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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

US Department of Labor Issues Home Care Specific “Sleep Time” Guidance

May 5, 2016 03:10 PM

A longstanding area of confusion in federal minimum wage and overtime law has been the issue as to when an employer can exclude sleep time from the calculation of “hours worked” for purposes of calculating employee compensation. With the advent of change in the application of federal overtime requirements to home care workers previously exempt from the Fair Labor Standards Act (FLSA), the sleep time standards have become a big home care issue. On April 25, 2016, the U.S. Department of Labor, Wage and Hour Division (DoL) issued detailed sleep time guidance focused on “domestic service,” specifically home care services. While the guidance does not establish any new standards, it applies existing standards to various home care situations.

As a general rule, an employer may exclude sleep time from the calculation of the number of hours worked. An employee is entitled to be paid only for hours worked, and the determination as to whether overtime is also owed depends on the total number of hours worked. However, there are numerous qualifications and limitations on an employer’s authority to exclude sleep time from hours worked. To start with, DoL divides home care into three categories for purposes of the sleep time guidance: live-in employees; those who work shifts of 24 hours or more; and those who work shifts of 24 hours or less.

Live-in employees

The guidance first sets out the standards for determining whether an employee meets the “live-in” standard. That requires the employee to reside at the worksite on a permanent basis, defined as seven nights a week and having no other home. Non-permanent live-in status requires working and sleeping at the worksite five days a week for 120 or more hours or five consecutive nights.

For sleep time of “live-ins” to be excluded from the number of hours worked, there must be a “reasonable agreement” between the employer and employee to exclude sleep time. In addition, the employee must have “private quarters in a homelike environment.” DoL is somewhat flexible on the "private quarters" requirement, recognizing the realities of today’s caregiving. Separate bedrooms with a bed, lighting, and a space or dresser to keep personal belongings are nearly a necessity although the use of a pull out couch in a living room “would likely qualify.” Sharing a bedroom in order to be close to the client would not.

With non-permanent “live-in” employees, up to eight hours per night of sleep time can be excluded provided the employee is paid for at least eight hours of work each 24-hour period. For permanent “live-in” employees, up to eight hours of sleep time can be excluded as long as the employee is paid for some other hours in the workweek. The sleep time that can be excluded must only be at night. The sleep time exclusion also only applies if the worker “regularly has the opportunity to sleep overnight.” There is no specific number of hours that must be paid to qualify if the employee is a permanent live-in.

Shifts of 24 hours or more

The standards for excluding sleep time are different for 24 hour shift employees than for live-ins. Instead of the requirement of “private quarters,” 24-hour shift workers must be provided “adequate sleeping facilities.” In addition, the shift worker must “usually enjoy an uninterrupted night’s sleep.” Finally, the parties must “have an expressed or implied agreement.” Accordingly, the qualification standards for excluding sleep time are distinct from the live-in standards.

DoL interprets the requirement for “adequate sleeping facilities” to include basic sleeping amenities, but does not require private space as with live-ins. DoL recognizes that this is an intensely factual matter where context is important.  

With respect to “uninterrupted night’s sleep,” DoL requires at least five consecutive hours of sleep. “Usually” means at least half of the time. Any time worked during the designated sleep period counts as time worked even if the “uninterrupted night’s sleep” standard is met. The sleep time need not be at night. However, it must be in a “fixed window.”

An employer of a 24-hour shift worker may exclude up to eight hours of sleep time each night as long as the employee receives some pay for the week. The calculation of the excluded time is based on the actual amount of sleep time that occurs, not the amount in the agreement.

Shifts of fewer than 24 hours

An employer may not exclude any sleep time from hours worked if the employee does not reside at her worksite and works shifts of fewer than 24 hours. That standard applies even if the employee is specifically permitted to sleep while on duty. Note that a worker working two separate 12 hour shifts on two different days is not a 24-hour shift employee.

Overall Limitations

There are limitations even where the sleep time exclusion qualifications are met. These limitations are:

  • Any interruption in sleep time must be treated as hours worked. For example, if the home care worker is needed to provide bathroom assistance during sleep time and it takes 20 minutes, that time is considered hours worked and is compensable.
  • No sleep time can be excluded on any given night unless the worker gets at least a total of five hours of uninterrupted sleep time. These five hours do not need to be continuous.


The DoL guidance includes numerous home care-related examples on the application of the sleep time exclusion standards. It would be stretch to say that the guidance is 100% clear and answers all questions that home care employers have. However, that lack of clarity and comprehensiveness does provide a clear message to employers that caution is essential whenever attempting to rely on the sleep time exclusion to calculate compensable hours worked in home care. Facts matter a lot on this issue. In addition, an employer’s plan on the hours worked and the sleep time excluded may not match reality and reality controls under the FLSA.

The DoL guidance is available here.




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