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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

National Association of Medicaid Directors Asks Secretary of Labor to Delay Implementation of the Companionship Services Final Rule

May 1, 2014 10:31 AM

The National Association of Medicaid Directors (NAMD) recently sent a letter to Labor Secretary Thomas Perez asking him to delay for 18 months implementation of its Final Rule, “Application of the Fair Labor Standards Act to Domestic Service,” which was issued October 1, 2013.

NAMD is a bipartisan organization that represents Medicaid Directors in the fifty states, the District of Columbia, as well as US territories. The Final Rule is of particular interest to NAMD because state Medicaid programs are responsible for the financing, delivery and oversight of services that are at the heart of the FLSA rule change, specifically, “Medicaid-financed in-home services, particularly for individuals with extensive home care needs.” NAMD had previously advocated against the proposed rule changes because of the financial and care impacts on state Medicaid programs nationwide.

NAHC has led the efforts to stop the Department of Labor’s changes in the companionship services and live-in rules that will require minimum wage and overtime compensation for personal care workers beginning in January 2015. NAHC worked with NAMD and the Center for Medicaid Services to gain their awareness of the rule impacts on Medicaid starting in 2000 when a previous rule change was proposed.

The new companionship rule redefines “companionship services” to be limited to “fellowship”, “protection”, and limited direct care. Care related services are limited to no more than 20% of the hours worked.  This definition means that the vast majority of Medicaid personal care services will be subject to minimum wage and overtime requirements. Private pay home care impact will vary on a client-specific basis. The new exemption also excludes employees employed by home care agencies (“third-party employers”) from any remaining exemption.  The exemption will remain for workers directly employed by the client or a family member. However, that exemption will apply only if the services are within the new, limited definition of companionship.

According to NAMD’s letter:

“We remain concerned that the current effective date of January 1, 2015, fails to provide sufficient time for the federal agencies and state partners to understand the policy and operational issues, develop workable solutions on key components and determine an appropriate course of action if we cannot identify a feasible solution.

We respectfully request that the Department of Labor extend the effective date for compliance for an additional 18 months. The extension will allow the Labor and Health and Human Services departments to work through and, where appropriate, reevaluate those areas where unforeseen issues have arisen and outstanding questions remain as it pertains to Medicaid. An extension will also allow the Administration to continue with more thoughtful discussions with states regarding the unintended impact on certain Medicaid-financed in-home services, particularly for individuals with extensive home care needs…

In addition, many states are increasingly concerned that the tools and technology to comply with the rule do not exist in some areas and may require a significant investment of resources in other areas. State legislatures will need to approve funding for any such investment in many states. More time is needed to refine the cost estimates and secure approval for such resources. State agencies will then need additional time to procure the vendor contracts and educate staff, providers and Medicaid enrollees about the new tools.”

During a teleconference shortly after the Final Rule was announced, NAHC’s Vice President for Law stated that under the new rule, “almost nothing in the realm of home care personal care has much of a chance for qualifying for the companionship exemption or the live-in care exemption…[Home care] workers are going to get the short end of the stick. It will become an industry filled with part-timers.”

If the Department of Labor honors NAMD’s request, the Final Rule - which is currently scheduled to go into effect on January 1, 2015 – would be delayed for 18 months, going into effect July 1, 2016 instead.

To read NAMD’s letter, please click here.

To read NAHC’s continuing coverage of this issue, please click here.




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