United States Department of Health and Human Services' Commemoration of the
40th Anniversary of the Civil Rights Act of 1964
July 13, 2004
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.