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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

House Small Business Subcommittee on Health & Technology Holds Hearing on the ACA Provision Defining 30 Hours as “Full Time”

NAHC Submits Testimony Addressing Consequences for Home Care & Hospice and Urges Support for Legislation Defining Full Time as 40 Hours
October 16, 2013 08:45 AM

The House Small Business Committee Subcommittee on Health & Technology recently held a hearing entitled, “The Effects of the Health Law’ Definition of Full-Time Employee on Small Businesses.” The subject of the hearing was a provision in the Affordable Care Act (ACA) that would define a “full time” employee as a person who works 30 hours a week rather than 40 hours a week, which is the standard definition of a “full time worker” in most cases. 

Currently the provision in the ACA that imposes penalties on employers with more than 50 full-time equivalent employees for not providing health insurance for their “full time” workers defines an employee working just 30 hours a week as full time.  This definition of full time is entirely out-of-keeping with standard employment practices across the country. 

Raymond J. Keating, Chief Economist, Small Business & Entrepreneurship Council; Steven Hermann, Vice President, Paul's Supermarket, Inc.; Stephen Bienko, President, Owner, Bienko Enterprises and Dean Baker, Co-Director, Center for Economic and Policy Research served as the hearing’s four witnesses and represented both industries that would be affected by the 30 hour provision as well as policy experts who shared differing opinions on what the true effect of the 30 hour rule would mean.  

In its testimony submitted for the record, the National Association for Home Care & Hospice (NAHC) stated that:

“The majority of personal care home care workers do not receive employee health insurance because home care agencies have three problems that are fairly unique: reliance on government programs such as Medicaid where payment rates as low as $11 an hour won’t cover the increased costs of providing health insurance; consumers of private pay home care that are often elderly and disabled with fixed low incomes; and a home care workforce with widely varying work hours primarily to accommodate the needs of their infirm clientele.

Home care agencies that are unable to provide health insurance or absorb the ACA penalties will have to restrict their employees to no more than 29 hours per week to ensure their workers are considered part-time under the ACA.  A survey that NAHC conducted earlier this year showed two-thirds of the private pay home care companies and three-quarters of the Medicaid home care companies are expecting to reduce working hours of staff to avoid the penalties. Millions of home care workers could find their hours, and thus their earnings, are cut back at a time when many of them are already struggling.”

NAHC’s testimony included comments from Patricia M. Krall-Dwyer, CEO of Health Force in Cheektowaga, NY. Ms. Krall-Dwyer’s statement reiterates the consequences this rule will have on the home care & hospice community, explaining that:

“Due to the continuing cuts to our reimbursement rates our agency has to remain very lean administratively to continue to operate in this current environment.  Increasing the hourly requirement to 40 hours to be considered a full time employee will accomplish a number of benefits and allow for the spirit of the Affordable Care Act to be implemented.  By using a 40 hour work week to define full time, our organization would be able to comply with the mandate without having to add an additional FTE to enforce compliance and would incent our team members to increase their hours to access affordable coverage instead of reducing hours to avoid it.  

Implementing this change could reduce our costs by nearly 40%.  We do not have other departments to help us absorb the costs of tracking, monitoring, yet another individual mandate.  We track our employees for 40 hours for overtime.  We track our employees for 40 hours for vacation.  This mandate of 30 hours will mean a massive IT overhaul and redevelopment of compliance processes.  Most small agencies do not have an IT department; it's us on the Internet trying to figure out how to adjust our computers.

It truly is small businesses that run this country. During the last economic period, it was small businesses that added jobs.  It was small business that increased economic growth.  I ask that Congress please not add us to the endangered species list.”

The same issues that affect the home care & hospice community are affecting many  other small business groups across the country – several of whom were represented during the hearing. Steven Hermann, representing the National Grocers Association (NGA), testified that:

“Employers are likely to hire fewer employees, especially full-time employees, learning to do more with fewer workers in order to control costs. Not only is the law redefining what it means to be a full-time worker in this country, but it’s permanently changing the American workforce by interfering with part-time workers’ ability to earn a living. Part-time employees in need of additional money may no longer be able to pick up an additional shift to pay for unexpected expenditures or earn extra money around the holidays.”

Similar to both NAHC’s concerns and those of the NGA, Stephen Bienko, a member of the International Franchise Association, told the Subcommittee that by,

“Defining full-time as 30 hours, will cause many employers - like me – to simply alter their employees’ hours in order to run a successful small business. This puts all of us at a loss; employers must implement new workforce management methods, and some team members will receive fewer hours and reduced take-home pay, not to mention they will still be ineligible for employer-sponsored health coverage.”

In order to prevent the 30 hour provision from going into effect and the consequences it would have on small businesses of every type in every sector of the economy, Senator Susan Collins (R-ME) introduced S. 1188, the Forty Hours is Full-Time Act, earlier this year.

The bill aims to modify the provisions in the Affordable Care Act (ACA) that define a “full-time employee” as someone who works thirty hours a week. S.1188 would allow employees to work more than 30 hours a week without triggering penalties under the ACA on the businesses that hire them.

For more on Senator Collins’ introduction of S. 1188, please see NAHC Report, from July 23, 2013.

S. 1188 currently has ten cosponsors and two companion pieces of legislation in the House of Representatives that aim to achieve the same result: H.R. 2575 was introduced by Congressman Todd Young (R-IN) and currently has 155 cosponsors. H.R. 2988 was introduced by Congressman Dan Lipinski (D-IL) and currently has eight cosponsors.

Home care agencies that are unable to provide health insurance or absorb the ACA penalties will have to restrict their employees to no more than 29 hours per week to ensure their workers are considered part-time under the ACA.  Millions of home care workers could find their hours, and thus their earnings, are cut back at a time when many of them are already struggling.

NAHC members are encouraged to contact their members of Congress and ask them to support legislation to amend the ACA to change the definition of full time to forty hours. To send a message through the NAHC Legislative Action Network, click here.

For more information on the hearing, please click here.

To read NAHC’s testimony, please click here.




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