The purpose of the national photo postcard campaign is to put a human face on the patients we serve, the families of these patients, and the home care and hospice workers who take care of them. We sought to find a way in which thousands and even millions of home care patients and their families can make their wishes known to Congress. We realized that while we can’t bring them all to Washington, DC, we can bring their words and pictures. It is a virtual March on Washington. This photo postcard campaign is inexpensive, highly personal, and will register with members of Congress and the national media. If we make our patients visible, Congress can and will reverse the cuts that have been made in the past and block the further cuts that are already scheduled.

It is as easy as 1-2-3...

1. Encourage our clients to get postcard-sized photos (4” x 6”).
2. Attach the enclosed label or glue paper to the back of the photograph.
3. Ask your client to write a few lines about their needs and the importance of home care to them and their family on the back of the photo. Have them sign their name and address.
4. Ask your patient to mail the card to their Senators and Congressmen, as well as to the governor of your state. Addresses can be found at www.senate.gov, www.house.gov, and www.nga.org.
5. Encourage them to send cards to the assignment editors at your local newspaper as well as your local television and radio stations.
6. Finally, please ask them to send NAHC a copy of the photo postcard as well. We will include all of the postcards we receive in a National Caring Quilt. Send the card to:

National Photo Caring Campaign
National Association for Home Care & Hospice
228 Seventh Street, SE
Washington, DC 20003

The deadline to send in postcards is July 4th—
Please help us celebrate Home Care Independence!

Why It’s Time for a National Photo Postcard Campaign
By Val J. Halamandaris

By now everyone knows that Congress is considering “reform” of both Medicare and Medicaid this year. Against the backdrop of the war and looming federal and state budget deficits, “reform” will likely involve the use of a scalpel.

These circumstances pose new treats to our already badly mauled industry. The threats could come in the form of Medicare payments or further cuts. The opportunities lie in the fact that home care offers the only way that I know to provide care for more people with the same money. Whether home care will benefit or be hurt depends upon our ability to make visible the 1.3 million Medicare patients who previously received home care services in 1997, as compared with 2002. We must wage a battle in the media, as well as in the Congress.

We should employ these strategies at the present time as follows:

1. Getting Senators, Congressmen, and Governors out on Home Care Visits. Every time we get a major policymaker into the home, they inevitably become fans. They appreciate what our nurses and aides do for people with major health care needs. Once in the home, we need to make sure they are photographed with the patient and the nurse, and share these photos with the elected official and the press. We need to write down a quote from the officeholder (sometimes called a sound bite) and share this with the newspapers and television stations when we send them the photo, together with the story of the visit. Examples exist in CARING Magazine: August 2002, which described the home care visit of Senate Majority Leader Tom Daschle (D-SD); November 2002, which included a story about a visit by the ranking Democrat on the Senate Finance Committee, Senator Max Baucus (D-MT); and January 2003, which included a story about a similar visit by Senate Finance Committee Chairman, Charles Grassley (R-IA).
   
   
2. Orchestrating a National Photo Postcard Campaign. Postcards have found new acceptance on Capitol Hill after the anthrax scare. Letters that are sealed in envelopes bound for Capitol Hill are diverted to Ohio and are irradiated. This takes several days. Postcards, however, are allowed to go right through. They also cost less. Some trade groups, like the gun lobby, have effectively used postcards with a pre-printed message that is signed by a constituent and mailed to a Congressman or Senator. It is evident that cards have been orchestrated by some interest groups and they are impersonal. This can be a problem. However, the way to get around this is for us (with the permission of clients and former clients) to take their photo and turn it into a postcard. You have seen people do this at Christmas. Whether the photos are digital and printed out on postcard stock, or actual photographs printed from film processed at the local drug store or Wal-Mart, does not matter. I would use a 4” x 6” photo for maximum impact. On the back of it, encourage the patients to give their names and addresses, why they are (or were) getting home care, and ask Congress not to allow further cuts to go into effect. Like any postcard, we would leave room on the right for the address. Copies should be sent to all local newspapers and TV stations, as well as to Congress and to NAHC.
   
   
3. Involving our Nurses in Educating Congress and the Media. Nurses and firemen are the two most respected professions in the United States. They have amazing credibility in Congress. Members know that one of every 44 voters is a nurse and that they are in a position to influence millions of voters who trust their judgment. We should get our nurses involved by taking photos of them, which we would turn into postcards, telling their stories of what has been going on in home care. You can't write a lot on a postcard, but you can get the point across about the effect of devastating cuts, the choking red tape, and the effect of still further cuts on patients. Such highly personal pleas would receive much attention. Copies again should be sent to local and state newspapers, television stations, as well as to Congress and NAHC.
   
   
4. Involving Family Members to Send in Their Photos and Sign Petitions. The photos of family members with their parents who are receiving (or were receiving) home care converted into postcards can be very effective for all of the reasons stated above. In addition, we should get them to sign petitions like we did in 1998. These petitions were on 8 by 10 paper. We provided the text. Families signed them, put their address on them, and sent them into NAHC. In 1998 we taped these together like a roll of toilet paper and called a press conference, which brought out the participation of about a dozen members of the House and Senate. We rolled out the petition starting on the Capitol steps, ran it down the Mall, around the Washington Monument, and back up to the Capitol steps. Our intent would be to do this again.
   
   
5. Getting Governors & State Medicaid Directors Involved. Governors are our natural allies. The National Governors Association has, for many years, been in support of a resolution to expand federal funding for home care services. Some 40 states are looking at huge budget deficits this year and next. We need to remind them of the causal connection between federal cuts in Medicare and the increased burdens felt by Medicaid. The 1.3 million people who no longer get home care under Medicare (2.4 million patients qualified for such services last year, down from 3.7 million who received them in 1997), either went without care, went into hospital emergency rooms, died or went on Medicaid, which in most states means nursing home placement. My column in the April issue of CARING described this “waterbed principle,” for when costs are reduced in Medicare home health, they inevitably pop up in the form of increased nursing home spending under Medicaid. New York may be the one exception because it is the only state that has a large Medicaid home care program. The point is that more cuts in Medicare home care will lead to still more state Medicaid expenditures, exacerbating state budget deficits. We should enlist the Governors to resist further cuts in home care, and to advocate increased federal home care expenditures as a way of making sure their budgets balance, and that people's needs are met.
   

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