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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

NAHC Survey on the Role of Non-Physician Practitioners in Home Care: Preliminary Results

Survey results strongly support advocacy efforts for legislation allowing NPPs to certify home health plans of care
October 16, 2015 04:49 PM

The National Association for Home Care & Hospice (NAHC) recently conducted a nationwide survey of the use of and impact of Non-Physician Practitioners (NPPs) in Medicare home health services. The purpose was to develop additional information that could be used in our advocacy to gain the right of NPPs to authorize Medicare-covered home health services.

NAHC would like to thank all of those who completed the recent survey on the role of NPPs in home care. NAHC received 667 responses to the survey, which is one of the best ever responses to a NAHC survey. Multiple responses came from every state.

The questions focused on the impact and outcomes of the Medicare limitation on certification authority. The intent was to elicit the positives and negatives of the current limitation as well as the likely outcomes if NPPs are given Medicare authority comparable to physicians. As NAHC predicted, the preliminary survey results will bolster our advocacy efforts in support of the Home Health Care Planning Improvement Act of 2015 (S. 578/H.R. 1342) to allow NPPs to certify Medicare home health plans of care.

First, the results demonstrate that reliance on NPPs as primary practitioners is indeed growing among Medicare beneficiaries across the country. 55.65% of responders stated that 41-100% of their patients rely on an NPP as their primary or significant “medical” practitioner rather than a physician. Unfortunately, Medicare remains stuck in the 1960s by allowing only physicians to establish the patient’s plan of treatment and to certify Medicare eligibility for the home health services benefit. The high percentage of patients relying on NPPs as their primary practitioners indicates the need to enact S. 578/H.R. 1342 to change Medicare’s antiquated policy.

The results also support NAHC’s argument that NPPs gaining the authority to certify Medicare home health plans of care would not increase costs, because it would result in NPPs substituting for physicians rather than increasing utilization. Nearly 40% of responders stated that 91-100% of NPPs currently have a relationship with a physician who is available and willing to certify Medicare home health services. This high percentage of NPPs with a close working relationship with a physician indicates that NPPs would easily substitute for physicians as the primary practitioner without increasing Medicare spending on home health services. It is very important that the Congressional Budget Office (CBO) understands that the bill would provide authorization for NPPs to substitute for physicians, since increased utilization would result in CBO scoring the bill as having an increased cost to Medicare (see previous NAHC Report article regarding NAHC’s recent meeting with CBO here).

In addition, responders by high percentages predicted the following positive outcomes as a result of the legislation to allow NPPs to certify Medicare home health services:

  • 88.94% predicted reduced delays in care and access;
  • 85.93% predicted improved patient care;
  • 83.58% predicted improved patient satisfaction;
  • 77.55% predicted reduced administrative burdens;
  • 65.33% predicted lower care costs;
  • 51.42% predicted less paperwork.

These preliminary results from the survey are for use by the home care community in its advocacy efforts supporting the legislation on Capitol Hill. However, given that the analysis is still preliminary, NAHC recommends that you wait to use the White Paper report that is in development and will be released shortly. When that is available, please contact your members of Congress using NAHC’s Legislation Action Center (click here) with the request that they cosponsor the legislation.




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