Memorandum of Law in Opposition to the Motion of Defendant Califano to Dismiss, or in the Alternative, for Summary Judgment

     [||e6671b44-20e7-4c04-ae85-31ffa39e123e||] May. 7, 1977 

Hon. Phil M. McNagny, Jr. 
United States District Judge 
United States District Court 
Northern District of Indiana 
Federal Building, 502 State Street 
Hammond, Indiana 46325 

Re: Wesson et al. v. Methodist Hospital 
of Gav, Inc., et al,, Cause No. H 76-373 
  

Dear Judge McNagny: 

I have enclosed herewith a copy of the Memorandum 
of Law in Opposition to the Motion of Defendant 
Califano to Dismiss, or in the Alternative, for 
Summary Judgment; and Certificate of Service in 
the above-captioned case. Another copy has . 
been mailed to the Clerk of the District Court 
for filing. 

Thank you in advance for your careful consideration 
of this matter. : 

Very truly yours, 

Beth J. Lief 
Attorney for Plaintiffs 

BJL/r 

Enclosures 

  

10 COLUMBUS CIRCLE 586-8397 NEW YORK, N.Y. 10019 

  

  

     



  

May 7, 1977   
Hon. Francis T. Groudys, Clerk 
United States District Court 

Northern District of Indiana 

Federal Building, 502 State Street 
Hammond, Indiana 46325 

Re: Wesson et al. v. Methodist Hospital 
of gary, Inc,, et al,, Cause No. B 76-373 
Ga : 

Dear Mr. GrQudys: 

  

I have enclosed herewith, for filing, Memorandum 
of Law in Opposition to the Motion of Defendant 
Califano to Dismiss, or in the Alternative, for 
Summary Judgment; and Certificate of Service 
in the above-captioned case. 

Thank you for your handling of this matter. 

“ 

Very truly yours, 

[x pA ( Af 

Beth J. Lief 
Attorney for Plaintiffs 

BJL/r 
Enclosures 

  

10 COLUMBUS CilRCILE 586-8397 NEWYORK, N.Y. 10019 

    
       



  

IN THE UNITED STATES DISTRICT COURT 

FOR THE NORTHERN DISTRICT OF INDIANA 

HAMMOND DIVISION 

  

BARBARA LEEX WESSON, : 

BERNICE TERRY, 

EDDIE GRAY and 

ROSA KEETON, 

Plaintiffs, 

Vv. 

METHODIST HOSPITAL OF GARY, INC., Cause No. H 76-373 

An Indiana Not-For-Profit 

Corporation, and JOSEPH CALIFANO, 

United States Secretary of Health, : 
Education and Welfare, 

0
 

Defendants. 

  

  

  

MEMORANDUM OF IAW IN OPPOSITION TO THE MOTION 

OF DEFENDANT CALIFANO TO DISMISS, OR IN 

THE ALTERNATIVE, FOR SUMMARY JUDGMENT 

  

  

JACK GEEENBERG 

te 
BETH J. LIEF 

PUNT S\mmIS 10 Columbus Circle 
} Jew 1 

CWALLLS wa cam yi York, Ney Yorn 10019 

JULIAN ALLEN 

200S Broadway 

Gary, Indiana 46407 

MARILYN G. ROSE 

1751 NN Street, N. WN. 

Washington, D. C. 20036 

Attorneys for Plaintiffs 

 



  

IN THE UNITED STATES DISTRICT COURT 

FOR THE NORTHERN DISTRICT OF INDIANA 

HAMMOND DIVISION 

  

BARBARA LEEK WESSON, 
BERNICE TERRY, 
EDDIE GRAY and 

ROSA KEETON, 

Plaintiffs, 

Ve 
: Cause No. H 76-373 

METHODIST HOSPITAL OF GARY, INC., 

An Indiana Not-For-Profit 

Corporation, and JOSEPH CALIFANO, 

United States Secretary of Health, 

Education and welfare, 

Defendants. 

  

MEMORANDUM OF LAW IN OPPOSITION TO THE MOTION 

OF DEFENDANT CALIFANO TO DISMISS, OR IN 

THE ALTERNATIVE, FOR SUMMARY JUDGMENT 

I. 

INTRODUCTION 
  

This case was commenced by four black citizens of the 

City of Gary, Indiana on December 29, 1976 against the 

Methodist Hospital of Gary, Inc., (hereinafter Methodist 

Hospital) and the United States Secretary of Health, Education 

and Welfare (hereinafter HEW). Plaintiffs charge defendants 

with violating their obligations and plaintiffs' rights under 

 



  

Title VI of the Civil Rights Act of 1964, 42 U.S.C. § 20004 

(hereinafter Title VI), and their right to equal protection guar- 

anteed by the Fifth and Fourteenth Amendments to the Constitution 

of the United States. Defendant HEW did not file an appearance 

in this action until April 1, 1977 when it moved to dismiss the 

complaint or, in the alternative, for summary judgment on the 

grounds that (1) plaintiffs have failed to exhaust administrative 

remedies and (2) the complaint fails to allege facts upon which 

relief can be granted. Plaintiffs submit this memorandum in op- 

position to that motion. 

The complaint arises out of the creation and perpetuation of 

a discriminatory and segregated health care system that is financed 

in substantial part by federal funds and grants which HEW approved. 

Plaintiffs charge HEW with violating their civil rights by subsi- 

dizing and enabling this discrimination by Methodist Hospital. At 

the outset of its memorandum, however, defendant attempts to distort 

these allegations and the plaintiffs’ attempt to enforce their 

rights by insinuating shat the filing of the lawsuit arises not 

out of concern for nondiscriminatory and quality health care, but, 

rather, is the result of a political dispute. 

It is worth note that the defendant does not challenge the 

standing of plaintiffs to bring this case. If defendant sincerely 

believed that plaintiffs and the class they wish to represent 

wD 

 



  

were not seeking to redress the injury suffered by segregated 

and discriminatory health care, that route was plainly avail- 

able and, indeed, in our system of jurisprudence, was the 

proper route. Instead, by innuendo and accusation, defendants 

attempt to obfuscate the issues raised. Plaintiffs strenuously 

object to this treatment of so critical a case which they 

brought only as a good faith attempt to secure equal treatment 

under the law. 

 



  

i 8 

PLAINTIFFS HAVE EXHAUSTED THEIR ADMINISTRA- 

TIVE REMEDIES, ANY FURTHER ATTEMPT TO SECURE 

RELIEF THROUGH THE ADMINISTRATIVE PROCESS WOULD 

BE FUTILE, AND THE DOCTRINE OF EXHAUSTION OF 

ADMINISTRATIVE REMEDIES IS INAPPLICABLE TO THE 

CAUSES OF ACTION AGAINST THE DEFENDANT HEW. 
  

Defendant HEW concedes that the rights conferred by Title 

VI apply to both the Hill-Burton direct grant program and loan 

guarantee program, the programs pursuant to which Methodist 

Hospital has received and is continuing to receive federal fund- 

ing to subsidize the construction and, now expansion, of its 

suburban hospital, Broadway Methodist. See, 42 C.F.R. § 53.112(¢c); 

1/ 
45 Cc. F.R. §85 80.2,:80.134F). Defendant argues, however, that 

this Court lacks subject matter jurisdiction over the complaint 

because plaintiffs failed to exhaust the administrative procedure 

set forth in 45 C.F.R. § 80.7(b). The sequence of events which 

HEW itself outlines in its memorandum of law proves otherwise. 

A. 

On or about October 1, 1976, numerous individuals, including 

plaintiff Wesson, sent letters and mailgrams to the Regicnal 

Office of HEW to protest the grant of federal funds to Methodist 

Hospital. At that time, prior to the filing of this lawsuit, 

HEW properly treated those protests as complaints pursuant to 

45 C.F.R. § 80.7 (b) and responded to those complaints by letter 

  

l/ Contrast the position of HEW with that taken by defendant 
Methodist Hospital concerning the applicability of Title VI. See 

Memorandum of Methodist Hospital In Support of Motion To Dismiss, 

8-10. 
-—dl 

= 

 



  

and report dated October 21, 1976. See Exhibit 12 attached to 

Memorandum in Support of Motion to Dismiss or In the Alternative 

for Summary Judgment by Defendant Secretary of Health, Education, 

and Welfare (hereinafter Exhibit 12). The eleven page summary 

which was sent to the complainants, including plaintiff Wesson, 
  

concluded that "the Office of Civil Rights found the applicant 

[Methodist Hospital] to be in compliance with Title VI and 

recommended clearance to the Public Health Services. We have 

been informed that the applications were approved and that funds 

were granted," Exhibit 12 at p. 11. That summary constituted 

final resolution of the complaints pursuant to 45 C.F.R. § 80.7 

(d) (2) which provides: 

"If an investigation does not warrant 

action pursuant to subparagraph (1) of 

this paragraph the responsible Department 

official or his designee will so inform 

the recipient and the complainant, if any, 

in writing.” 

Having exhausted their administrative remedies, plaintiffs are now 

entitled to pursue their complaint in federal court. 

HEW received a complaint filed by Steven Tallackson on behalf 

of the Gary Human Relations Commission on September 29, 1976, 

approximately the same time that the other complaints were received. 

See Exhibit 13. HEW at that time treated this complaint along with 

those of plaintiff Wesson and other persons, and sent the October 

21, 1976 response to all these individuals, including not only Mr. 

Tallackson, but, as noted above, plaintiff Wesson. See Exhibit 12. 

-5= 

 



  

After the complaint in this case was filed on December 29, 

1976, HEW sought an extension of time in which to enter an 

appearance and began to conduct a further investigation of the 

serious allegations raised in the complaint. On March 29, 1977, 

a mere three days before HEW moved to dismiss or for summary 

2/ 
judgment, HEW issued a second report. However, in contrast to 

its initial, and, at the time, final report and conclusions, HEW 

3/ 
only sent this second report to Mr. Tallackson, despite its 

earlier treatment of the complaints filed by plaintiff Wesson and 

others. HEW now makes the incredible argument that only Mr. 

4/ 
Tallackson filed a complaint , and that the "letters and mailgrams® 

which the Office of Civil Rights received "from interested persons 

3/ 
in Gary," including plaintiff Wesson, were not complaints. On 

the basis of this retrospective self-serving recharacterization, 

  

2/ The motion of HEW was filed April 1, 1977. 

2/ See Exhibit 17. 

4/ See Memorandum of HEW at p. 1ll. 

5/ See Memorandum of HEW at p. 10. 

 



  

HEW argues that plaintiffs have not filed any complaints and have 

consequently failed to exhaust administrative remedies. The 

facts, as outlined above, plainly demonstrate that this is simply 

not so. 

Thus, in contrast to the cases cited by defendant, the ex- 

hibits filed by HEW to support its motion conclusively establish 

that plaintiffs did not "bypass" the administrative process. 

Green Street Assoc, v. Daley, 373 7.24 1, © {7th Cir. 1970); 
  

Dupreg v. City Of chattanooga, 'Temm., 362 2. Supp. 1136, 1141 
  

(E.D. Tenn. 1973). (It was undisputed plaintiffs failed to exhaust 

their administrative remedies,) See McGee v. United States, 402 
  

U.S. 479, 488 (1971) (Plaintiffs' "bypass was deliberate and with- 

out excuse.") HEW cannot be allowed at this eleventh hour to 

ignore its own treatment of the administrative complaints prior 

to the filing of this action in federal court in order to escape 

5/ 
liability for its violation of plaintiffs' rights and the law. 

On October 21, 1976, when HEW responded to complaints that 

Methodist Hospital was guilty of discrimination, Alfred Sanchez, 

Chief, Health and Social Services Branch, Office For Civil Rights, 

Region V, informed the complainants that HEW's Office of Civil 

Rights found no violation of Title VI, Bxhibit 12; affidavit of 

  

86/ In considering a motion to dismiss, the allegations in the 
complaint are accepted as true. E.g.,Radovitch v. National 
Football L.eague, 352 U.S. 445 (1957). 

  

  

Bey 20 

 



  

Alfred Sanchez, Exhibits 4, 99 5, 6. This determination was 

the final action taken on the complaints (except that of Mr. 

Tallackson), after which plaintiffs were free to pursue judicial 

remedies. The cases cited by defendant, Green v. Cauthen, 379 
  

F. Supp. 361 (D.S.C. 1974) and Feliciano v. Romney, 363 F. Supp. 
  

656, 669 (S.D. N.Y. 1973) are thus inapposite since, in contrast 

to this case, in those cases there had either been no final agency 

action taken or the administrative investigation was "still in progress." 

The Sit ennt by HEW to reopen the adninistvative process after 

the filing of this complaint in federal court by undertaking a 

new investigation (Exhibit 17) cannot serve to preclude access to 

this Court by plaintiffs. To begin with, as HEW never reopened 

the complaint of plaintiff Wesson, her administrative channels are 

closed. More importantly, to allow HEW to frustrate judicial re- 

view by continually reopening investigations would result in a 

total denial of a mechanism by which beneficiaries of institutions 

subject to Title VI could obtain final administrative determination. 

In such circumstances, the Supreme Court has held, "neither the 

principle of 'exhaustion of state remedies' nor the doctrine of 

‘primary jurisdiction' has any application to the situation.” 

Rosado v. Wyman 397 U.S. 397, 406 (1970). In Rosado, the petitioners, 
  

who were welfare recipients, did not seek review of an adminis- 

trative order prior to proceeding to Federal court, nor could they 

pe, Yon 

 



  

as HEW had no procedures whereby they "could trigger and partic- 

ipate in HEW's review of state welfare programs," and obtain a 

Final decision,” Id. The procedures provided for HEW to follow 

when it decides to terminate federal funding to state welfare plans 

are similar to the procedures for terminating funds to recipients 

of federal funds who violate Title VI, except that beneficiaries of 

Title VI programs may file complaints and obtain decisions by HEW 

concerning their grievances. Compare, 42 U.S.C. §§ 604 (a), 1316 

with 45 C.F.R. Part B80. If HEW's attempt to reopen final agency 

determinations and to continue review indefinitely were to succeed, 

the result here and under other ritle VI situations would be iden- 

tical to that faced by the petitioners in Rosado v. Wvman: plaintiffs 
  

could obtain no final agency decision. According to the decision of 

the Supreme Court, in the absence of a mechanism to obtain such a 

final determination, the exhaustion requirement is inapplicable. Id.:; 

Liovéd v, Regional Transportation Authority, 548. 7.24 1277, 1287 (7th 
  

Cir... 1977), 

The administrative process may be "bypassed" if the issue 

raised by plaintiffs "cannot be raised upon judicial review of an] 

+ =» « Order of the agency.” Borden, Inc. v. PIC., 495 7.28 785, 
  

786-7 (7th Cir. 1974). In addition, the exhaustion reguirement is 

inapplicable where review of the agency determination would provide 

"an inadequate remedy." Jewel Companies, Inc. v. FTC., 432 F.2d 
  

 



  

1155, 1158; compare Skinner & Eddy Corp. v. United States, 249 
  

U.S. 557 (1919) with Myers v. Bethleham Shipbuilding Corp., 303 
  

U.S. 41 (1938). In this case, were HEW's argument to prevail, the 

review of the administrative decision would not be inadequate; it 

would be nonexistent. 

As the Supreme Court stated in McKart v. United States, 395 
  

U.S. 185, 193 (1969), "[alpplication of the [exhaustion of admin- 

istrative remedies] doctrine to specific cases requires an under- 

standing of its purposes and of the particular scheme involved." 
  

(Emphasis added.) Accord, Weinberger v. Salfi, 422 U.S. 749, 764- 
  

768 (1975). In cases brought under Title VII of the Civil Rights 

Act of 1964, alleging racial discrimination in employment, the 

statutory provisions specifically state that while a plaintiff must 

file a charge of discrimination with the Equal Employment Opportunity 

Commission prior to filing in federal court, the Commission must make 

a final determination or issue a "right to sue" letter within 180 

days entitling the plaintiff to proceed to federal court, 42 U.S.C. 

§§ 5(a) and 2000e-5(e). The Supreme Court had held that "[Tlhe Act 

does not restrict a complainant's right to sue to those charges as 

to which the Commission has made findings of reasonable cause, and 

we will not engraft on the statute a requirement which may inhibit 

the review of claims of federal employment discrimination in the 

federal courts." McDhonnell Douglas Corp. v. Green, 411 U.S. 792, 
  

798-799 (1973). 

wlOw 

 



  

Similarly, judicial review of alleged violations of Title 

VI are not limited solely to those cases in which HEW has made 

a determination of a violation. Adams v. Richardson, 480 F.2d 
  

1159 (p.C.C. 1973). Moreover, the lack of any specific statutory 

or regulatory time limitation in which HEW must act cannot act 

to preclude indefinitely the right of plaintiffs to seek judicial 

relief. See id. Indeed, in Adams v. Richardson, the district 
  

court by supplemental order filed March 14, 1975 enjoined HEW to 

make a determination as to whether there is a Title VI violation 

in school districts receiving federal aid "{w]ithin 90 days of 

receipt by HEW of a complaint or other information of racial dis- 

crimination." Paragraph F(a) of Supplemental Order, (a copy 

of which is attached to this Memorandum of Law as Exhibit A). 

It has been more than seven months since HEW received complaints 

alleging violations of Title VI by defendant Methodist Hospital. 

Plaintiffs suggest that there is no reason why a specific time 

limitation for reviewing complaints should not be imposed on 

HEW's investigation of hospital complaints, just as they are sub- 

ject to in school cases. In any event, HEW cannot be allowed to 

frustrate judicial review indefinitely by continual reopening of 

investigations or similar dilatory tactics. 

“lle 

 



  

5. 

Even assuming arguendo that plaintiffs did not exhaust their 
  

administrative remedies, the doctrine of exhaustion is inapplic- 

2hte to the instant case because it is clear that further resort 

to such procedures would be futile; and plaintiffs cannot obtain 

the complete relief they seek through administrative channels. 

In the report and findings of October 21, 1976, HEW responded 

2 
to the plaintiff Wesson's charge of racial discrimination with 

8/ 
the comment that racial segregation "too is a reality," and stated 

that assessment of the reduction of quality of care for the minor- 

ity citizens of Gary "is a complex issue which this Office is not 

4 
qualified to assess." 

In addition, HEW conceded that in 1971 it was predicted that 

there would be "maldistriction of resources among geographic areas 

and population groups" but nevertheless excused Methodist Hospital 

10/ 
on the legally irrelevant ground that "it is not solely to blame." 

  

1/ Exhibit 12 at'p.. 4. 

