ORIGINAL P.- , ; k. i : `.< / , ADDRESS BY C, EVERETT KOOP, MOD, SURGEON GENERAL US, PUBLIC HEALTH SERVICE AND DEPUTY ASSISTANT SECRETARY FOR HEALTH UA DEPARTMENT OF HEALTH AND HUMAN SERVICES PRESENTED TO THE 1986 "EMPLOY THE HANDICAPPED" PROGRAM NATIONAL INSTITUTES OF HEALTH BETHESDA, MARYLAND OCTOBER 22, 1986 1 (GREETINGS TO HOSTS, GUESTS, FRIENDS, ETCJ I APPRECIATE BEING GIVEN THIS CHANCE TO CONTRIBUTE TO TODAY'S PROGRAM, LAST WEEK, WHILE THINKING ABOUT THE FEW MOMENTS I WOULD HAVE AT THIS PODIUM, I DECIDED THAT WHAT I REALLY WANTED TO DO WAS TO BRING YOU TWO MESSAGES: FIRST, A SHORT ONE,, ,AND NEXT, A MESSAGE THAT'S A LITTLE LONGER AND MAYBE, FOR MANY OF YOU, A NEW MESSAGE, HERE'S THE SHORT MESSAGE: I'M DELIGHTED TO TAKE PART IN THIS ANNUAL EVENT, BUT I'M NOT DELIGHTED WHEN THAT'S WHAT IT IS CONSIDERED TO BE, anNOTHING MORE THAN A ONE-TIME ANNUAL EVENT, 2 BECAUSE IT ISN'T, WE MUST MAINTAIN A SENSITIVITY AND AWARENESS YEAR-ROUND TO THE IDEA THAT MANY DISABLED PEOPLE ARE FULLY QUALIFIED FOR MOST OF THE JOBS WE CONTROL, THIS ONE-DAY EVENT, PART OF A ONE-WEEK PROGRAM, IS A GOOD EVENT, BUT THE LEGAL AND MORAL REQUIREMENT TO HIRE THE HANDICAPPED IS NOT A ONE-DAY- OR A ONE-WEEK-A-YEAR REQUIREMENT, IT'S YEAR-ROUND, AND THAT'S MY FIRST MESSAGE, NOW, I'M GOING TO BEGIN MY SECOND MESSAGE WITH A BIT OF HISTORY, 3 ON SEPTEMBER 26, 1973, A REVISED REHABILITATION ACT BECAME PUBLIC LAW 93412, THE BILL THAT WAS SIGNED INTO LAW HAD NOT HAD AN EASY JOURNEY, TWO EARLIER VERSIONS HAD GONE TO PRESIDENT NIXON AND WERE VETOED, WHAT FINALLY EMERGED WAS WHAT EVERYONE COULD AGREE ON, ONE OF THE MAIN PURPOSES OF THE LAW, STATED RIGHT AT THE BEGIN- NING, WAS TO,,, "PROMOTE AND EXPAND EMPLOYMENT OPPORTUNITIES IN THE PUBLIC AND PRIVATE SECTORS FOR HANDICAPPED INDIVIDUALS AND TO PLACE SUCH INDIVIDUALS IN EMPLOYMENT," IN ADDITION THE CONGRESS INDICATED THAT THE NATION OUGHT TO PLACE ITS EMPHASIS ON "SERVING FIRST THOSE WITH THE MOST SEVERE HANDICAPS, SO THAT THEY MAY PREPARE FOR AND ENGAGE IN GAINFUL EMPLOYMENT," 4 THE VERY LAST SENTENCE IN THAT LAW, SOME OF YOU MAY RECALL, IS SECTION 504, WHICH SAYS THAT,,, "NO OTHERWISE QUALIFIED HANDICAPPED INDIVIDUAL IN THE UNITED STATESwSHALL, SOLELY BY REASON OF HIS HANDICAP, BE EXCLUDED FROM PARTICIPATION IN, BE DENIED THE BENEFITS OF, OR BE SUBJECTED TO DISCRIMINATION