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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

Role Nurses Play in Addressing the Looming Demand for Care as Americans Age

New policy brief from Robert Wood Johnson Foundation finds that Nurses are creating innovative long-term services and supports that improve quality of life for older Americans
February 13, 2015 11:07 AM

Within four decades, as many as 84 million Americans will be 65 or older — twice the current number of seniors, and almost 20 percent of the total U.S. population. The great majority of these Americans will likely seek assistance in maintaining their health and well-being, making it essential that the nation develop effective and affordable ways to provide the long-term services and supports (LTSS) they need.

The latest issue of the Robert Wood Johnson Foundation’s Charting Nursing’s Future (CNF) policy brief series offers ample evidence that nurses have developed creative, sustainable, and compassionate ways to care for people who, because of disability, frailty, or illness, cannot care for themselves. In a variety of ways, nurses are making it easier for older, chronically ill individuals to stay healthier, remain in the community with their families, and avoid developing expensive debilitating conditions. The brief describes a number of innovative LTSS programs, as well as their collective potential to reshape the future of care for older Americans.

The policy brief’s findings reinforce what has long been known within the home care and hospice community – that the overwhelming majority of seniors prefer to age in place, and high-quality home care costs only a small fraction of what institutional care does. This is possible due in part to the creative approach and caring philosophy of dedicated home care and hospice nurses.

“Home care represents the best tradition in American health care,” said NAHC President Val J. Halamandaris. “Home care is the most effective form of health care, and there is very high consumer satisfaction associated with care delivered in the home. What’s more, home care is given by special people. By and large, home care nurses and aides look at what they do as a calling not as a job.”

Among the programs analyzed by the Robert Wood Johnson Foundation, a number of goals and approaches were discovered, including:

  • Improving care transitions,
  • Enabling older adults to live in the community,
  • Preventing physical and cognitive decline,
  • Coaching and supporting family members, and
  • Making institutional care more homelike.

Transitional Care

Nurses have long worked to find better ways for patients to transition from hospital to home. One early innovator was Mary D. Naylor, PhD, RN, FAAN, Marian S. Ware professor in gerontology at the University of Pennsylvania, who pioneered the design of a transitional care model that uses advanced practice registered nurses (APRNs) to coordinate care for high-risk older adults within and across health care settings. The model has been shown to reduce readmissions, improve patients’ quality of life, and save money. Another model, developed by University of Colorado professor Eric Coleman, MD, MPH, uses RNs and has also produced impressive results. The success of these models led Congress to allocate $500 million for such efforts as part of the Affordable Care Act.

Supported at Home

Twenty years ago, Jennie Chin Hansen, RN, MS, FAAN, recognized the potential of a pioneering local initiative serving San Francisco’s low-income frail, older adults and helped turn it into the federally funded Program of All Inclusive Care for the Elderly (PACE). It now serves 30,000 beneficiaries through 104 programs in 31 states.

PACE provides health promotion, health maintenance, and full medical and social services to adults 55 and older who qualify to be in nursing facilities but who instead remain in their homes with significant support from PACE. Each program uses a PACE center as a focal point for providing services. Enrollees spend two to three days a week at the centers, where they can see a primary care provider, receive physical therapy or personal care, refill prescriptions, and join in social activities. PACE provides care from a home health aide when necessary and evaluates members’ homes to ensure a safe living environment. Interventions range from removing hazards such as poorly placed electrical cords to installing assistive devices.

Nurses have a high degree of clinical autonomy within the program, and they often operate as leaders of health care teams that include physicians, other nurses, social workers, dietitians, nurses’ aides, drivers, and physical, occupational, and recreational therapists.

Delaying Decline, Coaching Family Caregivers

Nurses have taken the lead in creating several innovative programs intended to delay patients’ physical and cognitive decline, and support family caregivers—two strategies for postponing the need for LTSS.

For example, in 2001, Claudia Beverly, PhD, RN, FAAN, director of the Hartford Center of Geriatric Nursing Excellence at the University of Arkansas for Medical Sciences College of Nursing, facilitated the launch of the Arkansas Aging Initiative. The statewide network of nine aging centers serves as many as 1,600 older adults.

Each center is owned and managed by a local hospital and employs a geriatrician, an APRN, and a social worker to provide both primary care and education about chronic conditions. The team supports people as they navigate various health care settings and provides care in the home when needed. The centers also offer programs to family caregivers, health professionals, and students on how to assist people with LTSS needs. In addition to coping strategies, family caregivers learn the proper use of such assistive devices as hospital beds, walkers, canes, lifts, and transfer equipment.

In Milwaukee, WI, Beth Meyer Arnold, RN, MS, a specialist in gerontology, and Lyn Geboy, PhD, an environmental gerontologist, have developed “Optimize: Your Brain and Health.” The eight-week program for people with mild cognitive impairment aims to slow the course of their decline and to support care partners. The curriculum emphasizes a healthy lifestyle and physical and social activities that engage the brain. Once a week for two hours, individuals with mild cognitive impairment meet in a group. They exercise, learn about cognitive functioning, and work on creative artistic projects to keep the brain challenged. Participants learn about diet, communicating effectively, and other strategies for managing cognitive deterioration.

An RN or social worker meets separately with the individuals’ care partners to teach them about the progression of dementia, coping strategies, and community resources for support.

Educating Nurses for the Future

As the brief notes, fewer than one percent of the nation’s RNs are certified gerontological nurses, many fewer than will be needed in a few years. That looming shortage prompted the Institute of Medicine to call on nursing schools to do more to educate students about geriatric care.  Foundations, nursing schools, and professional associations are collaborating on a number of initiatives to breathe life into this effort.  Additionally, the Affordable Care Act authorized $200 million over four years for a novel Graduate Nursing Education Demonstration program whose goal is to increase the number of APRNs trained to provide primary care to Medicare beneficiaries.




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