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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

Two House Committees Convene Hearings on Impacts of the ACA Employer Mandate

Statements and testimony cite employers reducing hours to avoid penalties
April 15, 2015 12:00 PM

Two U.S. House Subcommittees—the Ways & Means Health Subcommittee and the Education & the Workforce Subcommittee on Health, Employment, Labor, and Pensions—convened hearings today that focused on the impact of the employer mandate included in the Affordable Care Act (ACA).  The hearings received testimony from business owners, think tanks, and trade associations about the negative consequences of the mandate on both employers and employees, as well as other aspects of the ACA.

In his opening statement, House Subcommittee on Health, Employment, Labor, and Pensions Chairman David P. Roe (R-TN) gave specific example of employers that have reduced hours or altered staffing in order to avoid penalties under the employer mandate.

“More than 450 employers have publicly stated they are cutting hours or making other staffing changes to avoid the law’s punitive mandates, including the University of Colorado in Colorado Springs, Trig’s Supermarkets and Coach’s Fast Food in Wisconsin, Shari’s restaurants in Oregon, and the Henrico County School District – as well as other school districts – across the Commonwealth of Virginia,” Chairman Roe stated.

Roe explained that the employer mandate has negative consequences not only for employers but also workers.  “The Congressional Budget Office estimates the law will result in two million fewer full-time workers.  Many of these difficult changes are taking place in the service industry, which means lower-wage workers are bearing the brunt of the ObamaCare burden.  Schools are also cutting hours, undermining the quality of education America’s students deserve.  We’ve heard time and again from the administration that these are mere anecdotes or, in the words of then-Secretary Sebelius, ‘speculation.’  Yet even those who supported the health care law have no choice but to recognize its harmful consequences.”

House Ways & Means Health Subcommittee Chairman Kevin Brady (R-TX) recounted stories from business owners about the impact of the mandate.  “I have a local restaurateur who has instructed his four store managers they will never again hire a full time worker,” Brady said.  “He has been advised by his accountants that he would—because of the ACA—would actually be more profitable by closing three of the stores and going with one, which is exactly what he doesn’t want to do. He wants to have a pizza small business in Willis, TX, and would like to expand to two neighboring communities. But primarily because of this, he can’t afford to do so.”

In a sign of bipartisan support for addressing some of the issues with the employer mandate, Congressman Jim McDermott (D-WA), who has been critical of efforts to repeal the ACA, indicated willingness to consider legislation that would ease the reporting requirements on employers for offering coverage to workers.

The testimony and statements during the hearing reflect concerns expressed by the National Association for Home Care & Hospice (NAHC) that many home care agencies will be unable to provide health insurance or unable to pay the ACA penalties.  As a result, home care agencies will be forced to cut their employees’ hours to less than 30 in order to avoid the health insurance requirement.  In its 2015 Legislative Blueprint for Action, NAHC recommends Congress should: modify the employer responsibilities in the ACA to address home care specific needs; exempt home care providers from the employer responsibilities; fund the cost of health insurance for full time workers; help the states ensure that low wage home care workers have health insurance through Medicaid or otherwise; provide subsidies or tax credits to cover the increased cost of care as a result of the employer mandate.  Consumers of private duty care should not need to pay higher rates of care. 

Another proposal that NAHC strongly supports would amend the definition of full-time work from 30 hours or more per week to 40 hours or more per week.  The House passed this legislation earlier this year in January, and similar legislation has been introduced in the Senate.  The ACA imposes penalties on employers with more than 50 full-time equivalent employees that do not provide health insurance for “full-time” workers, which it defines as those working just 30 hours or more a week.

NAHC plans to submit statements for the record for both Committee hearings.  NAHC has also received information that Congress intends to hold more hearings on the employer mandate, and NAHC will continue to address home care and hospice specific needs with regards to the ACA’s employer requirements.

NAHC conducted a survey in December 2014 that found the employer mandate would negatively impact home care and hospice agencies.  The results found it 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.  Here are the results of the study:

  • 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.

While the House has already passed a bill changing the full-time definition in the employer mandate, the Senate has not yet passed the legislation.  Senate leaders have indicated they will bring the bill to a vote if there are enough votes to pass it.  Please contact your Senators using NAHC’s Legislative Action Center to cosponsor legislation defining 40 hours as full-time.




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