Fighting the Good Fight for Home Health Advocacy

These are phrases we hear over and over again from owners, employees and others in this industry. It’s easy to feel that things are hopeless, especially in the face of dramatic change.

But there’s another constant, and that’s the people who show up to make a difference. Industry advocates use their voices to explain the value of providing care and equipment in the home, speaking on behalf of everyone who works in homecare.

There are dozens of them working at the local, state and national level. And it’s not as hard as it looks for anyone to join their ranks. In this special feature, we share a few of their stories—and some tips if you’re inspired.

Fleece’s involvement in healthcare began on the legal side—after he graduated from the Saint Louis University School of Law in 1997, he was certified in health care law in the state of Florida and worked for a legal services company where he focused on providing counsel to various medical-related industries. 

Fleece worked in healthcare law for several years, where his interest in laws and policies surrounding the topic grew. It was a personal tragedy, however, that connected him to advocacy. During the early stages of his career, his first child died as a result of a fatal heart defect—and that horrible time in his life permanently shaped his understanding health care. 

He started volunteering in the home-based care industry, specifically in end-of-life and hospice care. Having experienced hospice bereavement services, Fleece felt a personal connection to the subject. He began paying close attention to how policy decisions directly affect access, dignity and outcomes for patients and families. He felt, he said, that it really became a responsibility. His journey inspired him to leave law and instead focus on leading an organization with similar values, which led him to Empath Health. 

“I truly believe in speaking up for the people who depend upon the organizations and the missions that we serve,” Fleece said. “You know, I wake up every day and think about the mission and the people that we serve, and the colleagues that serve those patients, families and loved ones that are at the core of what we do. So, I focus a component of every day on making sure that we’re investing in our people.”

Fleece is engaged with organizations such as the National Alliance for Care at Home and the Florida Hospice and Palliative Care Association, and he is working to get more involved with organizations such as the American Health Association and the Florida Health Care Association. His days are spent working on healthcare policy, philanthropy and engaging in community care organizations and supporting local foundations.

The effort is paying off. He says a recent win was being able to elevate the voices of home-based care and hospice by speaking before Congress. In 2025, amidst major conversations around Medicare payment cut proposals, Fleece spoke at a House Ways and Means Health Care Subcommittee hearing on behalf of the home health and hospice industry. Fleece said the moment in his life was “life changing.”

“It was inspiring, it was humbling, it was purposeful and I think it was impactive,” he said. “Standing before Congress and helping our lawmakers understand that care at home is really not optional—it’s essential. It really felt like progress, and fortunately, when the final payment rules came out for this fiscal year and certainly conversations for the future, I feel like our advocacy helped.”

For those wanting to get involved in advocacy, education is key. Fleece said people should start by educating themselves on local and national policies, rules and regulations that impact health care state to state. He added that voting is a major part of advocacy that everyone can take part in.

“We all have a voice, and we should all make our voice heard, [and] that’s literally voting in elections,” he said. “That’s a form of advocacy because we’re casting an American right to vote for our leaders to get heavily involved in advocacy.”

The need for home health and hospice are common across all communities, regardless of societal hierarchy or location, Fleece said. 

“When you survey Americans, there’s an overwhelming desire for people to want more care at the home,” he said. “I mean, we receive so many of our consumables and our purchases right there at the doorstep. So why should healthcare, or big chunk of healthcare, be any different?

“It has been shown over and over and over again from the evidence that that home health improves outcomes, healthcare outcomes and reduces costs,” Fleece continued. “So, if we don’t speak up, decisions are going to be made. They’re going to limit choices, they’re going to strain families and they’re going to push back to the legacy way of doing things, which is more expensive. I think investing more in home healthcare at home works—it’s compassionate, it’s cost effective, it’s what people want. It produces better outcomes in many, many cases, and it really needs defending and advocacy.”