UNDER ANY PROGRAM OR ACTIVITY RECEIVING FEDERAL FINANCIAL ASSISTANCE," PERIOD, THAT WAS VERY DIRECT AND EXCITING STUFF, NEVERTHELESS, IT TOOK ANOTHER 4 YEARS BEFORE THE FINAL REGULATIONS WERE PUBLISHED, WHILE SECTION 504 WAS ONLY ONE BRIEF SENTENCE IN THE 1973 LAW, ITS IMPLEMENTING REGULATION OCCUPIED 24 PAGES IN THE MAY 4, 1977, EDITION OF THE -REGISTER, 5 WHO WERE THE PEOPLE THAT WERE SUPPOSED TO BENEFIT FROM SUCH A LAW AND REGULATIONS? THE COUNTRY IN GENERAL WOULD BENEFIT, OF COURSE, BUT FOR OUR PURPOSES TODAY, LET ME GIVE YOU 2 OR 3 MORE SPECIFIC EXAMPLES, THERE'S THE EXAMPLE OF KENT CULLERS, HE WAS BORN 37 YEARS AGO,, m TOTALLY BLIND, HE DECIDED ON A LIFE OF SCIENCE, AND HE'S ACHIEVED IT, WITH A PH,D, IN PHYSICS FROM THE UNIVERSITY OF CALIFORNIA AT BERKELEY, DR, CULLERS IS NOW EMPLOYED AT N,A,S,A,'s AMES RESEARCH CENTER, HE'S A TEAM LEADER \/ITHIN A GROUP WHOSE ASSIGNMENT IT IS TO SEARCH FOR EXTRATERRESTRIAL INTELLIGENCE, SOMEDAY, WHEN WE ASK, "WHO'S OUT THERE?", , ,DR, CULLERS WILL TELL us, ANOTHER EXAMPLE IS DR, ANN SWANSON, A 38-YEAR-OLD BIOCHEMIST WITH A PH,D, FROM THE UNIVERSITY OF WISCONSIN AT MADISON, SHE IS VERY SMALL OF STATURE AND HAS OSTEOGENESIS IMPERFECTA, SOMETIMES CALLED "BRITTLE BONE DISEASE," A SEVERE HANDICAP, DR, SWANSON IS A VERY GOOD BIOCHEMIST, SHE ADVISES THE NATIONAL SCIENCE FOUNDATION ON ITS COLLEGE INSTRUMENTATION PROGRAM AND HAS SERVED ON A NUMBER OF COMMITTEES FOR THE AMERICAN CHEMICAL SOCIETY, BOTH THOSE ORGANIZATIONS ARE DELIGHTED TO HAVE HER GOOD COUNSEL, ANOTHER GRADUATE OF BERKELEY WITH A PH,D, IN ORGANIC CHEMISTRY IS DR, TODD BLUMENKOPF, THIRTY YEARS AGO TODD BLUMENKOPF WAS BORN WITH SPINA BIFIDA, ANOTHER VERY SERIOUS BIRTH DEFECT, 7 NEVERTHELESS, HE COMPLETED HIS STUDIES, WAS AN N, I ,H, POSTDOCTOR- AL FELLOW AT THE UC, IRVINE CAMPUS, AND IS NOW AN ORGANIC CHEMIST AT THE BURROUGHS WELLCOME CO, IN RESEARCH TRIANGLE PARK, NORTH CAROLINA, THESE AND HUNDREDS OF OTHER DISABLED MEN AND WOMEN ARE NOW IN OUR SCIENCE WORK-FORCE, CONTRIBUTING TO THE FUTURE OF BIOMEDICAL SCIENCE IN THIS COUNTRY, MOST OF THEM BEGAN THEIR PROFESSIONAL LIVES WELL IN ADVANCE OF SECTION 504 AND THE REGULATIONS FOR ITS IMPLEMENTATION, BUT CLEARLY THERE WERE MANY OTHERS WHO COULD NOT ACHIEVE THE SAME LEVEL OF PARTICIPATION IN SOCIETY WITHOUT THE HELP OF THE LAW, THE