ORIGINAL
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ADDRESS

BY

C, EVERETT KOOP, MOD,

   SURGEON GENERAL

US, PUBLIC HEALTH SERVICE

          AND

  DEPUTY ASSISTANT SECRETARY FOR HEALTH

UA DEPARTMENT OF HEALTH AND HUMAN SERVICES

PRESENTED TO THE 1986 "EMPLOY THE HANDICAPPED" PROGRAM

       NATIONAL INSTITUTES OF HEALTH

           BETHESDA, MARYLAND

           OCTOBER 22, 1986


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(GREETINGS TO HOSTS, GUESTS, FRIENDS, ETCJ

  I APPRECIATE BEING GIVEN THIS CHANCE TO CONTRIBUTE TO TODAY'S

PROGRAM,

  LAST WEEK, WHILE THINKING ABOUT THE FEW MOMENTS I WOULD HAVE AT
THIS PODIUM, I DECIDED THAT WHAT I REALLY WANTED TO DO WAS TO BRING
YOU TWO MESSAGES: FIRST, A SHORT ONE,, ,AND NEXT, A MESSAGE THAT'S A
LITTLE LONGER AND MAYBE, FOR MANY OF YOU, A NEW MESSAGE,

  HERE'S THE SHORT MESSAGE: I'M DELIGHTED TO TAKE PART IN THIS

ANNUAL EVENT,  BUT I'M NOT DELIGHTED WHEN THAT'S WHAT IT IS CONSIDERED
TO BE, anNOTHING MORE THAN A ONE-TIME ANNUAL EVENT,


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  BECAUSE IT ISN'T, WE MUST MAINTAIN A SENSITIVITY AND AWARENESS
YEAR-ROUND TO THE IDEA THAT MANY DISABLED PEOPLE ARE FULLY QUALIFIED
FOR MOST OF THE JOBS WE CONTROL,

  THIS ONE-DAY EVENT, PART OF A ONE-WEEK PROGRAM, IS A GOOD EVENT,
BUT THE LEGAL AND MORAL REQUIREMENT TO HIRE THE HANDICAPPED IS NOT A
ONE-DAY- OR A ONE-WEEK-A-YEAR REQUIREMENT, IT'S YEAR-ROUND,

AND THAT'S MY FIRST MESSAGE,

  NOW, I'M GOING TO BEGIN MY SECOND MESSAGE WITH A BIT OF
HISTORY,


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  ON SEPTEMBER 26, 1973, A REVISED REHABILITATION ACT BECAME PUBLIC
LAW 93412, THE BILL THAT WAS SIGNED INTO LAW HAD NOT HAD AN EASY
JOURNEY, TWO EARLIER VERSIONS HAD GONE TO PRESIDENT NIXON AND WERE
VETOED, WHAT FINALLY EMERGED WAS WHAT EVERYONE COULD AGREE ON,

  ONE OF THE MAIN PURPOSES OF THE LAW, STATED RIGHT AT THE BEGIN-
NING, WAS TO,,,

"PROMOTE AND EXPAND EMPLOYMENT OPPORTUNITIES IN THE PUBLIC AND
PRIVATE SECTORS FOR HANDICAPPED INDIVIDUALS AND TO PLACE SUCH
INDIVIDUALS IN EMPLOYMENT,"

  IN ADDITION THE CONGRESS INDICATED THAT THE NATION OUGHT TO PLACE
ITS EMPHASIS ON "SERVING FIRST THOSE WITH THE MOST SEVERE HANDICAPS,
SO THAT THEY MAY PREPARE FOR AND ENGAGE IN GAINFUL EMPLOYMENT,"


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  THE VERY LAST SENTENCE IN THAT LAW, SOME OF YOU MAY RECALL, IS
SECTION 504, WHICH SAYS THAT,,,

"NO OTHERWISE QUALIFIED HANDICAPPED INDIVIDUAL IN THE UNITED
STATESwSHALL, SOLELY BY REASON OF HIS HANDICAP, BE EXCLUDED FROM
PARTICIPATION IN, BE DENIED THE BENEFITS OF, OR BE SUBJECTED TO
DISCRIMINATION UNDER ANY PROGRAM OR ACTIVITY RECEIVING FEDERAL
FINANCIAL ASSISTANCE," PERIOD,