8/ 16. at p.wl0, 

3/38. arp. 8, 

10/ 14. at pp. 6. 

rl Doe 

 



  

Finally, in response to the allegation that the construction 

and expansion of Broadway Methodist Hospital has accelerated 

"white flight" and consequent segregation, HEW stated, " . . . 

while it may Ye argued that the Hospital is gulliy of racism by 

trying to join that exodus, it cannot be argued that it initiated 

11/ 
‘white flight'.™" 

12/ 
The further report of HEW issued on March 29, 1977 con- 

cedes that the equipment at Broadway Methodist Hospital is newer 

than that at Gary Methodist Hospital and that one hospital (Gary) 

13/ 
is 80% black and the other (Broadway) is 90% white. HEW 

further recognized that all foreign nurses, who have difficulty 

14 

communicating with patients, are employed at Gary, and not Broadway. 

  

1l/ Id. at p. 9. The day has long since passed when institutions 
can escape liability from racial discrimination and segregation be- 

cause others are also guilty or because of disagreement with the 

constitutional and statutory principal of equality. Cooper v. Aaron, 

358 U.5. 1 (1958); Brown v. Board of Zducation, 349 U.S. 294, 299-300 

{1955). 

  

  

12/ Exhibit 17 to Memorandum in Support of HEW's Motion to Dismiss 

or, In The Alternative, for Summary Judgment. 

13/ E=zshibit 17 at pp. 3-11, .22. 

4/ Id. at p. 14. 

“13 

 



  

Despite the clear acknowledgement that the facilities are not 

equal, HEW refused to find a Title VI violation because de- 

fendant Methodist Hospital had shown "a pattern of investment 

. « « to modernize the Gary facility" and because the hospital 

met the mimimum standards of the Joint Commission on Accreditation 

17 

of Hospitals and the Indiana State Board of Health.” 

In view of HEW's refusal to correct the racism, discrimination, 

inequality of the facilities, and perpetuation of segregation by 

Methodist Hospital, or, to deem such discrimination violative of 

Title VI, it is clear that further resort to HEW would be an exer- 

cise in futility. The doctrine of exhaustion of administrative 

remedies has no application where it is clear that the relevant 

administrative agency will not grant the relief in question. 

Clover v., St. Louls-San Francisco R, Co., 393 U.5. 324, 330-331 
  

{19569). 

Finally, plaintiffs are not required to exhaust administrative 

remedies insofar as they challenge HEW's procedures in failing to 

enforce Title VI or in granting Hill-Burton financial assistance 

to Methodist Hospital. The Court of Appeals held, in a similar 

  

15/ 38. at p. 25. The Joint Commission on Accreditation of 
Hospitals certifies only that a hospital meets required minimum 

guidelines, not that it is provided comparatively good, or equal 

health care. See CCH Medicare & Medicaid 9g 12,330, 12,660, 16,957, 

20,801. 

Fo 

 



  

Title VI case that where plaintiffs charged inadequacies in 

the procedures by which administrative officials exercise their 

administrative responsibilities under Title VI, that there are no 

administrative procedures to exhaust: 

", . «. the procedural afforded under the 

Civil Rights Act of 1964 are designed to 

provide redress against specific discrim- 

inatory acts and do not pertain to the 

adequacy of HUD procedures.” 

Shaymon Vv. fb, 436 F.2d 809, 820 (3rd Cir. 1970). See also Et
 

[()]
 

( 

    

  

County School District No. 4 vv. Gardner, 263 7. Supp. 26, 3% 

D.8.C. 1967). 

The complaint in this case charges HEW with violating the 

rights of plaintiffs guaranteed by Title VI. That violation 

necessarily includes not only the decision to continue funds to 

a hospital which discriminates and segregates persons on the basis 

of race, but also the failure of HEW's procedures to review 

recipients of federal funds adequately, and to prevent inequality 

la/ 

of health services to minority residents. As the Court stated 

in NAACP v. Brennen, 360 F. Supp. 1006, 1012 (@.D.C. 1973): 
  

  

16/ HEW's investigation adopted in large part the position and 

statements of Methodist Hospital and failed to conduct an adequate 

investigation pursuant to proper standards. For example, the 

report of March 29, 1977 accepted without question the truth of 

the statement by Methodist Hospital that the emergency room was 

"totally renovated” and failed entirely to consider, more importantly, 

whether it was adequate to serve the needs of minority patients. 

Exhibit 17.af p. 24. 
«1l5~ 

 



  

« « « both Title VI and the Fifth Amend- 

ment impose upon Federal officials not 

only the duty to refrain from partici- 

pating in discriminatory practices, but 

the affirmative duty to police the op- 

erations of and prevent discrimination 

by state or local agencies funded by them." 

Where, as here, plaintiffs charge HEW with failing to adopt pro- 

cedures and standards necessary to accomplish its "affirmative 

enforcement duty," administrative procedures need not be ex- 

hausted., Adams v. Richardson, 4380 F.28 1159, 1162 (.C. 

16/ 

1973. 

Cir. 
  

  

16/ Defendant incorrectly states that plaintiffs must demonstrate 
that HEW "colluded" in the discriminatory processes of Methedist 

Hospital. See Memorandum of HEW at p. 14. In Gautreaux v. Romney, 

448 F.247°731, 737=740 {7th Cir, 1971), aff'd sub nom., Sills vv. 

Gautreaux, 425 U.S. 284 (1976), the Court of Appeals did not re- 

quire that plaintiffs echaust remedies and held on the merits that 

HUD violated Title VI by dispersing funds in a manner which per- 

petuated a racially discriminatory housing system. Good faith 

attempts by HUD to accommcdate different factions did not relieve 

it Of liability in its "own right" for it was "an active partici- 

pant [in the discrimination] since it could have halted the dis- 

crimination at any step in the program. Hicks v. Weaver, 302 F. 

Supp. 81%, 623 (DD. La. 1969). HIw's action in approving funds 

to Methodist make it no less an active participant as HUD in 

Gautreaux and no less liable for violations of Title VI. 

  

    

  

  

  

Wo 

 



  

hk 

THE COMPLAINT, WHICH ALLEGES DISCRIMINATION BY 

HEW IN ITS FAILURE OR REFUSAL TO ENFORCE THE PRO- 

HIBITION AGAINST DISCRIMINATION BY A RECEIPIENT 

OF FEDERAL FINANCIAL ASSISTANCE, STATES A CAUSE OF 

ACTION UNDER TITLE VI; AND SUMMARY JUDGEMENT IS 

INAPPROPRIATE BECAUSE OF THE EXISTENCE OF GENUINE 

ISSUES OF MATERIAL FACT. 
  

Rule 12 (b) of the Federal Rules of Civil Procedure 

provides in pertinent part: 

"If, on a motion asserting the defense numbered 

(6) to dismiss for failure of the pleading to 

state a claim upon which relief can be granted, 

matters outside the pleading are presented to 

and not excluded by the court, the motion shall 

be treated as one for summary judgement and 

disposed of as provided in Rule 56..." 

As defendant HEW has submitted seventeen exhibits to support 

its motion to dismiss, the motion is properly considered as one 

for summary judgement. 

In ruling on a motion for summary judgement, a court is 

charged by Rule 56 of the Federal Rules of Civil Procedure with 

determining whether or not the "pleadings, ... together with the 

affidavits, if any, show that there is no genuine issue as to any 

naterial fact and that the moving party is entitled to a judgement 

as a matter of law." The Court of Appeals for the Seventh Circuit 

held in Rose v Bridgeport Brass Company, 487 F.2d 804, 808 (7th Cir. 
  

1973): 

" Qurs cases have uniformly placed upon the movant 

for summary judgement the burden of establishing 

hii the absence of a genuine issue of material fact. 

Carter v {iltliznms, 36) 7.26 189, 193 (7th Cir, 19686): 
  

-17- 

 



    

‘MotouXx v Gulling Auto Electric, Inc., 

295 »,.2d4 573, 576 {7th Cir. 1981. The 

burden is not lightly discharged." 

  

The Court in Rridgeport Brass added: 
  

"On a motion for a summary judgement the 

burden of establishing the nonexistence of 

any genuine issue of fact is upon the 

moving party, all doubts are resolved 

against him, and his supporting affidavits 

and depositions, if any, are carefully 

scrutinized by the court. Albert Dickenson 

CO, v Maellos Deanut Oo., 179 F.24 265, 268 

(7th Cir, 15950), 139 7.24 318,: 322 {8th Cir. 

1943) ." Id. (Emphasis in orginal). 

  

  

The very exhibits submitted by defendant to support its motion 

demonstrate the existence of a plethora of disputed material 

issues that relate directly to the issue of iARLevet HEW has 

violated its affirmative obligation and the plaintiffs' rights 

under Title VI. Since HEW has thus failed to discharge its 

heavy burden under Rule 56, the motion must be denied. 

As stated above, Title VI and the Fifth Amendment impose 

upon HEW "not only the duty to refrain from participating in dis- 

criminatory practices, but the affirmative duty to police the 

operations of and prevent discrimination by state and local 

agencies funded by them." NAACP v Brennen, supra 360 F. Supp. at 
  

1012; accord, e.g., Adams v Richardson, supra, 480 F.2d at 1162;   

Gautreaux v Romney, supra, 448 F.2d at 737-740; Hicks v Weaver, 
  

  

supra, 302 F. Supp. at 623. As defendant admits, Section 602 

of Title VI, 42 § 20000-1, directs each Federal agency adminis- 

-18=~- 

 



    

trating a program of Federal financial assistance to take 

action pursuant to regulation to effectuate the obligations and 

purposes of Title VI. Those regulations, promulgated by - 

defendant HEW, appear at 45 C.F.R. Part 80. Amcng the specific 

discriminatory actions prohibited is the provision by a recipient 

of federal financial assistance, including defendant Methodist 

Hospital of 

"...service, financial aid, or other benefit 

to an individual which is different, or is 

provided in a different manner from that 
provided to others under the program." 45 

C.P.R. $80.30) 41) (ii). 

The regulations also prohibit: 

"subject[ing] an individual to segregation 

or separate treatment in any manner related 

to his receipt of any service..." 45C.F.R. 
§ 80.3 (b) (I) (ii) (Emphasis added). 

and 

"Restrict[ing] an individual in any way in 

the enjoyment of any advantage or privilege 

enjoyed by others receiving any service,... 

or other benefit under the program." 45 C.F.R. 

S$ 80.30) (AY (iv) 

The data before this court raises serious and genuine issues of 

fact as to whether HEW is assuring, as it is obligated to do, that 

Methodist Hospital has not violated these provisions. 

w l72/ 
The reports conducted by HEW itself establish that 

defendant is aware that the two facilities of Methodist Hospital, 

Gary Methodist and Broadway Methodist, have segregated patient 

  

l7/ Zxhibits 12 and 17. 

-19- 

 



  

populations in violation of 45 C.F.R. § 80.3) (ii). — Almost 

fifteen vears ago, the Court of Appleals in Simkins v Moses Cone 
  

Hospital, 323 F.2d 959, cert. denied, 3786 u.s. 938 (1964) held that 
    

the provision of services on a "separate but equal" basis by 

hospitals receiving Hill-Burton funds violated the Constitution 

of the United States, vet HEW has by its own admission done 

nothing to correct this violation. Plaintiffs contend that the 

failure of HEW to take steps to have the recipient remedy this 

segregation is on its face a violation of plaintiffs' rights 

and defendants obligation, and the Court of Appeals for the 

Seventh Circuit has so held in an analagous case. Gatreaux v Romney, 
  

supra, 448 F.2d at 739-740; accord, Shannon v HUD, supra, Hicks v 
  

Weaver, supra. The mere fact that HEW conducted an investigation 
  

which uncovered this violation cannot, of course, satisfy its 

obligation; on the contrary, the conscious channeling of funds to 

segregated institutions flies in the face of the "expressed purpose 

of Congress." Adams v Richardson, supra, 480 F.2d at 1162. 
  

The plaintiffs charge HEW with violating Title VI not only 

because of the segregated operation of facilities by Methodist 

Hospital, but also because the provision of services is unegual.. 

As HEW-admits, the issue of quality of care is "complex". 19/ The 

Supreme Court has stated that "summary proceedings, however 

salutory where issues are clear-cut and simple, present a treacherous 

record for deciding issues [that involve complex and important 

  

18/ Gary Methodist is 80% black; Broadway Methodist is 90% white. 

3.9/ Exhibit 12. at 'p. 8. 
-20- 

 



  

constitutional questions]”. Xennedv v Silas Mason Co., 334 U.S. 
  

249, 256-7 (1948). In accordance with this pronouncement and with 

particular sensitivity accorded issues involving personal 

20/ 
liberties, the court stated in Sisters of Providence of St. 

  

Marv of the Woods v City of Evanston, 335 F. Supp. 396,399 
  

{D.C., X11. 1971), "It is especially in clvil rights disputes 

that we ought to be chary of disposing of the case on pre-trial 

motions..." Although the Supreme Court sanctions the grant of 

summary judgement where "solid bases of fact" are derived from 

21/ 
"a comprehensive statement of agreed facts," © plaintiffs do not 

in any way agree with the bases upon which HEW concluded that 

minority recipients of hospital services by Methodist are not 

discriminatory, or the conclusion reached. 

To begin with, as noted above, HEW accepted withcut 

question the fact that the emergency room at Gary Methodist 

Hospital, which serves the black residents of Gary, was "totally 

renovated" and is adequate to meet the needs of the plaintiff class. 

Critical facts remain to be discovered concerning whether these 

statements are in fact true. Summary judgement should not be 

granted without affording plaintiff extensive discovery, 

particularly since most of the facts are exclusively within the 

defendant's knowledge. Schoenbaum v First Brook, 405 F.2d 215 
  

{28 Cir. 1968), cert. denied, 395 U.S. 906 (1969). More im- 
  

  

20/ United States v Caroline Products, 304 U.S. 144,152 n.4 (1938) 
  

217. Kennedy v Silas Mason Co., supra, 334 U.S. at 257 
  

-21- 

 



  

portantly, on a motion for summary judgement, it is HEW and 

not plaintiffs who has the burden of establishing the truth of 

these statements. g.g., Rose v Bridgeport Brass Co., supra, 
  

487 F.2d at 808. That burden cannot be met and has not been met 

without facts as to the number of patients seeking treatment at 

the emergency room. 

In addition, HEW acknowledges that a linear accelerator, 

which provides radiation treatment, is available at Broadway 

Methodist but not at Gary Methodist and that minority residents 

of Gary can only receive such treatment by private transportation 

to Broadway, which is fifteen miles outside Gary. 22/ HEW 

summarily dismisses this discrepancy in an important service with 

the statement, "The physicians interviewed were not aware of any 

patient having difficulty as far as accessibility of treatment is 

23/ 
concerned,” . — Self-serving statements which are not in affi- 

davit form may not be considered as to whether a genuine issue 

of material fact exists. Tunnell v Wiley, 514 F.2d 971 (3rd 
  

Cir. 1975); Smith v Mack Trucks, Inc., 505 F.24. 1248 {oth Cir, 1974). 
  

Plaintiffs are in the process of collecting affidavits from black 

citizens of Gary which establish that they are in fact having 

serious difficulty in obtaining transportation to Broadway 

particularly since there is no public transportation to Broadway 

  

22/ Exhibit 17 at p. 22 

33 Id. 
he 0 

 



  

Methodist from the City of Gary. ~° Even if 

this were not so, however, the placement of the linear accelerator 

at the facility which serves a smaller, white population violates 

the mandate of 45 C.F.R. § 80.3 (b) (X¥) (iv) that minority recipients 

not be restricted "in any way in the enjoyment of any advantage 

or privilege enjoyed by others receiving any service." 

The assurances which HEW had Methodist sign prior to 

the grant of Hill Burton funds to construct Broadway Methodist 

Hospital did not mandate equally of care or intergration of patient 

populations, but only required that Gary Methodist be maintained 

as a viable hospital. 2 It is clear that both the statutory 

and regulatory language of Title VI, as well as case law, require 

much more: Title VI prohibits any discrimination. any denial of 

benefits and any segregation of black patients of defendant 

Methodist Hospital. Those assurances thus cannot discharge the 

obligation of HEW. In addition, HEW itself has seriously questioned 

whether Gary Methodist Hospital will be able to continue to 

operate as a viable institution. See Exhibit 3 where Mr. Sanchez 

felt "a dim picture is being painted for medical care [in the 

inner city] in the future." Serious issues of material facts exist 

as to the role that the construction and expansion of Broadway 

Methodist has played in the loss of doctors who had served the 

  

24/ See assurances attached to complaint. 

-23- 

 



      

inner tity. According to HEW, of the 165 physicians on the medical 

staff of Methodist Hospital, nearly half now practice primarily at 

Broadway, dispite the fact that Broadway has approximately 

one-third the number of beds as does Gary Methodist Hospital, 
25/ 

and Broadway has only half the number of patient days as does 

26 / : 
Gary. ~— According to Title VI regulations: 

"In determining the site or location of 
a facilities, an applicant or recipient 

may not make selections with the effect of 

excluding individuals from, deneying them 

the benefits of, or subjecting them to 

discrimination...on the ground of race, 

color-of national origin. 45 Cc. P.R. §'80.3 

(B) (3). 

The location of a brand new facility in an all white suburb has 

resulted .in the loss by minority residents of Gary of virtually 

half of the previously available doctors. Serious issues of 

fact exist as to the effect of the expansion of Broadway 

on the further drain of resources. 

In order to determine whether HEW has violated Title VI, 

it is obviously essential to determine whether Methodist Hospital 

is segregating and discriminating against minority residents of 

Gary in the provision of health services. If, as plaintiffs 

contend, this discrimination is occurring, than HEW is as a 

matter of law violating Title VI by continuing to channel funds 

  

25/ Txnibit 17 at'ps 17 and Complaint. 

26/ See letter and report dated January 19, 1977 R.B. Glesne, 
Administrator of Methodist Hospital to Alfred Sanchez, 

Attached as Exhibit B to this memorandum. 

«Dl 

 



  

to Methodist Hospital and by failing to cite Methodist Hospital 

for its violation. See Adams v_ Richardson, supra; Gautreaux v 
  

Romney, supra; Shannon v HUD, supra. The issues raised by this 
  

allegation are complex and varied and include the need not only 

for a complete record as to staffing, patient populations and 

services, but also as to the motive of Lithadtst Hospital for its 

consistent determination to channel the vast majority of Federal 

funds to the new, suburban facility as opposed to the older one 

which serves the black population. As the Supreme Court has 

stated, "where motive and intent play leading roles," it is unwise 

to grant summary judgement." Poller v Columbia Broadcasting Svstem, 
  

Inc., 368 U.S, 464, 473 (1952); gccord, Adickes v. S. HB. Kress (O., 
  

398 U.S. 144 (1970). HEW has not submitted a single affidavit 

to support the statements contained in its exhibits. Without 

clear proof to rebut the allegations in plaintiffs’ complaint, 

summary judgement cannot be granted. 

CONCLUSION 
  

For the reasons stated above, the motion of HEW must 

be denied. 

