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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

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

ACA Employer Mandate Survey Closed: Preliminary Results

December 4, 2014 10:01 AM

On January 1, 2015, many home care companies will face significant increased costs for employee health insurance or large financial penalties under the ACA employer mandate. That is the overall indication from responses to NAHC’s 2014 ACA Employer Mandate Impact Survey. “These results mirror the 2013 results, thereby indicating that home care companies have not found reasonable solutions to address the requirements of the ACA employer mandate,” stated Bill Dombi, NAHC’s VP for Law who managed the survey development.

A high priority policy issue for NAHC since the ACA was enacted in 2010, the organization has been to create solutions for home care companies relative to the employer mandate. NAHC has advocated for the elimination of the mandate, exceptions for home care and hospice companies, changes to the definition of “full-time” employee, delays in the effective date of the requirements, tax subsidies for private pay clients, increased Medicaid rates, and more in hopes of finding one or more solutions. NAHC President Val J. Halamandaris successfully took the message to the White House in 2012 and 2013, leading to delays in the application of the mandate.  However, beginning January 1, 2015, any employer of 100 or more full-time equivalent (FTE) employees will find the mandate taking effect.

To solidify NAHC’s advocacy on the employer mandate, nationwide surveys were conducted in 2013 and 2014 to demonstrate the real-life impact of this requirement. NAHC is now processing the survey responses and preliminary indications are that a high number of home care companies are at risk.

These preliminary results include:

  • 46.22% of home care companies of all types expect to be subject to a financial penalty as they do not provide a qualified health insurance to all their full-time (30 hours per week) employees
  • 22.16% of the home care businesses are considering closing entirely due to these costs
  • 73.3% of affected companies are considering a shift to a part-time workforce to avoid the impact of the mandate
  • 83.3% of survey respondents believe that the mandate will cause a reduction in access to home care
  • 88.46% of survey respondents believe that he mandate could significantly reduce access to care for Medicaid beneficiaries

The mandates hit two home care sectors particularly hard: private pay personal care services and Medicaid home care. For companies that predominately provide private pay services (41% or more of total company revenue), 92.59% do not provide health insurance to all of their workers. Of those companies, 51% expect a significant financial penalty with estimated penalties as high as $558,000 annually.

Medicaid-primary home care companies (41% or more Medicaid home care revenues) show similar risks. 85.42% of such survey respondents do not offer health insurance to all employees. Of those companies, 64.1% expect to face a steep financial penalty as high as $4.5 million annually. So far, no state Medicaid program has stepped up to provide home care employees with health insurance or improve payment rates to cover such cost. To date, the federal Center for Medicaid Services has been unwilling to consider the concerns of Medicaid stakeholders including those voiced by NAHC and advocates for persons with disabilities as part of an ACA Medicaid Coalition, instead merely indicating that CMS would pay the appropriate federal financial portion (FFP) of any state Medicaid costs that increase as a result of the employer mandate.

NAHC is developing a White Paper to fully display the survey results and provide a detailed impact analysis. When completed, the White Paper will be used in the national advocacy on this issue and made available to the press and public.

NAHC extends its thanks to all who took the time to respond to the survey. Information gained from such surveys is extremely valuable in advocacy efforts on behalf of home care and hospice. The ACA employer mandate survey is the only source of crucial information on the impact of the employer mandate on home care companies, employees, and care to patients and clients in home care. 




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