Voluntarism in the Governance of Tuscan Socio-health services:

Voluntarism in the Governance of Tuscan Socio-health services:

From the Aggregation to the Integration of Social, Organizational, and Individual Models

The phenomenon of voluntarism is increasingly achieving attention by management scholars, specifically focusing on the role of Non-profit Organizations (NPOs) in modern society and the way citizens actively commit themselves in the Third Sector in order to cope with government and business failures. Pertinent literature questions how the organized Civil Society successfully provides human service delivery, thus traditionally representing an important societal actor along with both the Public Entity, represented at a local level by Governmental Institutions (GOV), and the market, represented by enterprises and for-profit business (BUS).

In the present thesis, such a phenomenon has been conceptually and empirically analyzed following three perspectives, namely a ‘macro’, ‘meso’, and ‘micro’ perspective, which correspond to the three sections of the research. To this purpose, we chose an emblematic geographical area, the Region of Tuscany, which represents a paradigmatic excellence and national benchmark for the provision of emergency-urgency socio-health services. Actually, the Tuscan Third Sector has a historical and long-lasting tradition that started in the medieval period, precisely 1244 in Florence, and during the Centuries has significantly contributed to the evolution of regional welfare, especially by providing socio-health services to its own local community. What are the essential reasons, peculiar characteristics, and strategic levers that allow such a regional successful philanthropic reality?

To answer this question, we firstly analyzed the historical evolution of the institutional interactions between regional GOV and Tuscan NPOs. Drawing on partnership and strategic alliances literature, we focused on the notion of cross-sector social partnership (CSSP), which refers to strategic arrangements between the three societal actors, namely GOV, BUS, and NPOs, aiming at social purposes. CSSP literature conceptualizes such arrangements through a tripartite framework which is composed by three phases, namely formation, implementation, and outcome of the social partnership.

Further, each phase is characterized by stages which in turn are composed by micro-processes.

However, scarce attention has been given to the analysis of evolving CSSP focusing on dynamic and

contingent elements influencing and affecting such arrangements. We attempted to contribute to this

stream of literature by choosing the implementation stage of the CSSP between Tuscan GOV and

NPOs, and its three stages, namely selection, design, and institutionalization. By using critical event

analysis, we examined historical archives, documents, reports, legislative frameworks, interviews

with NPOs Presidents and Directors and GOV representatives, in order to assess the evolution of the

Tuscan CSSP in the last 35 years, particularly from 1978 (the creation of the Italian NHS) to the

present period (years 2013-2015). At this first ‘macro’ level of analysis, it emerged how the examined Tuscan CSSP has been characterized by an institutional ‘coercive isomorphism’ which imposed NPOs to adaptively respond to external pressures. These environmental factors resulted in five main CSSP internal outputs, namely legitimacy, power, trust, identity, and absorptive capacity, which dynamically evolve throughout the historical interactions between partners.

In the second section of the thesis we used a ‘meso’ perspective, particularly the analysis of a specific business and governance model which is increasingly characterizing NPOs realities, the hybrid model. Such a model refers to the implementation of both for-profit and non-profit activities within a single organization. Hybridization is actually an important element in modern organizations, mainly because many for-profit enterprises and traditional NPOs are converging toward the so-called ‘social enterprise’ model, which stresses the socially responsible entrepreneurial mindset of modern management and organizational structures. Such a phenomenon is progressively characterizing Tuscan NPOs, which have to arrange innovative forms of business model in order to be financially autonomous and thus becoming, on the one hand, more independent of regional GOV and, on the other hand, more trustworthy toward its own volunteers and local community. Pertinent literature has individuated two types of hybrid business and governance models, namely the integrated and disintegrated ones, although few attempts have provided managerial implications for such hybrid arrangements. We attempted to contribute to this stream of literature by conducting a multiple case study of three Tuscan ‘hybrid’ NPOs. Specifically, the coding analysis of semi-structured interviews with NPOs Presidents and Directors resulted in significant managerial implications for these organizations. Firstly, we conceptualized a third hybrid business and governance model, the semi- integrated one; second, we individuated six conceptual categories affecting the hybridization phenomenon – internal legitimacy, external legitimacy, monetary exchange and flows, organizational structure, loss of identity, growth constraints. Interestingly, the integrated model resulted affected by high critical levels of growth constraints; the disintegrated model by risk of loss of identity; and, finally, the semi-integrated model by internal legitimacy and growth constraints.

The third and final section of the thesis builds on a ‘micro’ perspective by firstly analyzing the socio-

anthropological concept of the gift and donation in the voluntary context, and secondly investigating

volunteers’ motivations, attitudes, and behavioral intention to donate in order to deepen how these

essential strategic resources of NPOs behave. While the first part of the section is a conceptual

analysis of the notion of gift-giving building on anthropological theories (e.g. The Theory of the Gift

by Marcel Mauss), the second part presents an empirical analysis using a structural equation model

(SEM), which allowed to simultaneously assess the hypothesized relationships between important latent dimensions of volunteers’ behavior, intention to donate, and attitude toward the NPO.

Particularly, we used validated psychological and managerial scales and collected 379 questionnaires completed by Tuscan volunteers of 20 NPOs. After an exploratory factor analysis of the analyzed latent dimensions – volunteers’ motivations (social, career, values, understanding, ego protection, ego enhancement), attitude toward charities, religiosity, positive and negative reciprocity, intention to donate – we implemented SEM procedure and evaluate both the ‘measurement’ model (fit indices) and the ‘structural’ model (hypothesized relationships) of the proposed constructs. Main managerial implications refer to the importance for NPO board to assess and understand volunteers’ relational signals, in order to appropriately respond to and incentive such crucial strategic resources of the organization. Actually, volunteers represent not only the main ‘provider’ of time, resources, know- how, and ability for NPOs, but also and at the same time the main ‘beneficiary’ of gratification and satisfaction derived from being part of a committed philanthropic association. Particularly, the reciprocal dimension of volunteers’ behavior, along with their intention to donate, stress how the relational element is important in the management of such realities, which presupposes a deep understanding of individual psychological traits, attitudes, and behavioral intention. Such elements make NPOs the effective and successful societal vehicles able to respond to community needs and to cope with government and market ‘failures’, thanks to their most precious resources, the volunteers.