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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

Heath 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

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

VA Inspector General Report Identifies Concerns Regarding Access to and Oversight of Home Health Services

December 8, 2015 10:11 AM

On November 16, 2015, the Department of Veterans Affairs (VA) Office of Inspector General (IG) Office of Healthcare Inspections released a report titled, “Access and Oversight Concerns for Home Health Services, Washington DC VA Medical Center, Washington DC.” The report followed an inspection conducted at the request of United States Senator Barbara Mikulski (D-MD), which resulted in the VA IG substantiating concerns that stemmed from allegations of a patient’s year-long wait after being approved for home health services in October 2013; during the wait time, the patient reportedly died in April 2014, months after being approved for home health services.

The inspection found that the facility’s wait times for home and community based services (HCBS) in fact exceeded a year, and that other facilities across the nation had similarly long wait lists. Incidentally, the inspection also found that local HCBS program managers failed to comply with certain “elements of national and local policy regarding quality of care, patient communication, and electronic health record documentation.” To address these concerns, the VA IG submitted recommendations (summarized below), all of which the VA has either completed or is in the process of implementing.

In October 2013 when the patient was approved for home health services, facility staff added his name to the HCBS electronic wait list (EWL) which “approximately a month later had 584 names and an estimated wait time of more than a year.” While the patient was notified that he had been approved for home health services, there is no evidence that the staff ever notified him that his name had been placed on the wait list or that the estimated wait time to receive care was over a year. Furthermore, during the period between when the patient was approved for home health services in October 2013 and the time of his death in April 2014, there was no documented outreach or assistance by the facility staff in order to provide information to the patient about reinitiating primary care or to facilitate continuity of care.

Veterans Health Administration policy requires that staff provide patients with information about their care and document in the electronic health record (EHR) to facilitate communication and continuity of care. “Omitting this information did not allow the patients and family members to understand fully the situation and options, or adequately communicate the same to other health care staff who accessed the EHR,” the VA IG stated in the report.

In addition the facility staff utilized “a manual spreadsheet to track HCBS patients until 2014 when they transitioned to the EWL,” despite the fact that VHA mandated the use of EWL for HCBS in 2006. “While the EWL is now in use, the delay and aforementioned concerns with quality of care, communication, and documentation reflect a lack of adequate ongoing facility-level oversight and monitoring mechanisms for the provision of HCBS,” the VA IG stated.

The Washington DC VA facility has since taken steps to reduce its wait time; however, the report also substantiated that “multiple facilities across VHA had similar challenges with HCBS EWLs,” and the total number of patients on the national EWL increased between September 2014 and March 2015. In September 2014, VHA reported that “27 facilities had HCBS waiting lists totaling 1,721 patients. Of these, seven facilities reported more than 75 patients on the HCBS EWL.” In March 2015, VHA reported “the total number of patients on the national HCBS EWL increased to 2,566. Of the VHA facilities with HCBS EWLs, 11 facilities reported more than 75 patients. Five facilities accounted for more than half of the patients on the national HCBS EWL. These five facilities included Los Angeles, CA; Pugent Sound, WA; Northport, NY; Salem, VA; and Portland, OR.”

The VA IG submitted the following recommendations, which have been completed or are in the process of being implemented by the VA:

  • VA IG recommended that the Under Secretary for Health require facilities to develop action plans to address the care needs of patients on home health services electronic wait lists.
  • VA IG recommended that the Facility Director ensure that staff comply with all elements of national and local policies regarding quality of care, communication, and documentation related to purchased home and community based services.
  • VA IG recommended that the Facility Director ensure that oversight and management of purchased home and community based services is adequate and in compliance with Veterans Health Administration policies.

The National Association for Home Care & Hospice (NAHC) has had multiple contacts with the VA about a number of emerging issues in VA home care. On paper, the VA has a significant set of home care benefits available to veterans. However, in practice, veterans wait far too long for care and providers of home care services are forced to navigate a complex system that adds payment delays and inconsistent payment rates to the burdens that ultimately impact veterans.

Last week NAHC stepped up its advocacy efforts in meeting with the Senate Veterans Affairs Committee staff. The primary purpose of that effort is to make sure that the home care issues with VA health care do not get lost in reforms intended to address the serious other issues facing the VA health system. Committee staff are engaged in these home care issues and indicated a strong intention to keep them in the forefront of their actions. NAHC has a further meeting planned with House Veterans Affairs Committee staff to keep them apprised of our concerns.

NAHC has also learned that a member of the VA staff has filed an internal complaint that alleges inappropriate action and inaction on the part of VA management regarding the home care program. Home care organizations with current VA home care experiences are encouraged to relay the facts of any problems to NAHC staff. Such information should be directed to Bill Dombi at




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