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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

Senators Collins and Schumer Introduce Bill to Allow More Health Care Professionals to Certify Home Health Plans of Care

Legislation Would Affect Nurse Practitioners, Clinical Nurse Specialists, Nurse Midwives, and Physicians' Assistants
July 19, 2013 02:04 PM
Senator Susan Collins (R-ME)  told  March on Washington attendees that she would reintroduce the "Home Health Care Planning Improvement Act," which she did earlier this week. Said Collins, “tell your senators about the compassionate care you provide and the budgetary problems you face.”

Senators Susan Collins (R-ME), the Ranking Minority Member on the Senate Special Committee on Aging, and Charles Schumer (D-NY), who serves on the Senate Finance Committee with jurisdiction over Medicare, have introduced S.1332, the "Home Health Care Planning Improvement Act," which would allow nurse practitioners, clinical nurse specialists, nurse midwives, and physicians' assistants to certify Medicare home health plans of care.

Senator Collins has introduced the same legislation in past Congresses, and committed to NAHC members during the March on Washington earlier this year that she would reintroduce the bill during the 113th Congress. Representatives Greg Walden (R-OR) and Allyson Schwartz (D-PA) have introduced a companion bill in the House, which currently has 28 cosponsors.

Senator Collins has frequently lauded the important role these health care professionals have in health care delivery and said the legislation would help "ensure that our seniors and disabled citizens have timely access to home health services under the Medicare program." The National Association for Home Care & Hospice (NAHC) assisted with the preparation and drafting of this legislation and is helping gather support for its passage.

"Nurse practitioners, physician assistants, certified nurse midwives, and clinical nurse specialists are all playing increasingly important roles in the delivery of health care services, particularly in rural and medically underserved areas of our country where physicians may be in scarce supply," Collins said in arguing the need for this legislation.

In 1997, Congress authorized Medicare to begin paying for physician services provided by additional health professionals when the scopes of their services are within their scope of practice under state law.

Senator Collins pointed out that non-physician health care professionals often have the best understanding of and relationship with the patient. "Under current law, only physicians are allowed to certify or initiate home health care for Medicare patients, even though they may not be as familiar with the patient's case as the non-physician provider," she noted. "In fact, in many cases, the certifying physician may not even have a relationship with the patient and must rely upon the input of the nurse practitioner, physician assistant, clinical nurse specialist, or certified nurse midwife to order the medically necessary home health care."

The requirement that only a physician can certify a home health plan of care "adds more paperwork and a number of unnecessary steps to the process before home care can be provided," Collins contended. "It can lead to needless delays in getting Medicare patients the home health care they need," she said, "simply because a physician is not available to sign the form."

In a previous statement to the Senate – as well as in similar statements to NAHC and other groups - Senator Collins described the inability of non-physician providers to order home health care as "particularly burdensome for Medicare beneficiaries in medically underserved areas where these providers may be the only health care professionals available."

The Senator from Maine recounted a series of examples to illustrate the urgency of need for this change in home health care certification. In one of several cases she cited, a Medicare patient in Nevada had care delayed for over a week because a physician assistant was the only health care professional serving the patient's small rural town. The supervising physician was 60 miles away.

NAHC has long urged the adoption of this overdue reform. In addition to NAHC, AARP, the American Nurses Association, the American Academy of Physician Assistants, American Association of Nurse Practitioners, the American College of Nurse Midwives, and the Visiting Nurse Associations of America have all endorsed the Home Health Care Planning Improvement Act.

To learn more about H.R. 2504 - the House version of this bill - please click here for a previous NAHC Report article on the legislation.

NAHC encourages all of its members to contact their Senators and Representatives and ask them to become sponsors of this important piece of legislation.




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