Skip to Main Content
National Association for Home Care & Hospice
Twitter Facebook Pintrest


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

Bill to Delay the Employer Mandate for Certain Medicare and Medicaid Providers Introduced in the House

Legislation would provide reprieve from the ACA’s employer mandate for Medicare and Medicaid-dependent businesses - including home health agencies and hospices - until January 1, 2016
July 17, 2014 12:22 PM

Congressman Steve Daines (R-MT) recently introduced legislation that would delay the Employer Mandate provisions of the Affordable Care Act (ACA) until January 1, 2016 for businesses that offer services through Medicare and Medicaid. The bill, entitled The Ensuring Medicaid and Medicare Access to Providers Act (H.R. 5098).

Congressman Daines was urged to sponsor a bill to bring about relief from the requirements of the ACA employer mandate by the ACA Direct Care Coalition of which NAHC/National Council on Medicaid Home Care is a founding member.  

The bill would exempt health care providers that receive 60 percent or more of their revenue from Medicare and Medicaid from the Affordable Care Act (ACA) employer health insurance mandate until January 1, 2016. Currently the mandate is scheduled to begin January 1, 2015 for businesses with more than 99 employees. NAHC encourages all of its members to contact their Representatives and urge them to cosponsor this legislation.

Most of the home care and hospice community is paid through the Medicare and Medicaid programs, and given recent and proposed payment cuts, H.R. 5098 would be welcome relief to home care and hospice providers that are already struggling to keep their doors open. The “burdensome employer mandate would force in-home care businesses to cut jobs or employee wages and in turn, hurt the elderly, disabled and low-income Montanans who rely on them for critical services,” Rep. Daines said on the House floor during the bill’s introduction. “The Ensuring Medicaid and Medicare Access to Providers Act protects Montanans’ access to care by exempting their health providers from [the] employer mandate and it protects healthcare workers from losing their jobs or getting their hours or their pay cut.”

Medicare and Medicaid’s reimbursement rates are considerably below comparable payments in the private market. As such, the ACA’s employer mandate would force many long-term care service provider agencies to cut jobs or reduce employee hours or wages in order to continue providing services to Medicaid or Medicare recipients, which would hinder both agencies that provide care, and more importantly, beneficiaries who receive care.

According to NAHC President Val J. Halamandaris, “this important legislation will help preserve access to home care for Medicare and Medicaid recipients while providing significant assistance to state Medicaid programs struggling to pay for home and community-based care on limited budgets.”

According to NAHC’s Legislative Priorities Document, the employer obligations under the ACA should be modified because:

“Home care businesses…have three problems that are fairly unique for employers impacted by the health care reform change. First, home care is most often paid either by government programs such as Medicaid and Medicare. These programs do not normally raise payment rates adequately or at all to cover increased costs. Second, the consumer of private pay home care is most often an elderly or disabled individual on a fixed or low income that cannot afford to absorb any price increase that would be needed to cover the cost of employee health insurance or the alternative penalty. Third, the home care workforce is employed often with widely varying weekly work hours because of changing clientele and changing client needs.”

A large coalition of groups including NAHC and its affiliate National Council on Medicaid Home Care have called on CMS to convene a stakeholder summit that brings together representatives from all stakeholder groups-consumers, providers, workers, and state Medicaid programs to develop and evaluate all of the potential options available that can result in health insurance coverage for the workers.  

While CMS has listened to these concerns, no concrete action has yet to occur. Another year delay in the employer mandate would provide much needed breathing room to allow such a summit to be convened. NAHC fully recognizes that this bill does not provide relief for private pay home care or all providers of Medicaid and Medicare home care services. However, it will serve a very useful purpose for all home care providers in that it will raise awareness of the special problems that exist in home care. In that regard, it can be a stepping-stone to more comprehensive relief.




©  National Association for Home Care & Hospice. All Rights Reserved.