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

U.S. Department of Labor Issues Significant Overtime Rule

May 19, 2016 09:43 AM

Federal agencies are busy clearing out pending rules this spring as the Obama Administration seeks to finalize policy changes through the federal system. One such change is in the standards for exemption from overtime for Executive, Administrative, and Professional personnel paid on a salary or fee basis issued on May 18 by the U.S. Department of Labor (DOL). The new requirements will affect industries of all kinds across the country. Health care is one of the areas that will be significantly impacted, including home care and hospice.

The Administration published the proposed rule in July 2015. It is generally known as the “white collar” exemption from overtime because of the nature of the affected employees. At the time of the initial proposal, the President emphasized that there had been no adjustment to the minimum salary requirements since 2004 and that it had not kept pace with inflation even then.

What is changed by the new rule?

There are several significant changes to the current overtime exemption requirements. These include:

  1. Raising the minimum qualifying salary level to $913 weekly in contrast to the current $455 weekly.
  2. Automatically adjusting the salary level minimum every 3 years to be set at the 40th percentile of full-time salaried workers in the lowest-wage Census region.
  3. Permitting non-discretionary bonuses, incentive payments, and paid commissions to count towards the minimum salary requirement up to 10% of the minimum amount.
  4. Increasing the Highly Compensated Employee standard from $100,000 annually to $134,000.
  5. Maintaining the long-standing “duties test” to determine whether an employee qualifies as an “Executive, Administrative, or Professional” employee for purposes of the overtime exemption.

When does the rule take effect?

The rule is effective on December 1, 2016. NAHC and others sought greater lead time, but DoL concluded that giving more than 6 months is far better than the normal 30 days.

Will Medicare and Medicaid adjust the payment rates to account for this new cost?

NAHC recommended that DoL suspend the rule until such time as government payers modified payment rates to cover the increased costs triggered by the rule change. DoL rejected that recommendation, stating that businesses have a variety of options to address the changes in the overtime requirements.

What should home health agencies and hospices do?

One big change that the rule requires is that businesses must understand how many hours salaried and “fee basis” employees are working. Per visit compensation may qualify as “fee basis.”

This is especially important in home care and hospice where service employees are out of the office most of the time providing patient care with tracking time becoming difficult. Providers need to recognize the “hours worked” include patient care time and any other activities on behalf of the employer such as certain time spent in travel, in-service training, and care documentation.

In addition, many home care and hospice companies pay professional service staff on a “per visit” compensation basis. If the company plans to continue that compensation method, it is essential that there be a full accounting of the hours worked whenever the compensation is less than $913 weekly.

NAHC recommends that home care agencies and hospice conduct full evaluation of their compensation methods and outcomes in relation to work hours to determine whether comparable circumstances will create overtime obligations in the future when the rule takes effect on December 1.

In some companies, the level of compensation in relation to the amount of employee-specific work hours may mean the rule change is inconsequential. For example, if a home health agency pays $75 per visit and a nurse typically works 20 visits a week, the total compensation exceeds the $913 minimum and no overtime is owed regardless of the number of hours. However, if the compensation rate is $40 a visit, 20 visits per week would not result in meeting the $913 minimum.

Please note that “per visit” compensation is not always compliant with the DoL requirements for “fee basis” compensation, which is an alternative to the salary test. Companies are advised to seek competent legal counsel to determine if their “per visit” compensation is a compliant method under federal and state law.

What are the options other than recording all working hours and paying overtime when an employee exceeds 40 hours in a week?

There are several options available, but each organization must determine what works best for it. DoL offers the following possible implementation options:

  1. Increase the employee’s salary to meet the new salary level minimum
  2. Pay overtime over 40 hours
  3. Reduce or eliminate overtime hours
  4. Reduce pay allocated to the employee’s base salary and add pay to account for overtime to hold total compensation constant with current compensation
  5. Use some combinations of these options

It is important for home care and hospice companies to evaluate the impact of the new rules soon as it takes time to implement compensation and operational changes such as controlling working hours. Unfortunately, there is no expectation that Medicare or Medicaid will adjust payment rates sufficient to cover any new overtime costs. Home care’s experience with the new overtime requirements for personal care services that began in October 2015 indicate that government payment sources simply leave providers to figure out on their own how to cope with potential new costs.

Where can I read more about the new rule?

The rule is found at: Also, there is a wealth of information available on the DoL website including the following:

Is there any chance that Congress will reverse the rule change?

That possibility exists, but it is very remote. Congress can pass legislation that blocks or reverses the rule, but that legislation must be signed into law by the President. In this case, President Obama would not be expected to sign off on such legislation. At the same time, a two-thirds vote is needed to override a President’s veto. In this election year, it would be unlikely that Congress would uniformly support eliminating a rule that is touted to protect the middle class.




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