The Senate Communicator

cultural

THE SENATE COMMUNICATORFall/November 2014 www.howard.edu/faculty/senate

A Case for

Howard University’s

Institute for Cultural Competency

A Conversation with Trustee Wiley

Reflections on a visit with Warner Lawson, Jr.,Recently Retired

I am delighted that colleagues from the University community chose to share their ideas and aspirations in this edition of the Faculty Senate Communicator! Many thanks go to the Editorial Board: Clint Wilson, Greg Carr, Kitty Ellison and Mercedes Tibbits for their comments. Many thanks, too, go to the Chair and Vice-Chair of the Faculty Senate for their leadership and contributions to this edition.

This edition could probably be labeled as, “The Future of Howard University”. First, there are two important interviews: one by Professor McDougall with Professor Warner Lawson. Professor Lawson is a former member of the Board of Trustees who served as the graduate representative from the School of Law for many years. Former Trustee Warner shares his views in his interview about the history of a sense of community at Howard and our need to preserve Howard’s legacy for social justice. I interviewed a current member of the University’s Board of Trustees, Benaree Pratt Wiley, the Chair of the Academic Excellence Committee and Vice-Chair of the Board of Trustees. In her interview, Trustee Wiley shares her vision of her role on the Board and the future of the University as the Board works to realize its priorities in this and the coming years. In both interviews, we have the opportunity to hear from those who have served or who are now serving and to envision the work of the Board.

From the Senate leadership, we have articles by Chairman Lorenzo Morris and Vice-Chair Veronica Clarke-Tasker. Chairman Morris puts into words the events of the tumultuous last year and brings us up to date on some of the positive changes that have since occurred. Vice-Chair Clarke-Tasker gives us a report on an important task force that has sought out and made recommendations for the most efficient ways that the Howard University Hospital can serve the faculty.

We close this edition with a provocative article by Professor Goulda Downer entitled, “A Case for Howard University’s Institute for Cultural Competency”. Professor Downer argues that African Americans have some of the most debilitating diseases and conditions in this country. This institute will place Howard University in the vanguard of training health practitioners and educators to be sensitive to the impact of culture on ameliorating diseases and disabling conditions, particularly with the unfolding of the Affordable Care Act (ACA), and to provide, therefore, the most culturally appropriate care.

A Word From the Editor

Joan Payne

A Better Way to Start the Academic Year Lorenzo Morris, Chair 2

A Conversation with Trustee WileyJoan Payne, Ph.D.

4

Reflections on a Visit with Professor Warner Lawson, Jr., Recently RetiredHarold McDougall, J.D.

6

Faculty Senate Task Force on Health Care (TFHC)Veronica Clarke-Tasker. Ph.D. 10

A Case for Howard University’s Institute for Cultural CompetencyGoulda Downer, Ph.D.

12

Editorial Policy 16

Table of Contents

THE SENATE COMMUNICATOR

The Senate Communicator is a publication of the

Howard University Faculty Senate 525 Bryant Street, NW, Rm. C-119

Washington, DC 20059Ph: (202) 806-7595

View on line at: www.howard.edu/faculty/senate/communicator

EDITORIAL BOARD:

Joan Payne, Chair

Clint Wilson

Table of Contents

PRODUCTION AND LAYOUT:Leslie R. Harris

November 2014 | 1

T

“While a great leap of prosperity may not be around

the corner for faculty, our salaries have for most part seen a significant upward

adjustment.”

he reopening of school this year could scarcely compete with last year’s media induced drama

that magnified financial uncertainty, distorted widespread administrative transition and twisted proposals for academic reform. Last August both print and electronic media recast our university life as adrift, disoriented or misdirected.

Most Howard faculty, whether on campus or away, must have been struck by the diligence which a Washington Post reporter seemed to be hunting for financial landmines in the university’s range of bank loans and credit. Most of us had to wonder what drew Post, New York Times and other reporters to cast apparent financial management problems as more than challenges but as overwhelming barriers to institutional development. Of course, it was a tempting story in an otherwise mundane history of news media indifference to all HBCUs.

Some professors, working abroad as I was, may have been surprised by the number of time zones through which Howard’s uncertain story traveled. I was awakened in my hotel room in Dakar Senegal by an insistent reporter from the Washington Post who implied he had a big story on which comments from all Howard sectors were needed.

How quickly big stories can fade, even if the problems highlighted by them persist. With the return to class this fall we have a stabilizing administration, a new, energetic president, Dr. Frederick, and a revitalized financial administration. Although the “moodiness” of Wall Street rating agencies (Moody’s) and bankers is always problematic, it does not seem to be unmanageable. While a great leap of prosperity may not be around the corner for faculty, our salaries have for most part seen a significant upward adjustment. Even if

the increase was not what everyone may have wanted, it is far more than most of us have become accustomed in more than a decade.

