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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

Proposed House Bill Would Mandate Electronic Visit Verification System for Personal Care Services under Medicaid

September 16, 2015 02:06 PM

Representative Brett Guthrie (R-KY-2) has introduced legislation that would require each state to use an electronic visit verification (EVV) system for personal care services under Medicaid. The bill would penalize any state that does not require the use of an electronic visit verification system for personal care services. For any such state, the legislation would reduce the Federal medical assistance percentage by 0.25 percentage points for calendar quarters in 2018 and 2019; by 0.5 percentage points for calendar quarters in 2020; by 0.75 percentage points for calendar quarters in 2021; and by 1 percentage point  for calendar quarters in 2022 and each year thereafter. At this point, Representative Guthrie is the only listed supporter of the legislation.

The bill was among several proposals discussed by the House Energy & Commerce Subcommittee on Health on Friday, September 11, during a hearing titled, “Strengthening Medicaid Program Integrity and Closing Loopholes.” Subcommittee Chairman Joe Pitts (R-PA-16) said, “It is my hope that through the policies we discuss today, and through future actions by this committee, we can work together on a bipartisan basis to boost Medicaid program integrity, while making the program more sustainable, accountable, and transparent.” Regarding H.R. 2446 specifically, Pitts said: “This common-sense proposal will ensure taxpayers only pay for the services delivered to Medicaid beneficiaries.”

Representative Guthrie, in discussing his legislation (H.R. 2446) at the hearing, said: “Medicaid personal care services are becoming increasingly more important as the need for them continues to grow. However, there is also growing concern about the high levels of improper payments in this area. My bill will help address these concerns by requiring states to adopt an EVV system to verify the date, time and site of the visit as well as the provider of the services. This is critical to ensure that beneficiaries receive the services they need. Many states already operate EVV systems and they have seen a decrease in improper payments and significant cost-savings for the states.”

Two witnesses spoke in support of the legislation. Nico Gomez, Chief Executive Officer of the Oklahoma Health Care Authority, stated in his testimony: “Through the first three years of the EVV system, Oklahoma had over a 5 to 1 return on its investment through resulting cost savings.” Additionally, John Hagg, Director of Medicaid Audits for the Office of Inspector General at the U.S. Department of Health and Human Services stated that there are “significant problems” with personal care services fraud.  He stated that EVV “may help” prevent instances of fraud and high error rates with personal care services: “When you have cases of lack of documentation, I would think EVV would help clear that up. You’re either providing the service at the location, or you’re not. The same thing with beneficiaries who are in institutions at the same time we’re receiving a bill. Same thing for when we have a time sheet of an attendant that says they were at a different location, yet we have a bill for somebody else. I think EVV would help, or may help, prevent those types of issues.”

At the same time, a number of Representatives expressed reservations or concerns about the proposal. One of the concerns highlighted by Representative Jan Schakowsky (D-IL-9) was the fact that there has not been a cost-benefit analysis of EVV. This concern was reiterated by witness Trish Riley, Commissioner of the Medicaid and CHIP Payment and Access Commission. The legislation “raises questions about the cost of that,” Riley said. “It’s again the cost-benefit trade-off. I think there are nine or ten states that currently have those systems. They have said that they are succeeding in getting savings from those activities, but we are not aware of any evaluations that have been underway or completed that would tell us really what the cost-benefit analysis of that verification activity is.”

Representative Schakowsky also expressed concern about the fact that the legislation penalizes state FMAP funds, while it does not provide startup funds for states to adopt EVV. “Personal care services may be an area that is vulnerable to fraud, and we must make sure that beneficiaries are receiving the services they need at the right time and the right way. However, I have concerns about a penalty on the states’ FMAP in an environment where Medicaid programs are really struggling right now administratively.” Schakowsky raised the question of whether the penalties coupled with the lack of incentives would force states to reduce spending on Medicaid services in order to implement EVV. Riley confirmed the lack of startup funds, and added that another problem is that there is a lower federal match rate for front-end activities such as EVV, compared to the higher match rate “to go get them when there is a mistake or fraud has occurred.”

In response to the issues of state cost to adopt EVV, Guthrie claimed that the legislation “would not cost the states money.” He justified this based on the fact that the bill requires states to use an EVV system, but does require states build their own systems.

Representative Frank Pallone (D-NJ-6) also expressed concerns with the legislation “as drafted.” He stated he looks forward to working with the committee on improvements, as it is an issue that should be addressed.

The National Association for Home Care & Hospice (NAHC) is evaluating the legislation with the design of developing improvements. There are some concerns with the present version of the bill as it may affect provider costs and multi-state organizations. In addition, NAHC believes that the bill should support uniform EVV system specifications that can be met by EVV vendors. Representative Guthrie has expressed a willingness to work with the home care provider community in refining the bill.

To review the proposed legislation, click here. For more information about the hearing, including witness testimony, click here.




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