ENACTMENT OF P,L, 93-112 WAS FOLLOWED BY THE EQUALLY IMPOR- TANT "EDUCATION FOR HANDICAPPED CHILDREN ACT OF 1975," 8 WITH THE HELP OF THESE NEW LAWS -- AND BENEFITTING FROM THE ENLIGHTENMENT AND GOOD WILL OF MANY SCHOOL AND COLLEGE ADMINISTRATORS -- MORE AND MORE HANDICAPPED YOUNG PEOPLE ASKED FOR AND WERE GIVEN THE BEST EDUCATION AND THE MOST EDUCATION THAT THEY COULD ABSORB, WHAT'S BEEN THE EFFECT? DO WE HAVE ANY EVIDENCE? I THINK WE DO, FOR EXAMPLE, WE HAVE THE "AMERICAN FRESHMEN: NATIONAL NORMS" SURVEY, FOR THE PAST 20 YEARS, THE AMERICAN COUNCIL ON EDUCATION HAS CONDUCTED THIS SURVEY OF FIRST-TIME, FULL-TIME FRESHMEN AT A LARGE SAMPLE OF FOUR-YEAR COLLEGES AND UNIVERSITIES, THE SURVEY ASKS ALL KINDS OF QUESTIONS, BUT IN THE FALL OF 1978 IT ADDED AN IMPORTANT QUESTION: IT ASKED THE ENTERING FRESHMEN IF THEY WERE DISABLED, 9 THE RESULTS IN 1978 INDICATED THAT LESS THAN 3 PERCENT OF THOSE FIRST-TIME, FULL-TIME FRESHMEN WERE DISABLED, APPLIED ACROSS THE SPECTRUM OF ALL FIRST-TIME, FULL-TIME FRESHMEN IN 1978 YOU COME UP WITH AN ESTIMATE OF 28,000 YOUNG MEN AND WOMEN WHO CONSIDERED THEMSELVES AS DISABLED IN SOME WAYmMISSING LIMBS, BEING DEAF, HAVING IMPAIRED VISION, AND SO ON, THAT SAME QUESTION HAS BEEN ASKED EVERY YEAR SINCE, IN LAST YEAR'S RESULTS, HOWEVER, WE FOUND THAT NEARLY 8 PERCENT OF ALL FIRST- TIME, FULL-TIME FRESHMEN DESCRIBED THEMSELVES AS DISABLED, AGAIN, APPLYING THAT TO THE TOTAL NUMBER OF ALL ENTERING FRESHMEN, WE ARRIVE AT A TOTAL OF 77,000 DISABLED STUDENTS, OR THREE TIMES THE ESTIMATE FOR 1978, 10 AMONG THOSE ENTERING FRESHMAN OF SEPTEMBER 1985 WE FOUND THAT,,, 1 OF EVERY 9, OR ALMOST 12 PERCENT, HAD A LEARNING DISABILITY,, , DYSLEXIC, FOR EXAMPLE ANOTHER I IN 9 HAD AN ORTHOPEDIC DISABILITY 1 OF EVERY 8 WAS PARTIALLY OR TOTALLY DEAF 1 OF EVERY 6 HAD SOME HEALTH-RELATED DISABILITY,, ,DIABETIC, FOR EXAMPLE, OR EPILEPTIC AND 1 OF EVERY 4 -- 27 PERCENT -- WERE PARTIALLY OR TOTALLY BLIND, 11 BUT 10 OUT OF EVERY 10 WANTED MORE EDUCATION, THEY HAD A DREAM ,,,AND THEY HAD THE AMBITION AND THE APTITUDE TO FULFILL THAT DREAM, AND I THINK THAT'S A FAIR MEASURE OF THE ESTIMATED 77,000 DISABLED MEN AND WOMEN IN THE CLASS OF 1989, BUT NOT ONLY OF THAT ONE CLASS, I THINK THAT'S ALSO THE MEASURE OF ALL THE GROWING NUMBERS OF DISABLED AND TALENTED YOUNG PEOPLE IN EVERY