The National Academy of Sciences, the presidential AIDS Commission, and other groups have called for a more effective national response to the AIDS epidemic. But what should that response be, and how are new government programs to be developed and implemented? The need for administrative models is large and growing as the AIDS epidemic spreads. New York State, which has more AIDS cases than any other state, has had to move earlier than most states in """"""""inventing"""""""" institutional mechanisms to cope with AIDS. We propose to study the New York State response to AIDS, with particular attention to the# AIDS Institute, the state's primary mechanism. Our intent is to determine the role played by the Institute in coordinating the state's response, including the work of a network of regional outreach organizations created and funded by the Institute to provide direct, local services; to determine what factors have led to successful actions by the AlDS Institute, and what factors have hindered success in attaining goals; and to draw lessons for possible application to federal and state policy from the New York experience. The AIDS Institute will be studied as an innovation in government emergency response, using a stage-process model. In this approach, the AIDS Institute is seen as the result of a policy innovation process. Once in being, it becomes the progenitor of other policy innovations. As an organization that combines attributes of centralization (to get resources) and decentralization (to deliver services), the AIDS Institute is an emergency response entity from which potentially important governmental lessons can be learned in combating AIDS. The research project will take 18 months. An interim report will be provided within the first 13 months, and the final report at the conclusion of the project.
