First Request for Admission to Defendant

     [||5c3ec893-f92d-4457-a891-fde819841030||] IN THE UNITED STATES DISTRICT COURT 

FOR THE NORTHERN DISTRICT OF INDIANA 

HAMMOND DIVISION 

  

RICHARD GORDON HATCHER, et al., 

Plaintiffs, 

v. ; Civil Action No. 

METHODIST HOSPITAL OF GARY, H 77-154 

INC., ef al.,, ) 

Defendants. ) 

  

PLAINTIFFS' FIRST REQUEST FOR ADMISSION 

TO DEFENDANT UNITED STATES 

SECRETARY OF HEALTH, 

EDUCATION AND WELFARE 

Plaintiffs, pursuant to Rule 26 (a) of the Federal Rules of 

Civil Procedure, request defendant Joseph Califano, United States 

Secretary of Health, Education and Welfare to admit within thirty 

(30) days from service of this request that the following is true. 

If defendant admits to parts of each item, such parts as are ad- 

mitted and such parts as are not admitted should be specifically 

stated: 

(2a) The attached copy of defendant Califano's Response to 

Plaintiffs' Second Set of Interrogatories in National Association 
  

For The Advancement of Colored People, et al. v. The Wilmington 
  

Medical Center, et al., Civil Action No. 76-298, U.S.D.C. D. Del., 
  

is a true and accurate copy of said response; 

(b) The general policy of the Department of Health, Education   
 



' 

RC 0 

  

and Welfare under Title VI and Section 504 as it relates to site 

selection of health facilities subject to Title VI and Section 

504 is stated in regulations of the Department of Health, 

Education and welfare, 45 C.F.R. 80.3 (b) (¢) and 45 C.F.R. 84.4 (b) 

(5). 

(c) The policy of the Department of Health, Education and 

Welfare with regard to investigations of relocation of health 

facilities under Title VI and Section 504 is as follows: 

The "effects standard" articulated 

in the regulation [45 C.F.R. 80.3 (Db) (3) 

and 45 C.F.R. 84.4 (b) (5)] is the begin- 

ning point of our investigation. The 

investigation primarily concerns the quality 

of care and access to care which may be ex- 

pected or which results from a plan by a 

recipient of federal financial assistance 

to relocate, or build a satellite or second 

health facility. Discriminatory effects of 

the relocation or construction and expansion 

of a second facility might include either or 

both (1) a disparity of services available 

to different races, and (2) avoidable racial 

segregation. 

The investigation involves the question 

of whether the result of the relocation, or 

construction or expansion of a second facility 

will be or is a unitary health care delivery 
system or two separate units. An investiga- 

tion involves a comparison between health care 

delivery prior to execution of a plan and pre- 

dictable or probable or actual health care 

delivery when the plans are carried out. 

The elements of the investigation under 

the site selection regulations include: (1) a 

demographic analysis of race, age, and disabil- 

ity/handicap clusters in downtown and out- 

county areas; (2) an analysis of the current racial 

configuration of hospital service utilization; 

(3) an analysis of available private and public 

transportation in the area, of feasible new 

transportation, and of municipal (jurisdictional) 

or physical impediments to access to the existing       
 



  

and proposed facilities; (4) an analysis of 

the proposed distribution of residents, in- 

terns, supervisors, and specialists; and 

(5) an analysis of current and projected 

employee transportation needs. 

Respectfully submitted, 

ALE IOAN RE SE 

JACK GREENBERG 

MELVYN R. LEVENTHAL 

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 N Street, N. W. 

washington, D. C. 20036 

Attorneys for Plaintiffs 

      
 



  

Certificate of Service 
  

I hereby certify that a copy of the attached PLAINTIFFS’ 

FIRST REQUEST FOR ADMISSION TO DEFENDANT UNITED STATES SECRETARY 

OF HEALTH, EDUCATION AND WELFARE was served by United States mail, 

postage prepaid on the 10th day of June, 1977 on the following: 

REBECCA IL. ROSS, ESQ. 

