Angelita S.

Pierce
3/03/2015
Wayne State University
SW: 4020

Introduction
This paper will hopefully inform the reader about my field place agency at Second
Chance Maternal Infant Health Program (MIHP). It will give the reader an understanding about
how the agency is ran as far as the organization itself and the type of services that we at the
MIHP provide to our consumers. The reader will also find Second Chance MIHP mission
statement along with the general MIHP goals for the program. Throughout the paper the reader
will get an understanding of the organizational structure and staffing at Second Chance MIHP,
and lastly the reader will gain an understanding of the Human Relations Theory as well as the
Theory Y.

Organization and Services

Second Chance Counseling Services is a Maternal Infant Health Program (MIHP).
Second Chance MIHP is a for profit organization that provides pregnant women and infants who
are Medicaid eligible with a team that consist of a licensed Social Worker and a Registered Nurse
and sometimes depending on the circumstances some will receive assistance from a Registered
Dietitian. The Medicaid eligible pregnant women will receive nine visits from the time they
enter the program until usually a few weeks after they have given birth. During the initial visit
an assessment will be done where the women will be asked a series of questions regarding their
health, abuse and violence, drug abuse, housing and other various questions. Normally the social
worker will have the first visit with the client where the social worker along with the client will
go over the clients assessment and discuss the resources that are available for the client, if the
client has scored high in any areas then usually there is some sort of intervention that will need

to be discussed and put in place. If a client doesnt score high in any of the areas then the
social worker and registered nurse will simply provide the client with the resources that they may
need which include housing, transportation, food and nutrition and many other resources.
Medicaid eligible infants are enrolled into the MIHP one of two ways. The first way is
once they have been born and after the mother is discharged from the MIHP the infant can be
enrolled into the program. The second way is if the infant is under a year old and Medicaid
eligible they can be enrolled into the
MIHP as well. Regardless of how the infant enters the MIHP they will receive nine visits from
the social worker and registered nurse and again in certain circumstances they will receive visits
from a registered dietician. The infants will be assessed as well but their assessment will be done
by their legal parent or guardian otherwise known as their advocate.

Mission and Goals

Second Chance Counseling Services Mission Statement is: To promote the delivery of
high quality, comprehensive, family-centered health services for pregnant women and infants
and to identify/assess the health factors and conditions of pregnant women that adversely affect
their social, economic and, health status in order to improve access and services for these women
and infants thereby decreasing infant mortality in the State of Michigan. The general goal for all
MIHPs is the same which is to support Medicaid beneficiaries in order to promote healthy
pregnancies, positive birth outcomes, and infant health and development. MIHP services are
intended to supplement medical (prenatal and infant) care. MIHP provides care coordination and
intervention services, focusing on the mother-infant dyad. Care coordination services are

provided by a registered nurse and licensed social worker, one of whom is designated as the Care
Coordinator. Intervention services are provided by a registered nurse, a licensed social worker,
registered dietitian (with a physician order), and an infant mental health specialist, depending on
the beneficiarys particular needs (Michigan.gov 2015). Within Second Chance MIHP there are
specific goals which have been put in place by the director, which are to just be the best you can
be and provide the client with the best and proper resources fit for the client.
Fortunately for Second Chance MIHP goal displacement has not occurred within the
agency, this is due to the fact that both the social workers and registered nurses pretty much
have the same values and beliefs which is very rare and regardless if their client(s) beliefs and
values differ from theres the social workers do not try and persuade the client to believe what the
social worker believes. Communication is a big key factor when it comes to goal displacement
not occurring at Second Chance MIHP agency whenever an issue arises no matter whose
attention it is brought to rather the office manager or the director of the program the issue is
often resolved in a timely manner.

