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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

Medicare-Medicaid Coordination Office Releases FY 2013 Report to Congress

March 22, 2014 10:36 AM

On March 13, the Medicare-Medicaid Coordination Office of the Centers for Medicare & Medicaid Services (MMCO CMS) released its Fiscal Year 2013 Report to Congress (the Report). The Report discussed key developments from MMCO CMS, as well as its legislative recommendations. The National Council on Medicaid Home Care – a NAHC affiliate - discusses the highlights of this Report, below:

Legislative Recommendations

Expand PACE to individuals between ages 21 and 55. As previously stated in the President’s March 4 budget proposal for the Department of Health and Human Services (HHS) for Fiscal Year 2015 (the Budget Proposal), the Report recommended to expand the Program for All-Inclusive Care for the Elderly (PACE) to those aged 21 through 55. PACE is a rebalancing program that provides community based long-term services and supports (LTSS) to dual eligibles via an interdisciplinary team. The Budget Proposal projected that this would have no budgetary impact. For details, see pages 81-82, here

Analysis.The Council supports continued efforts at rebalancing, as evidenced in the president’s recent budget proposal, including not only the proposal to expand PACE, but to expand Money Follows the Person (MFP) and to provide HCBS to children eligible for psychiatric residential treatment facilities. For a recent Council article on the Budget Proposal, please click here

Integrate Appeals Process. MMCO CMS, echoing last year’s report, recommended that Congress integrate the appeals process for dual eligibles. Different appeals processes currently exist between Medicaid and Medicare, and among the various parts of Medicare. While the Report comments that the Medicare-Medicaid Financial Alignment Demonstrations (Duals Demos) are working to integrate financing and service delivery of dual eligibles, an integrated appeals process would permit even greater efficiencies for stakeholders. The Report asks Congress to give more authority to the Secretary of the Department of Health and Human Services (HHS) to develop an integrated appeals system.

Areas of Interest

Coverage standards. The Report also stated areas of interest MMCO CMS is pursuing to “improve the experience” of dual eligibles, including coverage standards. MMCO CMS recognizes that Medicare and Medicaid coverage standards can overlap, and often have different rules, as in home health care.

Analysis. While MMCO CMS did not highlight a specific game plan regarding varying and overlapping coverage standards, the Council supports clear Medicare/Medicaid coverage standards for duals.  The Council also continues to advocate for minimal federal standards for home health coverage under Medicaid, including calling on Congress to expand the mandatory Medicaid home health benefit to include speech, occupational and physical therapy, and medical social work, as well as hospice care. Congress should also set minimum standards regarding the frequency and duration of care. The Council opposes block grants and other proposals which would grant states full authority to determine the scope, amount, and duration of home care benefits. For details, see the Council’s policy blueprint, page 32, and 61-62, here.

Various funding opportunities

After providing a brief review of the status of the Duals Demos, the Report gave updates on various funding opportunities in place with regard to dual eligibles.

Implementation. States that have signed memoranda of understanding (MOUs) with CMS for the Duals Demos are eligible to receive additional funds for implementation activities such as those that protect beneficiary rights and foster beneficiary participation generally. CMS has awarded such additional funds to California, Massachusetts, Minnesota, New York, and Washington. This funding opportunity has closed, as CMS is no longer receiving applications for it. For details on this funding opportunity, see here.

Ombudsman. CMS will also fund ombudsman programs of the Duals Demos, provided they have met certain requirements. CMS has so far extended awards to California, Illinois, and Virginia.  For more information, click here.

SHIPs and ADRCs. CMS has also agreed to provide funds for State Health Insurance Counseling and Assistance Programs (SHIPs) and Aging and Disability Resource Centers (ADRCs) to enable these institutions to counsel dual eligibles. CMS provided awards to Washington State in 2012, and California, Illinois, Virginia, and Massachusetts in 2013. For more information, click here.

Analysis. The Council supports these additional funding opportunities generally.  It remains skeptical of the overall strength of the ombudsman program. While addressing funding concerns, CMS had a very measured response to lingering stakeholder concerns regarding staffing and appropriate training of the ombudsmen prior to Demonstration enrollment. The Council analyzed that the duals MOUs largely fell short of the “five key elements” that an ombudsman program shouldhave to secure beneficiary rights, as identified by stakeholders. For previous Council briefs on the Duals ombudsman programs, including the “five key elements” and CMS’s measured response to an advocacy letter signed by the Council, click here and here.  

Quality Improvement

The Report also addressed the need to improve quality of care for the dual eligibles. It is doing this in partnership with the National Quality Forum, and together they have begun to develop quality measures for long term services and supports (LTSS). For a recent Council brief on this, click here.

Data Analysis 

Lastly, the Report commented on the need to improve data gathering on the dual population to further better care, and MMCO CMS’ progress in that regard. For details, see pages 16-18 of the Report, here.


The Council continues to make dual eligibles a priority in its advocacy efforts.  For its 2014 policy priorities, in addition to those stated above, the Council has placed emphasis on: establishing reasonable standards for consolidation of Medicare fee-for service payments with Medicaid for dual-eligible beneficiaries; restricting passive enrollment of dual eligibles in Medicare Advantage plans; and promoting Medicare-Medicaid coordination, especially with regard to streamlining payment recovery of providers for care to dual eligibles. For details, see pages 59-62 of the Council’s policy blueprint, here

Home care providers are encouraged to keep abreast of developments regarding dual eligibles on CMS’ website, and to contact the Council with any questions or concerns.




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