The temporary “fillings” at the heads of our schools and colleges seem fairly certain to be fulfilled by persons selected from within our ranks. As for the ominous shadows of unprofitable or mortgaged ownership, the future of the hospital remains a mystery with

rumors of a promised resolution just around the corner. The promised new buildings, in contrast, have rapidly sprung up in tight spaces casting a shadow over the reoriented old buildings like the new “institutional research” building which shares intimate spaces with the transforming Barnes and Noble Howard bookstore. Perhaps, all is well that begins well even if the loans, on which so much

A Better Way to Start the Academic YearBy Lorenzo Morris

2 | the senate communicator

depends, cloud our perceptions of the budgetary future.

Behind the numbers that hypnotize observers obsessed with rating agencies, real change is hobbled by continuing uncertainties. The lack of a new provost is steadily becoming old news although, fortunately, we have an interim provost whose grounding in Howard’s history can help guide perspectives on its future. We also have new leadership on the Board of Trustees, a change that correlates well with the demands of the last fall’s abrupt “no confidence vote” in the board’s executive leadership although any link between the two is ambiguous.

We also have new faculty representation on the Board. That change also correlates well with the “no confidence” vote even if any causal link between the two is also ambiguous. In any case, there are enough new faces and structural changes at the top to justification hope for new initiatives.

There are still a few longstanding expectations for substantive change that are gradually turning into somber ruminations on what have been or what remains of a fading expectation. The restructuring of the hospital might well be at the top of that list if it were not a sudden jolt in campus news pointing to a new management company taking the reins. Second, the searches to fill important deanships, like that of the College of Arts and Sciences, are still in process but the successful completion of searches, like that for the Law School, can add confidence to our impatience. Third, support services across the university have had their ups and downs but the partnership of Barnes & Noble with the Howard bookstore promises a new round of ups even if some expectations are yet to be materialized. Fourth, less sweeping changes, including the establishment of an “ombudsperson” office are picking up pace.

As for the special concerns of the Faculty Senate, several real challenges drew our attention last fall. Faculty healthcare benefits, insurance and services, were high on the agenda of concerns that needed

stronger faculty input. First, the FS Healthcare Task Force, led by Senate Vice-Chair, Dr. Clarke-Tasker, has been systematically examining most aspects of the faculty healthcare. The diverse group of faculty on the Task Force has explored issues with human resources administrators, insurance personnel, medical faculty, analysts, hospital administrators and others. Second, faculty salary issues drew our attention from the start but are obviously not a new issue. Understandably, we cannot take credit for the raises most faculty members recently received, nor can we forget about those who have been left out. Still, most faculty celebrated the increases. Third, the long delayed rewriting of the Faculty Handbook was finally brought to fruition under the direction of the administration, including Dr. Alvin Thornton, and faculty, including former Senate Chair, Professor Warner Lawson. Although delayed, the final stamp of approval has been promised.

Finally, too many continuing challenges faced us last fall to discuss in this space. Some, however, like the CIPAC committee chaired by Professor Kavoosi, have brought together a broad range of administrators and faculty from across the campus to make innovative recommendations and provide support for the university’s international activities. A very special challenge for us, the editing of the Senate Communicator, could only be met when Professor Joan Payne came to the rescue. And, we are enormously grateful. In the interim, we have depended on the FS Secretary, Professor Moses Garuba, to share important information. All of us depend in varying degrees on Ms. Leslie Harris, to help faculty “keep it together” for which I am very grateful.

Lorenzo Morris, PhDFaculty Senate Chair

ProfessorDepartment of Political Science

A Better Way to Start the Academic Year

November 2014 | 3

T rustee Benaree Pratt Wiley, a Washington native, is a 1968 graduate

of the College of Liberal Arts in Business. She credits a Howard professor with pointing her in the direction of business as an up-and-coming field for women and minorities. “We are classmates who graduated from Howard in the same year, and we reminisced about our families’ reactions to our pursuing careers that were unheard of in our communities at that time.” In fact, Trustee Wiley joked that her Grandmother, upon learning that she was a marketing major, asked whether that had anything to do with groceries. From Howard, she went on to earn an M.B.A and later, to become a successful and astute businesswoman. Since 2009, Trustee Wiley has served on the Board of Trustees at Howard, and she chairs the Academic Excellence Committee (AEC). This year, she was also named as one of the Vice Chairs of the Board.

