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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

NAHC Testifies Before the House Education and Workforce Committee’s Subcommittee on Workforce Protections Regarding the Companionship Exemption

Vice-Chair Lucy Andrews emphasizes the consequences that the Department of Labor’s Final Rule on Companionship Care will have on the Home Care & Hospice Community
December 3, 2013 09:15 AM

The House Education and Workforce Committee Subcommittee on Workforce Protections recently held a hearing entitled, "Redefining Companion Care: Jeopardizing Access to Affordable Care for Seniors and Individuals with Disabilities." The focus of the hearing was the Department of Labor’s recent Final Rule on the Companionship Exemption for home care workers.

For more on the Final Rule, please see NAHC Reportfrom September 18, 2013.

Lucy Andrews, RN, NAHC’s Board Vice-Chair was one of the witnesses. Ms. Andrews was joined be her fellow witnesses Mr. Joseph Bensmihen, President and CEO of United Elder Care Services, Inc; Ms. Karen Kulp, President and CEO, Home Care Associates; and Mr. Alexander J. Passantino, Senior Counsel, Seyfarth Shaw LLP.

 In his opening remarks, Chairman Tim Walberg (R-MI) stated that:

“For nearly 40 years Congress has recognized the invaluable service delivered by in-home companion care workers…Congress deliberately exempted in-home companion care workers…Policymakers realized many Americans rely upon the support of companion care workers in order to maintain a safe, healthy, and productive lifestyle in their own homes.

The need for in-home companionship care is tremendous, especially among elderly and disabled individuals. Roughly 57 percent of people receiving these services are age 65 or older and approximately 73 percent have functional limitations. The intent of Congress was to protect a vulnerable group of Americans, yet that protection is being discarded by the Obama administration.”

Later in the hearing, Chairman Walberg reiterated his own experience with home care workers who were companions to his mother for “over two years.”

Ms. Andrews was the first witness to testify, and emphasized the problems that home care agencies will face under the Department of Labor’s Final Rule:

“The U.S. Department of Labor has issued a Final Rule that dramatically changes longstanding overtime compensation exemptions that would effectively eliminate the application of the exemptions for home care services. Specifically, the rule redefines “companionship services” to limit the application of the exemption to primarily “fellowship.” “Fellowship” is not care and does little or nothing to keep people out of nursing homes or higher acuity facilities…

Based on our experiences in states that previously have required overtime compensation to personal care workers, we believe that the rule will trigger the following:

  • Moderate to significant increases in care costs

  • Restrictions in overtime hours to the detriment of the workers’ overall compensation
  • Loss of service quality and continuity
  • Increased costs passed on to the patients and public programs such as Medicaid that would decrease service utilization, increase unregulated “grey market” care purchases, and increase institutional care utilization rather than absorbing and covering the higher cost of care.

With the requirement for overtime compensation, I will either need to restrict their working hours or increase my charges to my clients.

If I raise the charges to my clients, I know that most will then limit the amount of care they purchase even if it is to a level less than needed. For clients on fixed incomes, the cost of increasing care will be too much for them to carry and they will look to other options, going with less care or using the underground market that, at best, leaves them with a stranger caring for them without the protections a third party employer offers. By default, the consumer will become the employer of record with all of the employer responsibilities and risks.

If I restrict the employees’ working hours, they will be paid less than they get today. For example, a client who has 10 hours of care a day will either have to pay the overtime or have two caregivers dividing the 10 hours into two shifts. This decreases the hours each employee work and decreases the continuity of care clients are used to when paying privately for care services.

Another option is that I reduce the employees’ base hourly wage to accommodate overtime costs.

Either approach will likely lead to higher turnover in my caregiving staff, increasing my costs of recruitment and training of new employees. Our industry is already struggling with high turnover rates and a cut in pay puts us at the bottom of the list of desirable work. Ultimately, it impacts access to the care that the increasing numbers of Baby Boomers and the disabled community rely on to stay at home.”

One of the four panelists, Karen Kulp, was in favor of the Final Rule, while Ms. Andrews, Mr. Bensmihen and Mr. Passantino emphasized the negative consequences of the Final Rule.

The hearing is a strong indication that the issues involving home care and the overtime exemption changes will not be allowed to go away easily. Despite the issuance of the Final Rule, the House committee is not giving up on finding better ways to protect both the workers and the vulnerable elderly and disabled that they provide care. Further, as noted by Congressman Joe Courtney (D-CT), who favors the rule change promulgated by the Department of Labor, the effective date of January 1, 2015 provides an opportunity to have the Department fix any of the problematic aspects of the rule.

NAHC and other organizations continue to work to remedy the challenges presented by the new rule. Discussions have occurred with federal Medicaid officials designed to find solutions to the likely cost and rate pressures that the rule will instigate in Medicaid home care. Also, the Government Accountability Office (GAO) is engaged in an analysis of the rule and its process of development. Finally, litigation is under serious consideration among the stakeholders rom the provider and disability communities.

For more information on the hearing, please click here.

To read Ms. Andrews’ full testimony, please click here.




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