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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

Senate Special Committee on Aging Holds Hearing on Advance Care Planning

July 17, 2013 07:57 AM

The Senate Special Committee on Aging recently held a hearing entitled “Renewing the Conversation:  Respecting Patients’ Wishes and Advance Care Planning.”  The hearing was held to examine the role of the Federal Government in encouraging individuals to talk about end-of life care preferences with their families, loved ones and health professionals.

The hearing’s witnesses were: James Towey, Founder, Aging with Dignity and President, Ave Maria University; Harriet Warshaw, Executive Director, The Conversation Project; Gloria Ramsey, RN, Associate Professor, Uniformed Services University of the Health Sciences; Amy Vandenbroucke, Executive Director, National Physician Orders for Life-Sustaining Treatment Paradigm Task Force. The National Association of Home Care & Hospice (NAHC) attended the hearing and recently published an article, “Considering the Conversation: How do We Want it to End?” in the April 2013 issue of CARING Magazine that also relates to this topic.

The witnesses all emphasized a common theme during the hearing – that physicians, patients and their families should routinely engage in dialog about plans for end-of-life care to ensure that the patient’s preferences are known and that a proper plan of care can be implemented.  Conversely, the witnesses emphasized that a lack of participation, planning or communication with respect to end-of-life care often leaves spouses, loved ones, or a proxy with emotional anguish and the stress of making vital medical decisions in times of need without knowing all of the patient’s preferences or care options.

Senator Susan Collins (R-ME), the Committee’s Ranking Minority Member, mentioned in her opening statement that 93 percent of Americans feel advanced care planning should be a priority, but only a small fraction of adult Americans have actually completed an advanced directive. “We are making some progress in meeting the wishes of those at the end of their lives.  More people over 65 are dying at home and in hospice care, and fewer are dying in hospitals,” said Collins. “While most Americans say that they would prefer to die at home, studies show that the vast majority still die in institutions where they may be in pain, and where they may be subjected to high-tech treatments that merely prolong suffering.”

Committee Chairman Bill Nelson (D-FL) concurred with Senator Collins – stating that only 29 percent of people report having end-of-life planning in their will. Senator Nelson suggested that “one option would be for the Centers for Medicare and Medicaid Services (CMS) to revisit its decision to remove advance care planning as something that could be reimbursed as part of the Medicare’s new annual wellness provisions.” Another suggestion Senator Nelson has was “for the Department of Health and Human Services to update research on advance directives, which was last done under the Bush Administration.”

Senator Nelson expressed his strong personal support for hospice care based on his own experiences seeing many of his family members utilize hospice services at the end of their lives.

Senator Collins mentioned in her opening statement her ongoing work and interest in end-of-life issues, referencing a bill that she introduced with Senator Rockefeller (D-WV) in 1997 entitled the “Advance Planning and Compassionate Care Act.” That bill would have facilitated dialogue about end-of-life issues and encouraged advance care planning by requiring every Medicare beneficiary receiving care in a hospital, nursing home, or other health care facility to be given the opportunity to discuss end-of-life care  - and the preparation of an advance directive - with an appropriately trained professional within the health institution.

During the hearing Mr. Towey advocated for an advance directive called Five Wishes, which is produced by Aging with Dignity. He stated that Five Wishes is in circulation around the world in 27 different languages among 35,000 partner organizations, including places of worship, hospitals, health systems, hospices, and other groups. Towey stated that Five Wishes is a tool that helps bring advance care planning out of the emergency rooms and into family living rooms to allow people to make important medical decisions on their own terms.

Amy Vandenbroucke, who testified on behalf of the National POLST Paradigm Program, noted the key differences between a POLST form and an advance directive in that a POLST form is a medical order rather than a legal document and is only intended for use by those with advance illness or frailty at any age, while an Advance Directive is for all competent adults over the age of 18, among other things.

Harriet Warshaw spoke of the Conversation Project’s national public engagement campaign to create a cultural paradigm shift so that it is no longer taboo for families and health care providers to engage in end-of-life conversations. One of the ways they intend to do this is by offering families a “Conversation Starter Kit.” Warshaw stated that 56 percent of adults in America have not communicated end-of-life wishes to their loved ones.

For more on this topic, a digital copy of the article “Considering the Conversation: How do We Want it to End” can be found by clicking here.

To watch the Aging Committee hearing on Advance Care Planning, or to read the materials submitted for the record, please click here.




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