As Chair of the AEC, she and other members of the Committee meet with the Faculty Senate leadership when they are in town for Board

meetings. Last month, however, she had to return home for a family emergency. However, Trustee Wiley graciously agreed to be interviewed during a conference call in the Faculty Senate conference room. When asked about other initiatives (in addition to AEC meetings with the Senate leadership) to strengthen the relationship between the Faculty and the Board of Trustees, she added that she also meets with senior management, deans and department heads with interim leadership, and faculty leaders across the campus to hear about successes and challenges within schools and colleges. Future initiatives, she said, should include more informal meetings so that Board members and faculty could get to know each other better as people who are invested in the future of the University. Fireside chats with different Trustees, she indicated, could be a way for the University family to come together around mutual concerns and to develop inclusive decisions.

Faculty membership on the Board, she indicated, was indeed “value added” in her opinion. The perspective of faculty trustees is

A Conversation withTrustee Wiley

By Joan Payne


Courtesy of Moorland-Spingarn Research CenterHoward University Archives

Courtesy of Moorland-Spingarn Research Center Howard University Archives

invaluable to the work of the AEC. In her opinion, faculty trustees bring a unique faculty perspective to a committee that has a very broad portfolio. The concept of a “new Howard” was not one with which she was totally familiar; however, she remarked that she senses electricity, optimism and a “lot of good energy on the campus”. She added that we all need to actualize the vision with more transparency and communication. All of this bodes well for Howard in the future. We need to be aligned and united.

When asked about her vision of the priorities this year, Trustee Wiley responded that the Board of Trustees has several. Her top three are the Howard University Hospital as a top priority for issue resolution; the financial stability of the University; and permanence and continuity in the University’s leadership infrastructure given that there are many deans and department heads who are currently serving as interims. The Board has additional areas of concern, such as academic renewal, faculty salaries, fund raising and development, athletics, and Board effectiveness and is continuing its mandate to generate funding for the University with a view toward the 150-year campaign.

Finally, when asked how she would like her tenure on the Board of Trustees to be remembered, Trustee Wiley responded that Howard holds an important place in her life and development. For that reason, she wants to be remembered as a good steward for Howard University who advanced the University’s mission of serving African Americans and the African Diaspora well and with integrity.

Joan Payne, Ph.D., ASHA FellowProfessor

Communication Science and DisordersEditor, Senate Communicator

Photos: Opposite page: (Top) Benaree Pratt Wiley, courtesy of B. Wiley; (Left) Benaree Pratt, 1968 Bison Year Book Photo, pg 340. This page: (Top,Left) 1968 Bison Year Book, Delta Sigma Theta, page 192

A Conversation with Trustee Wiley

November 2014 | 5

S itting in Warner Lawson’s kitchen in Upper Northwest Washington, once

called the “Gold Coast” by Howard faculty, I listened to stories of the Howard of legend. Warner told me about the administration of Howard’s first Black president, Mordecai Wyatt Johnson (1929-1958), a Morehouse graduate, who started his term as the Harlem Renaissance began. Johnson engineered his own renaissance, gathering a group of enormously talented Black scholars, professionals, and social activists who together accomplished great things, on campus and off, making Howard a “Mecca.”

This faculty community exchanged ideas and raised their children together, living in close quarters near the university and sharing a quality of life that sustained and bolstered their intellectual and artistic achievements. As one of these children, Warner grew up with a host of extraordinary role models, including his own parents, who he could see at work as well as at home. Such people, literally DuBois’ “Talented Tenth,” launched the first phase of the Civil Rights Movement, with Mordecai

recruit Charles Hamilton Houston, Dean of the Law School, leading the way.

President James Nabrit (1958-1968) took over as I entered my teens, and there, listening to Warner, I found my own memories kicking in. Out in the community, I saw the engine of the Civil Rights Movement move from the Talented Tenth to the grass roots, beginning with Dr. King’s bus boycott in Montgomery, Alabama (1958). Soon HBCUs were engaged in the Movement more by their students than their

faculty. Indeed, during Nabrit’s term, firebrand students like young Stokely Carmichael, a leader of Howard’s campus Nonviolent Action Group, often clashed with senior faculty and administrators who suddenly seemed conservative by comparison. During this time, an activist junior faculty member successfully sued the University for breaching employment obligations found in the Faculty Handbook, Nabrit’s creation, establishing a DC Federal Circuit Court precedent that still controls today.

Meanwhile, the “beloved community” of Howard faculty and their families began to fragment as people

Reflections on a Visit with Professor Warner Lawson, Jr.,

Recently Retired

By Harold McDougall


moved away from Howard environs, heading up 16th Street and eventually out to the suburbs. A spatial fragmentation along class lines swept the black community in the wake of the new Fair Housing Act (1968). Urban riots accelerated the process.

