Skip to Main Content
National Association for Home Care & Hospice
Twitter Facebook Pintrest


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

AARP Report Details LTSS Utilization in the Great Recession

July 26, 2013 02:07 PM

On July 16, 2013, AARP released a report entitled At the Crossroads: Providing Long-Term Services and Supports at a Time of High Demand and Fiscal Constraint (the Report).  The National Council on Medicaid Home Care, a NAHC affiliate, analyzes the Report’s major Medicaid-related findings.

Poor Economic Factors Threaten LTSS Utilization

The Report highlighted several economic trends that pose a threat to Medicaid LTSS utilization: 1) sixteen states project below 2007-level tax revenues for 2013; 2) many states, especially in the South and West, have not seen pre-recession tax revenues; and 3) states are continuing to cut staff. 

For details, see pages 4-9, here.

HCBS Waivers and Expenditures Projected to Increase

According to the Report, 36 out of the 47 states that responded stated that HCBS waiver recipients increased from 2011 to 2012, and 34 out of the 47 states projected the same for 2012 to 2013.  Out of the 44 states that responded, 34 stated that HCBS expenditures increased from 2011 to 2012, with 37 projecting the same for 2012 to 2013. 

For details, see pages 10-12, here.

Nursing Facility Population is Decreasing or Remaining Flat

In most states, the Medicaid nursing facility population is either decreasing or remaining stable.  However, 28 percent of the states surveyed did report an increase in this population in 2012.  

For details, see pages 12-13, here.

States are Adopting the ACA’s HCBS Options 

The Affordable Care Act (ACA) created or amended several HCBS options, including: health homes, improved care coordination for dually eligible individuals (Duals Coordination), Section 1915(i) Medicaid State Plan Amendment (1915(i) Amendment), Balancing Incentive Program (BIP), and Community First Choice Option (CFC).  Over 30 states are at least implementing health homes, 34 states are have or plan to implement Duals Coordination, 22 states are at least considering 1915(i) Amendments, 19 states are at least considering BIP, and 16 states are at least considering CFC.  For the full details, see page 21 and 24-29, here.

Duals Coordination Dominated by Managed Care

Twenty five out of the 33 states that described their duals coordination initiatives stated that they are adopting a risk-based managed care (RBMC) model, with only seven states adopting a managed fee-for-service (MFFS) or primary care case management (PCCM) model, and one describing an accountable care organization (ACO) model.  Rhode Island and Washington are implementing a hybrid RBMC/MFFS model. 

For details, see page 21-23, here

To see a Council article on an April AARP study on duals and on which the Report’s findings are based, click here.


States are undergoing cost containment strategies at a time where LTSS demands are on the rise.  In part to reduce costs, states have been moving towards RBMC models and emphasizing integration of care for dual eligibles.  Home care providers should continue to advocate for greater LTSS and HCBS - not only has demand for these services increased, but the current economic reality creates an opportune time for greater implementation of cost-effective HCBS models over institutionalization. 

Home care providers should continue to monitor developments in their states, and contact the Council with questions or concerns.






©  National Association for Home Care & Hospice. All Rights Reserved.