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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


Addus Partners with Two Illinois Plans to Provide Smartphones to Home Care Aides

By Steven W. Postal


Earlier this year, Aetna Better Health of Illinois (Aetna) and IlliniCare Health Plan (IlliniCare, a subsidiary of Centene Corp.) issued press releases announcing respective partnerships with Addus HealthCare (Addus) for the ICP Pilot study. The purpose of the study is to provide smartphones to home care aides (HCAs) serving Medicaid beneficiaries enrolled in Illinois’ Integrated Care Program (ICP). Launched in 2011, the ICP is mandatory Medicaid-managed care for Illinois seniors and disabled persons who live in Lake, Dupage, Will Kankakee, Kane, and suburban Cook counties. The program initially encompassed only acute medical services but effective February 1, 2013, the ICP expanded to cover long-term services and supports (LTSS) as well. The National Council on Medicaid Home Care interviewed representatives from both Addus and Aetna for details on the project and the ICP. Unfortunately, the Council could not reach IlliniCare in time for publication.


Addus continues to embrace new, innovative technology, including smartphones, as part of its electronic visit verification (EVV) system, designed to continually improve care outcomes.  EVV is a timekeeping system in which home care workers can use smartphones to clock in and out of their appointments. The ICP Pilot uses smartphone technology for basic EVV and to enhance Addus’s methods for providing care. The ICP Pilot marks Aetna’s first partnership with a Medicaid home care network provider to use technology for improving care.

Aetna began managing waiver services for its members when the ICP began to include LTSS in February 2013. Aetna recognized that Addus had deployed a unique technology-enabled model of care for its HCAs and sought to develop an innovative partnership, leveraging technology deployed for EVV as relevant for new applications, such as supporting the HCA workforce to improve client care. Addus and Aetna launched the pilot in the fourth quarter of 2013.


Currently, the pilot is active in the original counties that went live with ICP LTSS on February 1, 2013: DuPage, Kane, Kankakee, Lake, Will, and suburban Cook counties.  Aetna intends to expand the pilot into Chicago this spring when the ICP program expands.

In the ICP Pilot, Addus has approximately 175 HCAs working with over 200 clients enrolled in the two health plans. Of these, Aetna has approximately 110 members served by 85 different Addus HCAs who use smartphones.


Both Aetna and Addus agree that the pilot’s purpose is creating a partnership between provider and plan to improve clinical outcomes in home care. This is achieved by preparing HCAs to observe, identify, and report timely changes in condition. Clinically, the ultimate goal is to improve care outcomes by decreasing hospitalizations, readmissions, and ED visits. Additional goals include promoting better client compliance with care plans and encouraging clients to eventually make more preventive health care appointments.


Addus representatives found that smartphone technology has a great capacity for improving efficiency and care, as well as supporting basic EVV capabilities such as scheduling, payroll, and billing.

The smartphone’s most basic function is to communicate schedules with HCAs for both the current day and beyond. The schedule flows through the HCAs’ smartphones, tells them the addresses of their visits, and has them clock in and out for each appointment. For every client, an Addus employee inputs the individualized care plan and particular tasks (activities of daily living, or ADLs, and instrumental activities of daily living, or IADLs) into the central database. This information flows through the system, and appears on the smartphone. HCAs click “yes,” “no,” or “client refused” to indicate whether a task was completed, and if not the reason why. By this means, HCAs are able to document specific tasks laid out in a care plan.

Change-in-condition questions: Another basic function of the smartphone is to pose a set of change-in-condition questions about a client. These questions allow HCAs to report on physical, cognitive, and environmental changes. As HCAs clock out of visits, smartphones prompt them to provide information on clients. This information flows back to Addus and clients’ health plans for evaluation and intervention.

Case Management: Aetna assigns a care coordinator who visits each of its members every 90 days, or more frequently in certain cases. The case coordinator reviews a member’s level of need, collaborates with the member to develop a service plan, and tells the member how many hours of care they will receive. Incremental services can be added in the event an HCA reports a change in condition.

Pending functionalities: There are several functionalities that are currently in a “roll out” phase, including the ability for HCAs to use smartphones to update their home address and request time off.

Dual Eligibles: Aetna wanted to start the ICP Pilot last year because it expects the number of participating members to increase dramatically as Illinois begins its dual eligible demonstration. Both Addus and Aetna do not foresee the functionality of the smartphone (both from an EVV and a managing conditions perspective) materially changing with the duals. Instead, they foresee a wider deployment of the ICP Pilot, including such capabilities as sending pictures or videos.

Program integrity

Besides adding value both from a workflow and delivery of care perspective, smartphones also serve key program integrity functions.

Signature verification: After the visit is complete, the HCA documents tasks and answers the change-in-condition questions. The client must then sign the smartphone with their finger or a stylus in the field provided. The signature then flows through to the central database.

Scheduling: The smartphone can be set up with a variety of alerts, enabling Addus to monitor and adjust schedules in real time. So if, for example, the HCA has not logged in to start a scheduled visit, a trigger will alert a scheduling coordinator who can then call the HCA, the client, or both. There are a variety of alerts to help monitor daily activities as they occur, giving Addus great visibility into its direct care workforce.

GPS: The smartphones have GPS capability, so Addus can monitor the locations of its HCAs. This also helps with program integrity and quality assurance.

Care plan task reporting: Before using EVV technology, Addus found that care plan task reporting was quite cumbersome. Addus believes that this function significantly helps providers remediate and challenge audit findings.

This functionality also allows the provider and health plan case manager to communicate more efficiently about changes in conditions, the provision of care or the absence of it, rather than having to sift through large amounts of documentation.

Recommendations to Providers

For providers seeking to engage in a similar partnership with plans, Aetna maintains that frequent dialogue between the organizations is critical to success. Besides the regular interface between Addus’s ICP supervisor and Aetna’s case management supervisor, Aetna and Addus hold bimonthly calls to update each other on the pilot. Other important recommendations include developing a successful operating model, having a good workflow for communication, having a good reporting tool, and agreeing on what metrics to evaluate.

Plans to Publish

Addus and IlliniCare hope to publish results of the pilot this year Similarly Aetna and Addus also intend to publish program results. Aetna will evaluate data from 0, 3, 6, and 12 months following implementation of the pilot, and specifically look at hospitalizations, readmissions, ED visits, and office visits (both specialty and PCP visits).   

To see Aetna’s press release, click here. To see IlliniCare’s press release, click here.

The Council’s Take

The Council supports the growing use of technology in Medicaid home care. As the Council has previously shown in the case of telehealth, such programs can be cost-effective and help produce better outcomes. Home care providers should note that the Council will continue to pursue greater payments for Medicaid home care generally. The Council also calls on state associations and other stakeholders to advocate on a state level to promote more application of smartphone technology and reimbursement to HCAs in Medicaid home care. Home care providers are encouraged to keep abreast of such developments, and to contact the Council with any questions or concerns.

The Council would like to thank the following people for their assistance in writing this article: Darby Anderson, Senior Vice President, Addus HealthCare; Kimberley Cox, Midwest North Regional Director, Addus HealthCare; William Gerardi, MD, Chief Medical Officer, Aetna Better Health of Illinois; and Diane Kumarich, VP National Contracts and Acquisitions, Addus HealthCare.

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