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National Association for Home Care & Hospice
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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

Comments Submitted on CMS’ Proposal to Allow Payment for Advance Care Planning Discussions

October 9, 2015 11:35 AM

The National Association for Home Care & Hospice (NAHC) has submitted comments to the Centers for Medicare & Medicaid Services (CMS) regarding CMS’ proposal to add new codes recognizing separate payment for advance care planning, as part of the proposed changes to the Medicare physician fee schedule in the Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2016. CMS proposed changing CPT codes 99497 and 99498 from “inactive” to “active” to allow payment for advance care planning discussions. CMS’ comment period on the proposal closed on September 8 (see previous NAHC Report article here), and according to reports CMS received approximately 600 comments regarding the advance care planning proposal, of which approximately 500 were in support.

NAHC, which has a long-held position supporting advance care consultations as part of patient planning and decision-making relative to serious illness, joined with other organizations earlier this year in urging CMS to include coverage of such planning in its 2016 physician payment rule. Following CMS’ release of the proposal, NAHC also submitted comments on the proposal to CMS in an individual letter, as well as in a group letter with other aging and health organizations, that expressed support for the new codes, and provided comments on the standards and goals that should be included in advance care planning conversations. “We applaud CMS for proposing this change,” NAHC stated.

In addition to expressing support for the change to allow payment to physicians for advance care planning discussions, NAHC advocated for a mechanism to allow payment for advance care planning discussions by other professionals, such as palliative care interdisciplinary team members. “As a patient’s condition changes through the course of an illness it is not uncommon for the patient’s direct relationship with a physician to become less prominent and the patient’s direct relationship with another professional (for instance, nurse practitioner, physician’s assistant, palliative care nurse or social worker) to become more prominent,” NAHC stated. “There are numerous reasons for this, including the fact that the patient sometimes can no longer physically travel to see a physician so other health providers visit the patient in their home or that some physicians and NPs have turned care over to home care providers and are not actively seeing the patient.”

Following are further recommendations for CMS that were submitted by NAHC and the organizations that signed the group letter on the advance care planning proposal:

  • Expand the scope of services payable under the advance care planning benefit to incorporate non-face-to-face services where necessary, such as communicating with designated family caregivers who are not able to attend in-person appointments, answering clarifying and follow up questions, or providing coordination and referrals to non-medical professionals such as clergy or legal services.
  • Develop clear standards for practices that furnish advance care planning services—such as, required adoption of certified electronic health records or required demonstrated use of evidence-based policies, procedures, and training—to ensure that practices have the capability to furnish these services at a high quality.
  • Proactively and explicitly engage an individual’s family and caregivers in the development of a care plan to ensure that the individual’s abilities, culture, values, and faith are respected and care instructions and action steps are more likely to be understood and followed.
  • Utilize technology to help make necessary information more readily available and actionable, connect all people who have a role in an individual’s care plan, and provide a shared platform for the ongoing maintenance and management of an individual’s care and wellbeing.
  • The Department of Health and Human Services should finalize the standards for patient information capture released in the 2015 Certified Health IT proposed rule, and CMS should then apply the standards to advance care planning in Medicare, to facilitate not only the documentation of the presence of an advance directive, but also allow for the viewing of the content.
  • Consider connecting provider reimbursements to the quality outcomes of advance care planning and not to the process alone.
  • Consider ways to make these codes work for beneficiaries and providers, such as allowing payment for these services for all Medicare beneficiaries, not only to ‘manage and treat’ a current condition, but also as a preventative service.
  • Eliminate cost sharing, as beneficiaries may forgo this service if it is coupled with an out-of-pocket cost.
  • Commit to significant beneficiary and provider education on the benefit.

CMS is expected to release the final payment rule for CY 2016 in the coming weeks. To read NAHC’s individual letter commenting on the advance care planning proposal, click here. To read the group letter from NAHC and other organizations, click here.




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