During the administration of James Cheek (1968-1990), the country shifted to the right, and the black community explored “Black Capitalism” (Richard Nixon’s brainchild). The Civil Rights Movement turned to legislation and policy fostering individual achievement in corporate and political America. A sense of community and commitment to social justice for the black masses began to fade, kept alive by a few radicals and dreamers. The black community that was, like the Howard that was, lacked a physical center a gathering place, now supplied only by churches one day a week.

President Jennifer and Acting President Ladner marked time between 1990 and 1995. President Swygert (1995-2007) attempted to ground Howard with new buildings and physical development. President Ribeau (2008-20013) tried to create cohesiveness and focus by concentrating departments and buying out older faculty. Then, in 2013, conflict on the Board of Trustees spilled onto the pages of the Washington Post. Ribeau resigned. A drop in bond rating followed, suggesting a Howard in need of new direction.

What’s next? From talking to Warner, it seems the Howard of old benefited greatly from physical proximity, a sense of community that our students today get by

living on campus or very close by. We as faculty don’t have that. There have been attempts to create a system of faculty housing, and those seem fruitful avenues to pursue. Broader access to day care on campus, for all employees, could also create a physical community nexus.

But there’s more. To recreate the focused brilliance of the Mordecai Wyatt Johnson years requires a renovation of the academic community. Not imposed from without, but germinating from within. The Lombardi Program on Measuring University Performance, a think tank at Arizona State University, paints a picture of faculty

“guilds” as the creative engines that drive the university’s teaching, research, scholarship, and quality. Their energy is reinforced by pride in their individual work and in the collective work of their guild as a whole.

Guilds ran older universities such as Oxford and Cambridge entirely, a model not followed in America because colonial authorities found insufficient numbers of senior faculty to implement guild governance. Instead, they set up nonprofit academic corporations, governed by “lay” boards of trustees. Certain tensions inherent in this model complicate academic life today.

Photos: (Top) Warner Lawson, Jr., with students; (Above) Law school students celebrating Professor Lawson’s legacy at his retirement party.

Revelations on a Visit with Professor Warner Lawson, Jr., Recently Retired

November 2014 | 7

“

“

My parents counseled that living well flowed from a love of learning, valuing one's teachers, and from the joy found in service to others. I have come to believe that these same elements are also valuable in helping one set a just value on life and as an antidote to the motley confusion of ones’ acts, omissions, regrets and hopes. The other major influence in my life is having lived six of the seven-tenths of my life at Howard University as campus brat, undergraduate, law student and on the law school faculty...

The trustees retain authority to determine overall policies and select a president, but they delegate authority to manage day-to-day operations to the President and administrative officers. The faculty typically sets its own professional standards and runs the educational program. In this way, the guild model survives.

Hopkins Professor Benjamin Ginsberg says things go awry when administrators encroach upon the guilds, imposing a profit-motivated business managerialism that makes no sense in a university. (The Fall of the Faculty: 2011) Guilds operate peer-to-peer, not top-down, collegially ensuring the professionalism and integrity of their work and thus the university’s ultimate success. If the guilds are not stepping up, they should be renovated, not undermined.

Guilds need a physical and social nexus to accelerate internal collaboration and mentoring, and thereby, excellence. They also need close contact with cognate guilds at other universities. Increased university support, financial and infrastructural, nurtures both processes.

The Howard guild Warner described was also distinguished by its commitment to social justice. To renovate that portion, we need stronger connections to living networks of people tackling complex and daunting social issues. We need mentoring and pipeline programs to broaden educational opportunity for young people in marginalized communities. We need to work with students, alumni, and social movement activists to right the economic, social, political, and environmental imbalances that undergird global inequality and exclusion. Talking with Warner, I saw this as the path for Howard to return to its rightful place, the place it deserves.

Harold McDougall, J.D.Professor

School of Law




November 2014 | 9

s Vice Chair of the Faculty Senate and a Professor in the College of Nursing & Allied Health Sciences – Division of Nursing I would like to first

thank the faculty and staff of this great university for your support. I have had many assignments during my first year as Vice Chair and have heard your concerns. I firmly believe that quality health care is a right and not a privilege. Therefore I quickly embraced the opportunity to lead.

In response to substantial changes in the administration, availability and coverage of university determined healthcare benefits, the Faculty Senate representatives concluded that widespread concerns expressed by the faculty warrant special action. Accordingly, the Chair of the Senate was authorized to establish a task force for the purpose of examining issues relating to healthcare programming, benefits and resources for all Howard University faculty.

