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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

Heath 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

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

Side-By-Side Comparison of the House- and Senate-Passed Budget Plans to Restructure Medicare and Medicaid

April 9, 2015 09:57 AM

Before adjourning for the Congressional April recess, the House and Senate both passed their respective budget resolutions.  Congress will return from recess on April 13.  The customary deadline for both houses of Congress to agree on a single budget blueprint  is April 15, leaving Congress with only two days after recess to resolve differences between the two plans and pass an agreed upon version.  Congressional members and staff have reportedly been working over the recess to iron out differences.

In the past several years, Congress has failed to pass a budget resolution.  Upon taking control of both chambers of Congress, Republican Congressional leaders expressed desire to return to “regular order” for the budget process, which would require Congress to pass a budget resolution by April 15. 

As previously reported, each budget proposes significant health policy changes, including restructuring Medicare and Medicaid and cutting spending on these programs.  The proposals in the budget resolutions do not have the force of law, apart from setting the level of discretionary spending for the coming fiscal year, and convey broad policy goals rather than specific legislation at this point.  However, the budgets do indicate Congress’s views and intentions on specific policy issues.  Furthermore, moving forward, Congress has the option of using a procedural tool known as ‘reconciliation’ to pass legislative changes in keeping with the goals set out in the budget resolution.  Congress can include reconciliation instructions in the budget resolution directing committees of jurisdiction to develop legislation in order to bring spending in accordance with the budget resolution.  A budget reconciliation bill needs only 51 votes in the Senate to pass, rather than the 60 votes needed for other legislation.

Both budgets proposals would balance the budget within 10 years through significant reductions to domestic spending.  Each budget proposal would repeal health insurance provisions in the Affordable Care Act (ACA), while keeping the ACA’s cuts to Medicare and other savings.  The House budget would reduce Medicare spending by $148 billion, as well as Medicaid and other spending by $913 billion over 10 years.  Meanwhile, the House budget would increase defense spending by $318 billion relative to the Budget Control Act caps.  The Senate budget by contrast would reduce Medicare spending by $431 billion over 10 years, without increasing defense spending.

Here is a side-by-side table comparing each budget’s proposals that would affect Medicare and Medicaid:

House Bill

Senate Bill

Reduce Medicare by $148 billion, along with Medicaid and other health care spending by $913 billion over 10 years.

Cuts Medicare by $431 billion over 10 years.

Changes Medicare to implement a “premium support” model.

Supports President’s target Medicare savings ($431 billion) but allows Congressional Committees to develop own policies to achieve the savings.

Repeals health insurance provisions in the ACA, while keeping the ACA’s cuts to Medicare and other savings.

Repeals health insurance provisions in the ACA, while keeping the ACA’s cuts to Medicare and other savings. Replaces ACA with “reserve funds” for future health reform legislation. 

Merges Medicare Parts A and B with a single deductible for seniors.

Does not endorse specific Medicare changes.

Repeals Medicare Physician Sustainable Growth Rate formula.

Requires that Medicare savings be devoted to Medicare rather than be used for other spending.

Repeals Medicaid Expansion under the ACA.

Repeals Medicaid Expansion under the ACA.

Merges Medicaid and the State Children’s Health Insurance Program into a single program.  Create a block grant program giving states flexibility to design their own Medicaid programs.

Restructures Medicaid based on the Children’s Health Insurance Program. Provides states with more flexibility in designing programs and administering benefits.


In its Legislative Blueprint for Action, the National Association for Home Care & Hospice (NAHC) has stated opposition to some of the proposals reflected in the House and Senate budgets plans. NAHC opposes restructuring Medicare to combine deductibles or to implement a “premium support” model.  NAHC also opposes turning Medicaid into a block grant program.  At this point, the proposals by Congress are broadly stated policy goals, rather than specific legislative changes.  However, as Congress moves forward with the budgetary process, NAHC will provide further analysis and oppose any change that harm home care and hospice.




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