  THAT WAS VERY DIRECT AND EXCITING STUFF, NEVERTHELESS, IT TOOK
ANOTHER 4 YEARS BEFORE THE FINAL REGULATIONS WERE PUBLISHED, WHILE
SECTION 504 WAS ONLY ONE BRIEF SENTENCE IN THE 1973 LAW, ITS
IMPLEMENTING REGULATION OCCUPIED 24 PAGES IN THE MAY 4, 1977, EDITION
OF THE -REGISTER,


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  WHO WERE THE PEOPLE THAT WERE SUPPOSED TO BENEFIT FROM SUCH A LAW
AND REGULATIONS? THE COUNTRY IN GENERAL WOULD BENEFIT, OF COURSE,
BUT FOR OUR PURPOSES TODAY, LET ME GIVE YOU 2 OR 3 MORE SPECIFIC

EXAMPLES,

  THERE'S THE EXAMPLE OF KENT CULLERS,  HE WAS BORN 37 YEARS AGO,, m
TOTALLY BLIND, HE DECIDED ON A LIFE OF SCIENCE, AND HE'S ACHIEVED

IT,

  WITH A PH,D, IN PHYSICS FROM THE UNIVERSITY OF CALIFORNIA AT
BERKELEY, DR, CULLERS IS NOW EMPLOYED AT N,A,S,A,'s AMES RESEARCH
CENTER, HE'S A TEAM LEADER \/ITHIN A GROUP WHOSE ASSIGNMENT IT IS TO
SEARCH FOR EXTRATERRESTRIAL INTELLIGENCE,

  SOMEDAY, WHEN WE ASK, "WHO'S OUT THERE?", , ,DR, CULLERS WILL TELL

us,


  ANOTHER EXAMPLE IS DR, ANN SWANSON, A 38-YEAR-OLD BIOCHEMIST WITH
A PH,D, FROM THE UNIVERSITY OF WISCONSIN AT MADISON, SHE IS VERY
SMALL OF STATURE AND HAS OSTEOGENESIS IMPERFECTA, SOMETIMES CALLED
"BRITTLE BONE DISEASE," A SEVERE HANDICAP,

  DR, SWANSON IS A VERY GOOD BIOCHEMIST, SHE ADVISES THE NATIONAL
SCIENCE FOUNDATION ON ITS COLLEGE INSTRUMENTATION PROGRAM AND HAS
SERVED ON A NUMBER OF COMMITTEES FOR THE AMERICAN CHEMICAL SOCIETY,
BOTH THOSE ORGANIZATIONS ARE DELIGHTED TO HAVE HER GOOD COUNSEL,

  ANOTHER GRADUATE OF BERKELEY WITH A PH,D, IN ORGANIC CHEMISTRY IS
DR, TODD BLUMENKOPF, THIRTY YEARS AGO TODD BLUMENKOPF WAS BORN WITH
SPINA BIFIDA, ANOTHER VERY SERIOUS BIRTH DEFECT,


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  NEVERTHELESS, HE COMPLETED HIS STUDIES, WAS AN N, I ,H, POSTDOCTOR-
AL FELLOW AT THE UC, IRVINE CAMPUS, AND IS NOW AN ORGANIC CHEMIST AT
THE BURROUGHS WELLCOME CO, IN RESEARCH TRIANGLE PARK, NORTH CAROLINA,

  THESE AND HUNDREDS OF OTHER DISABLED MEN AND WOMEN ARE NOW IN OUR
SCIENCE WORK-FORCE, CONTRIBUTING TO THE FUTURE OF BIOMEDICAL SCIENCE
IN THIS COUNTRY, MOST OF THEM BEGAN THEIR PROFESSIONAL LIVES WELL IN
ADVANCE OF SECTION 504 AND THE REGULATIONS FOR ITS IMPLEMENTATION,

  BUT CLEARLY THERE WERE MANY OTHERS WHO COULD NOT ACHIEVE THE SAME
LEVEL OF PARTICIPATION IN SOCIETY WITHOUT THE HELP OF THE LAW,

