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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

The NAHC Strategic Planning Congress: Setting an Agenda for Action

April 15, 2014 09:20 AM

“We’re all a product of decisions we make in our life,” NAHC President Val J. Halamandaris recently told attendees at the NAHC Strategic Planning Congress. “The fact that you have taken the time away from your business to be here says it all. You’re making an investment in the future. You’re making an investment in NAHC and all your patients, especially the 78 million baby boomers who are going to need home care and hospice. Without us they’re not going to get what they want,” he warned. “So I commend you for choosing to be here,” he told a group made up of NAHC’s board of directors and heads of its Forum of State Associations, along with key leaders of home care and hospice.

The Strategic Planning agenda was designed to give home care and hospice a unified vision, imbue it with a fresh sense of mission, and chart a course ahead. All three are needed because life’s no beach right now for home care and hospice. The industry faces new rules and laws that pose problems for both providers and patients. “We’re being besieged on all sides,” said Michele Quirolo, president and CEO of VNA of Hudson Valley. “Unless we take time to get together and come up with an action plan, our industry will suffer. This is a good time to connect with people in all aspects of home care and hospice.”

“We need to come away with a unified plan that addresses the onslaught against home care so we can engage with our members.” And to succeed at it, “you need the most current information,” Quirolo explained. “I don’t want to read a 500-page bill, so I’m glad NAHC does such a good job of synthesizing what’s coming out of Washington, DC. The bottom line is you need to be informed. Coming to a conference like this is the easiest and best way to do it.”

To establish where DC is going, Halamandaris convened an expert panel of NAHC staff: Jeff Kincheloe, vice president for government affairs; Bill Dombi, vice president for law; Theresa Forster, vice president for hospice; Mary Carr, vice president for regulatory affairs; and Richard Brennan, vice president for technology policy. The panel discussed possible Medicare cuts, the implementation of health care reform, proposed home health copayments, proposals to pay for the SGR, face-to-face requirements, Medicaid, the employer mandate — and especially what’s on our lawmakers’ minds.

The consensus was that Congress is torn between saving home care and saving taxpayers’ cash. “The good news,” Kincheloe said, “is that there are members of Congress who see home and community-based care at the center of health care reform, so there are opportunities out there. The bad news is that lawmakers are eager to cut spending to Medicare fee-for-service providers,” like many of those in the room. “This is wonderful Washington,” Dombi said tongue in cheek. “They all tell you how much they love the home health benefit, but they don’t want to give it the support it ultimately needs. Entitlement is a dirty word in Washington today. It goes hand in hand with budget deficits. But advocates for home care are in a stronger position than those who want to do it damage. We can derail a lot of those things that are intended to do nothing more than spend less money,” Dombi pointed out.

Home care will find it harder to function if Congress acts on the president’s proposal to put in copays for Medicare home health. “The president’s proposal is probably the most reasonable of the ones that are out there,” Kincheloe said, “but it’s still egregious. It would be $100 for an episode beginning in the community if it hasn’t been preceded by a hospital or community stay. It would begin in 2017 and would apply to new Medicare beneficiaries who become eligible that year and beyond. If they go for that, our fear is they might choose to eliminate restrictions like implementation date. And of course we think it’s absolutely goofy to have to put someone in a hospital before you can give them home care.”

This attack on the home health benefit, Dombi said, “makes us feel like we’re under siege,” as does the recent rule to rebase home health by 14 percent over the next four years. The reason for the rule, Dombi explained, “is we’ve been too successful. The way MedPAC measures success is through profit margins, and their view is our profit margins are too high.” But what does too high mean in the commission’s view? “If you were to ask MedPAC commissioners what is too high, they would say anything above zero,” Dombi laughed. “They truly don’t understand what it takes to run a business. They rarely put their feet on the ground to understand that you have to make payroll, let alone invest in new technologies. Moreover, MedPAC doesn’t take into account all the accumulated cuts over the years. Somehow home care agencies manage to cope with payment reductions, so they’re testing you to see how far you can go before you break. The image of fraud and abuse is also an excuse to cut rates and make new rules. So we’ve given some constructive proposals to Congress and CMS for saving funds through value-based purchasing.”

Will they listen? CMS probably won’t, Carr scoffed as she recalled the constant complaints she’d heard about CMS. “Face-to-face is on top,” she said, “because of all the denials related to the rule. And this is a symptom of a much bigger problem. CMS is really scrambling about how to handle fraud and abuse. They’re using a lot of patchwork mechanisms, including 16 contractors who are doing medical reviews and tripping over one another. But face-to-face gets all the attention, and the only thing I can advise those of you who are out there working hard is to take it one day at a time.” And keep your eyes open, she advised. “We don’t know what they’re going to drop on us next.”

But one thing is clear, Dombi added. “Face-to face is an administrative burden beyond any administrative burden. It benefits the bad guys and burdens the good guys. But CMS has pretty much turned a deaf ear on this. We have a state of confusion about what acceptable documentation is, but CMS is absolutely convinced this rule is working because spending is down on home health. And spending is down not just in those areas they thought were risky. It’s down in all parts of the country. So it’s time to complain, and the complaints need to come from physicians. We’ve got to get the physicians to complain to their members of Congress, as well as to CMS. And maybe it’s time for us to file a lawsuit on the face-to-face encounter. We need to stand up for ourselves once again, even if there are risks involved. Sometimes you have to get punched in the face.”

To read the full article, please click here.




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