Emerging trends, challenges and change in Hawai'i's nonprofit health and human service delivery organizations

This dissertation explores what thirty-eight of Hawai'i's top health and human service delivery organization leaders think are the trends, challenges and changes that affect the ability of their respective organizations to provide services to families.;This study systematically attempts to apply qualitative methodology to understand the phenomenon of shared and unique experiences of nonprofit chief executive officers and board chairs governing selected organizations. In addition to traditional literature review, the methodology involves extensive interviews to develop a database thereby supporting analysis to go beyond the anecdotal experiences of the health and human service nonprofits. This study aims to share the findings with crucial decision-makers to help assure the viability of the safety net by applying these data to future capacity-building activities and initiatives in Hawai'i. By strengthening the statewide health and human service nonprofit organizations, strengthening the safety net may be achieved.;The two main areas of literature review involve leadership and change theory and the historical and contemporary evolution of health and human service organizations and their models of governance.;Key findings involve: (1) the daily challenge to promotion and to protection of organizational resources as a major function of leadership, thus allowing less time and emphasis on advocacy and public policy; (2) the insufficiency of future leadership; (3) the ongoing need for organizations to structurally address change; and (4) the need to educate the public on the value of health and human service nonprofit organizations.;Given the trend analysis, the conclusion depicts Hawai'i's future safety net, as one comprised of fewer but larger organizations providing fewer services. The study recommends that health and human service nonprofit leadership and government entities coalesce their energies to create a formal structure to dialogue, strategically-plan and create a safety net that is adequate and appropriate for Hawai'i's unique culture and unique health and human service needs.