  THE ENACTMENT OF P,L, 93-112 WAS FOLLOWED BY THE EQUALLY IMPOR-
TANT "EDUCATION FOR HANDICAPPED CHILDREN ACT OF 1975,"


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   WITH THE HELP OF THESE NEW LAWS -- AND BENEFITTING FROM THE

ENLIGHTENMENT AND GOOD WILL OF MANY SCHOOL AND COLLEGE ADMINISTRATORS
-- MORE AND MORE HANDICAPPED YOUNG PEOPLE ASKED FOR AND WERE GIVEN THE
BEST EDUCATION AND THE MOST EDUCATION THAT THEY COULD ABSORB,

WHAT'S BEEN THE EFFECT? DO WE HAVE ANY EVIDENCE? I THINK WE DO,

   FOR EXAMPLE, WE HAVE THE "AMERICAN FRESHMEN: NATIONAL NORMS"
SURVEY, FOR THE PAST 20 YEARS, THE AMERICAN COUNCIL ON EDUCATION HAS
CONDUCTED THIS SURVEY OF FIRST-TIME, FULL-TIME FRESHMEN AT A LARGE

SAMPLE OF FOUR-YEAR COLLEGES AND UNIVERSITIES,

   THE SURVEY ASKS ALL KINDS OF QUESTIONS, BUT IN THE FALL OF 1978
IT ADDED AN IMPORTANT QUESTION: IT ASKED THE ENTERING FRESHMEN IF THEY

WERE DISABLED,


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  THE RESULTS IN 1978 INDICATED THAT LESS THAN 3 PERCENT OF THOSE
FIRST-TIME, FULL-TIME FRESHMEN WERE DISABLED,

  APPLIED ACROSS THE SPECTRUM OF ALL FIRST-TIME, FULL-TIME FRESHMEN
IN 1978 YOU COME UP WITH AN ESTIMATE OF 28,000 YOUNG MEN AND WOMEN WHO
CONSIDERED THEMSELVES AS DISABLED IN SOME WAYmMISSING LIMBS, BEING
DEAF, HAVING IMPAIRED VISION, AND SO ON,

   THAT SAME QUESTION HAS BEEN ASKED EVERY YEAR SINCE, IN LAST
YEAR'S RESULTS, HOWEVER, WE FOUND THAT NEARLY 8 PERCENT OF ALL FIRST-
TIME, FULL-TIME FRESHMEN DESCRIBED THEMSELVES AS DISABLED,

  AGAIN, APPLYING THAT TO THE TOTAL NUMBER OF ALL ENTERING
FRESHMEN, WE ARRIVE AT A TOTAL OF 77,000 DISABLED STUDENTS, OR THREE
TIMES THE ESTIMATE FOR 1978,


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AMONG THOSE ENTERING FRESHMAN OF SEPTEMBER 1985 WE FOUND THAT,,,

1 OF EVERY 9, OR ALMOST 12 PERCENT, HAD A LEARNING DISABILITY,, ,
DYSLEXIC, FOR EXAMPLE

ANOTHER I IN 9 HAD AN ORTHOPEDIC DISABILITY

1 OF EVERY 8 WAS PARTIALLY OR TOTALLY DEAF

1 OF EVERY 6 HAD SOME HEALTH-RELATED DISABILITY,, ,DIABETIC, FOR
EXAMPLE, OR EPILEPTIC

AND 1 OF EVERY 4 -- 27 PERCENT -- WERE PARTIALLY OR TOTALLY BLIND,


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  BUT 10 OUT OF EVERY 10 WANTED MORE EDUCATION, THEY HAD A DREAM
,,,AND THEY HAD THE AMBITION AND THE APTITUDE TO FULFILL THAT DREAM,

  AND I THINK THAT'S A FAIR MEASURE OF THE ESTIMATED 77,000
DISABLED MEN AND WOMEN IN THE CLASS OF 1989,

   BUT NOT ONLY OF THAT ONE CLASS,
      I THINK THAT'S ALSO THE MEASURE
OF ALL THE GROWING NUMBERS OF DISABLED AND TALENTED YOUNG PEOPLE IN
EVERY COLLEGE AND UNIVERSITY GRADUATING CLASS,, ,FROM NOW ON,

