Organizational change in an HIV prevention program

Extract

[...] How has the Program Manager responded to change? Previous Manager initiated Prevention for (HIV) Positives intervention. This program has been expanded under the current Manager. Manager attempts to anticipate changes but shifting federal, state and regional priorities mean some plans must be abandoned and reformulated on short notice. Manager is learning new political skills as the environment between Counties in Region 3 shifts from cooperation to competition. Manager has invited Health Educators to give early input into program decisions. o She keeps them advised of what is going on politically in the Region. [...]

[...] The HIV Prevention program has been under increasing external pressure to change and narrow its programs. Requirements for change come from: o Centers for Disease Control and Prevention o State of Washington o Region 3 AIDSnet Funding available to the Program has been decreasing (Late, 2006). Program autonomy in intervention design/delivery has been drastically reduced; decisions are increasingly made at the regional, state and federal levels. Program staff have been directed to eliminate: o General education. Example: Positive Voices Speakers Bureau, providing HIV+ speakers to schools, community groups, partner agencies. [...]

[...] Critique In the HIV Prevention Program described above, the Manager has been reluctant to embrace many required changes. This has lead to confusion among her staff. For example, support staff realized a year ago that GLOBE funding would not continue. GLOBE is a valuable support for sexual-minority youth, but HIV prevention has become secondary. However, the Program Manager co-founded this group and knows that no substitute exists in the community. While Managers must often fight for programming, they need to view it in part as funders would and recognize when to let a particular project go. [...]

[...] The most relevant lesson for me in this case is that there are times in the change process where the most one can contribute to moving the organization forward is to step aside and let the change be lead by one who is better able to with the program.” Survey Questions A uniform set of questions was asked of all persons interviewed in preparing this report. They were: 1. From your perspective, how is the current HIV Prevention Program in Snohomish County different than it was 1 year ago? 5 years ago? 2. [...]

[...] The examples above illustrate that the HIV Prevention Program is currently in a “Decline or Renewal” phase described by Oakley and Krug (1991). The Manager and some staff operate from that prevent them from fully seeing beyond risk to the opportunity change can bring. There are ways to adapt required evidence-based programs to local populations, but this Program does not (McKleroy, Galbraith, Cummings, Jones, et al., 2006). If they continue to operate this way, they will find funding withdrawn and even stricter reporting required in an attempt to bring them into line with funder priorities. [...]