The Emergency Preparedness Project was sunsetted after the project period ended. This page served as the program page.

Emergency Preparedness

This project aimed to identify and bolster the public health preparedness of community health centers, including Federally Qualified Health Centers (FQHCs), nurse-managed health centers, and retail-based health care centers.

We assessed the landscape of training resources available to these centers and clinics, identified preparedness best practices, built useful tools, and provided training and technical assistance. Our educational efforts included presenting webinars and designing publications with the goal of better enabling health clinics and centers to be able to respond to a pandemic or other public health emergency.

The National Nurse-Led Care Consortium partnered with the Public Health Management Corporation’s Research and Evaluation Group and the Convenient Care Association for the public health preparedness project. This project was funded by the U.S. Centers for Disease Control and Prevention and the National Network of Public Health Institutes.

Emergency Preparedness Webinar Series 

Other Emergency Preparedness Resources

Health Center Stories

Our Nurse Home Visitors work alongside their clients to provide the best quality care using their nursing expertise, and connecting clients with our legal and professional partners, as well as resources within the clients’ own communities. Sometimes issues arise that have no clear solution, issues that are caused by systems-level barriers.

Joy Ahn, our Nurse Advocacy Manager, dedicates her time to systems-level change. She orients her work around the experiences of the home visiting nurses and clients to meaningfully inform public policy. At NNCC, she has created a system to collect client and nurse stories reflecting barriers to health and/or strategies to improve health and well-being.

As a former Nurse Home Visitor with our Philadelphia Nurse-Family Partnership program, Joy experienced first-hand the power of translating client experiences into advocacy. She shared her vision and method of systems-level advocacy at StartEarly's 2024 National Home Visiting Summit in Washington, D.C.

Using the development of the Coalition for Lactation-Friendly Schools as an example, Joy shared her advocacy method:

1. Identify the problem

As a Nurse Home Visitor, Joy had numerous clients who were forced to choose between continuing their education and breastfeeding their child. One client was told by their principal that they were not allowed to pump milk in school. Another client was told their grades would be adversely affected if they were late to class due to pumping.

2. Investigate and research

Joy found evidence that parents who continued to breast/chest-feed beyond six weeks reported significant emotional, informational, and instrumental support from family, friends, school, and their babies. (Wambach, et al, 2009).

3. Inquire where there is support

Joy spent time researching states that supported students and their goals to continue lactation. At the time she first looked into it, there were two states with legislation supporting lactating students: Virginia and California. Since then, other states have joined that group, including Nebraska, Illinois, Maryland, and Arkansas.

4. Identify who is in power

Joy learned from her time with clients and her research that legislative advocacy was the best way forward. Opportunities for change started locally and continued at the state and federal level. The power reached the PA House of Representatives and advocates within the US Breastfeeding Committee.

5. Intentionally form or find a network

After years of looking for an open window in related meetings, Joy was eventually connected with two other people interested in advocating for parenting students. The conversation grew from connections with the Food Trust and Women’s Law Project, to collaborating with Maternity Care Coalition, the Education Law Center, the Philadelphia Department of Public Health, the School District of Philadelphia, and others. Together, they formed the Coalition for Lactation-Friendly Schools.

6. Inform the policymakers

The Coalition for Lactation-Friendly Schools’ advocacy took many forms. They spoke with local media and wrote an op-ed, educated the public and legislators at community events, created model legislation, informed Representative Isaacson’s bill in the PA House (2019, 2021, 2023), and were awarded Advocate of the Year 2020 by PRO-LC.

7. Support next steps

Joy and the Coalition for Lactation-Friendly Schools know that the work doesn’t end when a bill is introduced or even once passed. They continue to inform stakeholders and legislators, conduct surveys of current school lactation policies, and organize supporters through targeted outreach like sign-on letters. They continue to cultivate varied subject matter expertise through their affiliated organizations and identified a fiscal sponsor to facilitate external support for education and advocacy related to lactating students.

The Power of Public Health Workers

When systems-level barriers repeatedly prevented Joy from providing the best care to her clients, she recognized that she needed to advocate upstream. Joy stepped up to the challenge by collecting as much data and information as possible, identifying who holds the power to enact change, intentionally forming a powerful network of advocates, and making their voices heard throughout the state. This system of identifying and working to solve ‘puzzling policies’ is not a skill only Joy holds - anyone can be an advocate.

Joy, a public health nurse and change agent, envisions a country where everyone who works in public health realizes their power to share their knowledge from boots-on-the-ground work to impact positive change in their organizations, their towns, their states, and their country. She truly believes that anyone can be an advocate on any level - all it takes is a phone call. Your story matters, and your experience is important and valid. If you see something that is not working and think, ‘Someone should do something about that,’ that someone might just be YOU.