  WE KNOW THAT A CERTAIN NUMBER WILL CONTINUE TO GO ON TO ADVANCED
DEGREES, AND I SINCERELY HOPE THAT MORE AND MORE OF THEM WILL CHOOSE
MEDICINE, DENTISTRY, PSYCHOLOGY, OR NURSING OR WILL PURSUE SOME
PROBLEM IN BIOMEDICAL OR BEHAVIORAL RESEARCH, ,,FOLLOWING THE LEAD OF
KENT CULLERS, ANN SWANSON, TODD BLUMENKOPF AND MANY, MANY OTHERS,


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  WE WANT TO RECRUIT THE VERY BEST PEOPLE WE CAN FOR THE MEDICAL
AND HEALTH DISCIPLINES, THAT HAS TO BE OUR PERSONNEL STANDARD: WE
WANT THE BEST,

  AND I BELIEVE THAT A GREAT MANY OF THOSE DISABLED YOUNG MEN AND
WOMEN COMING THROUGH OUR SYSTEM OF HIGHER EDUCATION, IN THIS AND
SUBSEQUENT DECADES, WILL PROVE TO BE JUST THAT: THE BEST,

BUT WILL WE BE READY FOR THEM?

WILL WE BE IN STEP WITH HISTORY?.

OR WILL HISTORY TAKE US BY SURPRISE, ,,AND THEN PASS US BY?


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  I HOPE IT DOESN'TmBUT I DON'T KNOW THE ANSWER FOR SURE, I ONLY
KNOW THAT I'M CONCERNED ABOUT HOW WELL WE'RE DOING TODAY AND WHETHER
WE'RE SENSITIVE ENOUGH TO THE CHALLENGES AHEAD OF US,,,TOMORROW,

9   TO BE SPECIFIC, I UNDERSTAND THAT, HERE AT N, I ,H, WE HAVE 205
  PERMANENT P,H,S, PHYSICIANS WHO ARE NOT IN THE UNIFORMED
  COMMISSIONED CORPS, OF THAT NUMBER, 8 ARE DISABLEDmABOUT 4

   PERCENT,

+

AND WHAT OF OUR NURSING PERSONNEL? N,I,H HAS ABOUT 600
PERMANENT, NON-COMMISSIONED CORPS NURSES, ABOUT A FOURTH OF
ALL THE NURSES IN THE PUBLIC HEALTH SERVICE, OF THAT 600,
SOME 16 ARE DISABLED -- LESS THAN 3 PERCENT -- AND NONE OF

THEM IS SEVERELY DISABLED,


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46   AND N, I,H, HAS ABOUT 880 MEN AND WOMEN IN SENIOR SCIENTIFIC

   POSITIONS -- PH,D, 'S PRIMARILY -- OF WHOM 40 ARE DISABLED, OR
  4% PERCENT, OF THAT NUMBER, 5 ARE SEVERELY DISABLED, ,,THAT
   IS, TOTALLY DEAF OR MISSING BOTH LEGS OR PARTIALLY PARALYZED

   AND SO ON,

   THIS IS OUR EMPLOYMENT RECORD OF DOCTORS, NURSES, AND BIOMEDICAL

RESEARCH SCIENTISTS, ,,BOTH THE ABLE-BODIED AND THE DISABLED, AND SO

FAR, RELATIVELY FEW OF THEM IDENTIFY THEMSELVES AS HANDICAPPED,

WHAT DO WE CONCLUDE FORM ALL THIS?

