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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

The Invisible Patients – Primary Healthcare for the Homebound

An Essay by Jessica Macleod, PhD, APRN
October 5, 2016 10:55 AM

The following essay was submitted to NAHC Report by Jessica Macleod, a family nurse practitioner working with patients who are homebound or home-limited. She does heroic work serving people who would otherwise be overlooked by the health care industry due to poverty or severe impairment.

Ms. Macleod and four of her patients are the subjects of The Invisible Patients, a new documentary film by Patrick O’Connor that will be shown at the NAHC Annual Meeting in Orlando, Florida later this month. The work Ms. Macleod and her colleagues do is invaluable and NAHC is delighted to present both the film and this essay to our members. We hope you will be inspired and enlightened.

The Invisible Patients – Primary Healthcare for the Homebound

By Jessica Macleod, PhD, APRN

I’ve been a family nurse practitioner (FNP) caring for patients with different backgrounds and health issues for 14 years.   

Early in my career my office work involved physicals, well-child exams, and treating minor acute illnesses. During this time I formed relationships with patients and families, helping them navigate issues like melanoma diagnoses, childhood diabetes, and unexpected pregnancies.    

In 2013, I started working with a primary home health care agency that provides health care to homebound and home-limited individuals who are unable to access the healthcare system due to functional impairment, chronic illness, and/or poverty. 

Now the patients I see are nearly invisible, living at the very edges of our healthcare system.  Taking care of them is by far the most challenging work I’ve ever done. 

In three years, my micro-practice has grown to a team of 4 primary care nurse practitioners; we care for over 460 patients in conjunction with a collaborating physician, community partners, and regional council on aging.

Researchers estimate that there are approximately five million adults in the US who are homebound or home-limited due to chronic illness or functional limitations. 

Despite calls to action to improve primary care and the fact that many of our patients would go without care if this service did not exist, there has been push-back from those still tethered to traditional health care delivery models. I was once called “a glorified hand-holder,” and an ER physician told one of my patients that she needed to get “a real doctor.” But the support from others has been overwhelming: specialty physicians have given me their personal cell phone numbers to collaborate on difficult patient cases; home health agencies work tirelessly to keep our most chronically ill neighbors out of what can be a revolving door of high-cost hospitalization; and hospice agencies provide exceptional end of life care.

When I told my friend Patrick O’Connor about the work I was doing, and he asked if he could make a documentary film about the patients I see every day, I said yes because I knew it would be an important tool to reach people and teach them about how we treat the homebound with dignity and respect.  Over the course of nearly a year, Pat followed my care of four patients – the result is THE INVISIBLE PATIENTS, an award-winning feature-length film that has been screened at film festivals in Indianapolis, Chicago and Louisville, and is scheduled to be screened at universities, colleges, and community and business venues around the country. 

Watching the film with an audience – colleagues, patients, and strangers – has been an emotional experience. I am humbled and proud when they react to the film with both tears and laughter. Many say that if they had not seen the film, they would have no idea that these types of patients exist. 

My work, and the work of my fellow nurse practitioners, is vital. We find ourselves in the center of important healthcare issues facing our country – how to take care of people who fall through the cracks, how to navigate end-of-life care, the burdens placed on families, and the emotional toll on those of us providing care outside of a traditional “accepted” health care model, in sometimes dispiriting situations. 

You can visit to learn more about the film and watch the trailer.




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