Respectfully submitted, 

t 

heat, QO Aud 
JACK GREENBERG VY 
BETH J. LIER 

10 Columbus Circle 

New York, New York 10019 

  

-25- 

 



  

JULIAN ALLEN 

2009 Broadway 

Gary, Indiana 46407 

MARILYN G. ROSE 

CHRISTINE B. HICKMAN 

1751 N Street, N.W. 

Washington, D.C. 20036 

Attorneys for Plaintiffs 

 



  

CERTIFICATE OF SERVICE 
  

I hereby certify that a copy of the foregoing MEMORANDUM 

OF LAW IN OPPOSITION TO THE MOTION OF DEFENDANT CALIFANO TO 

DISMISS, OR IN THE ALTERNATIVE, FOR SUMMARY JUDGEMENT, was 

served by United States Mail, postage prepared, on the 7th day 

of May, 1977, on counsel for defendants as follows: 

HODGES, DAVIS, GRUENBERG, COMPTON 

& SAYERS, BRUCE E. SAYERS, ESQ. 

5525 Broadway 

Gary, Indiana 46401 

MARVIN E. GARVIN & EDWARD L. KOVEN 

REGIONAL ATTORNEY & GENERAL ATTORNEY 

Department of Health, Education and 

Welfare 

300 south Wacker Drive, 18th Floor 

Chicago, Illinois 

RICHARD L. KIESER 

UNITED STATES ATTORNEY FOR 

THE NORTHERN DISTRICT OF INDIANA 

HAMMOND, INDIANA 

Fred W. Grady 

Assistant United States Attorney 

hei. Aol 
  

BETH J. LIEF 
Attorney for Plaintiffs 

 



  

  

  

  
  

  
  

  

  

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UNITED STATES DISTRICT COURT , i 
| FOR THE DISTRICT OF COLUMBIA j=} 
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; KENNETH ADAMS et al., Yo : 
4 : or ) i 

: Plaintiffs,  ) 
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: Pye WAY ) Civil Action No. 3095-70 
; phen % to, ; ) i 

og CASPAR W. WEINBERGER, individually ) 
; and as Secretary of the Department ) 
! of Health, Education and Welfare, ) : | 

; et al., ) IV ED) 
: ) El I : | 

! Defendants. ; MAR 141975 i 
JAMES FE. DAVEY, Clerk   SUPPLEMENTAL ORDER 

  

This cause came before this Court upon plaintiffs.’ Motion for 

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—
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Further Relief and the Opposition of the defendants thereto. After a 

review of the entire record, the Court inclines to the belief that sub- 

- 

stantial progress has been made in this difficult and complex area. On 

the other hand, without deprecating the value of voluntary settlement of 

these problems, thers appears to be an over-reliance by HEW on the use of 

voluntary negotiations over protracted time periods and a "reluctance in 

recent years to use the administrative sanction process where school 

  

districts are known to be in non-compliance ***" Report of United States 

Commission on Civil Rights, January 22, 1975, page 131, n. 1. Having 
  

| 
1 - 

considered the motion and opposition and the record before it, this Court 
| 

enters the following findings and remedial provisions. 

| : A. 125 Substantial Racial Disprovortion 

Th "Districts. : 

| rT 1/ 
As this Court found in its February 16, 1973 Order, the Supreme 

    
Court in Swann v. Charlotte-Mecklenburg Board of Education, 402 U.S. 1 
      

4 3 (1971) enunciated "a presumption against schools that are substantially 

disproportionate in their racial composition.” In Appendix B of that 

    1/° Adams v. Richardson, 356 F. Supp. 92 (1973). 
  

    
  

 



  

  

  

  
  

  

  

Te i 

February 16, 1973 Order, the Court listed 85 southern school districts 

having one or more schools substantially disproportionate in their composi- 

tion (because at least a.207 disproportion existed between the percentage 

hg of local minority pupils in the schools and the percentage in the entire 

school district). HEW not having required any of these 85 school districts 

to explain or rebut the substantial racial disproportions in the schools, 

this Court enjoined NEW to communicate with cach of the districts within 

—
 

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60 days, putting them on notice to rebut or explain the disproportions in 

one or more of their schools. HEW took appropriate acticn pursuant to 

{ 
this Order and substantial compliance progress resulted therefrom. However,   the record now reveals an additional 125 southern "HEW school districts” 

jy th one or more schools substantially disproportionate in their racial a 
| 

composition (see Attachment A), where HEW has not sought an explanation or 

rebuttal from the school district. ; i 

: WHEREFORE, in supplementation of ¥ III B (1) of this Court's 

i Order of February 16, 1973, defendants, their successors, agents and 

employees are required and enjoined within 80 days of the date of this 

Order to communicate with ach of the 125 districts listed in Attachment A, 

putting them on notice to rebut or explain the substantial racial dis- 

* proportion in one or more of the districts' schools. 

B. "293 Districts With Allegations of Miscellaneous 

"Violations. 
  

=e "  Plaintiffs' Motion for Further Relief alleges that there are 

293 additional districts where HEW has found presumptive Title VI violaticms. 

The daposition and affidavit of Dr. Lloyd R. Henderson, indicate however 

2 
that the statistical data on which this allegation is based demonstrate 

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n   possible Title VI problems and not presumptive violations. We accept for 

, the present HEW's assertion that one of the purposes of the Enforcement . : 

Analysis Tables compiled on a nationwide basis was to provide an indicatien 

  

2/ The data were extracted from Office of Civil Rights 

1972-1973 Enforcement Analysis Tables.   
  

    
  

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of those districts which might be likely candidates for Title VI compliance 

activity and to aid in the determination of priorities. 

, WHEREFORE, plaintiffs’ request for further relief in this area 

is denied at this time. 

C. 6 ESAA Districts. 
  

With respect to 116 alanentary and secondary school districts, 

where HEW had found probable violations of Title VI, this Court's 

Febriary 16, 1973 Order held that the time permitted by Title VI for 

seething voluntary compliance before commencing enforcement proceedings 

had org since passed (TY II A (5); III (A) (7)). HEW had found the 

districts In violation or presumptive violation of Title VI and had failed 

during substantial periods of time to achieve voluntary compliance. 

Accordingly, the Court ordered HEW within 60 days to commence enforcement 
. - | 

proceedings by administrative notice of hearing or any other means authorized 

by law against each of the districts in order to effect compliance with 

Title VI. In the spring of 1973, HEW declared 17 HEW districts in the | 

south ineligible for funding ender the Emergency School Aid Act of 1972 

because of substantial civil rights violations. Nine districts were the 

subject of HEW en Zorienent activity pursuant to specific directives of 

this Hourt's February 16, 1973 Order. Since the filing of the present 

Motion for Further Relief, Orangeburz, South Carolina has been found 

eligible for ESAA funding and Charles County, Maryland, has submitted a 

student assignment plan acceptable to HEW. In the remaining 6 districts, 

however, HEW has made no efforts to effectuate compliance with Title VI 

after indication of substantial civil rights violations. 

WHEREFORE, in supplementation of YY II B (1) and III B (2) of 

this Court's Order of February 16, 1973, defendants, their successors, 

agents and employees, are required and enjoined within 60 days of the date 

of the Supplemental Order* to commence enforcement proceedings by administra- 

tive notice of hearing or any other means authorized by law against each 

tek rd NC p————— 1 ———_ = . 

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of the school districts identified in Attachment B, in order to effect 
I 

complidnce with Title VI. 

D. 39 Unresolved Swi. Districts. 
  

In its February 16, 1973 Order, this Court found 85 school 

districts presimprively in vizl2vdnn of Swann and Title VI because they 

nel ode or wore sdhacle Substantial Th diepedvortionsts in their racial 

composition. This Court ordered defendants to communicate with each of 

these districts promptly, putting them on notice to rebut or explain the 

stbssidetal racial disproportions (Y III B (1)). HEW has done so. 

Thirty-one of these districts have since been found in compliance by HEW, 

and 15 others are in litigation or under court order. rl iaratr of 

the diierioe remain unresolved more than 25 months after the issuance of 

this Court's Order, but HEW has not initiated enforcement seocaedings 

against any of them. The time for securing compliance by merely voluntary 

means in these districts has passed. 

WHEREFORE, defendants, their successors, agents and employees, 

are’ diiutred gud grivined within 60 days from the date of this Order to 

commence enforcement Stacdedings by administrative notice of hearing or 

any other means authdrized by law, in order to effect compliance witt 

Title VI by each of the school districts identified in Ateichment C. 

: J 

E. Hundreds of School Districts Subject to 

“"Court Desegregation Orders. 
  

  

This Court's Order of February 16, 1973 (4 V B (2)) required HEW 

to Situs its findings of court order violations to the attention of the 

court concerned. Since that Order issued, HEW has identified numerous 

southern districts subject to judicial desegregation orders which, in 

violating or apparently violating Title VI, are in violation of sald 

court orders. 

  - 

3/ Defendants have admitted that 21 of these 39 districts 
remain unresolved, claiming that 18 districts of the 
39 are now in compliance. Since we are not advised 
either of the names of said districts or the reasons: 

why they should not be still included, they are covered 

by this Order. 

  

  

  

 



  

  
  

  

    
  

  

    

“Sw 

In cases where the United States is a party, HEW has referred 

some of this information of violations or presumptive violations of 

court orders to the Justice Department, but none of the information has 

been brought to the attention of the courts concerned. In cases of 

orders resulting from private litigation, such information has not been 

conveyed either to the courts or to the private attorneys of record. 

WHEREFORE, in supplementaticn of ¥ V B (1) and (2) of this 

Court's Order of February 16, 1973, defendants, thelr successors, agents 

and employees, through the Justice Department or other means, are required 

and enjoined within 120’ days of the date of this Supplemental Order to 

call to the attention of the courts concerned each of the violations or 

presumptive violations of court orders, unless defendants have made a 

administrative determination of compliance by the school district within 

5; 

the 120-day period. « 

F. Future HEW Compliance with Title VI. 
  

This Court has ruled in this case that HEW has a duty to 

commence prompt enforcement activity upon all complaints or other 

information of racial discrimination in violation of Title VI, aad that 

where it appears that a school district is in violation or presumptive 

violation of Title VI the agency has a duty under Title VI to commence 

enforcement proceedings by administrative notice of hearing or any other 

means authorized by law where efforts to obtain voluntary compliance do 

not succeed within a reasonable period. 

HEW has often’ delayed too long in ascertaining whether a complaint 

or other information of racial discrimination constitutes a violation of 

Title VI. HEW has also frequently failed to commence enforcement proceed- 

ings by administrative notice of hearing or any other means authorized by law 

  

  

  

 



           

  

  

  

  

  
| 

| 

rire BLA al R | Bi 

} 

1 

] although the efforts to obtain voluntary compliance have not succeeded : 

during a substantial period of time. As shown in Section D above, in 

39 "unresolved" Swann districts, HEW, having failed during a substantial | 
period of time to achieve voluntary compliance, has not commenced enforce- 

ment proceedings by administrative notice of hearing or any other means 

| authorized by law. Apart from the school districts expressly covered 

by this Court's February 16, 1973 Order, HEW has not initiated a single 

administrative enforcement proceeding against a southern school district 

since the issuance of this Court's Order 25 months ago. 

are required and enjoined hereafter to carry out their Title VI enforcement 

activities affecting public school districts in the 17 southern -and border   
I 
| 

i 
| 

[ 
) 

| 
| WHEREFORE, defendants, their successors, agents and employees 

: 

| states according to the following schedule: : 
= 

(a) Within 90 days of receipt by HEW of a complaint or other 

Information of racial discrimination, determine for 

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. administrative purposes whether the district is in or 

cut of compliance with Title VI:   
(5) Wherever there is not a determination of compliance by - 

the 90th day, attempt to secure compliance through 

voluntary means for an additional period not to exceed - 

90 days; 

i {¢) Where such compliance is not sacured within 180 days 

of the receipt of the complaint or other information 

of racial discrimination, commence within 30 days 

thereafter an enforcement proceeding through adminis- 

EE : trative notice of hearing or any other means . i   ' i authorized Hy law. : : | 

G. Supnlemental Reporting Provision. ‘ HH   

Supplementing the reporting provisions in this Court's Order of 

February 16, 1973, defendants, their successors, agents and employees, are   
  

  

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: | required and enjoined to provide in verified form to counsel for plaintiffs ; 

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5 ii within 150 days of the date of this Supplemental Order, and at the time 

i | | 
fi of all subsequent reports required by this Court's February 16, 1973 : 

“a J ‘ i : 

# 1 Order, a Summary of all steps tuken to comply with the injunctive provisions 

! : | : ; | 

} i set forth in the preceding paragraphs. 2 

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Toa 4 Unided States District Judge | i 

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Attachment A 

(Page 1 of 3 pages) 

  | 
| 
| 
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| 
i SUBSTANTIAL RACIAL DISPROPORTION DISTRICTS 
  

ARKANSAS 

Jonesboro School District #1 

DELAWARE, .. , 

Caesar Rodney . : 
De La Warr School Disiiict 

Newark 

FLORIDA 

Levy County 
Monroe County 

* GEORGIA 

Madison County 

Thomasville City : 

"KENTUCKY 

Covington City : 
Elizabethtown Independent 
Warren County 

LOUISIANA 

Allen Parish 
Vernon Parish 

MARYLAND 

Baltimore County 

Caroline County 

Cecil County Public Schools 

Frederick County : 
Howard County 

Montgomery County Pub. Sch. 

. Talbot County 
Washington County 

M1SsSISssirrl 

Lee County 

MISSOURI 

Cape Girardeau Public #63 
Joplin R-8 
Poplar Bluff R-1 

Special Sch. Dist. of St. Louis 
Springfield R-12 

  

  

  

 



  

  
  

  

  

      

} 

NORTH CAROLINA 
  

Burke County 
Caswell County 

Chatham County 

Hoke County 

Jackson County 

Madison-Mayodan City 

Onslow County 

Pender County 
Polk County Bd. of Educ. 

Randolph County 

Roancke Rapids Graded School 
Rowan County Schools : 
Shelby City Schools 
Stanly County 
Swain County Schools 
Union County 
Vance County 
Wayne County 

Wilkes County 

OKLAHOMA. 

Altus 

Bristow 

Claremore City 
Dutant Public Schools 
Enid Public Schools 

Moore : 
Moton ' 
Norman 
Sapulpa City Schools 
Shawnee 

SOUTH CAROLINA 

’ 

  

Aiken County 

Bamberg County 01 
Charleston County School Dist. 

* Edgefield County 
Greenwood County S50 

Marion County 01 

Orangeburg County 02 

Pickens County 

Richland County 01 

Richland County School Dist. #2 
Spartanburg County 02 

Spartanburg County 06 

Spartanburg County 07 

TENNESSEE 

Athens City Schools 
Dyer County 

Hamilton County 

Hardeman County Bd. of Educ. 

Lincoln County 

Morristown City 
Williamson County 

Attachment A 

(Page 2 of 3 pages) 

    

  

 



  

  
  

    

  

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TEXAS 

Alamo Heights ISD 

Alice Ind. School Dist. 
Amarillo ISD 

Arlington ISD 

Bay City ISD 

i Brazosport Independent School 
Cleburne ISD 

Cotulla Ind. School Dist. 

Dumas ISD 

East Central ISD 

Edinburg CCN Ind. Sch. Distr. 

El Campo Independent School Dist. 

El Paso Independent School Dist. 
Gainesville Ind. School Dist. 
Gregory-Portland ISD 

Harlandale ISD 

Harlingen CISC 

i Hereford Indept. School Dist. 

Irving Independent 

Xerrville ISD 

La Porte Indep. Sch. Dist. 
Livingston Independent School 

Marfa Ind. School Dist. 
McAllen Ind. School District 

Morton Ind. School Dist. 
‘New Boston ISD 
New Braunfels I SD 

North Forest ISD 

Palestine Ind. School District 
Pampa Indep. Sch. Dist. 
Pasadena Ind. School Dist. 

Pecos-Barstow Consolidated ISD 
Pleasanton ISD 
Round Rock I S D 

Sherman Ind. School District 
South San Antonio ISD 
Southwest ISC 

Tuloso-Midway Ind. School Dist. 

United Independent School Dist. 
Vernon Consolidated Independent 
Wharton Ind. Sch. Dist. 

Ysleta Independent Sch. Dist, 

© VIRGINIA 

Fairfax County 

Prince William County 
’ 

WEST VIRGINIA 
  

Fayette Co. Bd.. of Educ. 
Marion County Bd. of Educ. 

"Mineral County 
Mingo County 

* Ohio County 

Attachment A 
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THE METHODIST BOSPITAL OF GARY, INC. 
BROADWAY METHODIST HOSPITAL     

Reply to: [J 
Reply te [7] 

METHODIST HOSPITAL OF GARY : : BROADWAY METHODIST HOSPITA t 600 GRANT STREET 
8701 BROADWAY : GARY, INDIANA 46402 
MERRILLVILLE, INDIANA 44410 219 886-4000 
219 738.5500 

January 19, 1977 

| RECEIVE 
JAN on 3 Aa Alfred J. Sanchez Alt 20 1877 

Chief, Health and Social Services Branch 
Office for Civil Rights, Region V 
Department of Health Education and Welfare OFFICE FOR CIViL RIGHTS 
300 So. Wacker Drive 

Chicago, Illinois 60606 

Dear Mr. Sanchez: 

In response to your letter of 12/22/76, The Methodist Hospital of Gary, Inc., wishes to provide the following information specifically relating 
to each of the allegations made against the hospital. In addition, you should be aware of the following facts, in reference to the Civil 
Rights Assurances signed by The Methodist Hospital of Gary, dnc., in 
1873: 

1. There has been no reduction of services at the Gary hospital 
since the assurances were signed. 

2. A continuous capital equipment and renovation program has 
been in effect at the Gary hospital for at least twenty 
years. 

The programs and equipment found in the Gary hospital are 
among the most modern to be found in any urban hospital of 
comparable size and age. 

3. Every effort has been made by the Board and Administration 
of the two hospitals to operate the hospitals in a fiscally 
prudent and efficient manner. Basic services have been 
duplicated in the Gary and Broadway facilities, solely in the 
interest of effective care and service to the patient, whose 
interests must be given priority. 

The hospital has consciously kept your office advised of all it's plans 
for expansion and development of services at both hospital sites, and 
will continue to do so in the future should additional programs be 
contemplated at either site. 

Exhibit B 
0) 

. ’ 

 



Satan imate re’ Eton ins Een Ahi vain 2 SA ran, ei TE non Vt WALI ATCT PIE TR Sooners ot va Firms «mires PR : . 

i a » ki \ / ‘ 
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. 

