The oakland hiv/aids planning council: Its organizational form and environment

Abstract

An observational study of the Oakland Eligible Metropolitan Area and its Ryan White CARE Act Title I HIV health services planning council, officially known as the Alameda/Contra Costa HIV Planning Council, has been in progress since October 1992. Until June 1994, the Oakland planning council had a bifurcated organizational structure, with a component council for Alameda County and a component council for Contra Costa County. This case study focuses primary on the Alameda Component Planning Council (ACPC) and reveals that since its inception, the ACPC has struggled with numerous difficult issues, including volunteer membership, part-time staff support, membership selection and composition, conflict of interest, tensions among competing interest groups, conflicting demands from patientsJconsumers, and tensions among competing service delivery organizations. In spite of the substantial effort required to address these issues, the ACPC managed to fulfill its basic responsibilities of prioritizing the service needs of HIV-infected persons in the community and allocating funds to service providers to meet those needs. Over time, however, dealing with these issues took its toll on the planning council, resulting in a near complete turnover of members within 18 months. One reason that the planning council survived may be due to its unusual organizational form, which fits closely the definition of a minimalist organization. This form of organization is flexible and very efficient at adapting to changes in its environment. Previous studies of such minimalist organizations, however, have examined organizations functioning in stable, non-competitive environments. Whether HIV planning councils with this particular organizational form will be able to survive over a long period of time in turbulent environments is an important question for future research.