The Faculty Senate Task Force on Health Care was established on November 11, 2013 to study and report on healthcare programs, options, conditions and needs of the university faculty.

Purpose

• Assess the concerns, uncertainties and expressed needs of the faculty that may not have been adequately met or answered by existing university services;

• Consider and, where reasonable, suggest alternative ways of improving communication with faculty on healthcare benefits;

• Explore programmatic options relevant to the faculty where information is publicly accessible;

• Propose options for the choices of healthcare providers and arrangements where evidence may warrant.

Faculty Senate Task Force on Health Care (TFHC)By Veronica Clarke-Tasker

Structure

The task force nominated its own officers with the approval of the Senate Chair. A Task Force Chair and Secretary. were required and other offices designated by majority vote of the task force members with the approval of the Senate Chair. The TFHC Chair and Secretary must approve the final report of the task force to the Faculty Senate Council. The TFHC Chair is primarily responsible for completing the work of the task force.

The membership of the TFHC included faculty from most of the schools and colleges in the university.

Task Force Members:

Clarke-Tasker, Veronica, Nursing, Ex-officioAdams-Fuller, Terri, COAS-SociologyBurnett, Carol, Physical TherapyCallendar, Clive, MedicineDickson, Leon, COAS-BiologyHutchinson, Charmaine, NursingFarquharson, Andre, Dentistry Kumar, Krishna, PharmacyLawson, William, Medicine-PsychiatryLittleton, George, MedicineLivingston, Ivor, COAS-SociologyMurphy, Charles, BusinessStubbs, John, MedicineTrulear, Harold, Divinity

Responsibilities

Collect information from the faculty and relevant university administrative officers about the needs, benefits and options of current healthcare programs. The data should include information about faculty opinions


A

and experiences where concerns of confidentiality are not involved. Additional information on insurance options in use or potentially available should also be pursued. Similarly, currently and potentially available options for healthcare service access should be explored. Where the findings of the TFHC may warrant, recommendations for action by the Faculty Senate should also be proposed.

The committee convened and worked diligently during the past academic year meeting with Ms. Jeanette Gibbs, Mr. Herburt Buchanan, and Mr. Michael McFadden. Our meetings were lively and well attended.

Concerns Addressed And Outcomes To Date

CIGNA – Task Force presented Mr. Michael McFadden (Benefits) with the problems/concerns of faculty and retirees with CIGNA, our current provider. CIGNA will remain our insurance provider for the current benefit year (2014-2015). The Task Force also requested that members of the Task Force be part of the team as the University moves toward securing a provider for the next benefit year. Mr. McFadden has advised that a meeting will be convened shortly.

Howard University Hospital (HUH) - Ms. Jeannette Gibbs as well as Mr. Herburt Buchanan provided an overview of services being offered at the hospital. The conversations were lively as we reviewed “barriers to care” that faculty, staff and many of our family members have experienced. Several of the major “barriers” as we perceived them are limited service offerings, unprofessional behavior, and poor communication, just to name a few. Note: Ms. Gibbs and Mr. Buchanan were aware of many of our concerns and have been working to eliminate them. The Task Force toured the hospital where we were able to see some of the changes made to signage, for example, and to offer suggestions in improving services. In addition, we offered suggestions, for example, the need for more reader-friendly signage in the lobby and throughout the first floor of the hospital.

A survey was developed and sent through Survey Monkey in May, 2014, which requested faculty input on how the services at HUH can be improved to meet faculty’s health care needs. The response was poor. Look for it again with the next two weeks. We’ve been told if faculty and staff increased their current utilization of the hospital by 18%, we can make a big financial difference.

“Fast Track” – This service is not fully developed. It was developed to make the hospital more accessible to both faculty and staff. Many faculty are not aware of participating physicians and services currently being offered. Solution – Development of a brochure with a full description of service offerings which includes picture of providers.

Communications – There is a clear gap in communication between Howard University and Howard University Hospital! Separate email listings and telephone directories do not make it easy for employees to stay connected. Several examples of missed opportunities for employees were provided. We strongly suggest that communication regarding health fairs, visiting lecturers and other events be distributed to hospital and University employees via a newsletter, posting of signs and when possible our radio station.

I wish to personally thank the Faculty Senate Task Force on Health Care members for their hard work as well as our participating Hospital Administrators. I look forward to another productive year.

