Social Work Leadership Is Lifelong: Bernice Harper’s Inspiring Career
by Elizabeth J. Clark, Ph.D., MSW, MPH
The profession of social work has a long tradition of outstanding women leaders. If asked, you could easily come up with a list of pioneers and social work luminaries who have provided leadership, not only for establishing and developing our profession, but for leading the quest for social justice and better quality of life for our citizens. Names like Jane Addams, Jeannette Rankin, Mary Richmond, Edith Abbott, Frances Perkins, Bertha Reynolds, and more recent leaders like Dorothy Height, Barbara Mikulski, or Barbara Lee might come to mind. This article introduces you to a social work leader you may not know, but whose work has had a significant impact on several areas of practice and on many of our lives and those of our loved ones.
Dr. Bernice Catherine Harper has represented the most vulnerable and underserved and those most in need of available and affordable health care services in this country and abroad. She is especially known for her outstanding leadership in the hospice movement and for the national impact she had in establishing and financing hospice services under Medicare. Harper also authored a groundbreaking book on care for the dying in 1977 that helped to create the social work practice areas of medical (now health care) social work and what, today, we refer to as palliative care. She is aptly considered a transformational leader–-someone who creates an inspiring vision of the future, inspires others to engage in that vision, and then works continuously and collaboratively to deliver that vision.
One of 12 children in an African American family, Harper was born in the segregated south and began cleaning houses at age 10. She wanted to be a missionary in Africa, but didn’t know how to become one.
She was smart and did very well in school. She entered Virginia State College, at the time a segregated Historically Black College, and majored in education and psychology. She needed help paying for college, and she so impressed the president of Virginia State College that he provided housing for her in his own home. He also helped her find a summer position with a Quaker family to serve as a companion to an older woman in Princeton, NJ. The luggage of a deceased family member, Beatrice Whitson, was stored there, and the initials “BW” were on the luggage. The family thought it must have been meant for Harper, whose maiden name was Wright. Beatrice Whitson had been a social worker and had established a college scholarship in social work. The family decided that the scholarship, along with the luggage, should go to Bernice Wright (Harper).
Harper considers this “something like divine intervention.” She notes, “I knew absolutely nothing about social work. I knew what teachers and nurses did, and I even knew about sociology, but I didn’t know what social work was.” She felt she had been “called” to social work, and her career was set.
When segregation prevented her from pursuing a Master of Social Work degree in her home state of Virginia, she became one of the first out-of-state students at the University of Southern California, obtaining her MSW in 1948. She also became the first woman of color to earn a Master of Science in Public Health from Harvard University in 1959, and she was awarded an honorary doctorate by Faith Grant College in Birmingham, AL, in 1994.
Harper began her social work career at the Children’s Hospital Society of Los Angeles. She worked at the City of Hope National Medical Center in Durate, CA, from 1961 to 1976, beginning as a home care coordinator, but quickly becoming director of the social work department. After consulting on national committees for several years, Harper accepted a permanent position at what is now the United States Department of Health and Human Services (HHS) and moved to Washington, DC, in 1977. Her career in government spanned more than 30 years (or as she jokingly declared during her retirement in 2006, “35 years, 11 months, and 23 days of service…everyone expected me to die at my desk”).
Harper’s awards and honors are many and varied. Among others, she received the U.S. Health and Human Services Department’s Distinguished Service Award, and she was the first recipient of the NASW Foundation’s Knee-Whitman Outstanding Achievement in Health/Mental Health Policy Award. She has been designated a Social Work Pioneer® by the NASW Foundation, and most recently she was recognized by inclusion in the California Social Work Hall of Distinction.
Her achievements are too numerous to list in full, so three are described below to highlight her leadership and her impact for the profession, the country, and internationally.
Hospice
Harper is recognized as a giant in hospice care. In the years she spent as a medical advisor at the Department of Health, Education, and Welfare (HEW, now HHS), she is credited with many successes. One is that her advocacy helped incorporate hospice care benefits into Medicare.