Organizational Structure and Staffing

At Second Chance MIHP the organizational structure is as follows, there is the director of
the Second Chance MIHP followed by the office manager, four social workers who mainly work
outside the office with the clients, two registered nurses who also mainly work outside the office
with their clients and lastly there are two college interns myself being one of them who
sometimes work outside of the office under the supervision of the licensed social worker and
other times we work in the office doing computer work and often filing paper work. The
distribution of power is limited between the director of the program and the office manager. The

director majority of the time relays messages to the office manager who will then relay the
messages to the program employees. If necessary the directory will call a office meeting where
all the employees including the interns will attend and there we will discuss monthly goals, client
progression, making improvements etc. If every there is a concern from an employee of the
MIHP it is brought to the office managers attention and if further action is needed then the
concern will be brought to the directors attention.
The lines of authority used at Second Chance MIHP are pretty simple, as a previously
stated Second Chance is a small, for profit organization with a total of eight employees not
including the office manager or the director. The social workers and the nurses both have to be
competent enough to know the proper resources they are able to provide a client with, and when
a problem arises that is out of there control they then must bring it to the office manager. The
office manager then has to make a decision about the situation at hand and must be able to figure
out if it is something that she can handle or if she must bring the issue to the directors attention.
When I briefly sat down with the director of Second Chance MIHP I asked her What do you do
when employees come to you with problems? Her response was Well depending on what the
problem is I either help them to solve the problem, or I tell them to take it to the manager, thats
what I pay her for (Ginger Bradfield-Clark 2015). From Mrs. Bradfield-Clarks response it
seems as if she would like for issues and concerns to be brought to the office manager first and
then to her.
When it comes to management approaches at Second Chance MIHP the one that would
best describe the agency would be the taken from the book Social Work Macro Practice and is
referred to as Scientific and Universalistic Management, the goal for scientific management is to
find the optimal way of doing a job (Netting, p 217). At Second Chance MIHP and as stated in

the book individual social workers are expected to study the progress of clients in their
caseloads by using methods such as single-subject designs (Netting, p. 218). The social
workers at the Second Chance MIHP agency are expecting the find the proper resources for their
clients and if they feel that they are not competent to do such, then they are required to refer the
client to a social within the agency who is competent enough to do the job.
At the Second Chance MIHP there arent many levels of diversity, all of the employees
are women from the director down to the interns, which in my opinion is pretty unfortunate.
When I sat down with the office manager for a short interview I asked her why is it that the
agency doesnt have any male social workers or even male registered nurses working for the
MIHP agency she replied with, Since this is Maternal Infant Health Program Ginger feels that is
best to hire women who can relate with other women, regardless is the social worker or nurse is a
mother or notplus when we had a male social worker in the past the clients would always call
and request to have a female social worker (Brittni Crawford 2015). All but one of the
employees at the MIHP agency are African American, the other intern is a Caucasian female. I
had the chance to do a brief interview with her as well and when I asked her how she felt going
to see clients who majority were African American she replied with, I dont really see skin color
I see them as women who are in need of some sort of assistance (Allyson Richardson 2015).
All of the employees at the Second Chance MIHP agency are heterosexuals as well as none of
the employees have any mental or physical disabilities.

Internal and External Environment: Relationship with Community

Majority of the clients from the Second Chance MIHP agency come from all over the
Detroit Metropolitan area. Within the MIHP there is what is call a recruiter who is also a
licensed social worker who travels from various Detroit Human Service (DHS) offices and
various doctor offices primarily the offices of pediatricians and gynecologists. The recruiters in
a sense look for women who are pregnant that could benefit from the things that the MIHP has to
offer. The recruiter sits down with the women and gives them a brief summary about our
program and if the woman is interested she will give the recruiter her information such as name,
date of birth, best contact number and Medicaid number or social security number. The recruiter
then will turn in the information to the office manage who will verify the potential clients
insurance to make sure that she is Medicaid eligible and once the insurance is in place, the office
manager will then call the client to set up a time for the client to meet with another social worker
who will give the assessment. Another way clients join our MIHP is by word of mouth
throughout their community. A lot of times when potential clients call the office when often
asked How did you hear about our program, they often respond by saying that they were
referred to us by either a relative, their DHS case manager, or sometimes their doctor.
Second Chance MIHP agency as stated before is a for profit organization. Medicaid is
their primary source of funding, Second Chance MIHP is a contractual job therefore the
employees are paid based on the number of clients they see and how often they see the clients.
The director of the MIHP will bill Medicaid every Monday for all the clients who have entered
the program and for the clients who have had a visit from either the social worker or the
registered nurse the prior week.
When it comes to other MIHP agencies we are all each others competition. Within the
Crossroads building on eight mile and Northland Drive where Second Chance MIHP is located