Rev. Veronica Clarke-Tasker, PhD, RN, MBA, MPH, MDiv

Chair, TFHCVice Chair, Faculty Senate

Faculty Senate Task Force on Health Care

November 2014 | 11

For over a decade of unbroken service to ethnic and racial minorities, Howard University’s College of

Medicine (HU) has positioned itself as a leader in the delivery of training and Technical Assistance in the area of HIV and cultural competency; not just domestically but internationally. During this period, HU established and managed two renowned centers, namely the National AIDS Minority Training Center (NMAETC) and the AIDS Education and Training Center National Multicultural Center (AETC-NMC). At the helm of these centers, HU managed a consortium of partners, namely Charles Drew University of Medicine & Science; Colorado State University; Meharry Medical College; Morehouse School of Medicine; Tennessee State University; the NAVAJO AIDS Network: University of Texas at San Antonio; and XAVIER University. Together with its consortium of partners, HU has helped strengthen the US HIV clinical workforce by educating and training over 43,000 clinicians nationwide in providing culturally competent quality treatment and care to persons living with HIV/AIDS. As the current home of the Howard University Capitol Region Telehealth Project (HU-CRTP) a distance base e-Learning training program, HU now focuses its effort to help low-volume HIV clinicians in the District of Columbia, Delaware and Maryland hone their clinical skills, in an effort to resolutely reduce the HIV disparity in the region hardest hit by this stubborn disease.

The impact of this effort has resulted in the training of clinicians to better understand how beliefs about

disease, health, and perceived causes of sickness, stem in part, from an individual’s culture. To be effective, therefore, health care services should be responsive to, and respectful of, cultural and linguistic needs; essentially cultural competence – and how this can improve quality of care and health outcomes while simultaneously eliminating health disparity for persons living with HIV. The success of this body of work reinforces the need for an Institute for Cultural Competency (ICC). HU is uniquely qualified to establish and manage the HU-ICC.

The concept of “cultural competence” is not new. It has gained currency since the early 1990s, particularly in health science education and practice. In the broadest sense, cultural competence refers to a set of skills that allow health care providers to increase their understanding and appreciation of cultural differences between and within groups. This, along with specific skills, behaviors and policies that enable health care

providers to offer health guidance and treatment that respects the beliefs, values and traditions of those being served. Thus, cultural competence also takes into account the patient’s languages, cultural practices and living conditions.

Faced with an increasingly diverse population, the American health care system struggles to deliver high-quality health care to all. Disparities and inequities

A Case for Howard University’s Institute for

Cultural CompetencyBy Goulda A. Downer


continue to exist in our national healthcare system particularly among ethnic and racial minorities. However, disadvantaged populations such as the underserved, vulnerable, and marginalized are similarly impacted. As a result of this, disproportionate incidences of illness and death are evidenced across multiple diseases for these groups. To be effective, especially with the implementation of the Affordable care Act (ACA), it is critical to deepen our understanding of cultural competency so that we can continue to increase quality of care and health outcomes for our communities. The outcome of this effort is aimed at reducing disease burden as we acknowledge the critical role and impact of culture on disease prevention, care and support efforts.

Cultural competency is needed to respond to current demographic trends, improve patient outcomes, and increase the overall quality of care among our ever increasing multi-cultural and diverse communities nationwide. Cultural competence, because of its influence on thinking, perceiving and behaving, is critical to clinicians and the organizations that provide “standard of care” to patients with HIV and other diseases. This includes all components of cross-culture, inter- culture, and intra-cultural issues, from awareness through competence. As such, the values, needs, and preferences of the patient should always be taken into consideration.

The overarching aim of the HU-ICC is to strengthen the care providers’ awareness of cultural competence and its evolving role in improving quality of care. The NMAETC and AETC-NMC are the prototype for, and would become the core of the new Institute. NMAETC’s Cultural Competency and Capacity Building Workshops and teaching materials, as well as its cultural competency training model BESAFE publications and websites provide a model for the education of providers, trainers, and trainers-of-trainers in any health discipline or area of clinical practice. The leadership team heading the effort of these three Centers has developed a national network of collaborating partners and training alumni who are positioned to help broaden the reach of the existing Institute beyond its focus on AIDS to encompass the wider practice of medicine and health care, and would welcome the opportunity to assist the Institute in doing so.

In establishing the HU-ICC, Howard University will position itself as the premier institution in the country to identify, advance and sustain innovative research and practice that provide disadvantaged persons and

communities domestically and internationally with high quality culturally competent clinical care. Given the low numbers of minority clinicians that serve our communities, and that health disparity disproportionately impact minorities in general, and African Americans in particular; it is only fitting, that Howard, home to the nation’s only teaching hospital located on the campus of a Historically Black University, take up the challenge of

ensuring that health providers are fully equipped with the clinical and cultural competence skills to deliver optimal care to our community. The proposed Institute has the following overarching goals:

• Contribute to the knowledge base on culturally competent care through rigorous community-based participatory research conducted in conjunction with persons affected by and/or infected with chronic

diseases. The chronic diseases we plan to focus on initially are: - Heart and other cardiovascular; Cancer, Diabetes, Hypertension, Obesity HIV/AIDS.

