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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

Pennsylvania Submits Alternative Medicaid Expansion Waiver to CMS

February 26, 2014 02:05 PM

On February 19, Pennsylvania submitted its Section 1115 demonstration waiver application (the Waiver Application) to the Centers for Medicare and Medicaid Services (CMS) for an alternative to traditional Medicaid expansion. This followed a public comment period beginning on December 6. CMS will in turn submit the proposal for a 30-day public comment period, after which CMS and the State will negotiate the final waiver. Pennsylvania hopes to begin instituting the program, called Healthy Pennsylvania, in January 2015.

If granted as currently formulated, the waiver would expand Medicaid coverage via private insurance for those at least 21 years old but under 65 earning up to 133% of the federal poverty level (FPL). This expansion is expected to bring coverage to over 500,000 Pennsylvanians. Some of the important elements of the submitted Waiver Application are discussed below.   

Premium Assistance

Pennsylvania will pay premium assistance on the premium and cost-sharing elements. However, new enrollees will be required to pay a monthly premium. These monthly premiums will not exceed $25 for one adult, and $35 for a household with two or more adults. Dual eligibles will be exempt from paying premiums beginning in year two of the demonstration.

Incentives to Reduce Premiums

Beneficiaries can get their out-of-pocket monthly premiums reduced by either “engaging in healthy behaviors” or working at least 20 hours a week, or both. For the first three years, “healthy behaviors” include: paying premiums on time, getting health risk assessments, and getting annual wellness visits.

The precise incentives will vary but incentives will continue for the first three years of the demonstration. After three years, Pennsylvania reserves the right to revise the list of “healthy behaviors.” 

Work Search Requirements 

Unless otherwise exempt, all newly enrolled beneficiaries must be enrolled on a specified online unemployment website, and be searching for work as a condition of continued eligibility. Dual eligibles are one such group exempt from work search requirements.

Alignment of Populations 

The Waiver Application realigns the traditional Medicaid program by establishing the High Risk Benefit Plan (HRBP) and the Low Risk Benefit Plan (LRBP). HRBP is for Medicaid recipients deemed to have “more complex health needs” according to a health screening tool, while those with less complex health needs will be enrolled in the in the Low-Risk Benefit Plan (LRBP). The Waiver Application enrolls recipients of home and community-based services (HCBS), as well as dual eligible and those in Pennsylvania’s PACE program LIFE (Living Independence for the Elderly), PACENET, and PACE Plus Medicare programs, in the HRABP. Those deemed “medically fragile” will be enrolled in HRBP but have the option to enroll in LRBP.      

Covered Services 

Home Health, ICF/ID, and ICF/ORC. For HRBP, enrollees are entitled to unlimited home health care coverage within the first 28 days, and 15 days per month thereafter. These enrollees are also entitled to 365 days per year coverage of Intermediate Care Facilities for Individuals with an Intellectual Disability (ICF/ID) and Intermediate Care Facilities for Other Related Conditions (ICF/ORC). LRBP enrollees are entitled to 60 visits per year in home health care, and are not covered for either ICF/ID or ICF/ORC.

Hospice. For hospice coverage in both LRBP and HRBP, as stated in the Waiver Application, “the only key limitation is related to respite care, which may not exceed a total of 5 days in a 60-day certification period.”

Therapy. Therapy (hearing, language, speech) is covered in both LRBP and HRBP, as stated in the Waiver Application, “only when provided by a hospital, outpatient clinic, or home health provider.” 

For a full chart of covered services, see pages 44-49 of the WaiverApplication, here. For full details of Healthy Pennsylvania, clickhere.





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