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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

Minnesota Personal Care Workers Vote to Unionize

September 9, 2014 04:17 PM

On August 26, 27,000 personal care workers in Minnesota voted to join the Service Employees International Union (SEIU), or SEIU Healthcare Minnesota. While only 5,872 of the 27,000 eligible to vote did so, 60 percent of the 5,872 (3,543) voted to join the union. There are a total of 109,000 personal care workers in Minnesota.

According to the Wall Street Journal, SEIU now “represents 600,000 home-care workers in about 20 states, nearly a third of its 1.9 million members.” As described below, this organization of home care workers in Minnesota is based on a consumer-directed model of care.

For the full story, click herehere, and here.

Legal Challenge

The recent vote comes in the midst of an ongoing legal battle. On July 28, the National Right to Work Foundation filed a lawsuit, Bierman et al v. Dayton et al, in the United States District Court of Minnesota on behalf of nine home care workers which tried to stop the union vote. On August 20, the Court ruled that the Plaintiff’s lawsuit was “premature” given that the vote had not yet occurred, but stated that the Plaintiffs could renew their challenge if and when the vote made SEIU the exclusive representative. On August 27, following the voting results to that effect, the Plaintiffs re-filed their lawsuit. On August 28, the Court stated that it will make a ruling on the case. It gave the Defendants until September 10 to file a response to the re-filed lawsuit, and gave the Plaintiffs seven days following this filing to produce a reply brief.

Mark Mix, the president of the National Right to Work Foundation, vowed to continue its legal challenge to unionization in the state. Mr. Mix called the result of the recent vote a product of a “tyranny of a small majority.” He also stated that “No one is opposing the right of individual home-care providers to freely associate with the union if they so choose, but the issue raised in this legal challenge is whether those individuals who don’t want anything to do with the union can have it imposed on them.”

Facts as Alleged in the Complaint

As Plaintiffs state in the July Complaint and the August Amended Complaint, Minnesota provides Medicaid home care through four programs relevant to the lawsuit: 1) Community First Services and Supports Program (a program that is still under development); 2) Consumer Directed Community Supports Program; 3) Consumer Support Grant Program; and 4) Personal Care Assistance Choice Program. All four of these programs are governed by a consumer-directed model of care where Medicaid enrollees hire an “Individual Provider” that by statute, “does not include an employee of a provider agency, subject to the agency’s direction and control commensurate with agency employee status.” The Plaintiffs allege that there are approximately 26,000 such Individual Providers in Minnesota, including the Plaintiffs.

According to a law signed by Governor Dayton in May 2013, Individual Providers are state employees just for purposes of unionization. Under this law, the State must certify an “exclusive representative” for the Individual Providers based on a vote.  The exclusive representative then has the right to “meet and negotiate” with the State on behalf of the Individual Providers in relation to “compensation rates, payment terms and practices, and any benefit terms,” as well as “other appropriate terms and conditions of employment governing the workforce of individual providers.” The personal care workers voted to make SEIU their exclusive representative.

The Plaintiffs reject SEIU as their exclusive representative, and want to preserve their right to choose their own representative. Additionally, the Plaintiffs do not want to be forced to pay dues to SEIU. In the Complaint, Plaintiffs charge that the exclusive representative violates their First Amendment right to freely associate, and seek declaratory judgment and injunctive relief to prevent enforcement of the law passed by Governor Dayton.

For the full Complaint and Amended Complaint, click here and here.


Many groups such as the SEIU have accelerated the unionization of personal care workers in Minnesota and other states.  The primary approach taken by these unions is to push state Medicaid programs towards “individual providers” and a consumer-directed model of care, which excludes agency-model care delivery, and establishes a “public authority” employer for the personal care aides. This approach then facilitates the unionization of these workers.

A consequence of unions pushing exclusively for a consumer-directed care model is to exclude individuals who cannot manage that model of care from receiving home care. Such recipients are generally denied the opportunity to use services from a home care agency that offers a combination of trained workers, quality oversight, and caregiver replacement when the assigned aide is unavailable to provide care.

The National Council on Medicaid Home Care – a NAHC affiliate - opposes arrangements by unions that limit the employment rights and options of workers and service rights and options of consumers.  See page 36-37 of our 2014 Policy Blueprint, here.

Home health providers are encouraged to keep abreast of federal and state efforts on behalf of employee unions, and to contact the Council with any questions or concerns. The Council urges home care and hospice advocates to ask their Members of Congress to oppose proposals that would negatively impact their ability to deliver care to those who wish to utilize their organization’s services. 





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