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National Association for Home Care & Hospice
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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 Releases Survey Results on Medicaid Managed Care in Home Care

Survey of Council members highlights trends and concerns on the adoption of Medicaid managed care in home care
August 25, 2014 09:45 AM

In July and August, NAHC’s affiliate, the National Council on Medicaid Home Care, surveyed its members as to the status of their adoption of Medicaid managed care in home care. The Council conducted two surveys.  The first had 45 respondents, and the second, a modified and more detailed version of the first survey, had 67 respondents, for a total of 112 respondents. The Council discusses the results of these surveys in a new report, available here.

The survey results are based on the responses received from agencies and associations, and are not stratified by state. Therefore, some states may be represented by multiple responses. The survey results represent only a small cross-section of those adopting Medicaid managed care in home care nationally. The total number of states and enrollees adopting Medicaid long-term services and supports (MLTSS) is shown in tables 1 and 2 of the report that is linked above.


Affiliation. Most respondents were representatives of home care agencies rather than hospice companies or the Forum of State Associations. Out of both surveys, 81 stated that they represented a home care agency, 16 stated that they represented an agency that provides both home care and hospice, 13 stated they represented a member of the Forum of State Associations, and three stated that they represented a hospice company. Since the first survey did not delineate “hospice” as an independent category, one of the three that represented a hospice company indicated so in the “other” category in the first survey (in addition to responding that he/she represented a home care agency), so these numbers total 113 and not 112.

Current Implementation of Managed Care. Out of the total of those surveyed, 53 stated that their state now has managed care in home care, four stated that they have Medicaid managed care through coordination of dual eligibles, and 51 stated that their state has both Medicaid managed care in home care and through coordination of dual eligibles. Only three of those surveyed stated that their state does not have Medicaid managed care at all.

Services. The most popular services that respondents noted were already in Medicaid managed care in their states were: home health services (94), home and community based waiver services (67), personal care services (46), and hospice (42). The most popular services pending transition were:  home and community based waiver services (11), private duty nursing (10), mental health services (9), and personal care services (9).

Patient populations. The most common patient populations that respondents noted were already in Medicaid managed care in their states were: dual eligibles (73), elderly (68), physically disabled (54), and pediatric (46). The most common patient populations that were pending transition were: dual eligibles (16), intellectual or developmentally disabled (I/DD) (11), and physically disabled (9).

Level of Satisfaction with Managed Care. In both surveys, the Council asked respondents to rank numerous aspects of their transition to managed care on a scale of 1 to 5, with 1 being a very negative experience and 5 being a very positive experience. In both surveys, none of the aspects averaged a score of three (neutral) or higher. All of the responses averaged between a 2 (negative) and 3 (neutral score). This was true both looking at the two surveys independently of each other, as well as aggregating the results.


The survey results reflect a reaction to managed care from home care agencies, joint home care/hospice agencies, and state associations that can be described as lukewarm at best. While the transition to Medicaid managed care is filled with challenges, stakeholders are not powerless or voiceless in the matter. Agencies and associations alike should take opportunities to learn from previous experience. The Council provided key lessons regarding managed care in NAHC’s March on Washington, as well in its recently released toolkit on the transition to Medicaid managed care.

Stakeholders can be very useful in improving a state’s transition to managed care in Medicaid. Likewise, if these stakeholders have outright opposition to using managed care in Medicaid, or otherwise need to navigate their transition to managed care, they should consult with both their state associations and the Council.  Home care providers are encouraged to keep abreast of managed care transitions in their states, advocate on a state level, and to contact the Council with any questions or concerns.

To read the full report, please click here.




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