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Zero-Sum Politics, the Herbert Thesis and the Ryan White Care Act: Lessons from the Local Side of AIDS

Author: JAMES D. SLACK
Published in JHHSA, Vol. 24 No. 1

This study examines the dynamics of grass-roots decision making
processes involved in the implementation of the Ryan White
CARE Act. Providing social services to persons with HIV/AIDS,
the CARE act requires participation of all relevant groups,
including representatives of the HIV/AIDS and gay communities.
Decision making behavior is explored by applying a political
(zero-sum) model and a bureaucratic (the Herbert Thesis) model.
Using qualitative research techniques, the Kern County
(California) HIV Consortium is used as a case study. Findings
shed light on the decision making behavior of social service
organizations characterized by intense advocacy and structured
on the basis of voluntarism and non-hierarchical relationships.
Findings affirm bureaucratic behavior predicted by the Herbert
Thesis, and they also discern factors which seem to trigger more
conflictual zero-sum behavior.

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