  

Alfred J. Sanchez January 19, 1977 
Office for Civil Rights : Page 2 
Department of Health Education and Welfare : 
Chicago, l1linois 

& : The commitment of The Methodist Hospital of Gary, Inc., to its entire 
: service area of eastern Lake County has been a deep and abiding one for 

54 years. Within the limits of its.resources, the hospital organization 
will continue to provide the best possible facilities and programs of 
care to the patients throughout the area it serves regardless of their . race, creed, or national origin. 

We have answered the allegations within the time frame you proposed. 
} We have been forthright and direct in responding to these allegations, 

despite the fact that many of the allegations assumed facts which vere 
x not true. We have tried to provide you with the best information we 

could within the time allotted. 

Si rel 

7 R. B. Glesne 

Administrator 

RBG/bas 

Attachments 

 



  

The Methodist Hospital of Gary, Inc. 
  

Xerography Machine 
  

In regard to Xerography being available at Broadway Methodist 
Hospital but not at the Gary Hospital, it should be noted that 
xeromammography (available at Broadway) and xeroradiography 
(available at Gary) are both of equal value, accuracy and 
benefit. A recent article in the American College of Radiology 
by Dr. Lester who was Chief of Radiology at Duke University, 
stated that ''the two modalities are of equal value and benefit, 
but the determining factor is the expertise of the examiner'. 

The Xeromammography machine was not purchased at Broadway, but 
was rented in May 1976 on a temporary basis for testing and 
evaluation to evaluate if this service would be as reliable as 
the Xeroradiography machine at the Gary Hospital and also meet 
the needs of the medical staff. 

In the last several months the number of mammograms have de- 
clined markedly because of recent publicity in regard to adverse 
effects from radiation exposure. In 1975, there were nearly 600 
mammograms performed at the Gary Hospital whereas in 1976 there 
were less than 300 examinations. On reviewing our statistics 
it was noted that in August, September, October, and November 
of 1376 there was an average of less than 12 mammograms a month 
in contrast to 45 mammograms a month in 1975. It was for this 
reason that it was not advisable to duplicate both mammogram 
services at either hospital. : 

Urology Room 
  

One small cystology room is available at the Broadway Hospital 
adjacent to the surgical area. This room can function only as 
a diagnostic room; thus patients in need of surgery need to be 
transferred to the surgical area or scheduled for future surgery 
at a later date since this room is not suitable for surgery. 

A cystoscopy table at Gary is available in one of the larger 
surgical suites. The cystoscopy table at Gary can also function 
as a surgical table; thus immediate surgery can be performed 
following a diagnostic procedure. The ability to perform 
surgery following a diagnostic procedure is sometimes advanta- 
geous to the patient and attending physician. 

The administrative office has not been made aware that patients 
have to wait up to a week to have surgery scheduled at the Gary 
Hospital. There is usually open time available every day of 
the week and with proper scheduling there should be no waiting 
period. Since most of the medical staff urologists are also 

 



ve hc ; , iy = £ : or : ; : r n . 

  

staff members of at least 3-4 area hospitals, any scheduling wait 
is most likely created due to the weekly schedule of the operating 
physician. The hospital also has a very active medical staff, 
Utilization Review Committee, and daily surveillance is made on 
all hospitalized patients; thus authorization to have the patient 
wait in the hospital for a week for surgery would not be permitted. 

3. X-Ray Equipment in Surgery 
  

One control stand and one generator is available in surgery at 
the Broadway Methodist Hospital. This equipment can serve two 

ily. rooms. A similar machine is available at Gary Methodist Hospital 
in cone room. However, other surgical suite rooms have 240 volt 
shockproof outlets; therefore, a 200 KV portable machine can be 
used in any surgical room at Gary Methodist Hospital. 

x’ Gary Methodist Hospital has one operating room equipped with a 
well wired rapid changer machine able to perform angiography--- 

< this service is not available at Broadway Methodist Hospital. 

In the summer of 1976 bids were obtained to completely renovate 
one .of the fluorscopic and diagnostic X-ray units at the Gary 
Methodist Hospital. Work was begun in the fall of 1976 and 
completed the first week of January, 1977. There was a complete 
renovation of an entire room with the most modern expensive 
equipment available. This room is essentially the same as the 
facility at the new hospital in Merrillville. It should also be 
noted that bids are now also being obtained to renovate a second 

» room at the Gary Methodist Hospital and this work should be 
completed in 1977. 

Currently, there is discussion involving plans for enlarging the 
special procedures room in the Radiology Department at Gary 
Methodist Hospital. Hopefully, this expanded service will be- 
come operational by early 1978. 

[Te should be noted without anyone really having to point it out 
that when one builds a new hospital the most modern technological 

| equipment that budgetary allowances permit would be purchased. 
| 

The Gary Hospital has been in existence since 1923 and consequently 
\ the equipment is older and cannot be equated to. that going into a 
\new hospital. However, major pieces of equipment have besn pur- 
chased annually at the Gary Hospital in order to insure that 
quality services are available. These additions have always been 
undertaken at the hospital's initiative: witness our completely 
renovating and replacing one entire diagnostic unit, including 
image intensification and television control at the Gary Hospital. 

It should also be noted that at the Gary Methodist Hospital we 
have six rooms of diagnostic radiology equipment whereas at the 
Merrillville Hospital there are only four rooms of diagnostic 

}=19=-77 

 



  
oy 

equipment. 

Gary Methodist Hospital has 7 stationery x-ray machines with 
separate controls and generators. 

Broadway Methodist Hospital has 5 stationery machines with _ 
separate controls and generators. 

The same diagnostic procedures are performed at Gary Methodist 
Hospital as at Broadway Methodist Hospital namely: myelography, 
hysterosalpingography, arteriography, arthrography, lymphangio- 
graphy, tomography, mammography; in other words, all of these 
diagnostic procedures are performed at both hospitals. 

Film storage is a constant problem and it should be noted that 
Gary Methodist Hospital has 4 times the storage than is available 
at Broadway Methodist. 

Image Intensifiers 
  

There are 5 Image Intensifiers at Gary Methodist Hospital. Two of 
these are portable and can be used in any of the operating rooms, 
Intensive Care Units, or a patient room at the Gary Hospital. 

Broadway Methodist Hospital has a total of 2 Image Intensifiers 
which are permanently located and can only be used in the main 
Radiology Department. 

It should also be noted that Gary Methodist Hospital has 6 
portable x-ray machines, one of which is 3 panoramic machine. 
Broadway Methodist has only 2 portable machines. 

Portable Monitors in Recovery Room 
  

The recovery room at Broadway has portable monitors. There is one 
portable monitor and defribrillator available for use in the re- 
covery room at the Gary Hospital. 

There are current plans to add portable monitors for individual 
E.K.G. scope monitoring of patients at the Gary Hospital recovery 
room and these should be available in 1977. 

It should be noted that the essential modality of treatment is 
physical observation by the personnel. 

Automatic Patient Cart Washer 
  

There is an automatic cart washer at Broadway as this piece of modern 
technology was not available until the time the Broadway Hospital was 
built. 

 



  

® - ® = 

Carts at the Gary Hospital are hand washed with ''Beaucoup'' and 
within 3-4 minutes are germicidally clean and available for use 
when needed. All carts returned to Central Service are washed 
properly at both hospitals prior to returning to any of the 
hospital nursing stations. 

Combination Gas-Steam Autoclave Sterilizer with an Aeration Chamber 
  

Broadway Methodist Hospital has a gas sterilizer with a separate 
aeration chamber located in the central processing area. This 
equipment is used to sterilize catheters, trays, rubber and 
plastic supplies as well as surgical instruments. 

Methodist Hospital in Gary also has a smaller gas sterilizer located 
in the operating area but is seldom used because it is more convenient 
to send supplies to the Broadway Hospital for processing; thus avoid- 
ing duplication of effort and expensive equipment. 

A well scheduled transportation system operates between the two 
hospitals and provides for this type of service. For example, 
'""eut down'' needles are processed at the Broadway Hospital, using 
the Gas Sterilizer, and returned to Gary on a routine scheduled 
basis. 

It should be pointed out that other methods of sterilization can 
be used effectively and safely beside gas sterilization. Both 
institutions have steam autoclave sterilization, cold sterilization 
methods, as well as the gas sterilization technique. All methods 
are monitored by quality control methods; thus assuring the hospital 
that safe and effective sterile technique is being maintained. 

Ultra-Sonic Instrument Washer 
  

This is correct---there is an ultra-sonic instrument washer at the 
Broadway Hospital and nore at the Gary Hospital. Instruments are 
hand-washed at Gary, rinsed, wrapped, and autoclaved for sterile 
purposes. 

Ultra-sonic instrument washing is a modern cleaning technique and 
was installed in the Broadway Hospital at the time it was built. 
Instruments coming out of the ultra-sonic machine must also be 
checked for cleanliness by an employee before wrapping and sterili- 
zing. Both techniques are safe and acceptable standards of operation. 

Private Rooms 
  

All rooms at the Broadway Hospital are private. Again, this was 
the latest concept in patient care units at the time the hospital 
was designed and built. It was also pointed out in the literature 

 



  

10. 

11) 

to be the most reasonable in cost, because patient transfers would not be necessary and rooms could be utilized more effectively, 

Gary Methodist Hospital was built in 1523 when this concept was not recommended. In fact ''8 bed wards'' were considered to be the most modern concept in the delivery of patient care. Continuous re- modeling over the last 50 years has taken place at the Gary Hospital and at the present time there are no 8 bed wards or 4 bed wards. Our beds are all state conforming. It is our understanding that there are approximately 185 beds in the community that are not con- forming. 

Nurses 

Gary Methodist Hospital employees 156 nurses. 

*22 of whom are Filipino nurses 

Patient Average Census - 260 

Broadway Methodist Hospital employees 109 nurses. 

“None are Filipino 

Patient Average Census - 140 

*The Filipino nurses were employed at the Gary Hospital prior to the existence of Broadway Methodist Hospital. Like mans inter-city hospitals it is difficult to recruit an adequate number of nurses; 

on the 3rd floor of the Administration Center and since these nurses do not have transportation, they choose to stay and work at the Gary Hospital. They are welcome to work at both institutions. 

Physicians 
  

It is both prestigious and advantageous to the Gary Methodist Hospital to have a higher percentage of externs, medical students, and physi- cian residents at the Gary Hospital. These young men and women are from teaching institutions, which are the most respected medical schools and hospitals in the country, It is also a stimulus to the medical staff and the entire hospital personnel to have these medical professional workers in the Gary Hospital. 

I't should also be noted that the Gary Methodist Hospital has recently completed a very extensive Family Practice Residency Program curriculum 

- 5 = 

 



  

application and has been site surveyed by the American Medical Asso- 
ciation Academy of Family Practice. The residency is to be a three- 
year program and will be located at the Gary Hospital and serve the 
Gary community. The focus of this three-year program is on the 

, - delivery of quality medical care to families in need of health care 
: on a 24 hour basis. The residents in this program are licensed 

physicians and will spend a total of 3 years associated with family 
medicine under supervision and direction of a full time Medical 
Director and medical staff physicians willing to donate their time 

: teaching in this residency program at Gary Methodist Hospital. 

The Board of Directors of Methodist Hospital has also allocated 
$250,000 annually for operational support of this program. The 
3 million dollar building project at the Gary Hospital will include 
a floor devoted to this residency program. A total of 12 licensed 
physicians will compliment the residency program and serve the 

3 community and their medical needs. 

. 12. Rooms for Physicians on Call 
  

At the Broadway Hospital the only on call rooms are centrally 
available in one area of the hospital. Any physician needing to 
stay at the hospital must go to the 2nd floor of the hospital for 
sleeping accommodations. These physicians are then called to 
various areas of the hospital when their services are needed. 

At the Gary Hospital there are several on call rooms available for 
physicians located in numerous patient care areas. For example, 
the emergency room at Gary has an on call room for the physician 
in the immediate area, thus the physician is always immediately 
available. Likewise, in the 0.B. department at Gary, there are on 
call rooms available for physicians and anesthetist---this is not 
true at Broadway Hospital. The administrative building at Gary 
also has several rooms on the second floor that are available for 
physicians, technicians, or any hospital employee needing to stay 
on the hospital premises overnight. There is no administrative 
building at the Broadway Hospital that can offer these types of 
accommodations. 

13. Linear Accelerator 
  — 

The use of the linear accelerator is the latest modality of radiation 
treatment of cancer patients and this equipment has only been made 
available in the last few years. 

It should also be noted that the linear accelerator was placed at the 
hospital in Merrillville for several reasons: 1) It was recognized 
that St. Catherine's and St. Margaret's hospitals both had high 
energy sources of radiation and it was considered in the best interest 

“tw 

 



  

4. 

SACRE IR IN @® Ce te EN A SE » . a 

geographically, to install the new linear accelerator in the 

southern part of the County where high energy radiation sources 

were lacking or unavailable. In all probability planning would 
not allow a linear accelerator in Gary due to population needs, 

and close proxsimity to St. Catherine's and St. Margaret's, 
2) The room requires extensive architectural planning and 

would have been impossible to build in The Gary Methodist 

Hospital because of space considerations and architectural re- 
quirements. 

Cesium is available at both hospitals for implantation. 

Modernization of Gary Methodist Hospital 
  

a. Inadequate power plant---in 1972 a new boiler was added to 

the Gary plant at the cost of $160,000. The present power 
plant is adequate to carry the present hospital power needs. 

One of the building projects approved by H.E.W. is a new 
laundry facility. 

  

With a new modern laundry facility that will serve both insti- 
tutiors this will relieve the present power plant at the Gary 

Hospital and will allow for future expansion and remodeling 

projects. The hospital Board of Directors approved this project 

several years ago and we expect to start the building on this 

project along with the two other building projects when the 

present issues are resolved. : 

'b. Radiology (X-Ray) Department---please refer to question #3 and #4. 
  

c. Emergency Room---the present emergency department at Gary Methodist 
was totally renovated and replaced the former emergency room in 
August, 1973. 

  

The remodeled area consists of 6 treatment bays, 2 treatment carts 
in a self-contained ''trauma room'', a ''triage' room which can 
double as a minor treatment room, a pediatric treatment room, 
and a orthopedic cast room which is located off the emergency 
department/out-patient lobby. The Gary facility can routinely 
care for 9 patients on carts, simultaneously, with a total capa- 
city for 12 occupied carts. 

The Broadway Emergency Department has 4 treatment bays with carts 
and a combination Cast/Trauma Room which has 2 carts for a total 
capacity of 6 patients on carts. The fourth treatment bay doubles 
8s an examining area for the Pre-admission Center, while Gary 
Methodist has a separate and much larger Pre-admission Center. 
Both hospital emergency room facilities are equally equipped, in- 
cluding one crash cart and one portahle EKG Monitor-defibrillator 
which is used during patient transport situations. 

 



  

Staffing Patterns: 
  

The Gary Emergency Department: 
  

1 - Head Nurse (R.N.) 
6 - R.N.'s (full-time) 
] 

7 
L.P.N. (full-time) 

EMT-11 Paramedics 

2 - full-time 

5 - part-time 

EMT- | 

2 - full-time 

3 - part-time 

1 - Physician Assistant 

full-time, evening shift 

wv
 ] 

He The Broadway Emergency Department: 
  

X 1 - Head Nurse (R.N.) 
: L - R.N.'s (full-time) 

1 = EMT-1 (full-time nights) 
plus Crown Rescue EMT |/EMT Il Paramedics who function 
as E.R. personnel while waiting for emergency runs. 

The EMT's are frequently called away from the department on emergency 
runs at the Broadway Hospital. This does not occur at the Gary 
Hospital since the EMT's are not scheduled on emergency runs while 

i working at the hospital. Both Emergency Departments share a common 
medical department director and a common E.M.S. physician group. 
Both departments have one physician on duty at all times. 

 



a tam A A Caaeen mpm ~ Siena - a “te tes Su vm i - - ps T — . 

® : 5 ; 

  

  

Health Education 

Health education offers a wide variety of programs as well as individual 
counseling at the Gary Hospital, including diabetic classes which meet 
every day during the week for both inpatients and outpatients. There are 

; pre-natal classes twice weekly as well as groups of evening classes four 
: times per year for the community. 

Health education has post-partum classes three times a week and infant 
care programs twice weekly. In addition to those, there are classes 
on tubal ligation and other preoperative preparation classes. 

Hypertension counseling and coronary classes are provided. There is 
much individual counseling for families with incidencies of ulcers, 

, Wh asthma, etc. Also, there is individual counseling for families regarding 
tube feedings, colostomy care, self-catheterization, mastectomy, etc. 

There are scoliosis classes held two times per month In correlation with 
the scoliosis clinic. 

At the Broadway facility there are classes in coronary and hypertension 
along with individual counseling. There are no pre-natal classes there, 
however, there are post-partum and infant care programs. There are 
classes on radiation therapy at Broadway that include a variety of in- 
formation relevant to those who are receiving treatments. There are 
diabetic classes held at Broadway, also. 

3 

In the community, the health education department is involved with the 
radio program WLTH, relating to a wide variety of health programs. The 
staff of the department also direct special presentations to area P.T.A. 
groups. They additionally give classes on C.P.R., diabetes, hypertension 
and coronary problems relevant to the families! needs. 

bJ 

 



    
Patient Days 
  

  

  

Gary Hospital . Broadway Hospital 

id Medicare Patient Days 20,000 13,900 

; Medicaid Patient Days | 17,500 1,350 
| Total Patient Days 97,526 45,321 

Admissions Policy 
  

  

  

X There is no separate admissions policy at either hospital regarding Medicare and Medicaid patients. 
\ 

Improvements and Additions of Service 
at Gary Hospital 

1976 

No reduction of services at Gary Methodist Hospital. 

1. Epilepsy Clinic added to existing Clinic Services 

2. Combined Employee and Medical Staff Library 

3. Regional Coordinating Center for EMT/Paramedic 
Training for 7 Counties: 

Lake 

LaPorte 
Jasper 

Pulaski 
sh Newton 
wit. Porter 

Stark 

4. Expanded and Extended Patient and Community Education Services/Programs 

5. Presently Enlarging Electro-Diagnostic Department and Services 

6, Presently Enlarging Nuclear Medicine - 'Wet Lab Services for Assay Testing 

7. Presently Enlarging Cast Clinic and Waiting area for Emergency Room and and Orthopedic Patients. 

JO 

 



  

8. Presently Expanding Laboratory Department---for Mini-Stat Lab Services 

'9, Remodeled Radiology Room 2 - Furnished with most modern up-to-date 

radiology equipment. 

10. Up-dated Library Texts and Reference Materials. 

11. Pilot Project with St. Vincent Hospital, Indianapolis - Family Practice 
Residents (physicians) working with 0.8. clinic under supervision and 
direction of Medical Director. 

