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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

Heath 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

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

The National Council on Medicaid Home Care Hosts a CMS Panel Discussion during the March on Washington

April 4, 2014 10:09 AM

The National Council on Medicaid Home Care – a NAHC affiliate - held an educational session during NAHC’s March on Washington entitled “The Future of Medicaid: CMS Panel of Experts.” The session featured the following panelists:

  • Edo Banach, Senior Advisor, Acting Director, Models Demonstrations and Analysis Group, Medicare Medicaid Coordination Office (MMCO), Centers for Medicare and Medicaid Services
  • Dianne Kayala, Technical Director, Disabled and Elderly Health Program Group, Center for Medicaid and CHIP Services, Centers for Medicare and Medicaid Services
  • Ralph Lollar, Disabled and Elderly Health Programs Group, Center for Medicaid, Centers for Medicare and Medicaid Services

Dual Eligibles

Mr. Banach spoke first, talking about the status of the demonstrations that MMCO was currently implementing, including the Financial Alignment Initiative (FAI) for the dual eligible population.  He stated that this demonstration was critical, as the dual eligible population, while constituting only 15% of the total Medicaid population, accounts for 39% of all Medicaid costs.  According to Mr. Banach, out of the eight states that have been approved under the FAI, only Massachusetts and Illinois are up and running.  He also mentioned that quality measures are in place with the FAI, and that MMCO was working with the National Quality Forum (NQF) to continue to develop these measures.  These include some measures that are related to home and community-based services (HCBS) specifically. 

Mr. Banach also discussed a MMCO demonstration aimed at reducing preventable inpatient hospitalizations among residents of nursing facilities. 

For Mr. Banach’s slides, click here.  For Council briefs on dual eligibles, click here

MLTSS Implementation

Ms. Kayala spoke about managed long-term services and supports (MLTSS) implementation nationwide.  She remarked that states with at least partial adoption of MLTSS grew from 8 to 16 from 2004 to 2012.  Rhode Island adopted voluntary MLTSS at end of 2013.

For Ms. Kayala’s slides, click here.  For Council briefs on MLTSS, click here

Rebalancing Update, HCBS Rule

Mr. Lollar discussed rebalancing long-term services and supports (LTSS) away from institutional care and towards HCBS.  He gave a quick status report on the Balanced Incentive Payments (BIP) and Money Follows the Person (MFP) programs.

BIP has been in place since 2011, giving states enhanced Federal Medical Assistance Percentages (FMAPs) depending on the extent to which they rebalance towards HCBS and away from institutional care.  Eligible states are those that that spend less than 50% of total Medicaid LTSS expenditures on community LTSS. 

States spending less than 25% of total Medicaid LTSS on community LTSS are eligible for a 5% enhanced FMAP, while those spending between 25% and 50% are eligible for 2% enhanced FMAP.  Total funding for BIP is not to exceed $3 billion, and the funding will end in 2015 or when all of the funds are expended.  The total award is $2.16 billion, with nineteen (19) states having been approved for rewards to date. 

MFP provides states with enhanced FMAPs if they develop sustainable HCBS infrastructure.  Currently, forty-four (44) states and DC have this program.

For more information on BIP and MFP, click here and here. For a Council brief analyzing the rebalancing statistics in Senator Harkin’s Report to Congress, click here.

Mr. Lollar then gave a synopsis of the new Home and Community-Based Services (HCBS) final rule.  For Mr. Lollar’s slides on the HCBS rule, click here.  For a previous Council brief on the rule, click here.

Program Integrity

Ms. Kayala gave a brief presentation on recent program integrity findings in home care, as reported by the Office of Inspector General of the U.S. Department of Health and Human Services (HHS OIG).  She stated that noncompliance ran the gamut and ranged from billing for services not rendered to not providing adequate documentation for services billed. 

Reasonable billing/billing for services not rendered.  Ms. Kayala stressed the need for “reasonable billing” stating that every nurse and home health aide should reasonably bill for services.  For example, a certified nursing assistant working for several different programs and billing more than 8 hours a day would be unreasonable, and indicate billing for services not rendered.

Good documentation.  Ms. Kayala stated that good documentation is essential. Without it, CMS treats the event as if it did not happen. 

Consolidation of regulation favored. Ms. Kayala also stated that HHS OIG hopes that states will consolidate and harmonize rules better with regard to different care settings (between residential group home and assisted living, for example).  She also expressed HHS OIG’s desire for states to consolidate their waiver programs generally.  HHS OIG believes that a streamlined approach to waivers will reduce non-compliance generally.

For a recent Council brief on the program integrity initiatives relevant to Medicaid home care in HHS OIG’s Work Plan for 2014, click here.  For a recent Council on relevant findings from the HHS OIG’s Annual Report, click here.




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