The Department of Health and Human Services "has absolutely never considered abolishing" its Office for Civil Rights, despite an options paper listing that as a possibility, and a plan to shift some enforcement functions to the department's inspector general has been placed "on a back burner," HHS chief of staff Thomas R. Burke said yesterday.
Burke said the idea of transferring some functions to Inspector General Richard P. Kusserow -- primarily, enforcement of rules against hospital "dumping" of emergency patients who cannot pay -- "wasn't designed to weaken civil rights enforcement but to strengthen it."
Kusserow, who has a reputation as a tough enforcer of fraud and abuse laws involving departmental programs, was viewed by many in the department as likely to do a better job on dumping than anyone else.
Burke said that because of preoccupations with other issues, "no decision is imminent" on proposals to alter the responsibilities of the Office for Civil Rights (OCR).
Reports that the department was considering a major restructuring of OCR surfaced during the summer because of what some officials viewed as a serious jurisdictional overlap between the civil rights office and Kusserow's office, which is the major auditing and investigative agency within the department.
The reports spurred a Sept. 23 letter to members of Congress from unidentified "concerned employes of the Office for Civil Rights" charging that the administration has "as its goal the complete repudiation of civil rights" including "the dismantling of the OCR."
Rep. Ted Weiss (D-N.Y.), chairman of a House Government Operations subcommittee that has criticized the office as too weak an enforcer in the past, wrote HHS Secretary Otis R. Bowen Oct. 1 that he feared splitting off some of OCR's authority would ultimately weaken the office.
"OCR should be strengthened and supported, not emasculated," Weiss wrote Bowen.
The office is the chief HHS civil rights enforcer, with a budget of more than $16 million and about 350 employes. It has responsibility for combating denial of services to people by federally assisted programs on the basis of race, color, national origin, disabilities, age and related factors.
It also is responsible for enforcing a law requiring hospitals that received construction funds under the Hill-Burton Act to provide various types of community services, such as free care to the needy including emergency services to people in their areas even if they cannot pay. (Hill-Burton was an early post-war era program designed to create hospitals at a time when more facilities were needed.)
Under a provision enacted last year, hospitals receiving Medicare funds (which means virtually all hospitals) are required to provide certain emergency services to anyone seeking them. The Medicare program has assigned a major role in enforcement of this provision to Kusserow.
That created an overlap of the Hill-Burton and Medicare emergency provisions. And it was this overlap, rather than any desire to weaken OCR, that lay behind proposals to shift certain functions, HHS officials say.
Kusserow, in a report widely circulated within the department, criticized OCR's Hill-Burton enforcement and suggested that his office take it over.
In July it appeared a decision backing a takeover had been made as part of a proposed new departmental budget, but in August a memo was circulated among high-level officials indicating that the takeover plan was only one option. Others included transfers of various other functions and even "transfer entire OCR" to Kusserow because of his "credibility and professional acumen."
Assistant Secretary for Planning and Evaluation Robert B. Helms indicated he did not view the transfer of all Hill-Burton functions as a good idea.
Burke said yesterday that dissolution of OCR and transfer of all its functions to Kusserow was never seriously considered.Staff writer Howard Kurtz contributed to this report.