PNP 6013 Module 3 Collaboration Analysis Example

From Confiscated Kits to Release-Day Naloxone: Analyzing a Three-Way Collaboration Between a Jail, a Health Department and a Harm Reduction Nonprofit

Student Name

American College of Education

PNP6013: Stakeholders and Roles in Public and Nonprofit Organizations

Module 3 Assignment

Instructor Name

October 26, 2026

Introduction

The weeks after release from jail carry a high risk of overdose death, because tolerance falls during incarceration and people often return to the same supply and circumstances. For years, people leaving the county detention center in central New Mexico received no naloxone and no information about that risk. Today, everyone released receives a naloxone kit and a short training, delivered through a partnership among the detention center, the county health department and the local harm reduction nonprofit. This paper analyzes that collaboration using a model of collaborative governance, asking how three organizations with a history of distrust built a working partnership and what it still needs.

The Model

Ansell and Gash (2008) reviewed 137 cases of collaborative governance and proposed a model with four parts. Starting conditions include imbalances of power and resources, incentives to participate and the history of cooperation or conflict among the parties. Facilitative leadership brings parties together and keeps them engaged. Institutional design sets the ground rules. At the center is a repeating process in which partners talk directly, build trust, commit to working together, reach a common understanding and win early results, the small successes that keep everyone at the table. Emerson et al. (2012) later described similar dynamics as principled engagement, shared motivation and the capacity for joint action. The model fits this case well because the partnership's history shows each element at work.

Starting Conditions

The starting conditions were poor. Power was unequal: the detention center controlled access to the people at risk, the health department controlled funding and standing orders, and the harm reduction nonprofit had relationships but no authority. The history was hostile. Deputies had confiscated naloxone kits during arrests until two years earlier, and the nonprofit's staff and participants remembered. Incentives were mixed. The health department was under state pressure to reduce overdose deaths. The detention center had seen two people die within a week of release, both reported in the local paper. The nonprofit wanted to reach people at a moment of high risk but feared being seen by its participants as working with law enforcement. In the language of the model, the prehistory of conflict was strong enough that the collaboration could easily have failed before it began.

Facilitative Leadership

Two people made the difference. The health department's harm reduction coordinator acted as a broker, meeting separately with the jail's medical director and the nonprofit's director before bringing them together, so that each heard the other's concerns in advance. The jail's medical director, a physician employed by the county's contracted health provider, became an internal champion, framing the program to the sheriff's command staff as a way to reduce deaths and liability rather than as a harm reduction initiative. Ansell and Gash noted that facilitative leadership matters most when starting conditions are unfavorable; this case supports that point. Neither leader had formal authority over the other organizations; their influence came from relationships and from a reputation for keeping their word.

Institutional Design

The ground rules were written into a simple memorandum of understanding after six months of meetings. It specifies that the health department buys and supplies kits under its standing order, that the nonprofit trains detention staff and provides a brief overdose education video shown at release, that the detention center gives every releasing person a kit with their property and that no information about who accepts a kit is shared with law enforcement. That last clause was the nonprofit's condition for participating, and the sheriff's counsel accepted it after the medical director explained that the program collects no personal data at all.

The Collaborative Process

The process followed the model's cycle. Face-to-face dialogue began with a tour of the jail's release area by nonprofit staff, which let them see the practical constraints the deputies faced. Trust grew slowly: the nonprofit tested the arrangement by asking for training access before agreeing to supply materials, and the jail tested it by asking the nonprofit to train staff without any public announcement. Commitment followed when both tests were honored. Shared understanding developed around a common phrase, release-day risk, that each partner could use with its own audience. The first intermediate outcome came three months after launch, when an EMS crew reported reviving a man with the kit he had received at release two weeks earlier. That story, shared at a coalition meeting, did more for commitment than any data.

What Nearly Failed

The partnership almost collapsed in its fourth month, when a new deputy, unaware of the agreement, questioned a released man carrying a kit outside the jail. The nonprofit's director heard about it the same day from participants. The memorandum had no procedure for incidents like this. The broker arranged a meeting within the week, the sheriff's office issued a short directive to all deputies and the nonprofit agreed to report future incidents to the medical director rather than publicly. Emerson et al. (2012) emphasized that the capacity for joint action includes procedures for handling conflict; the incident showed that the partnership lacked one, and it now has a written protocol.

Lessons for Other Collaborations

Three lessons from this partnership apply beyond it. First, a broker who meets each party separately before joint meetings can make a hostile history workable, which matches the observation that cross-sector collaborations need leaders able to build legitimacy with every partner (Bryson et al., 2006). Second, small tests of trust, each honored before the next is asked, build commitment faster than a comprehensive agreement negotiated in one round. Third, the clause that mattered most to the weakest party, here the promise to share no personal data, was the one that made the partnership possible; giving the least powerful partner a protection it values can be the price of collaboration and is often worth paying. These lessons will guide the coalition's next partnership, with the hospital systems, on linking emergency patients to treatment.

What the Partnership Still Lacks

Three gaps remain. There is no measure of whether release-day kits reduce deaths, because the agreement deliberately collects no personal data and linking releases to overdose records would require a separate data-sharing agreement with privacy protections. Funding for kits comes from a two-year state grant with no plan for after it ends. And people who have been incarcerated have no voice in how the program works, although they are best placed to say whether the video and the kit reach people in the hectic minutes of release. Each gap points to work for the coalition in Modules 4 and 5.

Conclusion

The release-day naloxone partnership overcame unequal power and a history of conflict through brokering leadership, a simple agreement with a privacy clause and a cycle of dialogue, tested trust, commitment and early wins. It nearly failed for lack of a conflict procedure and now has one. It still lacks outcome evidence, sustained funding and the voice of the people it serves. The case shows that the collaboration model's elements are not abstractions; each appeared at a specific moment in this partnership's history.

References

Ansell, C., & Gash, A. (2008). Collaborative governance in theory and practice. Journal of Public Administration Research and Theory, 18(4), 543-571. https://doi.org/10.1093/jopart/mum032

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

Emerson, K., Nabatchi, T., & Balogh, S. (2012). An integrative framework for collaborative governance. Journal of Public Administration Research and Theory, 22(1), 1-29. https://doi.org/10.1093/jopart/mur011