12, Affiliating with Purdue University (Added to numerous other Educational 
Hospital Affiliations) A.D. Nursing students to Gary/Broadway - 12 stu- 

dents at Gary and 12 students at Broadway 

13. Security Department---added additional workforce 

Xo 14, Total Number Manhours for Employee Staff Development and Continuing 

Education at Gary - 42,912 

15. Total number Manhours for Employee Staff Development and Continuing 
Education at Broadway - 40,882. 

16. Auxiliary Contributions: 

Scholarship Assistance 
  

Auxiliary-A.D. Nursing-ind. University $1,500.00 
Medical Staff H fl n J 1,500.00 

3 Auxiliary (1/2 Tuition for Hospital 4,029.00 
personnel - 1976) 

Auxiliary (Youth Volunteer Scholarship) 1,000.00 
Cytology Lab. Scholarship (Special Award) 500.00 

- Yi - 

 



  

IN THE UNITED STATES DISTRICT COURT 

FOR THE NORTHERN DISTRICT OF INDIANA 

HAMMOND DIVISION 

  

BARBARA LEEK WESSON, 

W BERNICE TERRY, 

EDDIE GRAY and 

" ROSA REETON, 

(1
] 

  

    

  

    

  

Plaintiffs, : 

V. : 

METHODIST HOSPITAL OF GARY, INC., Cause No. H 76-373 

An Indiana Not-For-Profit . 

Corporation, and JOSEPH CALIFANO, 

United States Secretary of Health, : 

Education and welfare, 

Defendants. 

MEMORANDUM OF IAW IN OPPOSITION TO THE MOTION 

OF DEFENDANT CALIFANO TO DISMISS, OR IN 

THE ALTERNATIVE, FOR SUMMARY JUDGMENT 

3 JACK GEEENBERG 
BETH J. LIEF 

~ 10 Columbus Circle 

New York, New York 10019 

JULIAN ALLEN 

2009 Broadway 

Gary, Indiana 46407 

MARILYN G. ROSE 

CHRISTINE B. HICKMAN 

1751 ¥ Street, N. W. 

Washington, D. C. 20036 

Attorneys for Plaintiffs 

 



  

IN THE UNITED STATES DISTRICT COURT 

FOR THE NORTHERN DISTRICT OF INDIANA 

HAMMOND DIVISION 

  

BARBARA LEEK WESSON, 
BERNICE TERRY, 
EDDIE GRAY and 
ROSA KEETON, 

Plaintiffs, 

Ve 

Cause No. H 76-373 

METHODIST HOSPITAL OF GARY, INC., 

An Indiana Not-For-Profit 

Corporation, and JOSEPH CALIFANO, 

United States Secretary of Health, 

Education and welfare, 

Defendants. 

  

MEMORANDUM OF LAW IN OPPOSITION TO THE MOTION 

OF DEFENDANT CALIFANO TO DISMISS, OR IN 

THE ALTERNATIVE, FOR SUMMARY JUDGMENT 

] I. 

INTRODUCTION 
  

This case was commenced by four black citizens of the 

City of Gary, Indiana on December 29, 1976 against the 

Methodist Hospital of Gary, Inc., (hereinafter Methodist 

Hospital) and the United States Secretary of Health, Education 

and welfare (hereinafter HEW). Plaintiffs charge defendants 

with violating their obligations and plaintiffs' rights under 

 



  

Title VI of the Civil Rights Act of 1964, 42 U.8.C. § 20004 

(hereinafter Title VI), and their right to equal protection guar- 

anteed by the Fifth and Fourteenth Amendments to the Constitution 

of the United States. Defendant HEW did not file an appearance 

in this action until April 1, 1977 when it moved to dismiss the 

complaint or, in the alternative, for summary judgment on the 

grounds that (1) plaintiffs have failed to exhaust administrative 

remedies and (2) the complaint fails to allege facts upon which 

relief can be granted. Plaintiffs submit this memorandum in op- 

position to that motion. 

The complaint arises out of the creation and perpetuation of 

a discriminatory and segregated health care system that is financed 

’ in substantial part by federal funds and grants which HEW approved. 

Plaintiffs charge HEW with violating their civil rights by subsi- 

dizing and enabling this discrimination by Methodist Hospital. At 

the outset of its memorandum, however, defendant attempts to distort 

these allegations and the plaintiffs’ attempt to enforce their 

re rights by insinuating shat the filing of the lawsuit arises not 

out of concern for nondiscriminatory and quality health care, but, 

rather, is the result of a political dispute. 

It is worth note that the defendant does not challenge the 

standing of plaintiffs to bring this case. If defendant sincerely 

believed that plaintiffs and the class they wish to represent 

we Di 

 



  

were not seeking to redress the injury suffered by segregated 

and discriminatory health care, that route was plainly avail- 

able and, indeed, in our system of jurisprudence, was the 

proper route. Instead, by innuendo and accusation, defendants 

attempt to obfuscate the issues raised. Plaintiffs strenuously 

object to this treatment of so critical a case which they 

brought only as a good faith attempt to secure equal treatment 

under the law. 

 



  

tt 4 

PLAINTIFFS HAVE EXHAUSTED THEIR ADMINISTRA- 

TIVE REMEDIES, ANY FURTHER ATTEMPT TO SECURE 

RELIEF THROUGH THE ADMINISTRATIVE PROCESS WOULD 

BE FUTILE, AND THE DOCTRINE OF EXHAUSTION OF 

ADMINISTRATIVE REMEDIES IS INAPPLICABLE TO THE 

CAUSES OF ACTION AGAINST THE DEFENDANT HEW. 
  

Defendant HEW concedes that the rights conferred by Title 

VI apply to both the Hill-Burton direct grant program and loan 

guarantee program, the programs pursuant to which Methodist 

Hospital has received and is continuing to receive federal fund- 

ing to subsidize the construction and, now expansion, of its 

suburban hospital, Broadway Methodist. See, 42 C.F.R. § 53.112(c); 

L/ 
45 Cc. F.R. §§ 80.2, 80.13(%). Defendant argues, however, that 

this Court lacks subject matter jurisdiction over the complaint 

because plaintiffs failed to exhaust the administrative procedure 

set forth in 45 C.F.R. § 80.7 (b). The sequence of events which 

HEW itself outlines in its memorandum of law proves otherwise. 

A. 

On or about October 1, 1976, numerous individuals, including 

" plaintiff Wesson, sent letters and mailgrams to the Regional 

Office of HEW to protest the grant of federal funds to Methodist 

Hospital. At that time, prior to the filing of this lawsuit, 

HEW properly treated those protests as complaints pursuant to 

45 C.F.R. § 80.7 (b) and responded to those complaints by letter 

  

1l/ Contrast the position of HEW with that taken by defendant 
Methodist Hospital concerning the applicability of Title VI. See 

Memorandum of Methodist Hospital In Support of Motion To Dismiss, 

8-10 ° 

AT 

 



  

and report dated October 21, 1976. See Exhibit 12 attached to 

Memorandum in Support of Motion to Dismiss or In the Alternative 

for Summary Judgment by Defendant Secretary of Health, Education, 

and Welfare (hereinafter Exhibit 12). The eleven page summary 

which was sent to the complainants, including plaintiff Wesson, 
  

concluded that "the Office of Civil Rights found the applicant 

[Methodist Hospital] to be in compliance with Title VI and 

recommended clearance to the Public Health Services. We have 

been informed that the applications were approved and that funds 

were granted," Exhibit 12 at p. ll. That summary constituted 

final resolution of the complaints pursuant to 45 C.F.R. § 80.7 

(d) (2) which provides: 

"If an investigation does not warrant 

action pursuant to subparagraph (1) of 

this paragraph the responsible Department 

official or his designee will so inform 

the recipient and the complainant, if any, 

in writing.” 

Having exhausted their administrative remedies, plaintiffs are now 

entitled to pursue their complaint in federal court. 

HEW received a complaint filed by Steven Tallackson on behalf 

of the Gary Human Relations Commission on September 29, 1976, 

approximately the same time that the other complaints were received. 

See Exhibit 13. HEW at that time treated this complaint along with 

those of plaintiff Wesson and other persons, and sent the October 

21, 1976 response to all these individuals, including not only Mr. 

Tallackson, but, as noted above, plaintiff Wesson. See Exhibit 12. 

-5 

 



  

After the complaint in this case was filed on December 29, 

1976, HEW sought an extension of time in which to enter an 

appearance and began to conduct a further investigation of the 

serious allegations raised in the complaint. On March 29, 1977, 

a mere three days before HEW moved to dismiss or for summary 

2/ 
judgment, HEW issued a second report. However, in contrast to 

its initial, and, at the time, final report and conclusions, HEW 

3/ 
only sent this second report to Mr. Tallackson, despite its 

earlier treatment of the complaints filed by plaintiff Wesson and 

others. HEW now makes the incredible argument that only Mr. 

4/ 
Tallackson filed a complaint , and that the "letters and mailgrams" 

which the Office of Civil Rights received "from interested persons 

3/ 
in Gary," including plaintiff Wesson, were not complaints. On 

the basis of this retrospective self-serving recharacterization, 

  

2/ The motion of HEW was filed April 1, 1977. 

3/ See Exhibit 17, 

4/ See Memorandum of HEW at p. 1ll. 

5/ See Memorandum of HEW at p. 10. 

 



  

HEW argues that plaintiffs have not filed any complaints and have 

consequently failed to exhaust administrative remedies. The 

facts, as outlined above, plainly demonstrate that this is simply 

not so. 

Thus, in contrast to the cases cited by defendant, the ex- 

hibits filed by HEW to support its motion conclusively establish 

. that plaintiffs did not "bypass" the administrative process. 

Green Street Assoc. v. Daley, 373 F.2d 1, 9 (7th Cir. 1970); 
  

Dupree v. City of Chattanooga, Tenn., 362 F. Supp. 1136, 1141 
  

{€.D. Tarm. 1973). (It was undisputed plaintiffs failed to exhaust 

their administrative remedies,) See McGee v. United States, 402 
  

U.S. 479, 488 (1971) (Plaintiffs' "bypass was deliberate and with- 

out excuse.") HEW cannot be allowed at this eleventh hour to 

ignore its own treatment of the administrative complaints prior 

to the filing of this action in federal court in order to escape 

8/ 
liability for its violation of plaintiffs' rights and the law. 

y On October 21, 1976, when HEW responded to complaints that 

Methodist Hospital was guilty of discrimination, Alfred Sanchez, 

Chief, Health and Social Services Branch, Office For Civil Rights, 

Region V, informed the complainants that HEW's Office of Civil 

Rights found no violation of Title VI, Exhibit 12; affidavit of 

  

6/ In considering a motion to dismiss, the allegations in the 
complaint are accepted as true. E.g.,Radovitch v. National 

Football Leaque, 352 U.S. 445 (1957). 
  

  

7 vo 

 



  

Alfred Sanchez, Exhibits 4, 991 5, 6. This determination was 

the final action taken on the complaints (except that of Mr. 

Tallackson), after which plaintiffs were free to pursue judicial 

remedies. The cases cited by defendant, Green v. Cauthen, 379 
  

F. Supp. 361 (D.S.C. 1974) and Feliciano v. Romney, 363 F. Supp. 
  

656, 669 (S.D. N.Y. 1973) are thus inapposite since, in contrast 

.. to this case, in those cases there had either been no final agency 

action taken or the administrative investigation was "still in progress." 

The attempt by HEW to reopen the administrative process after 

the filing of this complaint in federal court by undertaking a 

new investigation (Exhibit 17) cannot serve to preclude access to 

: this Court by plaintiffs. To begin with, as HEW never reopened 

the complaint of plaintiff Wesson, her administrative channels are 

closed. More importantly, to allow HEW to frustrate judicial re- 

view by continually reopening investigations would result in a 

total denial of a mechanism by which beneficiaries of institutions 

P subject to Title VI could obtain final administrative determination. 

In such circumstances, the Supreme Court has held, "neither the 

principle of 'exhaustion of state remedies' nor the doctrine of 

'primary jurisdiction' has any application to the situation." 

Rosado v. Wyman 397 U.S. 397, 406 (1970). In Rosado, the petitioners, 
  

who were welfare recipients, did not seek review of an adminis- 

trative order prior to proceeding to Federal court, nor could they 

-3 

 



  

as HEW had no procedures whereby they "could trigger and partic- 

ipate in HEW's review of state welfare programs," and obtain a 

final decision,” Id. The procedures provided for HEW to follow 

when it decides to terminate federal funding to state welfare plans 

are similar to the procedures for terminating funds to recipients 

of federal funds who violate Title VI, except that beneficiaries of 

Title VI programs may file complaints and obtain decisions by HEW 

concerning their grievances. Compare, 42 U.S.C. §§ 604 (a), 1316 

with 45 C.,F.R. Part 80. If HEW's attempt to reopen final agency 

determinations and to continue review indefinitely were to succeed, 

the result here and under other Title VI situations would be iden= 

tical to that faced by the petitioners in Rosado v. Wyman: plaintiffs 
  

could obtain no final agency decision. According to the decision of 

the Supreme Court, in the absence of a mechanism to obtain such a 

final determination, the exhaustion requirement is inapplicable. Id.:; 

Lloyd v. Regional Transportation Authority, 548 F.2d 1277, 1287 (7th 
  

Cir. 1977). 

The administrative process may be "bypassed" if the issue 

raised by plaintiffs "cannot be raised upon judicial review of a[n] 

o ee 0r8er Of the agency.” Borden, Inc. v. rTC., 495 r.24 785, 
  

786-7 (7th Cir. 1974). In addition, the exhaustion requirement is 

inapplicable where review of the agency determination would provide 

"an inadequate remedy." Jewel Companies, Inc. v. FTC., 432 F.2d 
  

 



  

1155, 1158; compare Skinner & Eddy Corp. v. United States, 249 
  

U.S. 557 (1919) with Myers v. Bethleham Shipbuilding Corp., 303 
  

U.S. 41 (1938). In this case, were HEW's argument to prevail, the 

review of the administrative decision would not be inadeguate; it 

would be nonexistent. 

As the Supreme Court stated in McKart v. United States, 395 
  

U.S. 185, 193 (1969), "[alpplication of the [exhaustion of admin- 

istrative remedies] doctrine to specific cases requires an under- 

standing of its purposes and of the particular scheme involved." 
  

(Emphasis added.) Accord, Weinberger v. Salfi, 422 U.S. 749, 764- 
  

768 (1975). In cases brought under Title VII of the Civil Rights 

Act of 1964, alleging racial discrimination in employment, the 

statutory provisions specifically state that while a plaintiff must 

file a charge of discrimination with the Equal Employment Opportunity 

Commission prior to filing in federal court, the Commission must make 

a final determination or issue a "right to sue" letter within 180 

days entitling the plaintiff to proceed to federal court, 42 U.S.C. 

§§ 5(a) and 2000e-5(e). The Supreme Court had held that " [T]he Act 

does not restrict a complainant's right to sue to those charges as 

to which the Commission has made findings of reasonable cause, and 

we will not engraft on the statute a requirement which may inhibit 

the review of claims of federal employment discrimination in the 

federal courts." McDonnell Douglas Corp. v. Green, 411 U.S. 792, 
  

798-799 {1873}. 

lle 

 



  

Similarly, judicial review of alleged violations of Title 

VI are not limited solely to those cases in which HEW has made 

a determination of a violation. Adams v. Richardson, 480 F.2d 
  

1159 (D.C.C. 1973). Moreover, the lack of any specific statutory 

or regulatory time limitation in which HEW must act cannot act 

to preclude indefinitely the right of plaintiffs to seek judicial 

relief. See id. Indeed, in Adams v. Richardson, the district 
  

court by supplemental order filed March 14, 1975 enjoined HEW to 

make a determination as to whether there is a Title VI violation 

in school districts receiving federal aid "[w]ithin 90 days of 

receipt by HEW of a complaint or other information of racial dis- 

crimination." Paragraph F(a) of Supplemental Order, (a copy 

of which is attached to this Memorandum of Law as Exhibit A). 

It has been more than seven months since HEW received complaints 

alleging violations of Title VI by defendant Methodist Hospital. 

Plaintiffs suggest that there is no reason why a specific time 

limitation for reviewing complaints should not be imposed on 

HEW's investigation of hospital complaints, just as they are sub- 

ject to in school cases. In any event, HEW cannot be allowed to 

frustrate judicial review indefinitely by continual reopening of 

investigations or similar dilatory tactics. 

—ile 

 



  

B. 

Even assuming arquendo that plaintiffs did not exhaust their 
  

administrative remedies, the doctrine of exhaustion is inapplic- 

able to the instant case because it is clear that further resort 

to such procedures would be futile; and plaintiffs cannot obtain 

the complete relief they seek through administrative channels. 

In the report and findings of October 21, 1976, HEW responded 

2 
to the plaintiff Wesson's charge of racial discrimination with 

8/ 
the comment that racial segregation "too is a reality," and stated 

that assessment of the reduction of quality of care for the minor- 

ity citizens of Gary "is a complex issue which this Office is not 

4 
qualified to assess." 

In addition, HEW conceded that in 1971 it was predicted that 

there would be "maldistriction of resources among geographic areas 

and population groups" but nevertheless excused Methodist Hospital 

10/ 
on the legally irrelevant ground that "it is not solely to blame." 

  

1/ Exhibit 12 at p. 4. 

8s/ Id. at pp." 10. 

9/ Id. at p. 8. 

o/ 1d. at pr. 5, 

-] Dw 

 



  

Finally, in response to the allegation that the construction 

and expansion of Broadway Methodist Hospital has accelerated 

"white flight" and consequent segregation, HEW stated, " . . . 

while it may be argued that the Hospital is guilty of racism by 

trying to join that exodus, it cannot be argued that it initiated 

11/ 
‘white £light’." 

12/ 
The further report of HEW issued on March 29, 1977 con- 

cedes that the equipment at Broadway Methodist Hospital is newer 

than that at Gary Methodist Hospital and that one hospital (Gary) 

13/ 
is 80% black and the other (Broadway) is 90% white. HEW 

further recognized that all foreign nurses, who have difficulty 

14 

communicating with patients, are employed at Gary, and not Broadway. 

  

1ll/ Id. at p. 9. The day has long since passed when institutions 

can escape liability from racial discrimination and segregation be- 

cause others are also guilty or because of disagreement with the 

constitutional and statutory principal of equality. Cooper v. Aaron, 

358 U.S. 1 (1958); Brown v. Board of Education, 349 U.S. 294, 299-300 

{1955), 

  

  

12/ Exhibit 17 to Memorandum in Support of HEW's Motion to Dismiss 

or, In The Alternative, for Summary Judgment. 

13 E=hibit 17 at pp. 3-1), 22. 

14/ Id. at. Pp. 14. 