Her efforts began in 1978, when she represented the Heath Care Financing Administration (HCFA) on a task force on hospice and she prepared a briefing paper for the Secretary of HEW. The Task Force meetings resulted in a demonstration project to determine the cost effectiveness of hospice care. Legislation for Medicare funding for hospice care was officially passed in September 1982. (P. L. 97-248).
Harper’s work did not stop there. As a medical care advisor, Harper reviewed and commented on the proposed regulations. She noted, “This was an ideal opportunity to influence policy.” The final regulations specified that, among other benefits, physicians’ services, nursing care, medical social services (italics added), and counseling would be included. Without Harper’s input and advocacy, hospice care might have remained unattainable for older patients with life-limiting illnesses, and social work may not have been included.
International End-of-Life Care
Harper’s vision regarding hospice care did not stop there. While on a trip to South Africa and Zimbabwe in 1996, she was overwhelmed by the lack of end-of-life services and pain control there. This visit was the impetus for establishing an organization called the Foundation for Hospices in Sub-Saharan Africa (FHSSA). Incorporated in 1999, Harper was its Founding President and Chair of the Board of Directors. Now called Global Partners in Care, the Foundation has raised millions of dollars, and with nearly 100 hospices in 15 countries, it has helped to alleviate the suffering for thousands of people dying in Africa and other countries. To acknowledge her international efforts, a scholarship program for African social workers was jointly established in her name by the National Association of Social Workers (NASW) and the National Hospice and Palliative Care Organization (NHPCO). When first learning about the honor, she claimed, “I feel I have finally realized my goal of becoming a missionary in Africa.”
The Comfort-Ability Scale
In 1994, Harper published the second edition of a groundbreaking book titled Death: The Coping Mechanism of the Health Professional. It was originally written in the 1970s, when she was directing the Social Work Department at the City of Hope. She recognized the need for training social workers to better cope with their death-related anxiety and professional grief, thereby avoiding burnout. Her book received the “Better Life Award” from the American Health Care Association. The schema, called “The Comfort-Ability Scale,” represents the normative sequence of emotional and psychological progress that a social worker must achieve to work effectively with patients who are dying. The guidelines that she laid out then are just as relevant today, and many health care and hospice social workers have benefitted, and continue to benefit, from the wisdom she accumulated and provided over a 50-year career.
As for many social workers, paid employment may end after retirement, but a dedication to the goals of the profession of social work continues on a voluntary basis. Among other activities, Harper is now a member of the U.S. Steering Committee of the International Council of Social Welfare, on the Board of NASW Pioneers, and on the NHPCO’s Task Force on Access to Hospice by Minority Groups, of which she recently served as chair. She also is the coordinator for the 25th anniversary of the Social Work Pioneer Program, which will take place this November. The program’s theme is “Recognizing our Past, Moving to Our Future.” Harper rarely looks back. Instead, her focus is on the next project, the next goal, and the next need. Her continuing service on behalf of others is an inspiration to all who know her.
When asked for specific advice about being a social work leader, Harper gave two insights. First, she emphasized that “in order to be a social worker, you must love people—all people.” Second, she thinks integrity is imperative, and “to be a leader, you must always set an example. This means doing the right thing, no matter what the outcome.”
Bernice Harper is a remarkable example of what one person—what one social worker—can do during a lifetime of leadership.
References
Harper, B. (2011). Palliative social work: An historical perspective. In T. Altilio and S. Otis-Green (Eds.), Oxford textbook of palliative social work, New York, NY: Oxford University Press, pp. 11-20.
Harper. B. (1994). Death: The coping mechanism of the health profession (2nd ed.). Greenville, SC: Southeastern University Press.
Elizabeth J. Clark, Ph.D., MSW, MPH, is the President of the Start Smart Career Center and former CEO of the National Association of Social Workers. Her clinical background is in oncology with an emphasis on hope, hospice, loss and grief. She recently published Choose Hope (Always Choose Hope), and daily messages of hope can be found at #alwayschoosehope.