the Department, who continue to invest their lives, their passion, and their
commitment to ensure that all of us in this country, including the most vulnerable, have equal
access and equal opportunity, in fulfillment of the promise of the Civil Rights Act. You make
reality out of the promise of the Act, and you confirm Martin Luther King's belief, that right
will triumph. We salute and thank you, and salute and thank all of you who came today to
celebrate this important Anniversary.
Thank you all very much.
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