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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

Senate Passes Amendment to ACA’s Full-Time Employment Definition

April 1, 2015 07:51 AM

Last week, the US Senate passed a budget resolution that included an amendment, introduced by Senator Susan Collins (R-ME), addressing the definition of full-time employment under the Patient Protection and Affordable Care Act (ACA). Budget amendments do not have the force of law. However, the amendment’s success demonstrates the strong support in Congress to amend the ACA’s definition of full-time employment.

Senator Collins (R-ME), in January, also introduced stand-alone legislation, the “Forty Hours Is Full Time Act” (S. 30), with bipartisan original cosponsors: Senators Donnelly, Manchin, and Murkowksi.

The Collins amendment was adopted as part of the Senate budget resolution by unanimous consent. Due to parliamentary rules for budget amendments, the amendment is different than S. 30. Rather than specifically changing the definition from 30 to 40 hours, the amendment expresses support for restoring a “sensible” definition of a full-time employee.

The purpose of the budget resolution is to establish the level of discretionary spending for the coming fiscal year. It also provides an opportunity for Congress to voice its priorities through nonbinding policy proposals, such as the Collins amendment.

The National Association for Home Care & Hospice (NAHC) strongly supports both Senator Collins’s amendment and S. 30.

Currently, the ACA imposes penalties on employers with more than 50 full-time equivalent employees that do not provide health insurance for a “full-time” worker—defined as those working just 30 hours or more a week. NAHC believes this definition is out-of-keeping with standard employment practices, and that it will harm many home care agencies and the patients they serve.

While the vast majority of home care agencies are small businesses according to the Small Business Administration, the ACA defines them as “large employers” based on the fact that they have 50 or more employees. Many home care agencies do not provide health insurance to home care workers for reasons that are fairly unique to the industry. The agencies are reliant on government programs such as Medicaid, which provides low payment rates that do not cover the costs of providing health insurance. Home care workers typically work widely varying hours, based on the needs of their home care clients.

Of concern, home care agencies that are unable to provide health insurance or pay the ACA penalties will be forced to cut their employees’ hour to less than 30 in order to avoid the health insurance requirement.

According to a NAHC survey from December 2014, the full-time definition in the ACA would weaken patient access to care, reduce wages and working hours of home care staff, and force home care companies to restructure their operations to rely on part-time caregivers:

  • 82.54% of home care and hospice companies do not provide health insurance to all of their employees because of reliance on government program payments and service to individuals with limited incomes
  • 46.2% of those companies face a financial penalty under the employer mandate ranging as high as $4.5 million
  • 73.3% of the companies would reduce the working hours of employees to under 30 per week in order to avoid the cost of health insurance or financial penalties that they cannot afford
  • 22.16% of the businesses expect to close because of the financial penalties
  • 83.2% of the companies expect that access to home care in their community would be reduced with fewer providers of care, more restrictive patient admission criteria to fit a part-time workforce, and restrictions on service areas.
  • 88.46% expect that access to Medicaid home care will no longer be sufficient to meet client’s needs

Please contact your members of Congress using NAHC’s Legislative Action Center to cosponsor legislation defining 40 hours as full-time.




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