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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

MedPAC Recommends Copays to Access Medicare Home Health: 'A Discredited Idea,' Says NAHC President

January 14, 2011 03:47 PM


For additional information:

Barbara D. Woolley
National Association for Home Care & Hospice
(202) 547-7424

WASHINGTON , D.C. (January 14, 2011) – The Medicare Payment Advisory Commission (MedPAC) voted yesterday to recommend that Congress impose a new copayment obligation on Medicare home health patients and that provider payment rates be cut in several ways starting in 2012 and thereafter. The National Association for Home Care & Hospice (NAHC) is coming out full force to explain why these are wrong-headed ideas that have not only been proven to have a number of detrimental effects on beneficiaries requiring services but to actually drive up health care costs.

The MedPAC copayment proposal would require seniors and disabled Medicare beneficiaries to pay a $150 copayment for each 60-day episode of home care where they do not go to a hospital or skilled nursing facility first. "Requiring the sickest of Americans to pay a fee to access home health care is an old and discredited idea," said Val J. Halamandaris, president of NAHC. "I know this because as a young man, I helped Senator Frank E. Moss and Congressman Claude Pepper write the original Medicare home health benefit, which had copays in it. These fees were removed by Congress for several reasons; the first was that there was no evidence that they saved money. In fact, they cost the government more to collect than their imposition saved the Medicare program."

"Second, copays had become nothing more than a 'sick tax' that fell heaviest upon the sickest, poorest, and most vulnerable members of society, impeding their ability to access home health services," Halamandaris continued. "Third, copays for home health care resulted in hundreds of thousands of infirm seniors and disabled persons being relegated to institutions at many times the cost to the government.

"Fourth, Medicare copays resulted in the limitation of the rights of seniors and disabled persons to exercise the freedoms preserved for all Americans in the Constitution and Bill of Rights. Fifth, then as now, there was no evidence that copays were needed to control utilization. In fact, there was ample evidence that too few seniors who were eligible for care at home received such services. Despite the 10 percent increase in eligible Medicare beneficiaries since 1997, the home health program today serves fewer patients and costs the government billions less than it did 15 years ago.

"Sixth, the imposition of Medicare copays was resulting in cost-shifting to state Medicaid programs. Experience shows that if copays are instituted, the number of chronically ill and disabled persons who be forced to take the 'pauper's oath' and apply for help from state Medicaid programs will again increase dramatically. The impact of such cost-shifting will precipitate a national crisis as states struggle to carry the weight of caring for the 78 million members of the Baby Boom generation who will require personal care assistance or help with the management of multiple chronic diseases.

"In the name of our mothers and fathers and grandparents, let's learn from the past and not repeat the same mistakes. I call upon all Americans to join me in a crusade to protect our loved ones and their right to be live free and be cared for at home. Email your members of Congress: 'Dump the sick tax!'" said Halamandaris, laying the groundwork for a major NAHC grassroots campaign over the coming months (click here to use the NAHC Legislative Action Network NOW to send this message to your legislators).

MedPAC also voted to recommend to Congress that home health payment rates be drastically cut beginning in 2012. Yet in the health care reform legislation last year, Congress already enacted a number of payment reforms in home health services that begin in 2011 and continue through 2017. Congress devised a carefully crafted schedule of reforms that balance the need for change with the goal of maintaining access to high quality care throughout the country.

"The MedPAC recommendations on payment rates would destroy the reform process that Congress mandated just last year," said Halamandaris. "While Congress recognized that abrupt payment rate cuts severely heighten the risk that home care will be lost to many throughout the country, MedPAC's desire for immediate and disasterous rate reductions ignores the reality that the majority of home health agencies today are barely paid the actual cost of the care they provide," said Halamandaris.

He noted that even the data that MedPAC itself use show that fully 35 percent of home health agencies are now paid less than the cost of care and that scheduled cuts will bring that number to nearly 50 percent by 2012. "Congress sensibly chose to phase-in rate cuts gradually in order to give providers a chance to control their current costs and continue to exist to provide care. MedPAC instead chooses to push the entire home care provider community off a cliff," Halamandaris contended.

NAHC believes that home care is not only the right way to save billions in Medicare expenditures, it is what the nation's seniors need to meet their increasing and complicated health care requirements. Put simply, there is no greater value proposition in the health care system than home care, which helps save and extend lives as well as prevent and manage chronic disease while creating jobs and directly contributing to the long-term health of the economy.

In its annual March report, MedPAC will deliver its recommendations to Congress. Further analysis on the recommendations -- and information on NAHC and the home care community's response to them -- will follow in future issues of NAHC Report.




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