   FIRST OF ALL, WE SEEM TO BE ABOUT WHERE THE NATION'S COLLEGES AND
UNIVERSITIES WERE NEARLY 10 YEARS AGO: THAT IS, WE HAVEN'T YET FELT
THE FULL EFFECTS OF SECTION 504, AND SO WE HAVE A LITTLE TIME -- NOT

MUCH, BUT A LITTLE TIME -- TO UNDERSTAND JUST WHAT THOSE EFFECTS MIGHT

BE ON N, I ,H, AND ON THE WHOLE P,H,S,


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  I THINK IT'S IMPORTANT THAT WE DO ENGAGE IN THAT KIND OF STUDY,
I HOPE WE DON'T REMAIN STUCK IN OUR CURRENT lo-YEAR-OLD POSITION, WE
KNOW THAT MORE AND MORE DISABLED STUDENTS ARE ENTERING HIGHER
EDUCATION AND GOING ON FOR ADVANCED DEGREES,

  WE MUST CONCLUDE, THERFORE, THAT THIS YEAR, ,,NEXT YEAR, ,,THE YEAR
AFTERwAND FROM THEN ONmWE'LL BE SEEING MORE AND MORE FULLY QUALI-
FIED, TOP-NOTCH HEALTH PROFESSIONALS HEADING FOR A LIFE IN MEDICINE,
NURSING, OR RESEARCH, ,,EAGER TO MOVE QUICKLY FROM COLLEGE TO CAREER,, ,
ALL OF THEM INTENSE YOUNG PROFESSIONALS WHO -- INCIDENTALLY -- ARE
ALSO DISABLED,

  I WANT THE U, S, PUBLIC HEALTH SERVICE TO SAY THAT WE HAVE GOOD
JOBS FOR THEM, ,,THAT WE WELCOME THEM TO OUR ORGANIZATION AS WE WELCOME
ANYONE WHO IS SMART AND WANTS TO WORK,


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   I WANT N,I,H, AND, INDEED, THE WHOLE PaHaS, TO SAY THAT WE LIKE
TO HIRE PEOPLE WHO KNOW WHAT THEY'RE DOING,,,AND DO IT WELL,

  THEY MAY CARRY OUT THEIR ASSIGNMENTS A LITTLE DIFFERENTLY, IN
ORDER TO OVERCOME -- OR COMPENSATE FOR -- THIS OR THAT HANDICAP, BUT

I WOULD HOPE THAT WE'D BE OPEN TO THAT KIND OF EXCEPTIONAL JOB PER-

FORMANCE,

  MAKING THOSE ADJUSTMENTS WILL ALSO BE PART OF THE CHALLENGE AHEAD
OF US,

   I THINK WE CAN DO IT, THE HANDICAPS IN OUR OWN MENTALITY ARE

REALLY EASY TO OVERCOME, COMPARED TO WHAT SOME OF OUR COLLEAGUES FACE,


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  DR, LINDA FAY, FOR EXAMPLE, IS 39,,,IS A GRADUATE OF HARVARD
MEDICAL SCHOOL,,, SHE'S CURRENTLY IN THE GEORGETOWN/PROVIDENCE FAMILY
PRACTICE RESIDENCY PROGRAMmAND SHE'S A PARAPLEGIC,

  STEVEN RATTNER IS 32,,,IS A GRADUATE OF THE UNIVERSITY OF MARY-
LAND, ,,PRACTICES DENTISTRY IN GREENBELT,, BAND WAS BORN DEAF,

  THE ROLL-CALL OF DISABLED, HANDICAPPED, AND IMPAIRED PROFES-
SIONALS IS LONGwAND WE HOPE IT WILL GET LONGER AS EACH YEAR PASSES,

  SO FAR N,I,H, AND THE PUBLIC HEALTH SERVICE HAVE OFFERED
EMPLOYMENT OPPORTUNITIES TO MANY DISABLED PROFESSIONALS, BUT OUR
RECORD IS STILL VERY LEAN, MAYBE THAT'S BECAUSE THE FULL IMPACT OF
SECTION 504 OF THE REHABILITATION ACT JUST HASN'T CAUGHT UP WITH US
YET,


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  IF THAT'S THE CASE, THEN LET'S BEGIN NOW TO PREPARE OURSELVES TO
RECEIVE THE NEW PEOPLE COMING OUR WAYmHANDICAPPED PEOPLE WHO ARE
TALENTED, AMBITIOUS, AND EXPERIENCEDmTHE VERY KIND OF PEOPLE WE'RE
ALWAYS GOING TO NEED,

LET'S MAKE SURE WE'RE READY -- AND ABLE -- TO RECRUIT THEM,

THANK YOU,

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