Ryan White CARE Act Title II consortia: A case study to explore the relationship of an organization's membership and structural characteristics and their impact on the HIV/AIDS service delivery system in Louisiana
Description
The purpose of this study is to describe the organizational components and activities of three Ryan White CARE Act (RWCA) Title II consortia in Louisiana (referred to as Bayou Consortium, City Hall Consortium, and Farmstead Consortium). A historical analysis is conducted to determine how the consortia's membership characteristics and level of formalization affected their ability to successfully support services that address the needs of persons living with HIV/AIDS (PLWH). Intervening variables related to this outcome are also identified and analyzed. Drawing from the literature, the primary theoretical frameworks reviewed are organizational theory and coalition development, including how networks develop, function, and impact the service environment for various populations This exploratory study incorporates elements of a multi-subject, time-series case study. Three regional RWCA Title II consortia in Louisiana are selected and retrospective membership and organizational data from annual funding applications that were submitted to the Louisiana Office of Public Health, HIV/AIDS Program from 1999--2002 are collected. In addition, data which identified service needs and service gaps from three separate statewide Needs Assessments of Persons Living with HIV/AIDS in 1998, 2000, and 2002 are collected. To assess the HIV service delivery system in the three selected regions, organizational information of the service providers is collected, and finally, service utilization data are compared to surveillance information related to PLWH in the three corresponding regions This study concludes that the membership characteristics and organizational structure of three regional RWCA Title II consortia in Louisiana influenced each consortium's ability to identify service needs and gaps and to allocate funds to support services for PLWH. Issues of membership diversity, consumer participation, and organizational representation are recognized as critical factors in consortia's decision-making. The study also highlighted the importance of organizational structure, supporting the position that a formalized structure will improve consortia's level of efficiency. However, findings presented a cautionary tale of the need to avoid a highly rigid and inflexible structure, which may lead to exclusivity and lower participation by members. Ultimately, this may limit a consortium's ability to accomplish its goals and subsequently, impact the level and appropriateness of service delivery to PLWH