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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

Countdown to the Midterm Elections: 20 Days Out

October 15, 2014 10:05 AM

In just 20 days – on November 4 - the Midterm elections will be held and will determine the make-up of both chambers of Congress. 33 Senate seats and the entire House of Representitives is standing for election this cycle. At stake is the control of the United States Senate, and the size of the GOP majority in the House. The Midterm elections will inevidably shake-up of the Congressional committees that work on issues that are important to the home care and hospice community.

NAHC members have a rare and important opportunity to engage with their House and Senate candidates and ask questions that could affect the entire home care and hospice community once the new Congress is sworn in.

NAHC is urging home care and hospice advocates to contact those who are running for Congress back in the state and districts over the election recess to raise home care and hospice concerns and ask for support. For a list of suggested grassroots action steps over the recess, see NAHC Report, August 1, 2014.

Pose Questions to Congressional Candidates

One of the most effective ways to become a home care and hospice advocate is to ask pertinant questions to congressional candidates to see where they stand on important issues. Advocates may pose questions to candidates at their town hall meetings or election rallies; at other public events around their state or district; by email, fax, Twitter, Facebook or Postal Service; in face-to-face meetings with them or their staff, or on pre-arranged home visits.

Below are some suggested questions on current home care and hospice issues that may be posed to those seeking election or reelection.

  1. Some are suggesting the imposition of a Medicare home health copay for purposes of deficit reduction and/or offsetting the cost of fixing the flawed Medicare physician payment formula. There is evidence that a home health copay would fall most heavily on the oldest, sickest, poorest seniors; shift seniors to more costly hospital or nursing home settings; and increase Medicare and Medicaid costs. A Medicare home health copay was repealed in 1972 because of the burden it placed on seniors, collection costs, and the services it shifted to more costly settings. Would you oppose the imposition of a Medicare home health copay?
  2. The Medicare home health benefit has been cut through legislative and regulatory actions by $110 billion for the period 2009-2019 according to the Congressional Budget Office.  Most recently CMS issued a home health rebasing rule that will cut home health payment rates by 14 percent between 2014 and 2017.  As a result of these payment cuts the National Association for Home Care & Hospice projects that 56 percent of home health agencies will be underwater by 2017—that is, paid less than their costs by Medicare. CMS concedes that at least 43 percent of home health agencies will be underwater by 2017. Would you support legislation to suspend the rebasing payment cuts and require CMS to reassess its rebasing rule and set rates that protect access to home health care?  Would you oppose any additional cuts in home health payments for deficit reduction or to offset the cost of fixing the flawed Medicare physician payment formula?
  3. The Institute of Medicine (IOM) in a report on the future of nursing recommended that nurses should practice to the full extent of their education and training. The IOM called on Congress to amend the Medicare program to authorize advanced practice registered nurses (APRNs) to certify patients for home health care services. APRNs and physician assistants (PAs) can order Medicare skilled nursing facility care, but cannot place beneficiaries into more cost effective home health care. PAs are not permitted to continue to serve as an attending physician for their patients when they enter hospice. These professionals are taking on increased responsibilities in America’s health care system, especially in rural and other underserved areas. Would you support legislation that would permit APRNs and PAs to order Medicare home health services, and allow PAs to serve as attending physicians when their patients enter hospice?
  4. The Supreme Court held in Olmstead v. L.C. that state Medicaid programs were required under the Americans with Disabilities Act to undertake steps to support access to home care options as an alternative to institutional care. It has been long established that home care is cost effective, improves outcomes, and prevents more costly hospitalizations and nursing home stays. Do you believe it should be the responsibility of the state to ensure that beneficiaries understand and have available home care options before putting them in institutions? Should the federal government provide additional assistance to the states to rebalance their Medicaid programs in favor of home care?
  5. Medicaid and private pay providers have recognized the significant efficacy of using technology to supplement the services of health professionals. Tele-homecare technologies can enable the monitoring of patients at home from other locations. Medicare has not even included tele-homecare as part of post-acute care. Would you be supportive of at least conducting a Medicare pilot test of a tele-homecare benefit?
  6. Home care providers will be saddled with significant new responsibilities under the Affordable Care Act to provide insurance for their employees or pay a $2000 penalty for each full time employee. There are no provisions for increasing Medicare and Medicaid rates to accommodate these increased costs or any help for consumers who must pay privately for home care services. Would you support provisions to exempt home care providers from these new obligations? Would you support a requirement that all government health care programs adjust provider rates to meet the additional costs incurred to make health insurance available to all home care employees? Would you support providing tax credits to help individuals in need of home care services pay the increased cost resulting from the new employer obligations? Would you support a delay in implementing the employer mandate?
  7. Findings from numerous polls and studies indicate that the American public strongly supports increased public discussion of end-of-life treatments and wants to better understand the options available to them when faced with a terminal or life-limiting illness. Most importantly, people want to know that their wishes for treatment when they are seriously ill will be honored. What steps do you believe should be taken to increase the public discourse on care at the end of life, and to provide greater assurance to our citizens that their treatment choices will be honored?

In addition to asking the above questions, the following are issues that home care and hospice advocates may wish to raise with their Members of Congress over the recess, along with NAHC Legislative Action Network links that provide background information, talking points, and sample messages on each issue:

  • Suspend and reassess the Medicare home health payment rebasing rule --Contact Your Legislators.
  • Reform the face-to-face physician encounter documentation requirements for home health services:Contact Your Legislators.
  • Refine hospice face-to-face requirement, require demonstration of hospice payment reform, and increase hospice survey frequency. The absence of a required frequency for hospice surveys has been the subject of great concern for hospice advocates and in recent media reports.  Support the Hospice Evaluation and Legitimate Payment Act (S.1053; H.R.2302).-- Contact Your Legislators.
  • Modify the employer mandate in the Affordable Care Act to address home care specific needs --Contact Your Legislators-- and delay implementation of the employer mandate – H.R. 5098: Contact Your Legislators;  S. 1330: Contact Your Legislators.
  • Oppose home health and hospice payment cuts and copays – for home health: Contact Your Legislators; for hospice: Contact Your Legislators.
  • Preserve the companionship services exemption --Contact Your Legislators.
  • Permit Nurse Practitioners and Physician Assistants to sign home health plans of care. Support the Home Health Care Planning Improvement Act (S.1332; H.R.2504)) -- Contact Your Legislators.
  • Offer incentives for the adoption of telehomecare technologies. Support the Fostering Independence through Technology Act (S.596) -- Send a letter to your Senator.
  • Define full-time for purposes of the ACA employer mandate as 40 hours a week (S. 1188; H.R.2575; H.R. 2988) -- Contact Your Legislators.

For talking points on other priority issues for home care and hospice providers, please review the 2014 NAHC March on Washington Resources and NAHC’s Legislative Priorities.




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