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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

NAHC Submits Comments on CMS’ Proposed Rule on Accountable Care Organizations

February 11, 2015 01:05 PM

Earlier this month, the National Association for Home Care and Hospice (NAHC) submitted formal comments to CMS on their proposed rule on Accountable Care Organizations (ACOs) within the Medicare Shared Savings Program. NAHC’s comments focused on three main areas:

1.   Waivers for telehealth services;

2.   Waiver of the homebound requirement and other payment waivers, and;

3.   Waivers for referrals to post-acute care settings

NAHC states in its comments that:

“NAHC recommends that any waiver should apply to beneficiaries in Track 2 in addition to Track 3 ACO MSSPs. Limiting to waivers to Track 3 may discourage ACOs that are currently in Track 1 from participating in a Medicare Shared Savings Program for fear of taking on too much risk unless if wavers are also applied to Track 2 ACO agreements. Any ACO that assumes some level of risk should have the flexibility to provide care that achieves the dual goals of positive patient outcomes and Medicare savings.”

With respect to waivers for telehealth services, NAHC’s comments state that:

“NAHC supports CMS’ proposal to waive certain telehealth requirements for beneficiaries in a Medicare Shared Savings Program (MSSP). Expanding the geographic area and the originating sites for telehealth services will greatly enhance the Accountable Care Organization’s (ACOs) ability to coordinate care and improve accessibility and timeliness of needed care.  The increased flexibility in the use of telehealth will also create better efficiencies in providing care to individuals with chronic diseases and the vulnerable elderly.

NAHC urges that CMS permit the beneficiary’s home to be an approved originating on site for the telehealth waiver. Permitting payments to ACOs for telehealth services in beneficiaries’ homes would provide the ACO with a mechanism to readily address the needs of high risk patients, who are often confined to the home. Practitioners could intervene at critical points, thus avoiding more costly interventions. In addition, providing telehealth services in the home would go a long way in maintaining the beneficiary’s health status and prevent unnecessary hospitalizations.

Homebound patients cannot readily avail themselves of useful telehealth services under the current originating site restrictions. Today’s portable telehealth equipment performs the same functions as equipment stationed in a hospital or nursing home. As such, the originating site restrictions unnecessarily limit access to telehealth services and the resulting improvements in care quality and efficiency.”

NAHC’s comments relative to waiving the homebound requirement once again raise the organization’s concerns with CMS’ proposed start rating system, stating that:

“NAHC applauds CMS’ proposal to waive the homebound requirement for certain beneficiaries in MSSPs. NAHC also appreciates that CMS recognizes that the homebound requirement could impede the ACO’s ability to effectively care for high risk patients. Home health agencies have been at the forefront of innovation in caring for patients with multiple chronic conditions with the explicit goal of preventing re-hospitalizations. We believe the ACOs, as well as the beneficiaries will benefit tremendously if home health care can be provided before a patient’s condition deteriorates to the point of rendering a patient homebound.

CMS proposes to only permit waiver of the homebound requirement for those home health agencies that have a quality rating of 3 or more stars.

NAHC recommends that CMS not apply a star rating system as a quality metric for home health care for the MSSP. NAHC has concerns with CMS’ proposed star rating system, particularly, the measure selection and the rating calculation methodology. In addition, a star rating for home health care has yet to be fully developed and tested. More importantly, the star rating on an HHA is not a measure of its ability to achieve Medicare program savings.”

In its comments, NAHC also recommends how CMS could more properly provide waivers for referrals to post-acute settings, stating that:

“CMS proposes to waive the requirement thatthe hospital maynot specify or otherwise limit the qualified provider which may provide post-hospital home services’’when providing the beneficiary with a list of qualified post-acute care providers. The ACO would be permitted to recommend preferred providers. However, the beneficiary’s freedom of choice would be maintained when selecting a post-acute provider. 

Recommendations: NAHC supports the waiver to permit the ACO to list and recommend preferred providers on the hospital post-acute care provider list under certain conditions:

First, patients in the ACO realm should be notified in advance that participation in the ACO may mean that the ACO directs patients to certain pre-identified post-acute care providers.

Second, hospitals participating in the ACOs should be required to provide written and verbal notice to the individuals in need of post-acute care of their right to choose any qualified provider in advance of making a recommendation. Along with the notice, the hospital should provide detailed information about any qualified provider that the patient wishes to consider and arrange for an in-hospital visit with the patient for that post-acute provider.

Third, the hospital must disclose to patients and providers the criteria applied in making provider-specific recommendations.”

To read NAHC’s full comments, please click here.




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