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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

Addus Partners with Two Illinois Plans to Provide Smartphones to Home Care Aides

January 24, 2014 02:46 PM

Earlier this month, Aetna Better Health of Illinois (Aetna) and IlliniCare Health Plan (IlliniCare, a subsidiary of Centene Corp.) issued press releases announcing respective partnerships with Addus HealthCare (Addus) for a pilot study (the ICP Pilot) to provide Smartphones to home care aides (HCAs) serving Medicaid beneficiaries enrolled in Illinois’ Integrated Care Program (ICP). 

The ICP is mandatory Medicaid managed care for Seniors and Persons with Disabilities in Illinois, covering Lake, Dupage, Will, Kankakee, Kane and suburban Cook counties when launched in 2011.  The program initially encompassed only acute medical service but effective February 1, 2013, the ICP was expanded to cover long-term services and supports (LTSS) as well.  The National Council on Medicaid Home Care – a NAHC affiliate - interviewed representatives from both Addus and Aetna for details on the project and the ICP. IlliniCare could not be reached in time for publication.


Addus continues to embrace new, innovative technology including Smartphones as part of an Electronic Visit Verification (EVV) system to continually improve client care outcomes.   EVV is a time keeping system in which home care workers can clock in and out of their appointments using these devices.  In the ICP Pilot, Smartphone technology is used for basic EVV but also expanded to support Addus’ methods to improve client care.    The ICP Pilot marks Aetna’s first partnership with a Medicaid home care network provider to use technology to improve care outcomes.

Aetna began managing waiver services for its members when the ICP expanded to include LTSS in February 2013.  Aetna recognized that Addus had deployed a unique technology-enabled model of care for its HCAs and sought to develop an innovative partnership, leveraging technology deployed for EVV as relevant for new applications, such as supporting the HCA workforce to improve client care.  Addus and Aetna implemented the launch of the pilot in the fourth quarter of 2013.


Currently, the pilot is active in the original counties that went live with ICP LTSS on February 1, 2013: DuPage, Kane, Kankakee, Lake, Will, and suburban Cook counties.   Aetna intends to expand the pilot into Chicago this spring when the ICP program expands. 

In the ICP Pilot, Addus has approximately 175 HCAs working with over 200 clients enrolled in the two health plans.  Of these, Aetna has approximately 110 members served by 85 different Addus HCAs who use Smartphones.


Both Aetna and Addus agree that purpose of the pilot is to create a partnership between provider and plan to improve clinical outcomes in home care.  This is achieved through best preparing HCAs to observe, identify, and report timely changes in condition.  Clinically, the ultimate goal is to improve care outcomes by decreasing hospitalizations, readmissions, and ED visits. Additional goals include promoting better client compliance with care plans, and to eventually encourage more preventative health care appointments by the client.


Addus representatives found that the Smartphone technology has a great capacity for improving care efficiency, as well as supporting basic EVV capabilities such as scheduling, payroll, and billing. 

The Smartphone’s most basic function is to communicate schedules with the HCAs, not only for the day, but going forward.  The schedule flows through the Smartphone and tells HCAs the address of their visits, and has them clock in and clock out for each appointment.  For every client, an Addus employee inputs the individualized care plan and particular tasks (Activities of Daily Living, or ADLs, and Instrumental Activities of Daily Living, or IADLs) into the central database.  This information flows through the system, and appears on the Smartphone.  To indicate whether the tasks were completed, the HCA clicks “yes,” “no,” or “client refused” for each task, as well as why a task, if applicable, was not completed.  By this means, the HCA is able to document specific tasks according to care plan. 

Change in condition questions

Another basic function of the Smartphone is a set of change in condition questions.  These questions allow the HCA to report on a change in client condition that could include physical, cognitive, or environmental conditions.  As the HCA clocks out of a visit, the Smartphone prompts her or him to provide information on the client.  This information flows back to Addus and the client’s Health Plan for evaluation and intervention.

Case Management

Aetna assigns a care coordinator for its members, who visits each member every 90 days.  Some subsets of members receive more frequent visits as needed.  The case coordinator reviews the level of need the member has, develops a service plan in collaboration with the member, and communicates to the member the number of hours of care she will receive.  Incremental services can be added in the event the HCA reports a change in condition. 

Pending functionalities

There are several functionalities that are currently in a “roll out” phase, including the ability for HCAs to use the Smartphone to update their home address and request vacation time off.

Dual Eligibles

Aetna wanted to start the ICP Pilot last year because it expects the number of members participating to increase dramatically as Illinois begins its dual eligible demonstration.  Both Addus and Aetna do not foresee the functionality of the Smartphone (both from an EVV and managing conditions perspective) materially changing with the duals.  Instead, they foresee a wider deployment of the ICP Pilot including such capabilities as sending pictures or videos. 

Program integrity

In addition adding value both from a workflow and delivery of care perspective, the Smartphone also serves key program integrity functions.

Signature verification: After the visit is complete, the HCA documents tasks, and answers the change in condition questions.  The client must then sign the Smartphone in the field provided, either with their finger or with a stylus.  The signature then flows through to the central database.

Scheduling: The Smartphone can be set up with a variety of alerts, enabling Addus to monitor and adjust schedules in real time.  So if, for example, the HCA has not logged into start a scheduled visit, a trigger will alert a scheduling coordinator who can then call the HCA or the client or both.  There are a variety of alerts to help monitor daily activities as they occur, giving Addus great visibility into its direct to care workforce.

GPS: The Smartphones have GPS capability, so Addus can monitor the locations of its HCAs.  This also helps with program integrity and quality assurance. 

Care plan task reporting:  Before using EVV technology, Addus found that care plan task reporting was quite cumbersome.  Addus believes that this function significantly helps providers remediate and challenge audit findings. 

This functionality enables more efficient communication between the provider and the health plan case manager to clarify changes in conditions or the provision or absence of care, rather than having to sift through large amounts of documentation. 

Recommendations to Providers

For providers seeking to engage in a similar partnership with plans, Aetna maintains that frequent dialogue between the organizations is critical to success.  Outside of the regular interface between Addus’ ICP supervisor and Aetna’s case management supervisor, Aetna and Addus hold bimonthly calls together to update each other on the pilot.  Other important recommendations include: developing a successful operating model, having a good workflow for communication, having a good reporting tool, and agreeing on what metrics to evaluate.

Plans to Publish

Addus and IlliniCare hope to publish results of the pilot this year, while Aetna and Addus also intend to publish program results.  Aetna will evaluate data from 0, 3, 6, and 12 months following implementation of the pilot, and specifically look at hospitalizations, readmissions, ED visits, and office visits (both specialty and PCP visits).    

To see Aetna’s press release, click here.  To see IlliniCare’s press release, click here.


The Council supports the growing utilization of technology in Medicaid home care. As the Council has previously shown in telehealth, such programs can be both cost-effective and contribute to greater outcomes. 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 application and reimbursement of Smartphone technology to HCAs in Medicaid home care. Home care providers are encouraged to keep abreast of such developments, and to contact the Council with any questions or concerns.

The Council would like to thank the following people for their assistance in writing this article:  Darby Anderson, Senior Vice President, Addus HealthCare; Kimberley Cox, Midwest North Regional Director, Addus HealthCare; William Gerardi, MD, Chief Medical Officer, Aetna Better Health of Illinois; and Diane Kumarich, VP National Contracts and Acquisitions, Addus HealthCare.




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