Dr. Erin Graham, DNP, APRN

The National Nurse-Led Care Consortium (NNCC) provides pregnant and parenting persons in Philadelphia with community public health services through two evidence-based home visiting programs: Philadelphia Nurse-Family Partnership (NFP) and Mabel Morris Family Home Visit Program (Parents-as-Teachers). Our nurses visit families regularly throughout pregnancy and the early years of parenting and help them build a healthy foundation of wellness and resources. While our nurses are a critical part of their families' healthcare team, we believe that, for some families, bridging the care being offered in the home to clinical care settings can further improve their overall health.

For this reason, NNCC partnered with PolicyLab at Children’s Hospital of Philadelphia  to develop the Community Clinical Systems Integration (CCSI) initiative. CCSI is a model of care where our home-visiting nurses’ partner with CHOP primary care providers in assessing the needs of and supporting the health and development of each child. Facilitated by nurse access to their clients’ medical health records, the model improves communication between the pediatrician’s office and nurses and creates continuity of care that increases care team support and broader monitoring of the child’s health.

This shift in how the care team interacts across settings empowers families to recognize that they are an important piece in the decision-making process and increases their trust in health care. Dr. Erin Graham, DNP, APRN, NNCC’s Senior Director of Healthcare Integration who participates in the development of the CCSI initiative, described during the National Home Visiting Summit, what she felt was the greatest opportunity the initiative presents. This project is about finding effective ways to share information and creating less of a burden on all parties, home visitors, health care providers, and most importantly, families.” If we can prioritize the sharing of information as well as the individuals directly involved in the exchange of that information, we’re going to see overall satisfaction and engagement not only in families but also in providers and home visitors.

Anna Bechtel, MPH, BSN, RN

Anna Bechtel, MPH, BSN, RN has been an NFP nurse for five years and started working within the CCSI model two years ago. She shared a story during the Summit of a particular family that saw a big impact on their health. Their story is below, and the sections in bold highlight what CCSI made happen – and would not have happened without the permissions facilitated by CCSI. The names of the clients in the story were changed for patient privacy:

“When she was 8 months old, Jules was underweight and scoring behind on her gross and fine motor milestones. The family had been dealing with housing and food insecurity, and mom Denaya was under so much stress, that she hadn’t taken Jules to the pediatrician in the last 4 months of age. Denaya was worried about Jules’ weight but didn’t know what to do. I spoke to her more and found out that she had been trying to schedule a wellness visit but was having difficulty because she hadn’t shared what was going on with the pediatrician’s office.

With her permission, I emailed the pediatrician with the details of their situation and confirmed with the office that they would see her that same week. Afterwards, I read the note from their visit to see what the pediatrician had documented about their visit and then talked with Denaya to hear her interpretation of it.  Based on the communication from the pediatrician, I then supported the family in getting the high-calorie formula they were prescribed from WIC, helped them get a new SNAP card, and set up a ride to the store to get the items they needed. I was also able to look at the chart and see that Jules was supposed to be getting physical therapy (PT) and occupational therapy (OT) but had missed several appointments. After reviewing the developmental assessment with Denaya and helping her understand more about her daughter’s needs, she was motivated to get Jules back to therapy and we arranged for transportation. Throughout this, I continued to follow up with weight checks with Jules and added those weights to her medical chart so the pediatrician's office could also be informed.

As the family continues to struggle with housing, I have followed them and have been able to keep in continuous contact. Jules is now 16 months old and hasn’t missed any more wellness visits. She has had the necessary surgery required for her care followed up with PT and OT and is now walking on her own. The family is in stable housing and has access to enough food. Throughout this, I was able to update their pediatrician on the progress they’ve been making in between wellness visits, so the care team is all on the same page.”

The CCSI program provided a space for Denaya’s nurse home visitor to work directly with her pediatrician and find the best way to support Denaya and her daughter, despite all the obstacles that stood in their way. With every step made toward Jules's care, the CCSI program reinforced Denaya’s understanding of the complex medical situation and empowered her to make educated decisions for her daughter and family. By working together, home visitors and primary care providers can best serve people like Denaya and their families

The US Department of Housing and Urban Development (HUD) states that the Fair Housing Act (FHA) prevents direct providers of housing from discriminating against persons due to race, color, religion, sex, national origin, familial status, or disability. The purpose of the act is to promote equity in housing opportunities that these identifying features could limit. When the act was first passed, in 1968, it was meant as a follow-up to the Civil Rights Act of 1964.¹ Recently, in 2021, the federal government expanded enforcement of the FHA to include sexual orientation and gender identity. Some states, including Pennsylvania, also provide protections for individuals who are discriminated against for sexual orientation or gender identity, as do some municipalities. Despite these expansions, the FHA falls short - explore how here:

