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In the various roles he has undertaken through the years, Val J. Halamandaris has been a singular driving force behind the policy and program initiatives resulting in the recognition of home health care as a viable alternative to institutionalization. His dedication to consumer advocacy, which enhances the quality of life and dignity of those receiving home health care, merits VNA HealthCare Group’s highest recognition and deepest respect. 

VNA HealthCare Group

I have the highest respect for them, especially for the nurses, aides and therapists, who devote their lives to caring for people with disabilities, the infirm and dying Americans.  There are few more noble professions.

President Barack Obama

Home health care agencies do such a wonderful job in this country helping people to be able to remain at home and allowing them to receive services

U.S. Senator Debbie Stabenow (D-MI) Chair, Democratic Steering and Outreach Committee

Home care is a combination of compassion and efficiency.  It is less expensive than institutional care...but at the same time it is a more caring, human, intimate experience, and therefore it has a greater human’s a big mistake not to try to maximize it and find ways to give people the home care option over either nursing homes, hospitals or other institutions

Former Speaker of the U.S. House of Representatives Newt Gingrich (R-GA)

Medicaid covers long-term care, but only for low-income families.  And Medicare only pays for care that is connected to a hospital discharge....our health care system must cover these vital services...[and] we should promote home-based care, which most people prefer, instead of the institutional care that we emphasize now.

Former U.S. Senator Majority Leader Tom Daschle (D-CD)

We need incentives to...keep people in home health care settings...It’s dramatically less expensive than long term care.

U.S. Senator John McCain (R-AZ)


Home care is clearly the wave of the future. It’s clearly where patients want to be cared for. I come from an ethnic family and when a member of our family is severely ill, we would never consider taking them to get institutional care. That’s true of many families for both cultural and financial reasons. If patients have a choice of where they want to be cared for, where it’s done the right way, they choose home.

Donna Shalala, former Secretary of Health and Human Services

A couple of years ago, I spent a little bit of time with the National Association for Home Care & Hospice and its president, Val J. Halamandaris, and I was just blown away. What impressed me so much was that they talked about what they do as opposed to just the strategies of how to deal with Washington or Sacramento or Albany or whatever the case may be. Val is a fanatic about care, and it comes through in every way known to mankind. It comes through in the speakers he invites to their events; it comes through in all the stuff he shares.

Tom Peters, author of In Search of Excellence

Val’s home care organization brings thousands of caregivers together into a dynamic organization that provides them with valuable resources and tools to be even better in their important work. He helps them build self-esteem, which leads to self-motivation.

Mike Vance, former Dean of Disney and author of Think Out of the Box

Val is one of the greatest advocates for seniors in America. He goes beyond the call of duty every time.

Arthur S. Flemming, former Secretary of Health, Education, and Welfare

Val has brought the problems, the challenges, and the opportunities out in the open for everyone to look at. He is a visionary pointing the direction for us. 

Margaret (Peg) Cushman, Professor of Nursing and former President of the Visiting Nurses Association

Although Val has chosen to stay in the background, he deserves much of the credit for what was accomplished both at the U.S. Senate Special Committee on Aging, where he was closely associated with me and at the House Select Committee on Aging, where he was Congressman Claude Pepper’s senior counsel and closest advisor. He put together more hearings on the subject of aging, wrote more reports, drafted more bills, and had more influence on the direction of events than anyone before him or since.

Frank E. Moss, former U.S. Senator

Val’s most important contribution is pulling together all elements of home health care and being able to organize and energize the people involved in the industry.

Frank E. Moss, former U.S. Senator

Anyone working on health care issues in Congress knows the name Val J. Halamandaris.

Kathleen Gardner Cravedi, former Staff Director of the House Select Committee on Aging

Without your untiring support and active participation, the voices of people advocating meaningful and compassionate health care reform may not have been heard by national leaders.

Michael Sullivan, Former Executive Director, Indiana Association for Home Care

All of us have been members of many organizations and NAHC is simply the best there is. NAHC aspires to excellence in every respect; its staff has been repeatedly honored as the best in Washington; the organization lives by the highest values and has demonstrated a passionate interest in the well-being of patients and providers.