COLLEGE AND UNIVERSITY GRADUATING CLASS,, ,FROM NOW ON, WE KNOW THAT A CERTAIN NUMBER WILL CONTINUE TO GO ON TO ADVANCED DEGREES, AND I SINCERELY HOPE THAT MORE AND MORE OF THEM WILL CHOOSE MEDICINE, DENTISTRY, PSYCHOLOGY, OR NURSING OR WILL PURSUE SOME PROBLEM IN BIOMEDICAL OR BEHAVIORAL RESEARCH, ,,FOLLOWING THE LEAD OF KENT CULLERS, ANN SWANSON, TODD BLUMENKOPF AND MANY, MANY OTHERS, 12 WE WANT TO RECRUIT THE VERY BEST PEOPLE WE CAN FOR THE MEDICAL AND HEALTH DISCIPLINES, THAT HAS TO BE OUR PERSONNEL STANDARD: WE WANT THE BEST, AND I BELIEVE THAT A GREAT MANY OF THOSE DISABLED YOUNG MEN AND WOMEN COMING THROUGH OUR SYSTEM OF HIGHER EDUCATION, IN THIS AND SUBSEQUENT DECADES, WILL PROVE TO BE JUST THAT: THE BEST, BUT WILL WE BE READY FOR THEM? WILL WE BE IN STEP WITH HISTORY?. OR WILL HISTORY TAKE US BY SURPRISE, ,,AND THEN PASS US BY? 13 I HOPE IT DOESN'TmBUT I DON'T KNOW THE ANSWER FOR SURE, I ONLY KNOW THAT I'M CONCERNED ABOUT HOW WELL WE'RE DOING TODAY AND WHETHER WE'RE SENSITIVE ENOUGH TO THE CHALLENGES AHEAD OF US,,,TOMORROW, 9 TO BE SPECIFIC, I UNDERSTAND THAT, HERE AT N, I ,H, WE HAVE 205 PERMANENT P,H,S, PHYSICIANS WHO ARE NOT IN THE UNIFORMED COMMISSIONED CORPS, OF THAT NUMBER, 8 ARE DISABLEDmABOUT 4 PERCENT, + AND WHAT OF OUR NURSING PERSONNEL? N,I,H HAS ABOUT 600 PERMANENT, NON-COMMISSIONED CORPS NURSES, ABOUT A FOURTH OF ALL THE NURSES IN THE PUBLIC HEALTH SERVICE, OF THAT 600, SOME 16 ARE DISABLED -- LESS THAN 3 PERCENT -- AND NONE OF THEM IS SEVERELY DISABLED, 14 46 AND N, I,H, HAS ABOUT 880 MEN AND WOMEN IN SENIOR SCIENTIFIC POSITIONS -- PH,D, 'S PRIMARILY -- OF WHOM 40 ARE DISABLED, OR 4% PERCENT, OF THAT NUMBER, 5 ARE SEVERELY DISABLED, ,,THAT IS, TOTALLY DEAF OR MISSING BOTH LEGS OR PARTIALLY PARALYZED AND SO ON, THIS IS OUR EMPLOYMENT RECORD OF DOCTORS, NURSES, AND BIOMEDICAL RESEARCH SCIENTISTS, ,,BOTH THE ABLE-BODIED AND THE DISABLED, AND SO FAR, RELATIVELY FEW OF THEM IDENTIFY THEMSELVES AS HANDICAPPED, WHAT DO WE CONCLUDE FORM ALL THIS? FIRST OF ALL, WE SEEM TO BE ABOUT WHERE THE NATION'S COLLEGES AND UNIVERSITIES WERE NEARLY 10 YEARS AGO: THAT IS, WE HAVEN'T YET FELT THE FULL EFFECTS OF SECTION 504, AND SO WE HAVE A LITTLE TIME -- NOT MUCH, BUT A LITTLE TIME -- TO UNDERSTAND JUST WHAT THOSE EFFECTS MIGHT BE ON N, I ,H, AND ON THE WHOLE P,H,S, 15 I