Designing cutting-edge, experimental but community-based studies to expand the knowledge base around the nexus of clinical knowledge and cultural competence in health care is a key mandate of the Institute. The severity of chronic diseases in African American communities is astounding. For example, the HIV epidemic in the District of Columbia, coupled with the relatively small geographic size of the city and its population creates optimal conditions in which the HU-ICC can plan and implement a variety of studies designed to foster new and refine existing models of care. As the current home of Howard University Capitol Region Telehealth Project (HU-CRTP) and the former home of the NMAETC and AETC-NMC Howard has a rich and extensive history of pragmatic inquiry that can serve as a catalyst to the Institute’s research portfolio. For example two landmark compendia prepared by Howard - HIV in Communities of Color: The Compendium of Culturally Competent Promising Practices: The Role of Traditional Healing in HIV Clinical Management and HIV in Communities of Color: A Compendium of Culturally Competent Promising Practices raise challenging questions that merit further exploration. The proposed HU-ICC will continue these investigations and

A Case for Howard University’s Institute for Cultural Competency

November 2014 | 13

With over 43,000 providers trained HU has consistently addressed the goals of workforce development and capacity building within organizations that serve the communities hardest hit by the HIV epidemic.

also branch out into patient-centered outcomes research in chronic diseases and translational and dissemination research aimed at propagating the latest findings in the field of cultural competency and Chronic Disease care and treatment as widely as possible.

• Expand the Cultural Competency Curriculum of Howard University Health Sciences Students

One focus of the new Institute will be on the training of practitioners and educators. To this end, the Institute will collect and produce training materials, and provide both virtual and in-person training workshops. The primary pedagogical methodology will be problem-based learner-centered discussion of actual and/or specifically designed cases; these would be selected or constructed to illustrate a broad range of cultural challenges and to stimulate student discussion and collaboration. Research on learning convincingly demonstrates that this form of participatory learning is far more successful, both for long-term retention and for fostering behavior change, than is mere reading, listening, and the viewing of PowerPoint presentations given by experts.

A partnership of the HU-ICC with our Clinical Skills and Simulation Center (CSSC) provides further the opportunity to simulate patient encounters and direct clinical care experience. The technology within the CSSC is a web-based digital solution which allows faculty to capture, debriefing and assessment of these encounters. Video allows the faculty to assess the learners and provide feedback but most importantly it allows learners the opportunity to self-assess their skills.

• Deliver technical assistance to Health Care Organizations

Precedence for the proposed Institute has been set. Through the NMAETC and AETC-NMC, Howard has positioned itself as a leading provider of technical assistance to HIV/AIDS serving organizations not just domestically but internationally. With over 43,000 providers trained HU has consistently addressed the goals of workforce development and capacity building within organizations that serve the communities hardest hit by the HIV epidemic. Case Studies, Tutorials, Online Trainings, Webinars, Provider Cultural Competency Self-Assessment, and preceptorships are but a few of the technical assistance vehicles that the HU-CRTP is highly skilled at employing. The HU-CRTP uses distance-based technologies to provide clinical consultation, education and mentoring for healthcare professionals, health care organizations and health care networks who provide treatment, care and support to individuals diagnosed with HIV.

Howard’s reputation for excellence in cultural competence technical assistance for HIV providers has spread internationally to include 14 Caribbean nations that have sent cadres of clinicians and administrators to be trained by the Howard University Caribbean Clinician Preceptorship Program (HU-CCPP). Since 2009, HU-CCPP has trained over 80 clinicians from 14 countries and these in turn have trained over 3,000 of their peers and impacted the care and treatment delivered to over 9,000 patients. In each of the Caribbean countries that HU-CCPP served the Program met with approval and support from the highest levels of government, including the ministries of health. Some of the Program alumnae have been able to create and launch nationally recognized models based on their experiences at Howard University. In the case of Barbados, the Ministry of Health is so pleased with the Program and the impact program graduates have had on the country’s overall health system



strengthening, that it now has a standing policy to send cadres of clinicians to be trained by Howard in culturally competent HIV/AIDS clinical care and administration in sessions specially designed to be relevant to the Barbadian health services context.