Department of Justice 

10th and Pennsylvania Avenue, N.W. 

washington, D. C. 

MARVIN E. GARVIN & EDWARD L., KOVEN 

REGIONAL ATTORNEY & GENERAL ATTORNEY 

Department of Health, Education and Welfare 

300 South wacker Drive, 18th Floor 

Chicago, Illinois 

FRED W. GRADY, ESQ. 

ASSISTANT UNITED STATES ATTORNEY 

United States District Court 

Northern District of Indiana 

Federal Building, 502 State Street 

Hammond, Indiana 46325 

Bev, A Jott 
  

/ Attorney for Plaintiffs 

      
 



  

  

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UNITED STATES DISTRICT COURT 
FOR THE DISTRICT OF DELAWARE 

NATIONAL ASSCCIATION FOR THE 

ADVANCEMENT OF COLORED PEOPLE 

ET AL., 
Plaintiffs : 

Vv. Civil Action No. 76-298 

THE WILMINGTON MEDICAL CENTER, 

ET AL. 

h, 

Defendants 

P
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4 

  

DEFENDANT CALIFANO'S RESPONSE 

TO PLAINTIFFS' SECOND SET 
OF INTERROGATORIES 
  

Defendant, Joseph A. Califano, Secretary of the United 

Staied Deparinent of Health, Education and Welfare, by his 

undersigned attorneys, pursuant to Rule 33 of the Federal 

Rules of Civil Procedures hereby responds to plaintiffs’ 

second set of interrogatories ai Lollove, 

Interrogatory 
  

A. For each hospital 1/ which has been partially or 

fully relocated, and has been previously investigated 

or subjected to a compliance review in connection with 

the relocation by the Office for Civil Rights, give the 

following information: 

"1. Legal name of hospital. 

2. Name, address, and number of inpatient beds at 

each facility of hospital, including satellites, branches, 

and affiliates. 

v. 3. Identification of which facility named in #2 is 

the new facility, date of NEW approval and relocation, and 

date of opening of the new facility. 

  

1/ As used herein, the term "hospital' means the collective 
of all facilities, and the term "facility" means each separate 
branch, satellite, or affiliate. 

     
    

   

   

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4, Specification of whether relocation involved: 

| a) total removal; b) creation of satellite facility; 

c) partial removal, with new facility becoming the principal 

(or larger) facility and old facility becoming satellite; 

d) other (specify). 

  5. Specify whether additions and expansions have been 

wid made at the relocated facility, and whether further contractions 

(or closures) have occurred in the remaining 2aLiTity since: 

the original relocation. If there have been additions, expansions, 

contractions, and closures, specify by facility, service number 

of inpatient beds (if inpatient service), number and/or percentage 

» Fi of increase or decrease of visits (if outpatient service). 
v 

6. Composition of the population by race and national 

| origin of the census tract and zip code of each facility, 

and of the area from which each facility draws the majority 

of its patients 2Z/: 

(i) Original Facility (at time relocation occurred) 

i ; 

  
  

  

| Census Tract Zip Code. Service Area 

Fn Black % % | 2% 

1 Hispanic % % | % 

| ea 0 White % % % 

Other % % | % 

(ii) Original Facility (for most recent fiscal year, 

whether or not original facility still open) 

L 4 

  

  

  

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. Census Tract Zip Code Service Area 

B | | Black . % % fr 

| ¥ Hispanic % % i % 

Ba White % % | % 

; Other % % % 

  

2/ As used herein, the area comprises the fewest number of 

census tracts and/or zip codes which produce 51% of the. 

facility's patients. 

