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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

Bipartisan Legislation to Repeal Independent Payment Advisory Board Introduced in the House

March 16, 2015 01:06 PM

Last week Congressman Phil Roe (R-TN) and Congresswoman Linda Sánchez (D-CA), along with over 200 bipartisan original cosponsors, introduced the Protecting Seniors’ Access to Medicare Act (H.R. 1190), which would repeal the Independent Payment Advisory Board (IPAB), a provision of the Patient Protection and Affordable Care Act (PPACA). The IPAB has faced widespread opposition from a variety of health care organizations, including The National Association for Home Care & Hospice (NAHC), due to concerns that it would limit access to care for Medicare beneficiaries, shift costs to consumers, and usurp the authority of Congress. 

With the introduction of the House bill, versions of the legislation repealing the IPAB have been filed in both chambers of Congress. Senator John Cornyn (R-TX) in January introduced a Senate version, S. 141, which has 37 cosponsors. 

Congressman Roe had also sponsored the bill last Congress when the effort ultimately received 227 bipartisan cosponsors. “As a physician with more than 30 years of experience, I find the ability of this board to intervene in the patient-doctor relationship particularly troubling,” Roe said about identical legislation last Congress. “I believe my bill is a testament to the fact that members of Congress can put party politics aside, come together and do what’s right for our seniors. I will continue to push for a full repeal of the IPAB, and I look forward to working with my colleagues—both Republicans and Democrats—to protect and preserve Medicare.”

While Congresswoman Sánchez had not previously been the lead Democratic sponsor of the bill, she has long opposed the IPAB and had cosponsored the legislation in the past. At the time Congress passed the PPACA, Sanchez supported the underlying bill but raised concerns specifically about the IPAB provision. “Without doubt, this is not a perfect bill,” Sánchezsaid in 2010 when announcing her support for the PPACA. “It [the PPACA] contains an Independent Payment Advisory Board, which would severely limit Congressional oversight of the Medicare program and place authority within the executive branch, without Congressional oversight, judicial review, or state or community input… Just about every bill can be improved in one way or another.”

The IPAB provision of the PPACA (P.L. 111-148) created a board of presidential appointees with the power to make recommendations to cut Medicare if expenditures reach a certain level. The actions by the IPAB would be subject to little oversight, and the provision prohibits judicial review once the Secretary of Health and Human Services implements an IPAB recommendation.

While proponents of the IPAB claim it could result in health care delivery reforms, a requirement in the provision that IPAB must achieve savings within one year would force the IPAB to focus on short-term payment cuts to providers rather than long-term reforms. According to an issue brief by the Kaiser Family Foundation, the requirement to achieve Medicare savings in the implementation year “may discourage the type of longer-term policy change that could be most important for Medicare and the underlying growth in health care costs, including delivery reforms.” Instead, “the IPAB may be more likely to consider more predictable, short-term scoreable savings, such as reductions in payment updates for certain providers.”   

In addition to the concerns about harming access and cost-shifting, NAHC has objected that the authority granted to the board should belong of Congress. It would be unprecedented for an unelected board to have the authority to put forth reductions to Medicare, rather than Congress considering such changes. The democratically elected members of Congress should have the authority to debate and make changes to Medicare, which is a public program upon which millions of seniors and disabled persons rely. By usurping the authority of Congress, the provision also limits the power of citizens to petition Congress and meaningfully participate in the lawmaking process.

NAHC has called for repeal of the IPAB as part of its Legislative Blueprint for Action. Please stay tuned to for further details and NAHC Action Alerts on this effort.  




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