“l= 

 



  

Despite the clear acknowledgement that the facilities are not 

equal, HEW refused to find a Title VI violation because de- 

fendant Methodist Hospital had shown "a pattern of investment 

. « « to modernize the Gary facility" and because the hospital 

met the mimimum standards of the Joint Commission on Accreditation 

| 15/ 
of Hospitals and the Indiana State Board of Health." 

In view of HEW's refusal to correct the racism, discrimination, 

inequality of the facilities, and perpetuation of segregation by 

Methodist Hospital, or, to deem such discrimination violative of 

Title VI, it is clear that further resort to HEW would be an exer- 

cise in futility. The doctrine of exhaustion of administrative 

remedies has no application where it is clear that the relevant 

administrative agency will not grant the relief in question. 

Clover v, St. Louis~-San Francisco R., Co., 393 U.S. 324, 330-331 
  

(1969). 

Finally, plaintiffs are not required to exhaust administrative 

remedies insofar as they challenge HEW's procedures in failing to 

enforce Title VI or in granting Hill-Burton financial assistance 

to Methodist Hospital. The Court of Appeals held, in a similar 

  

15/ Id. at p. 25. The Joint Commission on Accreditation of 
Hospitals certifies only that a hospital meets required minimum 

guidelines, not that it is provided comparatively good, or equal 

health care. See CCH Medicare & Medicaid gg 12,330, 12,660, 16,957, 

20,801. 

~ld- 

 



  

Title VI case that where plaintiffs charged inadequacies in 

the procedures by which administrative officials exercise their 

administrative responsibilities under Title VI, that there are no 

administrative procedures to exhaust: 

"., . « the procedural afforded under the 

| Civil Rights Act of 1964 are designed to 
3 provide redress against specific discrim- 

inatory acts and do not pertain to the 

adequacy of HUD procedures." 

Shannon v. HUD, 436 F.2d 809, 820 (3rd Cir. 1970). See also Lee 
  

County School Digtrict No. 4. v., gardner, 263 ¥. Supp. 26, 31 
  

(D.8.C. 1967). 

The complaint in this case charges HEW with violating the 

rights of plaintiffs guaranteed by Title VI. That violation 

necessarily includes not only the decision to continue funds to 

a hospital which discriminates and segregates persons on the basis 

of race, but also the failure of HEW's procedures to review 

recipients of federal funds adequately, and to prevent inequality 

1le6/ 

of health services to minority residents. As the Court stated 

in NAACP v. Brennen, 360 F. Supp. 1006, 1012 (D.D.C. 1973): 
  

  

1l6/ HEW's investigation adopted in large part the position and 
statements of Methodist Hospital and failed to conduct an adequate 

investigation pursuant to proper standards. For example, the 

report of March 29, 1977 accepted without question the truth of 

the statement by Methodist Hospital that the emergency room was 

"totally renovated" and failed entirely to consider, more importantly, 

whether it was adequate to serve the needs of minority patients. 

Exhibit 17 at po. 24. 
«15. 

 



  

", «. +. both Title VI and the Fifth Amend- 
ment impose upon Federal officials not 

only the duty to refrain from partici- 

pating in discriminatory practices, but 

the affirmative duty to police the op- 

erations of and prevent discrimination 

by state or local agencies funded by them." 

Where, as here, plaintiffs charge HEW with failing to adopt pro- 

cedures and standards necessary to accomplish its "affirmative 

enforcement duty," administrative procedures need not be ex- 

hausted. ‘Adams v. Richardson, 480 P.28 1159, 1162 (.C. Cir. 

16/ 

1973. 

  

  

16/ Defendant incorrectly states that plaintiffs must demonstrate 

that HEW "colluded" in the discriminatory processes of Methodist 

Hospital. See Memorandum of HEW at p. 14. In Gautreaux v. Romney, 

448 F.24. 731, 737-740 (7th Cir. 1971), aff'd sub nom., Hills v 
Gautreaux, 425 U.S. 284 (1976), the Court of Appeals did not re- 

x quire that plaintiffs echaust remedies and held on the merits that 

HUD violated Title VI by dispersing funds in a manner which per- 

petuated a racially discriminatory housing system. Good faith 

attempts by HUD to accommodate different factions did not relieve 

it of liability in its "own right" for it was "an active partici- 

pant [in the discrimination] since it could have halted the dis- 

crimination at any step in the program. Hicks v. Weaver, 302 F. 

Supp. 619, 623 (D. La. 1969)." HEW's action in approving funds 
to Methodist make it no less an active participant as HUD in 

Gautreaux and no less liable for violations of Title VI. 

  

  

  

  

  

«16 

 



  

III 

THE COMPLAINT, WHICH ALLEGES DISCRIMINATION BY 

HEW IN ITS FAILURE OR REFUSAL TO ENFORCE THE PRO- 

HIBITION AGAINST DISCRIMINATION BY A RECEIPIENT 

OF FEDERAL FINANCIAL ASSISTANCE, STATES A CAUSE OF 

ACTION UNDER TITLE VI; AND SUMMARY JUDGEMENT IS 

INAPPROPRIATE BECAUSE OF THE EXISTENCE OF. GENUINE 

ISSUES OF MATERIAL FACT. 
  

Rule 12 (b) of the Federal Rules of Civil Procedure 

provides in pertinent part: 

"If, on a motion asserting the defense numbered 

(6) to dismiss for failure of the pleading to 

state a claim upon which relief can be granted, 

matters outside the pleading are presented to 

and not excluded by the court, the motion shall 

be treated as one for summary judgement and 

disposed of as provided in Rule 56..." 

As defendant HEW has submitted seventeen exhibits to support 

its motion to dismiss, the motion is properly considered as one 

for summary judgement. 

In ruling on a motion for summary judgement, a court is 

charged by Rule 56 of the Federal Rules of Civil Procedure with 

determining whether or not the "pleadings,... together with the 

affidavits, if any, show that there is no genuine issue as to any 

naterial fact and that the moving party is entitled to a judgement 

as a matter of law." The Court of Appeals for the Seventh Circuit 

held in Rose v Bridgeport Brass Company, 487 F.2d 804, 808 (7th Cir. 
  

1973): 

" Qurs cases have uniformly placed upon the movant 

for summary judgement the burden of establishing 

li the absence of a genuine issue of material fact. 

carter v Williams, 361 P.24 189, 193 (7th Cir. 1966); 
  

 



  

Motoux v Gulling Auto Electric, Inc., 

295 F.28.573, 576 (7th Cir. 1961. The 

burden is not lightly discharged." 

  

The Court in Bridgeport Brass added: 
  

"On a motion for a summary judgement the 

burden of establishing the nonexistence of 

any genuine issue of fact is upon the 

moving party, all doubts are resolved 

against him, and his supporting affidavits 

and depositions, if any, are carefully 

scrutinized by the court. Albert Dickenson 

Co. vv Mellos Peanut Co., 179 F.24 265, 268 

{7th Cir. 1950), 1397.24 318, 322 {8th Cir. 

1943) ." Id. (Emphasis in orginal). 

  

  

The very exhibits submitted by defendant to support its motion 

demonstrate the existence of a plethora of disputed material 

issues that relate directly to the issue of whatever HEW has 

violated its affirmative obligation and the plaintiffs' rights 

under Title VI. Since HEW has thus failed to discharge its 

heavy burden under Rule 56, the motion must be denied. 

As stated above, Title VI and the Fifth Amendment impose 

upon HEW "not only the duty to refrain from participating in dis- 

criminatory practices, but the affirmative duty to police the 

operations of and prevent discrimination by state and local 

agencies funded by them." NAACP v Brennen, supra 360 F. Supp. at 
  

1012; accord, e.g., Adams v Richardson, supra, 480 F.2d at 1162; 
  

Gautreaux v Romney, supra, 448 F.2d at 737-740; Hicks v Weaver, 
  

  

supra, 302 F. Supp. at 623. As defendant admits, Section 602 

of Title VI, 42 § 20000-1, directs each Federal agency adminis- 

 



  

trating a program of Federal financial assistance to take 

action pursuant to regulation to effectuate the obligations and 

purposes of Title VI. Those regulations, promulgated by - 

defendant HEW, appear at 45 C.F.R. Part 80. Among the specific 

discriminatory actions prohibited is the provision by a recipient 

of federal financial assistance, including defendant Methodist 

Hospital of 

"...S8ervice, financial aid, or other benefit 

to an individual which is different, or is 

provided in a different manner from that 

provided to others under the program." 45 

CR. RR. §80.3¢b) (1) (ii). 

The regulations also prohibit: 

"subject[ing] an individual to segregation 

or separate treatment in any manner related 

to his receipt of any service..." 45C.F.R. 
§ 80.3 (b) (I) (ii) (Emphasis added). 

and 

"Restrict[ing] an individual in any way in 

the enjoyment of any advantage or privilege 

enjoyed by others receiving any service,... 

or other benefit under the program." 45 C.F.R. 

§ 80.3(b) (1) (iv) 

The data before this court raises serious and genuine issues of 

fact as to whether HEW is assuring, as it is obligated to do, that 

Methodist Hospital has not violated these provisions. 

17/ 
The reports conducted by HEW itself ™ establish that 

defendant is aware that the two facilities of. Methodist Hospital, 

Gary Methodist and Broadway Methodist, have segregated patient 

  

17/ Exhibits 12 and 17. 

-19- 

 



  

18/ 
populations in violation of 45 C.F.R. § 80.3 (b) (ii). = Almost 

fifteen years ago, the Court of Appleals in Simkins v Moses Cone iy 
  

Hospital, 323 PF.24 959, cert. denied, 376 U.S. 938 (1964) held that 
    

the provision of services on a "separate but equal" basis by 

hospitals receiving Hill-Burton funds violated the Constitution 

of the United States, vet HEW has by its own admission done 

nothing to correct this violation. Plaintiffs contend that the 

failure of HEW to take steps to have the recipient remedy this 

segregation is on its face a violation of plaintiffs' rights 

and defendants obligation, and the Court of Appeals for the 

Seventh Circuit has so held in an analagous case. Gatreaux v Romney,   

supra, 448 F.2d at 739-740; accord, Shannon v HUD, supra, Hicks v 
    

Weaver, supra. The mere fact that HEW conducted an investigation 
  

which uncovered this violation cannot, of course, satisfy its 

obligation; on the contrary, the conscious channeling of funds to 

segregated institutions flies in the face of the "expressed purpose 

of Congress." Adams v Richardson, supra, 480 F.2d at 1162. 
  

The plaintiffs charge HEW with violating Title VI not only 

because of the segregated operation of facilities by Methodist 

Hospital, but also because the provision of services is uneqgual.. 

As HEW-admits, the issue of quality of care is "complex". 19/ The 

Supreme Court has stated that "summary proceedings, however 

salutory where issues are clear-cut and simple, present a treacherous 

record for deciding issues [that involve complex and important 

  

18/ Gary Methodist is 80% black; Broadway Methodist is 90% white. 

19/ Exhibit 12 at p. 8B. 
-20- 

 



  

constitutional questions]”. Xennedy v Silas Mason Co., 334 U.S. 
  

249, 256-7 (1948). In accordance with this pronouncement and with 

particular sensitivity accorded issues involving personal 

20/ 
liberties, the court stated in Sisters of Providence of St. 

  

Mary of the Woods v City of Evanston, 335 F. Supp. 396,399 
  

(D.C. Ill. 1971), "it is especially in civil rights disputes 

that we ought to be chary of disposing of the case on pre-trial 

motions..." Although the Supreme Court sanctions the grant of 

summary judgement where "solid bases of fact" are derived from 

2A 
"a comprehensive statement of agreed facts," = plaintiffs do not 

in any way agree with the bases upon which HEW concluded that 

minority recipients of hospital services by Methodist are not 

discriminatory, or the conclusion reached. 

To begin with, as noted above, HEW accepted without 

question the fact that the emergency room at Gary Methodist 

Hospital, which serves the black residents of Gary, was "totally 

renovated" and is adequate to meet the needs of the plaintiff class. 

Critical facts remain to be discovered concerning whether these 

statements are in fact true. Summary judgement should not be 

granted without affording plaintiff extensive discovery, 

particularly since most of the facts are exclusively within the 

defendant's knowledge. Schoenbaum v First Brook, 405 r.2d 215 
  

(2d Cir. 1968), cert. denied, 395 U.S. 9206 (1969). More im- 
  

  

20/ United States v Caroline Products, 304 U.S. 144,152 n.4 (1938) 
  

217 Kennedy v Silas Mason Co., supra, 334 U.S. at 257 
  

-2)~ 

 



  

portantly, on a motion for summary judgement, it is HEW and 

not plaintiffs who has the burden of establishing the truth of 

these statements. E.g., Rose v Bridgeport Brass Co., supra, 
  

487 F.2d at 808. That burden cannot be met and has not been met 

without facts as to the number of patients seeking treatment at 

the emergency room. 

In addition, HEW acknowledges that a linear accelerator, 

which provides radiation treatment, is available at Broadway 

Methodist but not at Gary Methodist and that minority residents 

of Gary can only receive such treatment by private transportation 

to Broadway, which is fifteen miles outside Gary. ed HEW 

summarily dismisses this discrepancy in an important service with 

the statement, "The physicians interviewed were not aware of any 

patient having difficulty as far as accessibility of treatment is 

23/ w——r 
concerned." Self-serving statements which are not in affi- 

davit form may not be considered as to whether a genuine issue 

of material fact exists. Tunnell v Wiley,. 514 F.24 971 (3rd 
  

ok Cir. 1975); Smith 'v Mack Trucks, Inc., 5305 P.2d4.1248 {9th Cir. 13974). 
  

Plaintiffs are in the process of collecting affidavits from black 

citizens of Gary which establish that they are in fact having 

serious difficulty in obtaining transportation to Broadway 

particularly since there is no public transportation to Broadway 

  

22/f EBxnibit 17 .at pn. 22 

23/ Id. 
DD 

 



  

Methodist from the City of Gary. ~~ Even if 

this were not so, however, the placement of the linear accelerator 

at the facility which serves a smaller, white population violates 

the mandate of 45 C.F.R. § 80.3 (b) (¥) (iv) that minority recipients 

not be restricted "in any way in the enjoyment of any advantage 

or privilege enjoyed by others receiving any service." 

The assurances which HEW had Methodist sign prior to 

the grant of Hill Burton funds to construct Broadway Methodist 

Hospital did not mandate equally of care or intergration of patient 

populations, but only required that Gary Methodist be maintained 

as a viable hospital. 2 It is clear that both the statutory 

and regulatory language of Title VI, as well as case law, require 

much more: Title VI prohibits any discrimination, any denial of 

benefits and any segregation of black patients of defendant 

Methodist Hospital. Those assurances thus cannot discharge the 

obligation of HEW. In addition, HEW itself has seriously questioned 

whether Gary Methodist Hospital will be able to continue to 

operate as a viable institution. See Exhibit 3 where Mr. Sanchez 

felt "a dim picture is being painted for medical care [in the 

inner city] in the future." Serious issues of material facts exist 

as to the role that the construction and expansion of Broadway 

Methodist has played in the loss of doctors who had served the 

  

24/ See assurances attached to complaint. 

-23- 

 



  

inner vity. According to HEW, of the 165 physicians on the medical 

staff of Methodist Hospital, nearly half now practice primarily at 

Broadway, dispite the fact that Broadway has approximately 

one-third the number of beds as does Gary Methodist Hospital, 

25/ 
and Broadway has only half the number of patient days as does 

26 / : 
Gary. ~— According to Title VI regulations: 

"In determining the site or location of 

a facilities, an applicant or recipient 

may not make selections with the effect of 

excluding individuals from, deneying them 

the benefits of, or subjecting them to 

discrimination...on the ground of race, 

color of national origin.” 45 Cc. P.R.. "SS 80.3 

(b) (3). 

The location of a brand new facility in an all white suburb has 

resulted in the loss by minority residents of Gary of virtually 

half of the previously available doctors. Serious issues of 

fact exist as to the effect of the expansion of Broadway 

on the further drain of resources. 

In order to determine whether HEW has violated Title VI, 

it is obviously essential to determine whether Methodist Hospital 

is segregating and discriminating against minority residents of 

Gary in the provision of health services. If, as plaintiffs 

contend, this discrimination is occurring, than HEW is as a 

matter of law violating Title VI by continuing to channel funds 

  

2 Exnibit 17 at p. 17 and Complaint. 

26/ See letter and report dated January 19, 1977 R.B. Glesne, 

Administrator of Methodist Hospital to Alfred Sanchez, 

Attached as Exhibit B to this memorandum. 

D4. 

 



  

to Methodist Hospital and by failing to cite Methodist Hospital 

for its violation. See Adams v Richardson, supra; Gautreaux v   

Romney, supra; Shannon v HUD, supra. The issues raised by this 
  

allegation are complex and varied and include the need not only 

for a complete record as to staffing, patient populations and 

services, but also as to the motive of Methodist Hospital for its 

consistent determination to channel the vast majority of Federal 

funds to the new, suburban facility as opposed to the older one 

which serves the black population. As the Supreme Court has 

stated, "where motive and intent play leading roles," it is unwise 

to grant summary judgement." Poller v Columbia Broadcasting System, 

Inc., 368 U.S. 464, 473 (1962); accord, Adickes v S.HE, Kress CO.. 
  

398 U.S. 144 (1970). HEW has not submitted a single affidavit 

to support the statements contained in its exhibits. Without 

clear proof to rebut the allegations in plaintiffs’ complaint, 

summary judgement cannot be granted. 

CONCLUSION   

For the reasons stated above, the motion of HEW must 

be denied. 

Respectfully submitted, 

  

Ho wt QO. deed 
JACK GREENBERG V 
BETH J. LIEF 

10 Columbus Circle 

New York, New York 10019 

-25- 

 



  

JULIAN ALLEN 

2009 Broadway 

Gary, Indiana 46407 

MARILYN G. ROSE 

CHRISTINE B. HICKMAN 

1751 N Street, N.W. 

Washington, D.C. 20036 

Attorneys for Plaintiffs 

 



  

CERTIFICATE OF SERVICE 
  

I hereby certify that a copy of the foregoing MEMORANDUM 

OF LAW IN OPPOSITION TO THE MOTION OF DEFENDANT CALIFANO TO 

DISMISS, OR IN THE ALTERNATIVE, FOR SUMMARY JUDGEMENT, was 

served by United States Mail, postage prepared, on the 7th day 

of May, 1977, on counsel for defendants as follows: 

HODGES, DAVIS, GRUENBERG, COMPTON 

& SAYERS, BRUCE E. SAYERS, ESQ. 

