Nonprofit organizations, community participation, and health and human services planning in the postindustrial period: A case study of the New York HIV Planning Council (Immune deficiency)

The case of the New York HIV Planning Council, a participatory planning body created through Title I of the Ryan White CARE Act (P.L. 101-381), suggests that nonprofit service providers play an important role in social policy-making. Comparing the New York HIV Planning Council to the historical community participation systems of the Community Action Program (1960s) and the Health Systems Agency Program (1970s) indicates that this role has grown because of the development of the nonprofit sector as a powerful “third sector” over the last thirty years and because of the sector's relationship to the new social movements, which emerged in the 1970s and 1980s. Nonprofit providers are strategically positioned in the policy-making process “between” community and government, which provides them with a community advocacy orientation that is balanced by an ability to weigh competing needs.; Participant-observation, key-informant interviews, and a survey of HIV Planning Council members shows that nonprofit providers who are most influential in the planning process are somewhat trusted by other Council members and are responsive to consumers. To some extent, the study also shows that nonprofit providers are able to transcend narrow self-interest. Still, the danger that heads of small nonprofit agencies will be driven by the imperatives of agency survival clearly emerged as a concern. Consumers also voiced frustration about being excluded from decision-making, which was driven by key providers and government staff.; Despite its problems, the New York HIV Planning Council process appears to be responsive to community needs. Survey results also show high member satisfaction. The many checks and balances built into the Council structure have helped to safeguard against dominance by government staff or nonprofit providers. The AIDS movement has also created a community that “watches” the Council and provides a sense of unity among all Council members that helps to counter-balance conflict. The dominance of AIDS movement ideology in the planning process, however, limits the range of policy options considered. Other reasons for the Council's responsiveness are its well-defined powers and scope of work, and the high level of involvement of the federal government in ensuring that the process is inclusive.