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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

A Care Model for Children with Complex Medical Needs

August 8, 2013 04:03 PM

The Children’s Hospital Association issued a special report that examines children with medical complexities (CMC) and the gaps that currently exist in meeting the needs of these children.

The report, The Landscape of Medical Care for Children with Medical Complexities, distinguishes children with complex medical needs from those with special needs in that CMC have more intensive health care needs.  Although our health care system has been designed to meet the needs of special needs children they do not adequately meet the needs of children with medical complexities.

As a result, care for this unique pediatric population is often fragmented, uncoordinated, crisis-driven and has a tendency to over-medicalize - while failing to support the family and caregivers. 

The report outlines three key areas needed for reform:

  1. Clear definitions of who CMC are, and what are their core health care needs;
  2. Identification of what evidence-based care processes have the greatest impact on their health and functional outcomes; and
  3. Determination of what amount of cost savings, if any, might be achievable with improved health care delivery.

Although there is no standard definition of medical complexity, four cardinal domains characterize CMC:

  1. Chronic, severe health conditions;
  2. Substantial health service needs;
  3. Major functional limitations;
  4. High health resource utilization.

CMC likely represent less than 1% of all children, yet they account for over one-third of pediatric health care costs. Inpatient care is responsible for as much as 80% of health care cost for CMC and use of the hospital is increasing for CMC over time. It is hypothesized that some inpatient utilization for CMC could be avoided with better ambulatory care.

The ideal model of care for CMC is suspected to be one that:

  • Provides urgent care in the outpatient setting to treat acute health problems;
  • Contains at least one outpatient provider who comprehensively addresses acute and chronic medical, functional and psychosocial needs;
  • Coordinates decision making among all participating health care providers;
  • Develops effective, proactive plans of care to maximize the child’s well-being and proactively anticipates health problems that are likely to occur.

Pediatric home care providers routinely provide care to children with complex medical needs using components of the care model outlined in the report.  The holistic approach to care delivery that is inherent in home health care will allow pediatric home care providers to be valuable partners with other community providers striving to provide adequate care to CMC.

The Pediatric Home Care Association of America, a NAHC affiliate, values the  research and ideas in the report and will continue to advocate  for the children in the community and for these medically fragile children.

To view the entire report click here.

The Landscape of Medical Care for Children with Medical Complexities.

Jay G. Berry, MD, MPH;1 Rishi K. Agrawal, MD, MPH;2 Eyal Cohen, MD, MSc;3 Dennis Z. Kuo, MD, MHS4

1 Boston Children’s Hospital, Harvard Medical School, Boston, MA;2 Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University School of Medicine, Chicago, IL

3 The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada

4 Arkansas Children’s Hospital, University of Arkansas for Medical Sciences, Little Rock, AR





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