there are five total MIHP agencies in the building, competing for the same thing which are the
clients. The MIHP agencies cannot operate without the clients, some agencies are dishonest
when it comes to promises that they make to their clients and one rule about all MIHP agencies
is that the employees are not to make false promises to their clients regarding things that they can
do which they are not allowed to do. A lot of our clients have what we call transfer into our
MIHP and naturally we have to ask why they want to transfer into our program majority of the
clients claim that they were promised certain things and their social worker could not deliver the
things promised to the clients, and naturally no one likes to be lied to. We have also gotten
transfer clients due to the fact that the client felt that their previous social workers from other
MIHP agencies were rude, incompetent and even not reliable when it came to providing
resources. We have also had clients request to be transferred from our MIHP to another MIHP
because of the things they were promised by another MIHP, yet soon enough the client realize
that they things they were promised they will not receive and they eventually end up transferring
back into the Second Chance MIHP.

Theoretical construct of organization

Based on what I have learned about my organization the organizational theories that
would best describe my organization in terms of its overall functioning, management structure,
decision-making practices, and organizational culture would be Human Relations and Theory Y.
Both theories are very similar as stated in the text book, these theories assume that workers are
motivated by factors other than wages (pg 222). The social employees at Second Chance MIHP
are truly dedicated to their clients and their well-being rather than collecting a pay-check. At

Second Chance MIHP the director leaves room for ideas and appreciated ideas from all the
employees and even the interns.
These theories would help a client to understand the agency because they will read and
know that unlike other agencies that are salary based and are not contractual they will know that
the employees at Second Chance MIHP cant survive without them the outsider will also know
and feel that if they become a client or refer someone to Second Chance MIHP agency that they
will be in good hand and receive all the benefits/resources that the program has to offer, the
potential will also feel like more than a client without breaking any of the NASW Code of
Ethics.
Recommendation
Gathering information from the SWOT Analysis regarding Second Chance MIHP
majority of the weaknesses within the agency are not within our control. One weakness about
the agency was the fact that a lot of our clients are not in stable homes and the often move
around which makes it hard for the Social Workers to visit the client (see SWOT Analysis).
Unfortunately we cannot control when and where the client(s) move to. There are many reasons
for a client to relocate such as for safety, some cannot afford their rent and are forced to move in
with other friends or family members and sometimes even move into women shelters. Usually
when a client relocates the client rarely informs their social worker for reasons unknown, and
also some sometimes with the change of address comes the change of phone numbers. Another
weakness of the agency was the fact that there are limited funds for housing and MIHP agencies
like Second Chance have limited resources to find housing. The two popular resources for
housing are Section8 and Low-income apartments, both resources have waiting list that can
range from as short as 90 days for a home or apartment to become available and us up to 5 years

10

for a home or apartment to become available which makes it difficult for clients who are in dire
need of a place to live. Im not sure as to how the director of Second Chance MIHP goes about
getting additional funding for housing or even if additional funding is available, this would be
something I would personally need to ask her to know for myself.

Conclusion
Originally when I was assigned this paper I immediately became frustrated with the
assignment, simply because I had issues gather information for the previous assignment
regarding my field placement. Second Chance MIHP has only been around for years which
compared to other MIHP agencies whove been around for many years I was afraid that I would
not have luck when it came to accessing the information that I needed. However I was able find
all the information I needed to complete the assignment and more, doing this assignment I really
had to put my social work skills to the test and do a lot of research which in the end I am glad I
did. I am a little uncertain about the different theories, but for me that just means I need to do
more research to fully understand them for the near future

11

References

Netting, F. Ellen., Peter M. Kettner, and Steven Lloyd. McMurtry. Social Work Macro Practice.
New York: Longman, 1993. Print.

Ginger Bradfield-Clark, personal communication. February 11, 2015

Brittani Crawford, personal communication. February 21, 2015
Caballero, M. Daniela, Bert Hayslip, Lahner, M. Jessica, McKelyy N. Tara.
International Journal of Aging & Human Development. 2014, Vol. 70 Issue 3,
p225-255. 31p
5 Charts.