No other HBCU has achieved a similar record of unbroken and impressive service to a sub-population of the Black Diaspora that has been severely impacted by HIV/AIDS. The proposed Institute continue to carry this mantel of service; expanding beyond the Caribbean to the African continent. Since HU-CCPP was launched several African nations, including Cameroon, Nigeria and South Africa have expressed an interest in being part of a similar program created for African clinicians. Part of the attraction, beyond the impressive results from HU-CCPP, is that Howard, and indeed the District of Columbia in general, has so many talented African and Caribbean faculty and staff that the services Howard delivers are truly culturally competent; that is, designed for the African-American, African and Caribbean cultures by experts who themselves hail from these cultures. Again, no other academic institution in the United States boasts such an impressive and diverse group of seasoned professionals.

• Enhancing the exchange of critical data and information between and among private and public clinicians and stakeholders impacting on and affected by related diseases.

Howard is renowned for the data-driven decision making process it has employed with the NMAETC and AETC-NMC. In an era of scarce resources and competing priorities, Howard’s ability to justify programming with needs assessment and epidemiological surveillance data greatly heightened the credibility of its service delivery models. Currently, the HU-CRTP website (www.capitolregiontelehealth.org) features data on cultural competency training needs by AETC region but the AETC-NMC is aware that much more data are needed to fully inform policy making and service design and delivery in the field of HIV/AIDS.

The proposed Institute will continue Howard’s tradition of rigorous data collection and interpretation

and seek to fill gaps in disease prevention, service utilization and service outcomes data so that policymakers, providers, patients and their advocates can themselves engage with confidence in data-driven decision making. Under the skillful direction of Howard’s evaluators, the Institute will leverage provisions such as electronic health records mandated under the Affordable Care Act (ACA) to

expand the quality and quantity of data relevant to each disease entity. The Institute will also create

opportunities for junior and mid-career researchers and scholars to mine the data,

analyzing them, publishing the findings and positioning Howard as a leader in knowledge creation in the field of chronic disease management and cultural competency.

• Articulating to key decision-makers and a wide range of

stakeholders the special needs, opportunities and emerging trends

in HIV/AIDS that confront minority communities

Were Howard to establish the proposed Institute, this would greatly enhance the University’s

ability to compile and disseminate critical information relative to the developments in chronic diseases which disproportionately impact our Communities of Color. America is a country of many races and cultures, and with each passing year, more health care providers are recognizing the challenge of caring for patients that speak different languages or that have different cultural backgrounds. Understanding someone’s cultural background assists in creating an individual and comprehensive plan of care for the patient as people with different cultural backgrounds may have diverse perspectives on health and wellness. Research has shown that good communication between patients and health care providers is directly linked to patient satisfaction, treatment adherence and positive health outcomes. Becoming culturally competent is an ongoing process. It is important to realize that as society moves forward and grows more diverse, we must grow with it.

Goulda A. Downer, PhD, RD, LN, CNSPrincipal Investigator/Assistant Professor AETC Capitol Region Telehealth CenterHoward University College of Medicine202-865-8146. [email protected]


November 2014 | 15

The Senate Communicator Editorial Policy

The Communicator is the official publication of the HU Faculty Senate. Its mission is to publish articles, letters, reports, announcements, and other materials of interest to the university faculty at large, especially those that address issues of faculty governance, welfare, compensation, the quality of instructional and research programs, working conditions, faculty morale, and any other matters that affect the faculty. The responsibility for soliciting, accepting, and editing faculty contributions to the Communicator is delegated to an Editorial Board (EB) of three members selected by the Chair of the Faculty Senate in consultation with the Steering Committee. The work of producing each issue is shared by the EB and the Faculty Senate Administrator, but the EB retains complete responsibility for the content of the Communicator.

The EB invites scholarly analyses of activities of the faculty, the Administration, and the Board of Trustees, as well as proposals for improving university governance and faculty welfare and for reinterpreting or reaffirming the university’s historic mission in light of contemporary realities. It is especially interested in receiving suggestions for improving the effectiveness of the Senate in the following areas: enabling the faculty to fulfill its “substantial collective responsibility and authority to provide institutional leadership” (HU Handbook, 2.3.5); improving the administrative and physical infrastructure for research and instruction; and establishing or enhancing cooperative relationships between Howard University and the communities (local national, international) it serves. In the event that the EB decides not to publish a submission, the contributor may appeal the decision to the Steering Committee of the Council of the Senate. The decision of the Steering Committee is final. However, the opinions expressed by contributors to the Communicator are their own and do not necessarily reflect the official positions of the Senate; therefore publication does not imply an official endorsement. A statement to this effect shall accompany each submission. The Editorial Board reserves the right to edit and verify the content of any submission.

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