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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

Nebraska Supreme Court Reverses Medicaid Home Care Denial for Disabled Child

May 29, 2015 09:44 AM

The Nebraska Supreme Court reversed a lower court ruling and an earlier administrative determination in granting Medicaid coverage of home and community based services (HCBS) to a severely disabled child who had been receiving Medicaid HCBS for over 12 years prior to the denial.  The court held that the Medicaid program, as well as the lower court, applied the wrong eligibility standards in determining that “Brayden O.” did not meet the requirements for a nursing facility level of care thereby failing to meet HCBS eligibility standards.  The court concluded that the standards applied by the state Medicaid program “placed a far greater burden on disabled children than similarly situated disabled aged persons and adults” by selectively relying on mobility and transferring capabilities.  Under the state’s standards, any child who could walk and get in and out of bed or a car was disqualified from HCBS coverage regardless of any other functional or cognitive limitations.

 Brayden suffers from Coffin-Lowry Syndrome, which is generally characterized by craniofacial abnormalities, skeletal abnormalities, short stature, and hypotonia (a condition causing low muscle tone and reduced strength).  She has also developed moderate kyphosis (a curving of the spine) and problems with her feet.  She lacks pain awareness and suffers from a seizure disorder.

Brayden has a high palate, which necessitates that she be monitored for choking when she eats. She requires assistance at all times in bathing, dressing, and grooming.  She is dependent on others and needs constant supervision in all parts of toileting.  There is evidence that she has lost bowel and bladder control. She has extremely limited cognitive ability.  She requires a hearing aid and has difficulty seeing a level of print.

At school and on the bus to and from school, Brayden requires constant supervision and has a one-on-one paraprofessional to assist her at all times.  Brayden has no sense of danger or safety.  She needs assistance on the playground, uneven surfaces, stairs, and curbs.  She is almost completely dependent on others in her ability to communicate.  She “communicates inappropriate intent” and is not able to effectively use communication boards or other adaptive devices.  As to her behavior, Brayden needs and receives regular intervention in the form of redirection because she has episodes of disorientation.  She does not have any sense of herself in relation to space and requires supervision with respect to orientation.  As to judgment, she lacks the ability to solve problems and make appropriate decisions.  She can find the letter “G” on a keyboard but has difficulty finding other letters.  She can identify the numbers 1 through 5 with 80-percent accuracy but cannot identify numbers 6 through 10, nor is she accurate in counting certain sets of items (e.g., two newspapers, three markers, et cetera).

Brayden O had been covered under Medicaid for HCBS since 2001.  Medicaid denied continued eligibility as a result of a periodic reassessment using an evaluation process established by Medicaid.  The Supreme Court found that the evaluation process used did not conform to the criteria for HCBS which conditioned eligibility on a determination that the individual would otherwise need a nursing facility placement.  The Court concluded that the eligibility process used was inconsistent with the existing regulatory requirements in that it did not take into consideration all the criteria set out in the Medicaid rules, including ADL limitations, risk factors, medical treatment and observation, and cognitive impairments.  The court found that Medicaid applied the standards for care planning rather than eligibility, standards that were different from each other.

While each state Medicaid program is different and HCBS eligibility standards can greatly vary, the Nebraska Supreme Court decision is an important example of how states can misinterpret and misapply their own rules in determining eligibility for home care programs.  Medicaid recipients have significant protections under federal law that require a continuation of services and benefits pending an appeal of any decision that terminates or reduces benefits.  Over the past few years, NAHC has observed that state Medicaid programs have tightened their reviews of long term HCBS beneficiaries leading to denials of benefits to individuals whose conditions and needs have not changed sufficiently to justify the termination of benefits.

The case referenced is entitled, Merie B. on behalf of Brayden O. v. State of Nebraska Department of Health and Human Services. The May 22, 2015 decision can be found here:​s/sc/opinions/scMay22S-14-007.pdf




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