‘ 2 id 

  
   



® i o of Tm i 

Ca Te | 

  

Re (iii) New Facility (for most recent fiscal year) 

* 
. / 

    

Census Tract Zip Code Service Arca 

Black % % i % * 

Hispanic % % | % | 

White % g % 

Other % % + 
y 

/ 

. 9. Give the following information concerning the 

race and national origin of-all patients: 

2 (i) Original facility (for last fiscal year 

  prior to relocation): y 

Inpatient Emergency Room Clinics 3/ 
    

, : : Adm. Days 
4 

® —— ———   

Black 

White 

Hispanic 

Other 

(ii) Original Facility (for most recent | 

fiscal year if still open): 
vb da 

Inpatient Emergency Room Clinics 
    

Adm. Days 
  

Black 

White 2 vas] Ni a] 

wn 
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Hispanic 
: | 

| a . Other 

(iii) New Facility (for most recent fiscal 

year) : : 

| - : Inpatient Emergency Room Clinics 

| Adm. — Days 
| 

    

Black 

White 

Hispanic 

Other 

  
  

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3/ As used herein, "clinic'" means primary care services for the 

Tndigent and medically indigent who do not have and/or cannot 

afford private physicians, \ : 

  

 



     

   

  

     
   
   

     

  

   
   

    

  

   
   

   

   

    
   
   
    

   

   
   
   

    

    

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8. Give the racial and national origin of physicians 

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and employees, in the categories noted below, at the original 

facility prior to the relocation, and at each facility currently: 

(1) Original Facility Prior to Relocation 
fie | 

Black Hispanic Asian Amer. Ind. White 

' 
  

    — ae ve 

  
  

* Administrative 
vo—] “vee ——— ————  p——— 

Clerical 
RE i. TRI] - -  ———————— —__ em sn .- ae. 

  
  

Registered Nurses       
  

Lic.. Prac. Nurses 
  

Aides and Orderlies 
  
  

Service 
  
  

Technical 
  
  

Physicians : 
  

Staff Physicians 4/ 
  

_ Employees     

* Interns 
  
    

Residents 
  
    

  

++ (ii) Original Facility (for most recent fiscal year if still open) 

I
 

    

Black Hispanic Asian Amer. Ind. White 

Administrative 
    
    

Clerical 
  

    

; . Registered Nurses 
        

  
    nk Lic. Prac. Nurses 

Jo Aides and Orderlies 
        

    
    

oh Service 

Technical 
    

    

    
; Physicians 

    
    

Staff Physicians 4/ 

Employees ; 
  

Interns : : 
    

Residents : hy 
  

  | 
| 4/ Staff physicians are those who are not employees but are private 

practitioners with staff privileges. 

     
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(111) New Facility (for most recent fiscal year) 
  

  

Black Hispanic Asian Amer. Ind. White 

Administrative 
  

Clerical 
  

Registered Nurses 
  

Lic. Prac. Nurses 
  

Aides and Orderlies 
  

Service 
  

Technical 
  

Physicians 
  

Staff Physicians 
  

Employees 
  

Interns 
  

Residents 
  

9. Where there are still multiple facilities, give the number f cb 

by race and national origin (Black, Hispanic, White, Other) which 

each staff physician admitted to each facility for the most recent 

fiscal yéar as follows: 

: Original Facility New Facility 

Staff Physicians Black White Hisp. Other Black White Hisp. Other 
  

    

Response to Interrogatory A 1-9 
  

All of the information contained in HEW files concerning- 

hospitals which have been partially or fully relocated has previously 

been made available to plaintiffs' counsel in the Response and 

Supplemental Response to Requests No. 4, J, 7, 8, and 9 of plaintiffs’ 

Request For Production, Inspection and Copying Of Documents served 

upon Defendant Secretary of Health, Education and Welfare on January 4, 

1977. To the extent that the answers to these interrogatories are 

not contained therein, the Secretary does not presently possess 

the information requested. 

Further, to the extent frat thoso interrogatories request 

that the Secretary identify, obtain, collate and analyze such 

material not presently in his possession, he objects Lg he 

  

 



. interrogatories as unduly burdensome and oppressive, and 
I 

that such information is not relevant or likely to add to 

  

the discovery of relevant evidence. NE 

Interrogatory : k | ii 
  

B. State specificly the "investigative hypothesis" under 

which the investigation team is proceeding separately, for: 

l. The Title VI allegations;   2. The Section 504 allegations; . es 

and identify and attach copies of all regulations, guidelines, 

: and/or policy statements upon which these investigative hypothesis 

are based. 

