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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

AARP Releases Article on Home and Community-Based Services

August 23, 2013 08:58 AM

On August 19th, AARP released an article entitled Home- and Community-Based Services [HCBS]: The Right Place and the Right Time,” where it called on the federal Commission on Long-Term Care (the Commission) to embrace HCBS.

Cost Effectiveness of HCBS

The article provided ample support for the cost effectiveness of HCBS over institutionalization.  For example, it cited that the cost of institutionalizing one person with physical disabilities in a nursing home is equal to the cost of providing HCBS to three such people.  Citing its own March 2009 and March 2013 studies, AARP mentioned that not only was HCBS cost effective, but it has slowed Medicaid cost growth even while including more people. 

Mixed Results of Rebalancing

The article painted a mixed picture of rebalancing.  Some states have now met the objective of rebalancing by spending over half of their Medicaid LTSS budgets on HCBS; these include Texas, California, Alaska, Oregon, Minnesota, Washington, and New Mexico.  However, the other states have not met this benchmark.  According to AARP’s LTSS Scorecard, in 2011, the percentages spent on HCBS varied from 64 percent (New Mexico) to 11 percent (North Dakota).  The median percentage for all states, according to the Scorecard, was only 30%.  

Rebalancing has also occurred much more successfully in younger than older people.  Citing Diane Rowland of the Kaiser Family Foundation’s recent testimony to the Commission, HCBS amounted to 63% of Medicaid LTSS spending in younger people, but only 28% for those over 65.

The Impact of Benchmarking

The article further commented that its rankings have had an impact on behavior.  When AARP ranked Tennessee as the worst in rebalancing, with only 1 percent of spending going towards HCBS in 2006, the state decided to take action.  From 2005 to 2010, the state’s spending on HCBS has increased by a factor of ten.  Now, Tennessee’s Medicaid Director, Patti Killingsworth, is calling on national Medicaid reform in favor of HCBS.

For the full AARP article, click here.

For previous briefs on HCBS from the National Council on Medicaid Home Care, a NAHC affiliate, click here and here.


The push towards rebalancing Medicaid spending to HCBS continues with full force. While there is a lot of work still to do, progress continues. Council encourages providers to continue to advocate in their state associations, as well as state and federal governments for greater support of HCBS. The Long-Term Care Commission has been deluged with advocates all demanding that reforms give the highest priority to access to HCBS. Home care providers are encouraged to keep abreast of HCBS developments in their states, and nationally, and to contact the Council with any questions or concerns.




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