Elaine Stephens, Director of Home Care of Steward Home Care/Steward Health Systems and former NAHC C

Home care increasingly is one of the basic building blocks in the developing system of long-term care.  On both economic and recuperative bases, home health care will continue to grow as an essential service for individuals, for families and for the community as a whole.

Former U.S. Senator Olympia Snowe (R-ME)

NCOA is excited to be part of this great event and honored to have such influential award winners in the field of aging.

National Council of Aging

Health care at home…is something we need more of, not less of.  Let us make a commitment to preventive and long-term care.  Let us encourage home care as an alternative to nursing homes and give folks a little help to have their parents there.

Former President Bill Clinton

California House Democrats Sign Letter Criticizing Dual Eligible Initiative

June 14, 2013 02:08 PM

On June 4, fourteen House Democrats from California wrote a letter to Marilyn Tavenner, Administrator of the Centers for Medicare & Medicaid Services (CMS), criticizing the state’s recently approved Memorandum of Understanding (MOU) with CMS to coordinate care for dual eligibles (the Demonstration). The effort was led by Rep. Linda Sanchez, and co-signed by House Energy and Commerce ranking member Henry A. Waxman. Primarily, the letter’s arguments involved issues of the Demonstration’s timeframe and scope, network adequacy and readiness, and savings rate calculations. The Demonstration has been delayed several times, and is currently set to start by January 2014 at the earliest.

Timeframe and Scope

While appreciating the fact that the Demonstration delays implementation in Los Angeles County, the letter criticized that statewide, “the timeframe and scope are not conducive to a seamless transition [from fee-for-service (FFS) to managed care] for beneficiaries.” Citing provider and beneficiary groups, the House members stated that providers are not prepared to absorb the approximately 250,000 duals into the Demonstration. They also questioned their ability to timely educate beneficiaries, caretakers, and providers on the Demonstration. Finally, the letter stated that the moving of 875,000 children from the California Healthy Families Program to MediCal and the rollout of the Affordable Care Act in California generally makes it extremely challenging to also adopt the Demonstration if the latter is not delayed.

Network Adequacy and Readiness

The letter also mentioned that both providers and beneficiaries are concerned about network adequacy and readiness. House members mentioned one organization, HealthNet, who dropped a large provider from its network shortly after signing on to the Demonstration in LA County. The letter complained of insufficient networks generally, and advocated that CMS closely monitor the Demonstration’s networks to make sure they are adequately established and that providers are sufficiently educated to address the needs of the dual eligible population.

While recognizing the “limited continuity of care for patients with pre-existing physician relationships,” the letter questioned the capacity of the Demonstration to give each beneficiary a needs assessment within a year of implementation. The letter called for CMS to mandate that states have concrete plans for assessments, and for CMS to ensure that there are enough providers to conduct the assessments. The letter questions the ability of plans to conduct care management without sufficient needs assessments.

Savings Rate Calculations

The letter, echoing provider and patient concerns, called the savings rate calculations in the Demonstration “overly ambitious and arbitrary” that “will simply encourage plans to pare down care, rather than providing beneficiaries with the complete array of services that they will need.” The letter also expressed concern with that the drive for savings will negatively impact quality of care, and criticizes the lack of information available regarding rate calculation.

To see a press release issued by Rep. Linda Sanchez’s office, along with the full letter to Ms. Tavenner, click here. To see the Council’s analysis of the Demonstration in California, click here.


While there are currently six states including California that have signed on to the Demonstration, many others have been dropping or delaying implementation. Concerns of timeliness and scope, network adequacy and readiness, and savings rate calculations have caused stakeholders attempt to mitigate implementation in California.

That said, home health providers can still look to the Demonstration as an opportunity to increased clinical coordination among the dual eligible population. In addition, the Demonstration will give home health providers rebalancing opportunities, as a stronger emphasis is placed on community based systems over institutional settings. Home health providers are encouraged to keep abreast of Demonstration developments on CMS’ website, and to contact the Council with any questions or concerns.




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