1. Breadth

Though the FHA covers “family status” and “sex” as discrimination categories, it does not cover all family statuses, such as single parents. Family status is meant as a term to cover discrimination against families with children or persons who are pregnant. “Sex” had to be explicitly expanded in 2021 to include gender identity and sexual orientation, and HUD still has nothing listed under examples² of discrimination against LGBTQ persons, while providing examples for all other categories. HUD does offer a separate guide for LGBTQ persons who are facing discrimination.³ Additionally, the law does not cover landlord-occupied buildings with four or fewer units, housing operated by religious groups or private clubs, and single-family homes directly sold or rented by the owner.⁴ In many areas, smaller rentals like these are the most accessible and affordable to marginalized groups.

2. Enforcement

Enforcement of the FHA requires a high level of legal literacy on the part of the wronged person. Knowledge of the laws, access to reporting methods, and time and resources to pursue justice are all required for the person to act. In many cases, the person may not even know they were wronged, as landlords may say things such as they “just rented the last apartment” or they’ll “let you know as soon as one is available,” or they charge fees they know will be prohibitive. Often, the search is so overwhelming that people lose track of where they’ve applied or assume that nothing is available if they don’t hear back.

3. Current Policy Proposals/Changes

Legislators in Pennsylvania have introduced bills to protect those searching for housing, especially those who’ve interacted with the justice system. Pennsylvania State Representative Donna Bullock proposed a bill in 2016 that would prevent landlords from asking about or requiring applicants to disclose some arrest records — such as juvenile records, arrests with no convictions, convictions other than felonies or misdemeanors, or convictions older than seven years — as a condition of housing. The bill was not passed then, but Bullock reintroduced the bill this April as House Bill 96.⁵ Conditions in the PA House look favorable for Fair Housing legislation, as the Pennsylvania House Housing and Community Development Committee unanimously advanced multiple Fair Housing-related bills in February 2024. A list of current legislation, as well as committee transcripts and reports, can be found here. The legislation also addresses affordable and accessible housing, often tied in the public’s mind to Fair Housing.

Federally, the Fair Housing Improvement Act of 2023, introduced by Senator Tim Caine of Virginia,⁶ would expand the Fair Housing Act to include discrimination based on source of income, veteran status, or military status. The proposed act is currently in the Committee on Banking, Housing, and Urban Affairs and is in hearings. If passed, the act would provide additional protection against discrimination to those receiving housing vouchers, rental assistance, and other subsidies from both government and private agencies, which are often disclosed during the housing application process.

What to do if you feel you have been discriminated against in housing:

Housing discrimination can be reported locally and federally. Federally, you can file a complaint online, by phone, or by mail at: https://www.hud.gov/fairhousing/fileacomplaint or 800-669-9777.

Locally, you can find your state’s fair housing assistance program here: https://www.hud.gov/program_offices/fair_housing_equal_opp/partners/FHAP/agencies

Private fair housing organizations also advocate on applicants’ behalf. A list of organizations by state can be found here: https://www.hud.gov/program_offices/fair_housing_equal_opp/contact_fhip

References:

1. History of Fair Housing. US Department of Housing and Urban Development. https://www.hud.gov/program_offices/fair_housing_equal_opp/aboutfheo/history
2. Examples of Housing Discrimination. HUD. https://www.hud.gov/program_offices/fair_housing_equal_opp/examples_housing_discrimination
3. Housing Discrimination and Persons Identifying as Lesbian, Gay, Bisexual, Transgender, and/or Queer/Questioning (LGBTQ). HUD. https://www.hud.gov/program_offices/fair_housing_equal_opp/housing_discrimination_and_persons_identifying_lgbtq
4. Housing Discrimination Under the Fair Housing Act. HUD. https://www.hud.gov/program_offices/fair_housing_equal_opp/fair_housing_act_overview#_What_Types_of
5. PA General Assembly. Bill Information. Retrieved 4/13/24 from: https://www.legis.state.pa.us/cfdocs/billInfo/billInfo.cfm?sYear=2023&sInd=0&body=H&type=B&bn=0096
6. Congress.Gov. S.1267 – Fair Housing Improvement Act of 2023. Retrieved 4/13/24 from https://www.congress.gov/bill/118th-congress/senate-bill/1267/text?s=1&r=22