Home care and hospice providers serve as patient advocates in many ways. Ensuring that local, state, and federal legislators are aware of the types of services provided in the home and the benefits of this kind of care is one example of advocacy. Our agency has found that inviting legislators on home visits changes the legislator's perspectives of home care and hospice with a deeper appreciation of home-based care. The following case study describes how a home health agency may introduce a patient to a legislator.

Although home health and hospice providers can easily relate to a "typical" patient-receiving services, there are key points to a successful visit with a legislator.

Tips for Successful Home Visits With Your Legislator

* Select a patient or family who is willing to share their story.

* Success of these home visits is impacted by the patient's or families willingness to freely discuss the benefits of receiving care at home.

* Select patient visits carefully.

* First, explore the willingness of the patient to allow the visit. Typically several "visitors" are present for such visits which can be overwhelming to the patient and caregiver.

* Second, consider the legislators reaction to the type of visit. Is the site of a large gaping wound or the presence of both wounds and drainage tubes going to be well tolerated?

* Select staff who can articulate and display strong patient and home care advocacy skills.

* Schedule more than one visit with varying diagnosis and home environments to demonstrate the vast difference in patient populations. Consider a Medicare patient (older adult), a pediatric patient, and others.

* Travel time offers a captive audience, so utilize "car time" to discuss concerns or support for current legislative action.

- Research your legislator and his or her voting record

- Ensure your comments demonstrate knowledge of the legislative action you are discussing

- Earn the legislators' respect by doing your homework on the issues.

* Research your legislator's position on home care issues and use of home care in the past, that is, family members who may have received home health or hospice.

* Research his or her experience with any home care organization.

* Educate your legislator on the number of patients you serve, the geographic areas, and volume of patients by age group, to indicate the impact that your organization has on his or her constituent group.

* Discuss the size and composition of your staff, reinforcing success as an employer and the importance of the services you provide, not only on the patients for whom you provide care but also your impact on the economics of the community.

* Provide bulleted written information that captures the elements of the discussion that your legislator can take back to his or her aide.

* Offer to be a resource person when the legislator has home care related questions or concerns. Keep your legislator and his or her informed on issues BEFORE they appear on the floor of the State House.

* Consistently schedule visits to your legislator's office when he or she is offering visiting hours back at home. Relationships are important and must be sustained for maximal effectiveness.

Other considerations

Staff selection for the visit also takes careful consideration. The clinician must be articulate and comfortable engaging in conversation with a legislator. He or she must be a strong home care advocate and a strong patient advocate. A professional, neat appearance and strong organizational skills related to the visit are also important. Professional behavior, beginning with personal presentation (neat dress, visible name tag, eye contact, a firm handshake, etc.) and extending these attributes throughout the visit, may reinforce staff competency and support the level of competent care that is provided in the home.

It is imperative to develop and maintain effective relationships with legislators on both a federal and state level. Although state legislators do not have direct control over federal monies, they do make decisions that impact state Medicaid programs, matching federal dollars and other state-backed initiatives. It is critical to know legislators as neighbors. Seek every opportunity to support their campaigns. Support is appreciated and remembered when critical legislation is reviewed in committee or presented for a vote.

Legislative involvement is a must for the future of home care and hospice. As home care and hospice providers facing multiple challenges, our voice and experience must be heard on Capitol Hill and in state government to survive. Legislators need to understand the importance of home care and hospice and what better way to earn this appreciation than to witness the benefit of our care. There is no substitute for face-to-face encounters. Know your legislative contacts at all levels-local, state, and national. State associations as well as national associations provide excellent resources.

Taking legislators on visits is an outstanding demonstration of patient advocacy. In the wake of budget cuts and fewer marketing dollars, arranging home visits is a cost-effective way to have far-reaching impact. Call your legislators today to schedule your visit!!