5525 Broadway 

Gary, Indiana 46401 

MARVIN E. GARVIN & EDWARD L. KOVEN 

REGIONAL ATTORNEY & GENERAL ATTORNEY 

Department of Health, Education and 

Welfare 

300 South Wacker Drive, 18th Floor 

Chicago, Illinois 

RICHARD L. KIESER 

UNITED STATES ATTORNEY FOR 

THE NORTHERN DISTRICT OF INDIANA 

HAMMOND, INDIANA 

Fred W. Grady 

Assistant United States Attorney 

fei § frp   

BETH J. LIEF 
Attorney for Plaintiffs 

 



  

  

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: UNITED STATES DISTRICT COURT 
FOR THE DISTRICT OF COLUMBIA 

KENNETH ADAMS et al., 

Plaintiffs, 

A
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We Civil Action No. 3095-70 

CASPAR W. WEINBERGER, individually 
and as Secretary of the Department 
of Health, Education and Welfare, 

EILED 

MAR 141975 

JAMES E. DAVEY, 
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Defendants. 

SUPPLEMENTAL ORDER 
  

This cause came before this Court upon plaintiffs.’ Motion for 

Further Relief and the Opposition of the defendants thereto. After a 

review of the entire record, the Court inclines to the belief that sub- 

stantial progress has been made in this difficult and complex area. On 

the other hand, without deprecating the value of voluntary settlement of 

these problems, there appears to be an over-reliance by HEW on the use of 

voluntary negotiations over protracted time periods and a "reluctance in 

recent years to use the administrative sanction process where school 

districts are known to be in non-compliance ***'" Report of United States 
  

Commission on Civil Rights, January 22, 1975, page 131, n. 1. Having 
  

considered the motion and opposition and the record before it, this Court 

enters the following findings and remedial provisions. 

A. 125 Substantial Racial Disproportion 

“Districts. 
  

1/ 
As this Court found in its February 16, 1973 Order, the Supreme 

Court in Swann v. Charlotte-Mecklenburg Board of Education, 402 U.S. 1 
    

(1971) enunciated "a presumption against schools that are substantially 

disproportionate in their racial composition.” In Appendix B of that 

  

1/° Adams v. Richardson, 356 F. Supp. 92 (1973). 
  

Exhibit A 

  

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February 16, 1973 Order, the Court listed 85 southern school districts 

having ane or more schools substantially Siorapaerionats in their conposi= 

tion (because at least a.207 disproportion existed between the percentage 

of toca} minority pupils in the schools and the percentage in the entire 

school district). HEW not having required any of these 85 school districts 

to explain or rebut the substantial racial disproportions in the schools, 

this Court enjoined HEW to communicate with cach of the districts within 

60 days, putting them on notice to rebut or explain the disproportions in 

one or more of their séhools. 
‘ { 

this Order and substantial compliance progress resulted therefrom. However, 

HEW took appropriate action pursuant to 

the record now reveals an additional 125 southern "HEW school districts" 

with one or more schools substantially disproportionate in their racial 
1 

composition (see Attachment A), where HEW has not sought an explanation or 

rebuttal from the school district. 

| WHEREFORE, in supplementation of Y III B (1) of this Court's 

Order of February 16, 1973, defendants, their successors, agents and 

employees are required and enjoined within 60 days of the date of this 

Order to communicate with each of the 125 districts listed in Attachment A, 

putting them on notice to rebut or explain the substantial racial dis- 

proportion in one or more of the districts' schools. 

B. "293 Districts With Allegations of Miscellaneous 

"Violations. 
  

Plaintiffs' Motion for Further Relief alleges that there are 

293 additional districts where HEW has found presumptive Title VI violations. 

The deposition and affidavit of Dr. Lloyd R. Henderson, indicate however 

2/ 
that the statistical data on which this allegation is based demonstrate 

possible Title VI problems and not presumptive violations. We accept for 

the present HEW's assertion that one of the purposes of the Enforcement 

Analysis Tables compiled on a nationwide basis was to provide an indication 

  

2/ The data were extracted from Office of Civil Rights 

1972-1973 Enforcement Analysis Tables. 

  

  

  
   



  
  

    
  

  

  

  

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of those districts which might be likely candidates for Title VI compliance 

| 

activity and to aid in the determination of priorities. 

WHEREFORE, plaintiffs' request for further relief in this area 

is denied at this time. 

C. 6 ESAA Districts. 
  

With respect to 116 elementary and secondary school districts, 

where HEW had found probable violations of Title VI, this Court's 

Febriary 16, 1973 Order held that the time permitted by Title VI for 

Sesuiing voluntary compliance before commencing enforcement proceedings 

had long since passed (YY IX A (5); III (A) (7)). HEW had found the 

districts In violation or presumptive violation of Title VI and had failed 

during substantial periods of time to achieve voluntary compliance. 

Accordingly, the Court ordered HEW within 60 days to commence enforcement 
| 

proceedings by administrative notice of hearing or any other means .authorized 
4 

) 

by law against each of the districts in order to effect compliance with 
i - } 

south ineligible for funding under the Emergency School Aid Act of 1972 

Title VI. In the spring of 1973, HEW declared 17 HEW districts in the 

because of substantial civil rights violations. Nine districts were the 

subject of HEW TI OR WERE, activity pursuant to specific directives of 

this Bourets February 16, 1973 Order. Since the filing of the prosent 

Motion for Further Relief, Orangeburg, South Carolina has been found 

eligible for ESAA funding and Charles County, Maryland, has submitted a 

student assignment plan acceptable to HEW. In the remaining 6 districts, 

however, HEW has made no efforts to effectuate compliance with Title VI 

after indication of substantial civil rights violations. 

WHEREFORE, in supplementation of YY II B (1) and III B (2) of 

this Court's Order of February 16, 1973, defendants, their successors, 

agents and employees, are required and enjoined within 60 days of the date 

of the Supplemental Order to commence enforcement proceedings by administra- 

tive notice of hearing or any other means authorized by law against each 

  

  

  
 



  

  
  

  

    

    
  

  

  
  

        

| «- 
i 

of the school districts identified in Attachment B, in order to effect 

compliance with Title VI. 

D. 39 Unresolved Swu.a. Districts. 
  

In its February 16, 1973 Order, this Court found 85 school 

districts presimptively in vi2l2%inn of Swann and Title VI because they 

nad ofl or ore echonls Subatanth din» disproportionate in their racial 

composition. This Court ordered defendants to communicate with each of 

these disuelots promptly, putting them on notice to rebut or explain the 

substbiseal racial disproportionms (Y III B (1)). HEW has done so. 

Thirty-one of these districts have since been found in compliance by HEW, 

and 15 others are in litigation or under court order. Totter ads of 

the diiertoes remain unresolved more than 25 months after the issuance of 

this Court's Order, but HEW has not initiated enforcement procesdings 

against any of them. The time for securing compliance by merely voluntary 

means in these districts has passed. 

WHEREFORE, defendants, their successors, agents and employees, 

ate fhmitzel and antolied within 60 days from the date of this Order to 

commerice enforcement btosasdings by administrative notice of hearing or 

any other means authorized by law, in order to effect compliance with 

Title VI by each of the school districts identified in Atescnmens Ce. 

( 

E. Hundreds of School Districts Subject to 
"Court Desegregation Orders. 
  

  

This Court's Order of February 16, 1973 (Y V B (2)) required HEW 

to piling its findings of court order violations to the attention of the 

court concerned. Since that Order issued, HEW has identified numerous 

southern districts subject to judicial desegregation orders which, in 

violating or apparently violating Title VI, are in violation of said 

court orders. 

  

 3/ Defendants have admitted that 21 of these 39 districts 
remain unresolved, claiming that 18 districts of the 

39 are now in compliance. Since we are not advised 
either of the names of said districts or the reasons 

why they should not be still included, they are covered 
by this Order. 

  

  

  

 



  
  

  

    

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. In cases where the United States is a party, HEW has referred 

some of this information of violations or presumptive violations of 

court orders to the Justice Department, but none of the information has 

been brought to the attention of the courts concerned. In cases of 

orders resulting from private litigation, such information has not been 

conveyed either to the courts or to the private attorneys of record. 

WHEREFORE, in supplementation of % V B (1) and (2) of this 

Court's Order of February 16, 1973, defendants, their successors, agents 

and employees, through the Justice Department or other means, are required 

and enjoined within 120' days of the date of this Supplemental Order to 

call to the attention of the courts concerned each of the violations or 

presumptive violations of court orders, unless defendants have made - 

administrative determination of compliance by the school district within 

% I * 
the 120-day period. be 

F. Future HEW Compliance with Title VI. 
  

This Court has ruled in this case that HEW has a duty to 

commence prompt enforcement activity upon all complaints or other 

tntoridtion of racial discrimination in violation of Title VI, and that 

where it appears that a school district is in violation or presumptive . 

violation of Title VI the agency has a duty under Title VI to commence 

enforcement proceedings by administrative notice of hearing or any other 

means authorized by law where efforts to obtain voluntary compliance do 

not succeed within a reasonable period. 

HEW has often delayed too long in ascertaining whether a complaint 

or other information of racial discrimination constitutes a violation of 
i 

Title VI. HEW has also frequently failed to commence enforcement proceed- 

ings by administrative notice of hearing or any other means authorized by law 

  

  

  

   



  
  

      

  
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although the efforts to obtain voluntary compliance have not succeeded 

diving a substantial period of time. As shown in Section D above, in 

39 weiiesolved” Swann districts, HEW, having failed during a substantial 

period of time to achieve voluntary compliance, has not commenced enforce- 

ment proceedings by administrative notice of hearing or any other means 

authorized by law. Apart from the school districts expressly covered 

by this Court's February 16, 1973 Order, HEW has not initiated a single 

sdnirigieteve enforcement proceeding against a southern school district 

since the issuance of this Court's Order 25 months ago. 

WHEREFORE, defendants, their successors, agents and employees 

are required and enjoined hereafter to carry out their Title VI enforcement 

activities affecting public school districts in the 17 southern and border 

states according to the following schedule: 

i Within 90 days of receipt by HEW of a complaint or other 

untoraarion of racial discrimination, determine for 

administrative purposes whether the district is in or 

out of compliance with Title VI; 

5) Wherever there is not a determination of compliance by - 

the 90th day, attempt to secure compliance through 

voluntary means for an additional period not to exceed - 

90 days; 

{¢) Where such compliance is not secured within 180 days 

of the receipt of the complaint or other information 

of racial discrimination, commence within 30 days 

thereafter an enforcement proceeding through adminis- 

trative Botice of hearing or any other means 

authorized Hy law. 

  

G. Supplemental Reporting Provision. : 

Supplementing the reporting provisions in this Court's Order of 

February 16, 1973, defendants, their successors, agents and employees, are 

  

  

  

 



  
  

    

    

  

  

  

  
    

-7- 
| 

required and enjoined to provide in verified form to counsel for plaintiffs 

within 150 days of the date of this Supplemental Order, and at the time 

of all subsequent reports required by this Court's February 16, 1973 

Order, a summary of all steps taken to comply with the injunctive provisions 

set forth in the preceding paragraphs. 

  

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y John H. Pratt 

United States District Judge 

March 14, 1975 

| 

4 

  

  

  

 



   

  

  
       

  

  

  

  

  

  

    

Attachment A 

(Page 1 of 3 pages) 
  

SUBSTANTIAL RACIAL DISPROPORTION DISTRICTS 
  

ARKANSAS 

Jonesboro School District #1 

Caesar Rodney o : 

De La Warr School Disirict 

Newark 

FLORIDA 

Levy County 

Monroe County 

© GEORGIA 

Madison County 

Thomasville City 

‘KENTUCKY 

Covington City 

Elizabethtown Independent 
Warren County 

LOUISIANA 

Allen Parish 

Vernon Parish 

MARYLAND 

Baltimore County 

Caroline County . 
Cecil County Public Schools 
Frederick County 
Howard County 

Montgomery County Pub. Sch. 
. Talbot County 

Washington County 

MISSISSIPP1 

Lee County 

MISSOURI 

Cape Girardeau Public #63 
Joplin R-8 
Poplar Bluff R-1 

Special Sch. Dist. of St. Louis 
Springfield R-12 

  

  

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  i Attachment A ! ! 

2 ark gd (Page 2 of 3 pages) . ! 

NORTH CAROLINA 
  

! 

. : Burke County ii 
Caswell County . p i 

: Chatham County . SEN 

Hoke County 
Jackson County : 

Madison-Mayodan City 

Onslow County : 

Pender County | 
| Polk County Bd. of Educ. 

} Randolph County 

: = Roantke Rapids Graded School 
Nr Rowan County Schools : : i 

: rT Shelby City Schools : 
i A "Stanly County 

Swain County Schools 
oh i Union County 

Vance County 

. Wayne County 
Wilkes County 

  

        OKLAHOMA. 

Altus 

Bristow | 

Claremore City . 
Durant Public Schools 
Enid Public Schools 

Moore 
Moton 

sgl! Norman 
Ler ‘ Sapulpa City Schools 

pr } Shawnee 

SOUTH CAROLINA 
  

Aiken County 

Bamberg County 01 
‘ Charleston County School Dist. 

] © Edgefield County 
: Greenwood County 50 

Marion County 01 
b.? Orangeburg County 02 
i Pickens County 

. Richland County 01 
id . Richland County School Dist. #2 

Spartanburg County 02 

‘cl ; Spartanburg County 06 

1 : Spartanburg County 07   TENNESSEE 

Athens City Schools 

! Dyer County 
| Hamilton County 

Hardeman County Bd. of Educ. 

Lincoln County 

Morristown City 
Williamson County   

      
  

 



  
  

    

  

  

    

TEXAS 

Alamo Heights ISD 

Alice Ind. School Dist. 
Amarillo ISD 

Arlingten ISD 

Bay City ISD 

i Brazosport Independent School 
Cleburne ISD 

Cotulla Ind. School Dist. 

Dumas ISD 

East Central ISD 

Edinburg CCN Ind. Sch. Distr. 

El Campo Independent School Dist. 
El Paso Independent School Dist. 
Gainesville Ind. School Dist, 

Gregory-Portland ISD 
Harlandale ISD 

Harlingen CISC 

f Hereford Indept. School Dist. 

Irving Independent 

Kerrville ISD 

La Porte Indep. Sch. Dist. 

Livingston Independent School 

Marfa Ind. School Dist. 

McAllen Ind. School District 

Morton Ind. School Dist. 

‘New Boston ISD 
New Braunfels I SD 
North Forest ISD 

Palestine Ind. School District 
Pampa Indep. Sch. Dist. 
Pasadena Ind. School Dist. 

Pecos-Barstow Consolidated ISD 
Pleasanton ISD 

Round Rock I S D 

Sherman Ind. School District 

South San Antonio ISD 
Southwest ISC 

Tuloso-Midway Ind. School Dist. 

United Independent School Dist. 

Vernon Consolidated Independent 

Wharton Ind. Sch. Dist. 

Ysleta Independent Sch. Dist. 

© VIRGINIA 

Fairfax County 

Prince William County 
i 

WEST VIRGINIA 
  

Fayette Co. Bd. of Educ. 

Marion County Bd. of Educ. 
"Mineral County’ 
Mingo County 

' Ohio County 

Attachment A 

(Page 3 of 3 pages) 
  

  

  

  

  
 



  
  

    

  

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EMERGENCY SCHOOL AID ACT DISTRICTS 
  

ARKANSAS 

Bearden PS 

MARYLAND 
Caroline Co. 

NORTH CAROLINA 
  

Chatham : i 

. SOUTH CAROLINA 
  

Lexington Co. #2 SD 
Spartanburg Co. #7 

Harlandale PS 

Attachment B 
  

  

  

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| UNRESOLVED SWANN DISTRICTS 

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$ ARKANSAS 

Hot Springs §6 
: : South Miss 

FLORIDA : 

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i Martin Co. 

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i GEORGIA 
Hall Co. 

  

  

  

  

  

  

    

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Normandy Co. 

MARYLAND : 

St. Mary's Co. 
Worcester Co. | 

‘Baltimore 

MISSISSIPPI 

Greene Co. 

‘MISSOURI 

Webster Grove 

Columbia 

St. Louis 
Kansas City 

University City 

Kirkwood 
Maplewood-Richmond 

Ritenour Consol. S. D. 

‘NORTH CAROLINA 
  

Kings Mountain City 
Cherokee Co, 

SOUTH CAROLINA 
  

Union Co. 

Horry Co. 

Florence 

Lancaster Co. 

Anderson {#5 

  

  

  

  

  

 



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3 \ Harding-Jefferson 

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Kingsville 

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Eo) : Co 

THE METHODIST HOSPITAL OF GARY, INC. 
BROADWAY METHODIST HOSPITAL     

Reply to: [J : Reply to [J 
METHODIST HOSPITAL OF GARY ; : BROADWAY METHODIST HOSPITA i 600 GRANT STREET 

8701 BROADWAY 
: GARY, INDIANA 46402 

MERRILLVILLE, INDIANA 46410 
219 886-4000 

219 738.5500 

January 19, 1977 

  

Alfred J. Sanchez JAN 20 1877 
Chief, Health and Social Services Branch 
Office for Civil Rights, Region V 
Department of Health Education and Welfare OFFICE FOR CIVIL RIGHTS 300 So. Wacker Drive 

Chicago, Illinois 60606 

Dear Mr. Sanchez: 

In response to your letter of 12/22/76, The Methodist Hospital of Gary, 
Inc., wishes to provide the following information specifically relating 
to each of the allegations made against the hospital. In addition, you 
should be aware of the following facts, in reference to the Civil 
Rights Assurances signed by The Methodist Hospital of Gary, Inc., in 
1873: 

1. There has been no reduction of services at the Gary hospital 
since the assurances were signed. 

2. A continuous capital equipment and renovation program has 
been in effect at the Gary hospital for at least twenty 
years. 

The programs and equipment found in the Gary hospital are 
among the most modern to be found in any urban hospital of 
comparable size and age. 

3. Every effort has been made by the Board and Administration 
of the two hospitals to operate the hospitals in a fiscally 
prudent and efficient manner. Basic services have been 
duplicated in the Gary and Broadway facilities, solely in the 
interest of effective care and service to the patient, whose 
interests must be given priority. 

The hospital has consciously kept your office advised of all it's plans 
for expansion and development of services at both hospital sites, and 
will continue to do so in the future should additional programs be 
contemplated at either site. 

Exhibit B sis 

4 y . ’ TE 

 



    

Alfred J. Sanchez January 19, 1977 
Office for Civil Rights : Page 2 
Department of Health Education and Welfare : 
Chicago, Illinois 

The commitment of The Methodist Hospital of Gary, Inc., to its entire 
service area of eastern Lake County has been a deep and abiding one for 
54 years. Within the limits of its.resources, the hospital organization 
will continue to provide the best possible facilities and programs of 
care to the patients throughout the area it serves regardless of their 
race, creed, or national origin. 

We have answered the allegations within the time frame you proposed. 
We have been forthright and direct in responding to these allegations, 
despite the fact that many of the allegations assumed facts which were 
not true. We have tried to provide you with the best information we 
could within the time allotted. 

