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National Association for Home Care & Hospice
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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/HAA Respond to Recent Misleading Article About Hospices in the Washington Post

January 7, 2014 10:21 AM

The Washington Post recently published an article entitled, “Hospice firms draining billions from Medicare.”  The Hospice Association of America (HAA) – a National Association for Home Care & Hospice (NAHC) affiliate – took umbrage with many of the article’s implications and offered a detailed response in the form of a Letter to the Editor signed by Carla Braveman, RN, MED, CHCE.  Braveman has served as Chair of HAA and as the Hospice Representative to the NAHC Board of Directors for the last four years.

NAHC delayed publication of its response to maximize the potential that the Letter to the Editor would be printed in the Post.  While Ms. Braveman’s letter was not published, it is supplied below in its entirety:

To the Editor:

Hospice care is highly regarded by patients, families, and health practitioners alike because it provides effective comfort, relief, and support to terminally ill individuals and their loved ones.  We read with great concern your recent investigative report, “Hospice Firms Draining Billions from Medicare”   (Washington Post, Dec. 26, 2013).  The article implies that hospices are taking advantage of the Medicare program on a widespread basis by admitting patients who “aren’t actually dying” and keeping those patients on service in order to reap profits —an implication we believe to be far from the truth.  It has been my experience that the great majority of hospice providers ethically fulfill their mission of caring for the dying, not bending the rules for profit.  And while Medicare bases eligibility requirements on a six-month prognosis, recent data from the Medicare Payment Advisory Commission (MedPAC) indicates that the average length of stay in hospice is less than 90 days.  Additionally, hospices throughout the nation report that the incidence of patients coming onto hospice care in the last few days of life has increased dramatically.  This means that patients and/or their families are delaying care beyond the point at which hospice can provide the greatest benefit.  This also means that many of these same patients may be utilizing intensive, costly and futile care that separates them from family and friends, provides little benefit, and diminishes quality of life in their final days. 

We also take issue with the authors’ premise that data from the state of California is typical of the nation as a whole.  Health care practices vary widely by geography, including end of life care, Extrapolation of data from one state to the entire country fails to recognize this known phenomenon.  Additionally, we believe it is important to recognize that live discharges from hospice occur for a wide variety of reasons – those of us working in hospice are very familiar with the circumstances under which patients or family members decide that they have acted too soon and should pursue curative care.  It is also frequently the case that a patient may enter hospice but actually improve as the result of the expertise and care rendered by the hospice team.  Hospices address these situations through education of the patient about their improved condition, and discharge the patient to more appropriate care.

The Medicare hospice benefit is currently undergoing considerable change.  As mentioned in the article, the Centers for Medicare & Medicaid Services (CMS) has taken numerous steps in recent years to increase accountability, and is conducting a thorough review of the payment system with the goal of addressing inappropriate incentives.  We strongly support efforts to safeguard the hospice benefit against inappropriate use.  At the same time, it is essential that these efforts be undertaken with great care.  In contrast to the 8.7 percent figure cited in the article, most recent MedPAC data estimates hospice Medicare financial margins for 2014 at 7.8 percent.  This figure excludes the impact of the 2 percent sequester and the cost of numerous nonreimbursable services offered by hospice programs (for example, family bereavement for 13 months following death; volunteer programs; massage, music and other therapies).  If the costs of these many services were included they would significantly reduce the average margin for hospice.

We must all do our part to ensure that hospice remains a viable choice for terminally ill patients and their loved ones.  Articles of this type may unwittingly discourage use of hospice care, thereby denying terminally ill patients and their families access to vital services that support and comfort them during and in the aftermath of one of life’s most difficult journeys.    Under these circumstances, no one is well served.  




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