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

Beneficiary Sues Pennsylvania Over Loss of HCBS Services

August 8, 2014 04:38 PM

In Smith v. Department of Public Welfare of the Commonwealth of Pennsylvania, a Plaintiff filed a lawsuit in the United States District Court for the Eastern District of Pennsylvania on behalf of herself as well as other “similarly situated persons” against the state for not providing them with community-based attendant care services in the Act 150 Program. The United States Department of Justice (DOJ) filed a statement of interest in the case on June 12. On June 30, the Department of Public Welfare (DPW) filed a response to that statement.

This case continues to be litigated.


According to the Statement of Interest, the physically disabled in Pennsylvania needing assistance in the home with activities of daily living can receive services through one of two funding sources. They can receive services through the federal and state funded Attendant Care Waiver based on clinical and financial eligibility, or through the state funded Act 150 program based on clinical eligibility.

Act 150 waiting list. The waitlist for the Act 150 program has grown incrementally. Before 2009, all eligible individuals were able to be enrolled. However, funding was decreased to the program. In fiscal year 2007 to 2008, funding stood at $45 million, but the program is currently funded at only $26 million. Budgeted slots for Act 150 services decreased from 2,479 in 2007-2008 to 2,277 in 2011-2012, and 2,016 in 2012-2013. At the same time, a waitlist for Act 150 program attendant care services has resulted, growing to 283 at the time of the Statement of Interest. Seven of those on the waitlist reside in nursing homes. For details, see page 3 of the Statement of Interest, here.

The Plaintiff. The Plaintiff is a 56-year old woman with multiple sclerosis who has been placed on the Act 150 waiting list. DPW found her eligible for the Attendant Care Waiver program, and she was later transferred to the Act 150 program. As with the waiver program, she continued to receive 35 hours of services a week, until she was taken off the Act 150 Program in 2008 after failing to pay her copayments. She re-applied for the Act 150 Program. While she is eligible for these services, she cannot receive them due to the waiting list. For details, see pages 7-12, here.


The Plaintiff brings her suit against DPW based on two grounds, alleging that the Defendant violated Title II of the Americans with Disabilities Act (ADA), and Section 504 of the Rehabilitation Act.

Serious risk of institutionalization. The Plaintiff alleges that the DPW puts her and others in institutions or at serious risk of institutionalization, given that DPW has not provided them with attendant care services in the community. For details, see pages 14, here. The DOJ, citing case law, further asserts that serious risk of institutionalization can be established by showing a “lack of sufficient state-sponsored community-based services” that in turn “will likely cause a decline in a plaintiff’s health, safety, or welfare that would lead to her eventual placement in an institution.” For details, see page 8, here.

State’s response. In response to that allegation, DPW alleges that the waiting list does not cause a serious risk of institutionalization. DPW cites the fact that the waiting list has existed for five years and there is no evidence that the waiting list has resulted in any institutionalization. Also, DPW asserts that less than 3% of those on the waiting list are institutionalized, and there is no evidence that they were institutionalized because of a lack of Act 150 services. For details, see page 1-2, here.

Lack of services and assessment. The Plaintiff also alleges that DPW doesn’t have a system in place which properly assesses which people on the waiting list are either institutionalized or at risk of institutionalization, and to provide such people “specific and concrete benchmarks and timelines” for the eventual provision of such services. Finally, the Plaintiff alleges that DPW serves less people through the Act 150 program despite a growing need for those services. For details, see page 15, here.

State’s response. DPW asserts that those on the waiting list can become eligible for home and community-based services through the Attendant Care Waiver by using pooled trusts to become income eligible. DPW asserts that such services have no waiting list. For details, see page 2, here.

Relief Requested and Class Status Sought

The Plaintiff seeks that this lawsuit be made into a class action, consisting of “[a]ll Pennsylvanians who are or will be placed on the waiting list for the Act 150 Program,” and declaratory and injunctive relief. For details, see pages 5 and 17, here.


While Pennsylvania argues that the Act 150 waiting list does not put people at increased risk for institutionalization, a recent study by the Department of Health and Human Services analyzed by NAHC’s affiliate the National Council on Medicaid Home Care suggests that nationally, waiting lists in fact do increase risk for institutionalization. The Council will continue to monitor the waiting list trend as it has in North Carolina, Michigan, and Kansas.

The Council further encourages providers to continue to advocate for greater support of HCBS through their state associations, as well as through state and federal governments. Home care providers are encouraged to keep abreast of HCBS developments in their states, and nationally, and to contact the Council with any questions or concerns.




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