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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

Congressional Budget Office Releases Options for Reducing the Federal Deficit

November 15, 2013 04:15 PM

The Congressional Budget Office (CBO) recently released a report that outlines several ways that Congress could act to reduce the Federal Deficit between 2014 – 2023. The CBO includes sixteen broad-based healthcare options within its proposal. Those options are:

  • Option 1 - Impose Caps on Federal Spending for Medicaid
  • Option 2 - Add a “Public Plan” to the Health Insurance Exchanges
  • Option 3 - Eliminate Exchange Subsidies for People With Income Over 300 Percent of the Federal Poverty Guidelines
  • Option 4 - Limit Medical Malpractice Torts
  • Option 5 - Introduce Minimum Out-of-Pocket Requirements Under TRICARE for Life
  • Option 6 - Convert Medicare to a Premium Support System
  • Option 7 - Change the Cost-Sharing Rules for Medicare and Restrict Medigap Insurance
  • Option 8 - Raise the Age of Eligibility for Medicare to 65 to 67
  • Option 9 - Increase Premiums for Parts B and D of Medicare
  • Option 10 - Bundle Medicare’s Payments to Health Care Providers
  • Option 11 - Require Manufacturers to Pay a Minimum Rebate on Drugs Covered Under Part D of Medicare for Low-Income Beneficiaries
  • Option 12 - Modify TRICARE Enrollment Fees and Cost Sharing for Working-Age Military Retirees
  • Option 13 - Reduce or Constrain Funding for the National Institutes of Health
  • Option 14 - End Enrollment in VA Medical Care for Veterans in Priority Groups
  • Option 15 - Reduce Tax Preferences for Employment-Based Health Insurance
  • Option 16 - Increase the Excise Tax on Cigarettes by 50 Cents per Pack 37

Some of the proposals cited by the CBO are of concern; NAHC has specifically opposed some of the proposed deficit reduction proposals in the past.

Most significantly, NAHC has developed in-depth arguments against the following proposals as they could limit access to affordable home health services and hospice care:

Option 1 - Impose Caps on Federal Spending for Medicaid

NAHC’s Legislative Blueprint for Action specifically addresses Medicaid caps, declaring that, “Congress should reject any consideration of placing caps on Medicaid spending and increase the federal match for state Medicaid programs, thereby bolstering efforts to bring states into compliance with the Olmstead decision.”

The rationale NAHC offers for opposing such caps to Medicaid is based on the fact that many states have begun to expand home and community-based alternatives to institutionalization in their Medicaid programs and that the federal government, through such programs as the New Freedom Initiative, has sought to facilitate this development. Federal assistance is essential to preserve and expand home and community-based care within the Medicaid program and help states to preserve their Medicaid programs with home and community-based care’s new, expanded role.

Option 7 - Change the Cost-Sharing Rules for Medicare and Restrict Medigap Insurance

NAHC has been very vocal in its opposition to changing Medicare’s cost-sharing rules to a system that would force upon beneficiaries a global deductible and copayment. Numerous groups have suggested such a proposal – including the Simpson-Bowles Commission on deficit reduction and several different proposals currently in Congress.

The primary objection that NAHC has to such a global deductible and copays is that, “Medicare beneficiaries who now receive home health services and hospice care without cost sharing would face significant financial obligations to access this care…The use of global cost sharing may have surface appeal, but it can act as a barrier to care that is less costly and clinically better than care in other settings.”

With respect to restricting Medigap insurance – usually referred to as prohibiting “first dollar coverage” – NAHC has stated in its Legislative Blueprint for Action that, “Medigap insurance should not be restricted as beneficiaries should have the right to protect themselves against the cost of health care.”

Option 10 - Bundle Medicare’s Payments to Health Care Providers

There have been a myriad of different proposals on how to bundle payments to health care providers. NAHC has opposed most of these proposals – where the bundled payment goes to hospitals and home care agencies are seen as tertiary – and has been more open to proposals where the bundled payment goes to the home health agency, which would be responsible for coordinating a patient’s care.

The Patient Protection and Affordable Care Act (ACA) called for launching a post-acute care bundling pilot program by 2013. Among the bundling options that is being tested is one where the bundled payments for post-acute services would be held by home health agencies. NAHC encourages this pilot program, and urges Congress’ support.

With the Congressional Conference Committee still in negotiations on a budget resolution, these and other proposals will likely be on the table. NAHC encourages all of its members to contact their elected officials and urge them to support home care and hospice by rejecting any additional cuts or copays to the Medicare home health and hospice programs.

To read the CBO’s full report, please click here.

To read NAHC’s Legislative Blueprint for Action, please click here.

To take action and write your legislators, please click here.




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