Sipeprel 

/ R. B. Glesne 
Administrator 

RBG/bas 

Attachments



  

  

The Methodist Hospital of Gary, Inc. 

Xerography Machine 
  

In regard to Xerography being available at Broadway Methodist 
Hospital but not at the Gary Hospital, it should be noted that 
xeromammography (available at Broadiiay) and xeroradiography 
(available at Gary) are both of equal value, accuracy and 
benefit. A recent article in the American College of Radiology 
by Dr. Lester who was Chief of Radiology at Duke University, 
stated that ''the two modalities are of equal value and benefit, 
but the determining factor is the expertise of the examiner'. 

The Xeromammography machine was not purchased at Broadway, but 
was rented in May 1976 on a temporary basis for testing and 
evaluation to evaluate if this service would be as reliable as 
the Xeroradiography machine at the Gary Hospital and also meet 
the needs of the medical staff. 

In the last several months the number of mammograms have de- 
clined markedly because of recent publicity in regard to adverse 
effects from radiation exposure. In 1975, there were nearly 600 
mammograms performed at the Gary Hospital whereas in 1976 there 
were less than 300 examinations. On reviewing our statistics 
it was noted that in August, September, October, and November 
of 1976 there was an average of less than 12 mammograms a month 
in contrast to 45 mammograms a month in 1975. It was for this 
reason that it was not advisable to duplicate both Bog ran 
services at either hospital. 

Urology Room 
  

One small cystology room is available at the Broadway Hospital 
adjacent to the surgical area. This room can function only as 
a diagnostic room; thus patients in need of surgery need to be 
transferred to the surgical area or scheduled for future surgery 
at a later date since this room is not suitable for surgery. 

A cystoscopy table at Gary is available in one of the larger 
surgical suites. The cystoscopy table at Gary can also function 
as a surgical table; thus immediate surgery can be performed 
following a diagnostic procedure. The ability to perform 
surgery following a diagnostic procedure is sometimes advanta- 
geous to the patient and attending physician. 

The administrative office has not been made aware that patients 
have to wait up to a week to have surgery scheduled at the Gary 
Hospital. There is usually open time available every day of 
the week and with proper scheduling there should be no waiting 
period. Since most of the medical staff urologists are alsa 

 



  

staff members of at least 3-4 area hospitals, any scheduling wait 
is most likely created due to the weekly schedule of the operating 
physician. The hospital also has a very active medical staff, 
Utilization Review Committee, and daily surveillance is made on 
all hospitalized patients; thus authorization to have the patient 
wait in the hospital for a week for surgery would not be permitted. 

X-Ray Equipment in Surgery 
  

One control stand and one generator is available in surgery at 
the Broadway Methodist Hospital. This equipment can serve two 
rooms. A similar machine is available at Gary Methodist Hospital 
in one room. However, other surgical suite rooms have 240 volt 
shockproof outlets; therefore, a 200 KV portable machine can be 
used in any surgical room at Gary Methodist Hospital. 

Gary Methodist Hospital has one operating room equipped with a 
well wired rapid changer machine able to perform angiography--- 
this service is not available at Broadway Methodist Hospital. 

In the summer of 1976 bids were obtained to completely renovate 
one .of the fluorscopic and diagnostic X-ray units at the Gary 
Methodist Hospital. Work was begun in the fall of 1976 and 
completed the first week of January, 1977. There was a complete 
renovation of an entire room with the most modern expensive 
equipment available. This room is essentially the same as the 
facility at the new hospital in Merrillville. It should also be 
noted that bids are now also being obtained to renovate a second 
room at the Gary Methodist Hospital and this work should be 
completed in 1977. 

Currently, there is discussion involving plans for enlarging the 
special procedures room in the Radiology Department at Gary 
Methodist Hospital. Hopefully, this expanded service will be- 
come operational by early 1978. 
TN 

[It should be noted without anyone really having to point it out 
| 
i 
i 

| 

that when one builds a new hospital the most modern technological 
equipment that budgetary allowances permit would be purchased. 

The Gary Hospital has been in existence since 1923 and consequently 
\ the equipment is older and cannot be equated to that going into a 
\new hospital. However, major pieces of equipment have been pur- 
chased annually at the Gary Hospital in order to insure that 
quality services are available. These additions have always been 
undertaken at the hospital's initiative: witness our completely 
renovating and replacing one entire diagnostic unit, including 
image intensification and television control at the Gary Hospital. 

It should also be noted that at the Gary Methodist Hospital we 
have six rooms of diagnostic radiology equipment whereas at the 
Merrillville Hospital there are only four rooms of diagnostic 

 



  

equipment. 

Gary Methodist Hospital has 7 stationery x-ray machines with 
separate controls and generators. 

Broadway Methodist Hospital has 5 stationery machines with _ 
separate controls and generators. 

The same diagnostic procedures are performed at Gary Methodist 
Hospital as at Broadway Methodist Hospital namely: myelography, 
hysterosalpingography, arteriography, arthrography, lymphangio- 
graphy, tomography, mammography; in other words, all of these 
diagnostic procedures are performed at both hospitals. 

Film storage is a constant problem and it should be noted that 
Gary Methodist Hospital has 4 times the storage than is available 
at Broadway Methodist. 

Image Intensifiers 
  

There are 5 Image Intensifiers at Gary Methodist Hospital. Two of 
these are portable and can be used in any of the operating rooms, 
Intensive Care Units, or a patient room at the Gary Hospital. 

Broadway Methodist Hospital has a total of 2 Image Intensifiers 
which are permanently located and can only be used in the main 
Radiology Department. 

It should also be noted that Gary Methodist Hospital has 6 
portable x-ray machines, one of which is a panoramic machine. 
Broadway Methodist has only 2 portable machines. 

Portable Monitors in Recovery Room 
  

The recovery room at Broadway has portable monitors. There is one 
portable monitor and defribrillator available for use in the re- 
covery room at the Gary Hospital. 

There are current plans to add portable monitors for individual 
E.K.G. scope monitoring of patients at the Gary Hospital recovery 
room and these should be available in 1977. 

It should be noted that the essential modality of treatment is 
physical observation by the personnel. 

Automatic Patient Cart Washer 
  

There is an automatic cart washer at Broadway as this piece of modern 
technology was not available until the time the Broadway Hospital was 
built. 

 



    

Carts at the Gary Hospital are hand washed with '"Beaucoup' and 
within 3-4 minutes are germicidally clean and available for use 
when needed. All carts returned to Central Service are washed 
properly at both hospitals prior to returning to any of the 
hospital nursing stations. 

Combination Gas-Steam Autoclave Sterilizer with an Aeration Chamber 
  

Broadway Methodist Hospital has a gas sterilizer with a separate 
aeration chamber located in the central processing area. This 
equipment is used to sterilize catheters, trays, rubber and 
plastic supplies as well as surgical instruments. 

Methodist Hospital in Gary also has a smaller gas sterilizer located 
in the operating area but is seldom used because it is more convenient 
to send supplies to the Broadway Hospital for processing; thus avoid- 
ing duplication of effort and ‘expensive equipment. 

A well scheduled transportation system operates between the two 
hospitals and provides for this type of service. For example, 
'""eut down'' needles are processed at the Broadway Hospital, using 
the Gas Sterilizer, and returned to Gary on a routine scheduled 
basis. 

It should be pointed out that other methods of sterilization can 
be used effectively and safely beside gas sterilization. Both 
institutions have steam autoclave sterilization, cold sterilization 
methods, as well as the gas sterilization technique. All methods 
are monitored by quality control methods; thus assuring the hospital 
that safe and effective sterile technique is being maintained. 

Ultra=-Sonic Instrument Washer 
  

This is correct---there is an ultra-sonic instrument washer at the 
Broadway Hospital and nore at the Gary Hospital. Instruments are 
hand-washed at Gary, rinsed, wrapped, and autoclaved for sterile 
purposes. 

Ultra-sonic instrument washing is a modern cleaning technique and 
was installed in the Broadway Hospital at the time it was built. 
Instruments coming out of the ultra-sonic machine must also be 
checked for cleanliness by an employee before wrapping and sterili- 
zing. Both techniques are safe and acceptable standards of operation. 

Private Rooms 
  

All rooms at the Broadway Hospital are private. Again, this was 
the latest concept in patient care units at the time the hospital 
was designed and built. It was also pointed out in the literature



  

10. 

1) 

to be the most reasonable in cost, because patient transfers would not be necessary and rooms could be utilized more effectively, 

Gary Methodist Hospital was built in 1923 when this concept was not recommended. In fact "8 bed wards" were considered to be the most modern concept in the delivery of patient care. Continuous re- modeling over the last 50 years has taken place at the Gary Hospital and at the present time there are no 8 bed wards or 4 bed wards. Our beds are all state conforming. It is our understanding that there are approximately 185 beds in the community that are not con- forming. 

Nurses 

Gary Methodist Hospital employees 156 nurses. 

*22 of whom are Filipino nurses 

Patient Average Census - 260 

Broadway Methodist Hospital employees 109 nurses. 

*None are Filipino 

Patient Average Census - 160 

*The Filipino nurses were employed at the Gary Hospital prior to the existence of Broadway Methodist Hospital. Like many inter-city hospitals it is difficult to recruit an adequate number of nurses; thus the Nursing Service Administration actively recruited these nurses. The Gary Methodist Hospital had living quarters available on the 3rd floor of the Administration Center and since these nurses do not have transportation, they choose to stay and work at the Gary Hospital. They are welcome to work at both institutions. 

Physicians 
  

It is both prestigious and advantageous to the Gary Methodist Hospital to have a higher percentage of externs, medical students, and physi- cian residents at the Gary Hospital. These young men and women are from teaching institutions, which are the most respected medical schools and hospitals in the country. It is also a stimulus to the medical staff and the entire hospital personnel to have these medical professional workers in the Gary Hospital. 

I't should also be noted that the Gary Methodist Hospital has recently completed a very extensive Family Practice Residency Program curriculum 

-5 - 

1-19-77 

 



  

12. 

13. 

application and has been site surveyed by the American Medical Asso- 
ciation Academy of Family Practice. The residency is to be a three- 
year program and will be located at the Gary Hospital and serve the 
Gary community. The focus of this three-year program is on the 
delivery of quality medical care to families in need of health care 
on a 24 hour basis. The residents in this program are licensed 
physicians and will spend a total of 3 years associated with family 
medicine under supervision and direction of a full time Medical 
Director and medical staff physicians willing to donate their time 
teaching in this residency program at Gary Methodist Hospital. 

The Board of Directors of Methodist Hospital has also allocated 
$250,000 annually for operational support of this program. The 
3 million dollar building project at the Gary Hospital will include 
a floor devoted to this residency program. A total of 12 licensed 
physicians will compliment the residency program and serve the 
community and their medical needs. 

Rooms for Physicians on Call 
  

At the Broadway Hospital the only on call rooms are centrally 
available in one area of the hospital. Any physician needing to 
stay at the hospital must go to the 2nd floor of the hospital for 
sleeping accommodations. These physicians are then called to 
various areas of the hospital when their services are needed. 

At the Gary Hospital there are several on call rooms available for 
physicians located in numerous patient care areas. For example, 
the emergency room at Gary has an on call room for the physician 
in the immediate area, thus the physician is always immediately 
available. Likewise, in the 0.B. department at Gary, there are on 
call rooms available for physicians and anesthetist---this is not 
true at Broadway Hospital. The administrative building at Gary 
also has several rooms on the second floor that are available for 
physicians, technicians, or any hospital employee needing to stay 
on the hospital premises overnight. There is no administrative 
building at the Broadway Hospital that can offer these types of 
accommodations. 

Linear Accelerator 
  T— 

The use of the linear accelerator is the latest modality of radiation 
treatment of cancer patients and this equipment has only been made 
available in the last few years. 

It should also be noted that the linear accelerator was placed at the 
hospital in Merrillville for several reasons: 1) It was recognized 
that St. Catherine's and St. Margaret's hospitals both had high 
energy sources of radiation and it was considered in the best interest 

Ca am 

 



  

geographically, to install the new linear accelerator in the 
southern part of the County where high energy radiation sources 
were lacking or unavailable. In all probability planning would 
not allow a linear accelerator in Gary due to population needs, 
and close proxsimity to St. Catherine's and St. Margaret's, ~ : 2) 

The room requires extensive architectural planning and 
; would have been impossible to build in The Gary Methodist 
a : Hospital because of space considerations and architectural re- 

quirements. 

Cesium is available at both hospitals for implantation. 

% 8 14. Modernization of Gary Methodist Hospital 
  

a. 

  

Inadequate power plant---in 1972 a new boiler was added to 
  

the Gary plant at the cost of $160,000. The present power 
plant is adequate to carry the present hospital power needs. 
One of the building projects approved by H.E.W. is a new 
laundry facility. 

With a new modern laundry facility that will serve both insti- 
tutions this will relieve the present power plant at the Gary 
Hospital and will allow for future expansion and remodel ing 
projects. The hospital Board of Directors approved this project 
several years ago and we expect to start the building on this 
project along with the two other building projects when the 
present issues are resolved. : 

Radiology (X-Ray) Department---please refer to question #3 and #4. 
  

Emergency Room---the present emergency department at Gary Methodist 
was totally renovated and replaced the former emergency room in 
August, 1973. 

  

The remodeled area consists of 6 treatment bays, 2 treatment carts 
in a self-contained "trauma room", a "triage" room which can 
double as a minor treatment room, a pediatric treatment room, 
and a orthopedic cast room which is located off the emergency 
department/out-patient lobby. The Gary facility can routinely 
care for 9 patients on carts, simul taneously, with a total capa- 
city for 12 occupied carts. 

The Broadway Emergency Department has 4 treatment bays with carts 
and a combination Cast/Trauma Room which has 2 carts for a total 
capacity of 6 patients on carts. The fourth treatment bay doubles 
as an examining area for the Pre-admission Center, while Gary 
Methodist has a separate and much larger Pre-admission Center. 
Both hospital emergency room facilities are equally equipped, in- 
cluding one crash cart and one portahle EKG Monitor-defibrillator 
which is used during patient transport situations.



  

Staffing Patterns: 
  

The Gary Emergency Department: 
  

- Head Nurse (R.N.) 
- R.N.'s (full-time) 

L.P.N. (full-time) 

EMT-11 Paramedics 

2 - full-time 

5 - part-time 

5 - EMT-I 

2 - full-time 

3 - part-time 

} - Physician Assistant 
full-time, evening shift 

“
f
w
 

CN
 

The Broadway Emergency Department: 
  

1 - Head Nurse (R.N.) 

4 - R.N.'s (full-time) 
1 = EMT-1 (full-time nights) 

plus Crown Rescue EMT I/EMT || Paramedics who function 
as E.R. personnel while waiting for emergency runs. 

The EMT's are frequently called away from the department on emergency 
runs at the Broadway Hospital. This does not occur at the Gary 
Hospital since the EMT's are not scheduled on emergency runs while 
working at the hospital. Both Emergency Departments share a common 
medical department director and a common E.M.S. physician group. 
Both departments have one physician on duty at all times. 

¥=~19=77 

 



  

Health Education 
  

Health education offers a wide variety of programs as well as individual 
counseling at the Gary Hospital, including diabetic classes which meet 
every day during the week for both inpatients and outpatients. There are 
pre-natal classes twice weekly as well as groups of evening classes four 
times per year for the community. 

Health education has post-partum classes three times a week and infant 
care programs twice weekly. In addition to those, there are classes 
on tubal ligation and other preoperative preparation classes. 

Hypertension counseling and coronary classes are provided. There is 
much individual counseling for families with incidencies of ulcers, 
asthma, etc. Also, there is individual counseling for families regarding 
tube feedings, colostomy care, self-catheterization, mastectomy, etc. 

There are scoliosis classes held two times per month in correlation with 
the scoliosis clinic. 

At the Broadway facility there are classes in coronary and hypertension 
along with individual counseling. There are no pre-natal classes there, 
however, there are post-partum and infant care programs. There are 
classes on radiation therapy at Broadway that include a variety of in- 
formation relevant to those who are receiving treatments. There are 
diabetic classes held at Broadway, also. 

: 

In the community, the health education department is involved with the 
radio program WLTH, relating to a wide variety of health programs. . The 
staff of the department also direct special presentations to area P.T.A. 
groups. They additionally give classes on C.P.R., diabetes, hypertension, 
and coronary problems relevant to the families' needs. 

 



    

Patient Days 
  

  

  

Gary Hospital . Broadway Hospital 

Medicare Patient Days 20,000 13,900 

Medicaid Patient Days | 17,500 1,350 

Total Patient Days 97,526 45,321 

Admissions Policy 
  

There is no separate admissions policy at either hospital regarding Medicare and Medicaid patients. 

Improvements and Additions of Service 
at Gary Hospital 

1976 

  

  

  

No reduction of services at Gary Methodist Hospital. 

1. Epilepsy Clinic added to existing Clinic Services 

2. Combined Employee and Medical Staff Library 

3. Regional Coordinating Center for EMT/Paramedic 
Training for 7 Counties: 

Lake 
LaPorte 
Jasper 

Pulaski 
Newton 

Porter 

Stark 

4. Expanded and Extended Patient and Community Education Services/Programs 

5. Presently Enlarging Electro-Diagnostic Department and Services 

6, Presently Enlarging Nuclear Medicine - "Wet Lab Services for Assay Testing" 

7. Presently Enlarging Cast Clinic and Waiting area for Emergency Room and and Orthopedic Patients. 

“ JO 

 



  

8. Presently Expanding Laboratory Department---for Mini-Stat Lab Services 

'9, Remodeled Radiology Room 2 - Furnished with most modern up-to-date 
radiology equipment. 

10. Up-dated Library Texts and Reference Materials. 

11. Pilot Project with St. Vincent Hospital, Indianapolis - Family Practice 
Residents (physicians) working with 0.B. clinic under supervision and 
direction of Medical Director. 

i 12. Affiliating with Purdue University (Added to numerous other Educational 
- Hospital Affiliations) A.D. Nursing students to Gary/Broadway - 12 stu- 

: dents at Gary and 12 students at Broadway 

  

1 

"y 13. Security Department---added additional workforce 

: 14, Total Number Manhours for Employee Staff Development and Continuing 
: Education at Gary - 42,912 

\ 

15. Total number Manhours for Employee Staff Development and Continuing 
Education at Broadway - 40,882. 

16. Auxiliary Contributions: 

Scholarship Assistance 

Auxiliary-A.D. Nursing-ind. University $1,500.00 
Medical Staff " " " 1,500.00 

: Auxiliary (1/2 Tuition for Hospital 4,029.00 
personnel - 1976) 

Auxiliary (Youth Volunteer Scholarship) 1,000.00 
Cytology Lab. Scholarship (Special Award) 500.00 

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