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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

Misclassification of Independent Contractors Gains Attention in Home Care

August 14, 2015 09:54 AM

Recently, the US Department of Labor (DOL) implemented a project to reduce the improper classifications of employees as “independent contractors” in all types of workplaces (see more here). The DOL Misclassification Initiative involves an education campaign, clarified guidance, and collaborative efforts with state labor departments. The DOL concern with misclassifications is related to the impact on workers under the Fair Labor Standards Act (FLSA) protections for minimum wage and overtime compensation. Over the years, DOL has raised concerns about misclassifications in home care. Now, a federal court ruling against a home care registry highlights the risks of misclassifications in home care.

On July 30, 2015, the U.S. District Court for the Northern District of Florida issued an order finding that a home care registry, operating under Florida registry licensure, improperly classified a Certified Nursing Assistant (CNA) worker as an independent contractor. The court applied the “economic-reality” test applicable under the FLSA in reaching its decision. The economic-reality test is different than the standards applied by other federal and state agencies. As a result, a worker may be classified properly as an independent contractor under the IRS 20-factor control test, while the same worker may be considered an employee under the FLSA economic-reality test.

In a July 15, 2015 guidance issued by DOL, Administrator’s Interpretation 2015-1, DOL sets out the factors considered under the FLSA test (see more here). These factors include:

  • Is the work an integral part of the employer’s business?
  • Does the worker’s managerial skill affect the worker’s opportunity for profit or loss?
  • How does the worker’s relative investment compare to the employer’s investment?
  • Does the work performed require special skill and initiative?
  • Is the relationship between the worker and the employer permanent or indefinite?
  • What is the nature and degree of the employer’s control?

The court in the Florida case applied these same factors in reaching a finding that the CNA was the registry’s employee rather than an independent contractor. In that matter, the CNA could refuse work assignments without consequence and was not required to work a minimum number of hours or days. However, the CNA was paid by the hour with the rate dependent upon the registry’s contract with the referring government agency. The CNA was required to keep a record of time work and compensation was withheld in the absence of timesheet submission. The CNA was also subject to “persistent oversight” by the registry in the form of customer satisfaction surveys, supervisory visits, and incident reports. The registry also imposed a non-compete agreement limiting the CAN’s ability to work elsewhere. Certain worker standards also were imposed including appearance, conduct, and secondary employment. All worker functions were specified in detail. The court found that the registry exercised a significant degree of control over the CNA.

With respect to the other elements of the economic reality test, the court had mixed findings. It found that the CNA had no real opportunity for realized profit or loss as the registry controlled work assignments and compensation. There was no significant investment in equipment or materials by either party, so the court concluded that the “scales” were not tipped toward either employee or contractor status. The CNA skill requirements weighed in favor of contractor status because that was under the control of the worker. With respect to permanency and duration, the court concluded that the fact that the CNA worked with the registry for seven years, often working over 40 hour weeks favored employee status. Given that the registry was in the business of home care, the work performed by a CNA was considered an integral part of the registry’s business thereby weighing in favor of employee status.  

Overall, the court found that the relevant factors under the economic reality test results in an employee classification. Under the FLSA, the misclassification of workers as independent contractors can trigger significant liabilities including damages double the amount of compensation that would be due as an employee plus attorney’s fees and costs. While the Florida litigation is not completed, it is a lesson for other home care companies as to the risks taken in worker classification as an independent contractor. These are fact-dependent matters where small factual variations can lead to different conclusions.

Home care companies utilizing independent contractors are advised to rely on competent legal counsel when determining proper worker classifications. It is readily apparent that the federal and state labor departments are taking a special interest in home care on a variety of FLSA issues, including worker misclassification. These government entities have enforcement authority to prosecute cases on their own. However, they are joined by private attorneys that specialize in these types of cases and often prosecute them on behalf of a large class of workers against a single employer. Those private attorneys also have home care on their radar.  




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