Skip to Main Content
National Association for Home Care & Hospice
Twitter Facebook Pintrest


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 Releases Final Report on Non-Physician Practitioners Survey

Findings Support NAHC’s Advocacy Efforts in Support of Legislation Permitting NPPs to Authorize Home Health Services
October 21, 2015 12:42 PM

The National Association for Home Care & Hospice (NAHC) recently conducted a nationwide survey regarding the use 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. The total responses numbered 669, and the survey results included multiple responses from all 50 states and the District of Columbia, making it one of the best ever NAHC surveys.

NAHC has completed the final report based on the survey, which concluded that permitting NPPs to authorize home health services will result in “significant improvements” to the quality and timeliness of patient care, as well as cost efficiencies in the Medicare program. As a result, the final report will bolster NAHC’s 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.

The questions in the survey focused on the impact and outcomes of the Medicare limitation on certification authority, including:

  • What percentage of your patients would you estimate have an NPP or had an NPP prior to admission as their primary or significant "medical" practitioner rather than a physician?
  • What percentage of the NPPs that serve your community have a relationship or connection with a physician who is available and willing to certify Medicare home health services plans of treatment for the NPP's patients?
  • What of the following current outcomes has your agency experienced with patients who have an NPP involved in their care because of the requirement for a physician certification?
  • If NPPs are given authority to establish and certify Medicare home health services, will it increase utilization?
  • What outcomes would you expect if NPPs are authorized to establish and certify Medicare home health services?

Based on the responses to these questions, the final report released by NAHC reached the following findings:

  • A significant proportion of Medicare home health patients rely upon NPPs as their primary community practitioner.Over 55% of respondent home health agencies indicate that a minimum of 40% of their patients had an NPP as the primary practitioner prior to admission to home health services. Over 10% of the agencies indicate that 81-100% of their patients are under the care of an NPP. The responses support the contention that permitting NPPs to directly certify an individual’s eligibility would mean that the NPP substitutes for the physician as the certifying party. The responses indicate also that the inclusion of the NPP as a certifying practitioner would strengthen the integrity of the certification as the primary care practitioner is best positioned to understand the patient’s home health service needs in conjunction with Medicare coverage standards.
  • The vast majority of NPPs maintain relationships with their physician colleagues and health care professionals in the treatment of the NPPs patients.Nearly 65% of respondents indicate that over 71% of the NPPs in their community have relationships or connections with physicians available and willing to step in and certify the NPP’s patient’s plan of treatment. This means that NPPs would primarily continue their role as the practitioner of choice for the patient and would certify Medicare compliance as a substitute for the physician who assumes that responsibility upon transfer from the NPP due to the current restriction on authorizations.
  • The NPP’s lack of authority to certify Medicare coverage eligibility for home health patients brings significant and numerous negative consequences for patients, physicians, and home health providers.Respondents note a deep and varied set of negative outcomes primarily affecting patients such as timely care access, obtaining prompt orders for care, and care conflicts between the physician and NPP.
  • The establishment of Medicare coverage certification authorization for NPPs would improve care quality, efficiency, access, and patient satisfaction.All around improvement in home health care delivery, administration, and cost are the resounding forecasts of survey respondents when asked what they expected as outcomes from a change that would authorize NPPs to certify Medicare home health services coverage.
  • Medicare utilization of home health services will improve in terms of practitioner knowledge of the service appropriateness and capabilities, particularly in underserved rural areas.Overwhelmingly, survey respondents view the NPP authorization reform measure as removing barriers to the initiation and delivery of care rather than a means to increase Medicare home health utilization.

“Removing this barrier should not create program integrity or service utilization concerns as NPPs are sufficiently connected to physicians such that patients in need of home health services eventually get that care, but only after obstacles are overcome,” NAHC concluded in the report. “In return for eliminating the Medicare authorization barrier, Medicare beneficiaries can be expected to gain improved care quality and timeliness while Medicare benefits from new cost efficiencies.”

To view the report, click here. This report is for use by the home care community in its advocacy efforts supporting the legislation on Capitol Hill. For example, NAHC is working to persuade the Congressional Budget Office (CBO) 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).

Please contact your members of Congress using NAHC’s Legislation Action Center (click here) with the request that they cosponsor the legislation.




©  National Association for Home Care & Hospice. All Rights Reserved.