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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

Home Delivered Meals Promote Rebalancing, Save States Money, Says Health Affairs

October 18, 2013 04:39 PM

Earlier this month, Health Affairs released a study titled “Providing More Home-Delivered Meals is One Way to Keep Older Adults with Low Care Needs out of Nursing Homes” (the Study).  In the Study, authors Kali S. Thomas and Vincent Mor of Brown University demonstrated how programs that deliver meals to seniors can transfer “low-care” senior out of nursing homes into the home and community.  The Study showed 26 out of 48 states seeing savings, which would approach $110 million.  Highlights of the Study are discussed below.

Background Data

The Study gave 2011 expenditures on home delivered meals as totaling approximately $769 million nationally.  Baseline data from 2009 showed that approximately 3 percent of senior citizens nationwide received home-delivered meals, with state percentages varying from a high of 8 percent in Wyoming to a low of less than 1 percent in Maryland. 

Also, in 2009, low-care nursing home residents accounted for approximately 13 percent of the nursing home population, with state percentages varying from a high of 28 percent in Illinois to a low of 1 percent in Maine.  The Study defined “low-care nursing home residents” as “those who neither require assistance with the five core activities of daily living nor fall into the Clinically Complex or Extensive Rehabilitation Resource Utilization Groups.”

Assumptions and Results

Given that the authors’ “previous work” showed a correlation between increased expenditures of home-delivered meals and a decrease in proportion of nursing home residents that are low-care, the authors assumed that many low-care nursing home residents can live in the home or community if given proper access to home-delivered meals. 

The Study used data from 2005 to 2009 to draw cost saving and utilization projections of home-delivered meals.  Projections showed that if a state increased its proportion of senior citizens who received home-delivered meals by only 1 percent, that state would experience a 0.2 percent decrease in its low-care nursing home resident population.  Also, a total of 1,722 dual eligible, low-care nursing home residents would be able to leave the nursing homes and enter the community.

As a result, total savings to all state Medicaid programs would be greater than $109 million, with half of all states saving $1 million or more, and ten states saving greater than $3 million. New York would stand to save the most ($11.4 million), while Wyoming would see the least savings ($173,000).  The authors of the Study stated that, “what we believe to be most important is that states’ savings will increase as the number of low-care cases they avoid increases.”


The Study suggested that home-delivered meals promote rebalancing.  The Study cited that 92 percent of recipients of home-delivered meals stated that these meals helped them to stay in their homes.  The authors argued that increased investment in home-delivered meals would thus reduce the amount of those that are permanently placed in nursing homes.

Quality of Life

The Study also argued that home-delivered meals improves the recipients’ quality of life and helps to maintain their independence.  Of recipients surveyed, 90 percent rated their level of satisfaction with the meals as good to excellent.  Further, the Study claimed that the drivers delivering the home-delivered meals serve an integral function to many of the recipients: they serve as a human contact for many who would otherwise be isolated.  Further, the drivers can also help check up on the recipients.

To access the Study, click here.  For an article on the Study, click here.


The National Council on Medicaid Home Care – a NAHC affiliate - supports the growth of home-delivered meals in Medicaid home care. As the Study demonstrates, such programs are both cost-effective and contribute to greater rebalancing and quality of life. Home care providers should note that the Council will continue to pursue greater payments for Medicaid home care generally. The Council also calls on state associations and other stakeholders to advocate on a state level to promote an increased integration and coordination of home-delivered meals through Medicaid or other funding source.  Home care providers are encouraged to keep abreast of developments with regard to home-delivered meals, and to contact the Council with any questions or concerns.




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