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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

Coalition’s Advocacy Letter Calls for Changes to NY Duals Program

October 22, 2013 11:49 AM

The Coalition to Protect the Rights of New York’s Dually Eligible (the Coalition) recently wrote an advocacy letter (the Letter) to the New York State Department of Health (NYSDOH) and the Centers for Medicare and Medicaid Services (CMS) requesting “a seat at the table” in upcoming contract negotiations for the Fully Integrated Duals Advantage (FIDA) program implemented in New York between CMS, NYSDOH, and the FIDA plans.  The resulting contract will be based on the basic framework of the Memorandum of Understanding (MOU) signed by NYSDOH and CMS in August. The highlights of the Letter are discussed below.

Passive Enrollment

More detail needed on passive enrollmentThe Coalition advocated for more detail on the structure and mechanics of passive enrollment. 

Transition Periods

180-day transition period needed.  The Coalition remarked that while Virginia and Illinois dual demonstration MOUs contain 180-day transition periods for allowing enrollees to maintain their current providers, New York’s MOU only allows for a 90-day transition period.  The Coalition recommended a 180-day transition period, as it claimed “that the communications and processes…between plans, providers and enrollees” need more than 90 days to occur.

Care Coordination

Conduct assessments in hospitals and rehabilitation facilities.  The Coalition recommended that, for enrollees receiving temporary care in hospitals and rehabilitation facilities, the contract should mandate that FIDA Plans conduct assessments in these settings, especially to determine if home and community-based services (HCBS) are appropriate.  The Coalition remarked that failing to do so in managed long term care results in enrollees seeing a delay in receipt of HCBS.

Specify care manager’s licensing and credentialing requirements.  The Coalition recommended that the contract contain “specific qualifications of the care manager, including licensure and credentialing requirements and necessary training.”

Transitions to the Home and Community

Incorporate measures to further promote HCBS. The Coalition criticized the MOU for not sufficiently encouraging HCBS, as it merely promotes referral to either the Money Follows the Person (MFP) program or the Pre-Admission Screening and Resident Review (PASRR) evaluations).  The Coalition recommended that the FIDA Plans take on the responsibilities of MFP contractors, determine HCBS eligibility, and find housing options for eligible enrollees.  FIDA Plans should also be required to report extensively on HCBS statistics.  For details, see page 4, here.  Finally, FIDA Plans should receive incentives (either positive, negative, or both) to assess those institutionalized and triage those eligible to the home and community. 


Create high risk pools before capitation rates.  The Coalition noted that the MOU will set the Medicaid rate component based on capitated rates from Medicaid managed care.  However, NYSDOH recognizes “high need cases” (i.e. those needing 24/7 community-based or split-shift care) necessitate additional “financial incentives” to the FIDA plans to avoid institutionalization.  Therefore, the Coalition argued that these pools should be created before capitation rates are set for the entire program in order to insure its success.

ADA Compliance

Incorporate more protective accommodation language.  The Coalition called for language in the contract to include “more concrete ADA compliance standards” for providers.


Implement state-based quality standards. The Coalition recommended a reporting system run by NYSDOH which is based on the quality withholds standards in the MOU.

Network Adequacy

Increase accessThe Coalition advocates that the FIDA Plans contract with providers in areas where such services are scarce and/or provide more detailed assistance for accessing out of network care where needed.

To see the full Letter, click ​here.  To see a previous Council brief on New York’s MOU with CMS, click here.


The National Council on Medicaid Home Care – a NAHC affiliate – offers the following analysis of the letter and its consequences:

Passive Enrollment Process. The Council agrees that there should be greater clarity regarding the methodology of passive enrollment.  The Council would appreciate further detail on how continuity of care and consumer protections will be preserved with this model.

Transition Period.The Council agrees that a 180-day transition period would be preferred over a 90-day transition period.  The Council has previously petitioned CMS for more robust care continuity and transition standards, here

Assessments/Transitions to Home and Community.The Council also supports these positions of the Coalition, as they further the Council’s primary objective to encourage re-balancing of long-term services and supports. 

Rates.The Council generally supports greater transparency and clarity with regard to the dual demonstrations rate setting calculations.  For example, the Council found that California does not provide adequate assurances that quality and access are not sacrificed as a result of achieving savings, and advised California to provide such assurances in order to protect this vulnerable patient population.  Click here for details.  With that said, the Council believes that overall, the duals demonstrations’ savings calculations appear arbitrary and lacking in transparency. 

Click here for the Council’s general recommendations.

While the duals demonstrations will transform the way that dual eligibles receive care, many unknowns remain for providers, and home care providers specifically.  The MOU does not cover how providers will be compensated. The MOU also does not mention if there are any quality standards to which home care providers will be held as part of the demonstrations. 

Notwithstanding persistent stakeholder concerns (see here, here, and here) regarding these demonstrations, home care providers can look to them as opportunities to increase clinical coordination among the dual eligible population.  In addition, these demonstrations will give home care providers rebalancing opportunities, as a stronger emphasis is placed on community based systems over institutional settings. 

Home care providers are encouraged to keep abreast of demonstration developments on CMS’ website, and to contact the Council with any questions or concerns.




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