Response to Interrogatory B 
  

The general policy under Title VI and Sec. 504 as it relates 

to the site selection issue in.this case is stated in the HEW | 

site selection regulations (45 CFR 80.3(b) (3) and 45 CFR 84.4(b) 

(5)). The Director, OCR, has not yet determined the precise 

application of this general polich to the facts in Wilmington 

and this process will not be completed until all of the information 

gathered by OCR has been analyzed. Specific OCR policy as tor 

WMC will be fully defined in the letter of findings which will 

be sent to the hospital and filed with the court, as set forth 

‘in our Supplemental Report of May 5, 1977. In addition, the 

& OCR Director and his top level staff have taken office very 

dx recently; the new Director assumed his position on Monday, May 2, 

1977. | 
Ld 

. The "effects standard" Articuvated in the regulation,. 

however, is the beginning point of our investigation. In this 

case, the investigation primarily concerns the quality of care 

and access to, which may be expected under the proposed plan. 

Discriminatory ‘effects of the relocation might include either 

or both (1) a disparity of services available to different races,   and (2) avoidable racial segregation. 

   



  

  

  

In the present situation, involving a main hospital and 

a satellite Eosplital, the investigation involves the question 

of whether the result of the relocation will be a unitary 

health care delivery system or two separate units. Our 

investigation involves a domparizon between current health 

care delivery in the Wilmington area and predictable or ; 

probable health care delivery if relocation plans are carried 

out. : \ 

“The elements of the investigation under the site selection 

regulations include: (1) a demographic analysis of race, age, 

and disability/handicap clusters in downtown and out-county 

areas; (2) an analysis of the current racial configuration 

of hospital service wtilization (3) an analysis of available 

private and public transportation in the area, of feasible 

new transportation, and of municipal (jurisdictional) or. 

physical impediments to access to the existing and proposed 

facilities; (4) an analysis of the proposed distribution of 

residents, interns, supervisors, and specialists; and (5) an 

analysis of current and projected employee transportation needs. 

| 

As to the Answers herein: | 

I declare that the above answers are to the best of my 

knowledge and belief, true and correct. Declared 

be true and correct under penalty of perjury. / 
. 7 i 

David S. Tatel 
: . + Director 

> Office for Civil Rights 

; : ~ "Department of Health, Education 
\ : - and Welfare 1 

  

    [~ 7    

  

As to the Objections herein: 

  

James W. Garvin, Jr. 
United States Attorney 

ebecea LL. Ross 

Attorney: for Defendant. 

Attorneys, Department of Justice 
10th and Pennsylvania Ave., N.W, 

Washington, D.C. 20530 
Tel: (202) 739-4207 

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fq . 

CERTIFICATE OF SERVICE 

  

  

  z 

I certify that two (2) copies of Defendant Califano's 

"Partial Response to Plaintiffs' Second Set Of Interrogatories 

have been served this 18th day of May, 1977 by hand delivery 

to: 

Marilyn G. Rose 
Center for Law & Social Policy 
1751 N Street, N.W. | 
Washington, D.C. 20036 

and by mail, postage prepared to: 

-—
 
—
 

Joseph Flowers 
Community Legal Aid, Inc. 
204 W, 7th Street : 
Wilmington, Delaware 19801 

Charles H. Toliver, IV 
‘ s : Alan Scher 

a Assistant City Solicitors 
252 Public Building : 
Wilmington, Delaware 1980 

William C. Gordon, Director 
Health Planning Council, Inc. 
2501 Silverside Road 
Suite #5 
Wilmington, Delaware 19801 

Rodney M. Layton 

Richards, Layton and Finger 
. 4072 DuPont Building 

Wilmington, Delaware 19809 

oN | : Malcolm Cobin 
Assistant Attorney General 
Division of Public Health 

. State of Delaware 
Room 420 

Jesse Cooper Building 
Dover, Delaware 19901 

  

James W. Garvin, Jr.   

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