THINK IT'S IMPORTANT THAT WE DO ENGAGE IN THAT KIND OF STUDY, I HOPE WE DON'T REMAIN STUCK IN OUR CURRENT lo-YEAR-OLD POSITION, WE KNOW THAT MORE AND MORE DISABLED STUDENTS ARE ENTERING HIGHER EDUCATION AND GOING ON FOR ADVANCED DEGREES, WE MUST CONCLUDE, THERFORE, THAT THIS YEAR, ,,NEXT YEAR, ,,THE YEAR AFTERwAND FROM THEN ONmWE'LL BE SEEING MORE AND MORE FULLY QUALI- FIED, TOP-NOTCH HEALTH PROFESSIONALS HEADING FOR A LIFE IN MEDICINE, NURSING, OR RESEARCH, ,,EAGER TO MOVE QUICKLY FROM COLLEGE TO CAREER,, , ALL OF THEM INTENSE YOUNG PROFESSIONALS WHO -- INCIDENTALLY -- ARE ALSO DISABLED, I WANT THE U, S, PUBLIC HEALTH SERVICE TO SAY THAT WE HAVE GOOD JOBS FOR THEM, ,,THAT WE WELCOME THEM TO OUR ORGANIZATION AS WE WELCOME ANYONE WHO IS SMART AND WANTS TO WORK, 16 I WANT N,I,H, AND, INDEED, THE WHOLE PaHaS, TO SAY THAT WE LIKE TO HIRE PEOPLE WHO KNOW WHAT THEY'RE DOING,,,AND DO IT WELL, THEY MAY CARRY OUT THEIR ASSIGNMENTS A LITTLE DIFFERENTLY, IN ORDER TO OVERCOME -- OR COMPENSATE FOR -- THIS OR THAT HANDICAP, BUT I WOULD HOPE THAT WE'D BE OPEN TO THAT KIND OF EXCEPTIONAL JOB PER- FORMANCE, MAKING THOSE ADJUSTMENTS WILL ALSO BE PART OF THE CHALLENGE AHEAD OF US, I THINK WE CAN DO IT, THE HANDICAPS IN OUR OWN MENTALITY ARE REALLY EASY TO OVERCOME, COMPARED TO WHAT SOME OF OUR COLLEAGUES FACE, 17 DR, LINDA FAY, FOR EXAMPLE, IS 39,,,IS A GRADUATE OF HARVARD MEDICAL SCHOOL,,, SHE'S CURRENTLY IN THE GEORGETOWN/PROVIDENCE FAMILY PRACTICE RESIDENCY PROGRAMmAND SHE'S A PARAPLEGIC, STEVEN RATTNER IS 32,,,IS A GRADUATE OF THE UNIVERSITY OF MARY- LAND, ,,PRACTICES DENTISTRY IN GREENBELT,, BAND WAS BORN DEAF, THE ROLL-CALL OF DISABLED, HANDICAPPED, AND IMPAIRED PROFES- SIONALS IS LONGwAND WE HOPE IT WILL GET LONGER AS EACH YEAR PASSES, SO FAR N,I,H, AND THE PUBLIC HEALTH SERVICE HAVE OFFERED EMPLOYMENT OPPORTUNITIES TO MANY DISABLED PROFESSIONALS, BUT OUR RECORD IS STILL VERY LEAN, MAYBE THAT'S BECAUSE THE FULL IMPACT OF SECTION 504 OF THE REHABILITATION ACT JUST HASN'T CAUGHT UP WITH US YET, 18 IF THAT'S THE CASE, THEN LET'S BEGIN NOW TO PREPARE OURSELVES TO RECEIVE THE NEW PEOPLE COMING OUR WAYmHANDICAPPED PEOPLE WHO ARE TALENTED, AMBITIOUS, AND EXPERIENCEDmTHE VERY KIND OF PEOPLE WE'RE ALWAYS GOING TO NEED, LET'S MAKE SURE WE'RE READY -- AND ABLE -- TO RECRUIT THEM, THANK YOU, ##I###