PNP 6013 Module 2 Organizational Structures and Roles Comparison Example

Agencies, Nonprofits, Hospitals and Congregations: How Organizational Structure Shapes Roles in a County Overdose Prevention Coalition

Student Name

American College of Education

PNP6013: Stakeholders and Roles in Public and Nonprofit Organizations

Module 2 Assignment

Instructor Name

October 19, 2026

Introduction

Module 1 mapped the coalition's stakeholders by power, interest and salience. This paper asks why their roles differ, and the answer lies partly in structure. A county health department, a nonprofit harm reduction group, a hospital system, a church and a group of bereaved parents can share a goal while differing in who they answer to, what they are allowed to do, how fast they can move and what resources they control. ACE's description of this course points to exactly this: how the type of organization may affect collaboration and collective action. The paper compares five member types on four dimensions and then asks whether the coalition's own structure fits its members.

Five Member Types

The coalition's members fall into five structural types. The county health department and sheriff's office are government agencies, created by statute, governed through elected officials and funded by taxes and grants. The harm reduction organization and the treatment providers are independent nonprofits, governed by volunteer boards and funded by grants, contracts and donations. The two hospital systems are large nonprofit health organizations whose tax status carries community benefit obligations. The recovery ministry is a congregation-based program, governed within a church's structure and funded largely by members. The family support group is an informal network with no legal form, no staff and no budget. Two further members, the school district and the EMS agency, are public bodies with the same basic structure as the county agencies and are grouped with them for this comparison.

Authority

Government agencies carry legal authority no one else in the coalition holds. The health department can collect and publish surveillance data and issue standing orders for naloxone distribution; the sheriff's office controls the jail where release-related overdoses begin. That authority makes them indispensable but also constrains them, since they may act only within their mandates. Nonprofits hold no legal authority over others, but their independence lets them act where agencies cannot, such as operating syringe services that some elected officials avoid endorsing. Hospitals hold clinical authority within their walls and little outside them. The congregation and the family network hold moral authority, the credibility of people who have lived the problem, which is powerful in public debate but carries no formal weight.

Accountability

Each type answers to different people. Agencies answer to elected officials and voters, which can make them cautious about controversial strategies. Nonprofits answer to boards and funders, and the harm reduction organization in particular must satisfy funders who expect it to meet participants without judgment. Hospitals answer to boards, regulators and, through community benefit reporting, to the public. The congregation answers to its members and faith tradition, which shapes which services it will offer; it supports recovery but will not distribute syringes. The family network answers only to its members. These differing lines of accountability explain more of the coalition's friction than personalities do. When the harm reduction director and a sheriff's captain disagree about syringe services, each is responding faithfully to the people they answer to.

Flexibility and Speed

Small nonprofits and informal groups move fastest. When a contaminated supply caused a cluster of overdoses last spring, the harm reduction organization had warnings on the street within a day, while the health department's public alert required review by its communications office and took three days. Hospitals can mobilize large resources but slowly, through committees. Agencies move fastest when an emergency declaration gives them authority and slowest when new policy is needed. Recognizing these differences lets the coalition assign tasks by speed: rapid community warnings to nonprofits, data confirmation to the health department and sustained programs to hospitals.

Resources

Resources are distributed unevenly. Hospitals have the largest budgets and data systems; agencies have legal authority, surveillance data and access to state and federal funds; nonprofits have relationships with people who avoid institutions; the congregation has volunteers and meeting space; families have stories that move policymakers. No member has everything the coalition needs, which is the case for collaboration. Salamon (1987) argued that government and nonprofits complement each other because each compensates for the other's typical weaknesses, nonprofits for government's rigidity and government for nonprofits' limited and uneven resources. The coalition is a local example of that complementarity.

Roles That Follow From Structure

Matching roles to structure suggests a division of labor. The health department should hold data, convene meetings and use its authority for standing orders and alerts. The harm reduction organization should lead outreach to people who use drugs and serve as the coalition's early-warning link. Hospitals should lead programs that link emergency patients to treatment and fund shared activities through community benefit dollars. The sheriff's office and detention center should lead jail-release planning. The congregation should anchor recovery support and grief groups. The family network should shape public messaging and keep the human cost in view. Assigning roles this way uses each member's structural strengths rather than asking every member to do everything.

When Structure Blocks a Role

Structure sometimes prevents a member from filling the role that would suit it best. The detention center is the natural lead for jail-release planning, but county budget rules prevent it from paying for naloxone kits given to people at release, since the kits are classed as a health expense rather than a corrections expense. The harm reduction organization could easily supply the kits but cannot enter the jail without a memorandum of understanding that the sheriff's legal counsel has not yet approved. The solution lies across structures: the health department can purchase kits under its standing order and the harm reduction organization can train detention staff, with the memorandum limited to training access. Seeing the barrier as structural, rather than as unwillingness, made a workable arrangement easier to find.

Does the Coalition's Governance Fit?

Provan and Kenis (2008) described three ways networks are governed: by the members together, by a lead organization or by a separate network administrative organization. The coalition is led by the health department, which works well for convening and data but creates two problems. Nonprofit members sometimes see the coalition as the department's project, and controversial strategies stall because the department must answer to elected officials. Bryson et al. (2006) found that cross-sector collaborations benefit from structures that build legitimacy with all partners. A gradual move toward a network administrative organization, a small staffed entity housed at a neutral nonprofit with a board drawn from all member types, would reduce both problems. Because that change requires funding and trust, the paper recommends a first step: a steering group co-chaired by the health department and the harm reduction organization.

Conclusion

Five organizational types in the coalition differ in authority, accountability, flexibility and resources, and those differences explain much of how members behave and where they clash. Matching roles to structural strengths produces a clearer division of labor. The coalition's lead-organization governance suits convening but limits ownership and boldness, and a co-chaired steering group is a practical first step toward shared governance. Module 3 examines one collaboration within the coalition in detail.

References

Bryson, J. M., Crosby, B. C., & Stone, M. M. (2006). The design and implementation of cross-sector collaborations: Propositions from the literature. Public Administration Review, 66(s1), 44-55. https://doi.org/10.1111/j.1540-6210.2006.00665.x

Provan, K. G., & Kenis, P. (2008). Modes of network governance: Structure, management, and effectiveness. Journal of Public Administration Research and Theory, 18(2), 229-252. https://doi.org/10.1093/jopart/mum015

Salamon, L. M. (1987). Of market failure, voluntary failure, and third-party government: Toward a theory of government-nonprofit relations in the modern welfare state. Journal of Voluntary Action Research, 16(1-2), 29-49. https://doi.org/10.1177/089976408701600104