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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

Urban Institute Study Advances Analysis of Federal Long-Term Care Program Models

December 10, 2015 01:54 PM

The Urban Institute recently released a study analyzing several different models for financing long-term services and supports (LTSS) in order to meet the country’s growing need for long-term care services. The Urban Institute estimates that between 2015 and 2055, the number of older Americans with “severe LTSS needs will increase 140 percent” to a total of 15.1 million. Private insurance is not a realistic option for all income levels due to high premiums. Federal programs are also inadequate; Medicare does not cover LTSS, and while federal Medicaid provides funding to states, state eligibility requirements limit the program to individuals with disabilities and those with little financial resources.

“Because private insurance is not widespread and public financing is available only for people who have few financial resources or who have already spent nearly all of their resources, older adults with severe LTSS needs will pay about half of their expenses out of pocket,” the Urban Institute stated. “These expenses impose financial burdens on many older adults with LTSS needs.” The report states that, in addition to burdening individuals, the current lack of LTSS resources also burdens caregivers with financial and emotional stress, as well as Medicare with increased costs by forcing people into hospitalizations and other care that would have been avoidable with adequate LTSS assistance.

To analyze policy options to address the problem, the Urban Institute modeled several programmatic options and compared the results. While the report acknowledged that as many as half of those with LTSS needs are under 65, it only applied the model to those 65 and older due to the fact that the “underlying data that go into the model are available only for older adults.” Following is a description of the policy simulations included in the model:

….a program with a front-end benefit that begins after a ninety-day waiting period and covers a maximum of two years of need, a catastrophic-only or back-end program that begins after a waiting period of two years but provides a lifetime benefit thereafter, and a comprehensive program that begins after a ninety-day waiting period and provides a lifetime benefit. Each option was modeled as voluntary insurance and as a universal mandatory program for workers. For the voluntary options, we included subsidized and unsubsidized versions.

The results of the study found that a mandatory option would be more successful than a voluntary option in terms of increasing coverage, and that the comprehensive and back-end mandatory options would be most beneficial for reducing Medicaid costs. The Urban Institute’s full report, “Financing Long-Term Services And Supports: Options Reflect Trade-Offs for Older Americans And Federal Spending,” is available here.

In its 2015 Legislative Blueprint, the National Association for Home Care & Hospice (NAHC) states that “the federal government must take the lead in providing adequate coverage of long-term care needs for the physically disabled, chronically and terminally ill, and cognitively impaired,” including those under the age of 65. NAHC further states that the “already significant need will continue to grow substantially, as the baby boom population ages and new technologies emerge that enable people with disabilities to live longer.” NAHC outlines in detail its recommended provisions for inclusion in a federal long-term care program here.

The Affordable Care Act included a long-term care program that centered around an insurance-type model. It was termed the CLASS Act.  However, that program was suspended in 2011 amid concerns about its financial viability. A presidential commission on long-term care that followed the CLASS program suspension found a growing need for supports, but did not reach a consensus on the appropriate solutions. The Urban Institute’s report advances the analysis of potential solutions. It is hoped that the health care reform agenda in 2016 will include a significant focus on long-term care. NAHC is working to keep the issue on the front burner, including efforts to make it an issue for the 2016 presidential campaign.




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