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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

Adopting Information Technologies for Post-Acute and Long-Term Care: Achieving Care Continuity

Capitol Hill briefing focuses on IT tools for home care and long-term care
March 6, 2015 10:38 AM

What is the outlook for health IT? An expert panel recently addressed this question at a Capitol Hill briefing “Adopting Information for Technologies for Post-Acute and Long-Term Care: Achieving Care Continuity.” The briefing is part of a series of educational programs sponsored by the Capitol Hill Steering Committee on Telehealth and Healthcare Informatics in collaboration with the American Health Care Association (AHCA) and National Association for Home Care & Hospice (NAHC). It brought together federal agency leaders and industry experts at the Russell Senate Office Building where they explored ways health IT supports care delivery networks, drives value-based payment, and supports quality outcomes. The panel also discussed how some providers use health IT to engage with accountable care organizations (ACOs) and health plans, participate in bundled payment arrangements, and develop innovative practices like telehealth and monitoring in homes.

Health IT is a must in terms of long-term care continuity because “we can’t keep relying on physicians’ offices,” said Neal Neuberger, panel moderator and executive director of The Healthcare Information and Management Systems Society (HIMSS) Foundation’s Institute for e-Health Policy. His organization provides critical educational opportunities in the Washington, DC, area for public- and private-sector stakeholders who make health policy or are affected by it.

Among the heavy hitters in this area of health care is the Office of the National Coordinator for Health Information Technology. ONC works with the Department of Health and Human Services (HHS) to establish the national agenda for health IT and they have recently set expectations around the continuum of care, said Kelly Cronin, director of the Office of Care Transformation at ONC. Her office has come up with new goals for moving Medicare to value-based payment so that providers are increasingly held accountable. “This major shift in payment,” she said, “makes it explicit that long-term providers are partners,” across the continuum of care, so exchanging information is even more important. “HHS has set a three-year goal for most Medicare providers to be able to send, find, and exchange common data. And “there’s a good chance this interoperability goal is feasible,” she said, if we take some near-term actions: “refining what we have and making it usable, making it meaningful for providers, and making changes to how privacy and security are addressed. In addition, “we need to establish best available standards.”

These standards are laid out in the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014, said Liz Palena Hall, long-term and post-acute care coordinator in the Office of Policy at ONC. IMPACT, Hall explained, creates instruments to modernize Medicare payments to PAC providers and produce a more accountable, quality-driven PAC benefit. It encourages these outcomes “by requiring standardized patient assessment data” and “using all HHS policy levers to drive interoperability across the health care continuum.” In addition, ONC has issued certification guidance for developers of electronic health records and published its standards advisory for 2015. Where these standards are being implemented, there are uniform information systems for every patient. To nudge more providers in this direction, ONC has made a number of funding announcements, including one to educate health care professionals in health IT.

The benefits of health IT are apparent at Good Samaritan Health Society, which provides home and community, senior living, and rehab/skilled services to more than 20,000 people across the nation. “Technology is changing our organization,” said Rusty Williams, VP and CIO of Good Samaritan Health in Sioux Falls, South Dakota. The major driver of change, as he explained, is a service called Living Well at Home, designed to improve clinical productivity while cutting costs. “Living Well at Home collects and analyzes information for early detection of problems,” he said, “and empowers individuals to live at home.” The service collects data on mobility and vital signs, indicators that paint a good picture of an individual. After looking at the data, RNs follow up with clients, providing a personal touch that’s important to improving outcomes. To enhance the service even more, Good Samaritan is working on ways to share information with patients’ primary care doctors and they’re experimenting with point-to-point video conferencing so nurses can actually see their patients.

It’s worth the investment because the cost reductions are already clear, Williams observed. “We began with one nurse for 75 patients and we now have one nurse for 400 patients.” One of them is Connie Miller who appears in a commercial for Living Well at Home. The service has allowed her to monitor her blood pressure and oxygen levels, as well as provide her physician with information that helps — and make Connie feel safe. “When I was in trouble,” she tells viewers, “somebody would call me. I can see that I’m being cared for without nursing home care.”

Technology has also conferred tangible benefits on Mission Health Services, a Utah provider which crosses the spectrum in services for seniors. “We were struggling 12 years ago as we watched residents flow between different facilities in our organization,” said Gary Kelso, president and CEO of Mission Health. “We knew technology would help us in our clinical outcomes and we were very involved in cultural change to make greater use of data.” As a result, Mission Health has gone from average to best in class. The information they collected helped them know their residents better, and the improvements they saw led them to adopt an electronic medical record (EMR) system with support from the Utah Department of Health. As Mission Health used the new system and became more efficient with data, their deficiencies dropped and customer satisfaction rose.

EMRs have numerous benefits, as Kelso explained. “They let you know what you didn’t know, reduce survey deficiencies, give staff tools to manage the survey process without imposed survey outcomes, and provide information — all plusses that matter to potential partners. “If you don’t have an EMR,” Kelso pointed out, “you’re not at the table with managed care or accountable care organizations. The only way you’re going to get at the table with ACOs is with an EMR.”

EMRs are an important part of the thrust to save money and promote longitudinal coordination of care. “Interoperability is a way to get to a higher level of long-term care,” according to Richard D. Brennan, Jr., NAHC’s vice president of technology policy, government affairs, and executive director of its affiliated Home Care Technology Association of America. In his close study of providers, Brennan has seen that “home care has been making significant strides forward in the use of technology.” The figures show that 78.1 percent of home health agencies (HHAs) use electronic medical record systems, 57.8 percent of HHAs use point of point of care (POC) systems, and 28.7 percent of HHAs use telehealth/remote patient monitoring.

These figures matter even more as an aging population leads to more patients who have chronic conditions and can be cared for at home with the right hi-tech tools. “Over time,” Brennan pointed out, “aging in place will reduce hospitalizations,” and telehealth is already showing measurable results: a 72.9 percent increase in overall quality, a 64.4 percent increase in care coordination, a 64.2 percent increase in patient satisfaction, a 56.1 percent increase in patient self-care, and 65.1 percent fewer emergent care admissions, along with 69. 8 percent fewer unplanned hospital stays.

 Based on these improvements, “we are advocating that our home health agencies become sophisticated adopters of technology,” Brennan said. And it will be easier for them and other health care providers to advance along the high-tech highway if government takes steps to advance health IT.”HHS should focus on high value deliverables — such as exchange of transitions of care summaries and interoperable care plans — shared by doctors, hospitals, and long-term post-acute care providers. In addition, Congress should consider legislation to spread the use of interoperable health IT to all settings and authorize reimbursement for remote telehealth and remote patient monitoring in Medicare,” Brennan advised.

 And providers should always keep in mind that high tech and high touch work in tandem to produce the best results for both providers and patients. As Neuberger summed up, communities need to pay more attention to the Triple Aim set out by the Institute for Healthcare Improvement: improving the patient experience of care (including quality and satisfaction), improving the health of populations, and reducing the per capita cost of health care. “The sooner we get to that,” he concluded, “the better.”




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