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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


Ordinary People Doing Extraordinary Things

By Walter W. Borginis III

Last November, my father died at age 94. He had spent his last four weeks under the loving care of our hospice program, the VNA Hospice of Philadelphia, which delivered the appropriate services to him in his assisted living facility. Their caring methods and attention to his needs allowed him a peaceful and graceful decline.

Since that time, I have done a lot of thinking about my father’s life and about the overall quality of the services offered by hospice. During his stay in assisted living, I visited him often and we discussed the many things he had done. He had worked for 45 years in a Sunoco oil refinery as a machinist. His only break in service was when he was drafted during World War II. He missed the exemption from the draft for oil refinery workers by only two months.

My dad served four years in the U.S. Army in Europe. Based upon an aptitude test, he had started his basic training with courses related to an assignment in the Judge Advocate General section. Before he could complete that training, however, he received notice that he had volunteered for a combat glider unit. He had not actually volunteered, but he gave it serious thought when he found out the new assignment would pay more. Having a wife to support, he accepted the transfer and went into combat.

He very seldom spoke about his experiences in the war. My stepmother had lost two brothers in the war, so discussions of it were taboo. Still, I know he participated in six major battles in Europe, including landing at Normandy on D-Day. I found this out when he asked me to help obtain his combat medals that had been lost.

From our discussions, I learned that he performed his duties well and was one of the first to return home after the war. Despite his fine service record and extensive battle experience, he quietly returned to work at the refinery and never focused on his military service. He was an ordinary person who had been asked to do extraordinary things in a world at war.

Hospice folks don’t have to go into battle, but I believe the same is true for them. For the most part, they are ordinary people who choose to do extraordinary tasks. Every day they guide patients toward a peaceful end and help their families cope with loss. Dealing with the dying and their loved ones is a special calling that ignores the social taboos associated with the mere discussion of death. Hospice folks provide knowledge and guidance in an area that many are reluctant to think about let alone discuss with strangers. Despite their training in healing, they endure the continual loss of their patients.

And they are an answer to our dysfunctional health care system for the elderly, as I learned from being my father’s primary caregiver. His hospitalizations were frequently the result of the assisted living staff overreacting, especially on weekends when fewer staff members were present. The hospital told me that there was very little they could do to help him since many of his symptoms were indicative of advanced aging. When I saw how disruptive the hospital stays were for my father, I chose hospice as a way to keep in his assisted living home where he really wanted to be.

I cannot say enough good things about the services he received from hospice. They helped him prepare for the inevitable in a positive way. They gave him a whole new set of people to talk to: a social worker, chaplain, nurse, and home health aide. They gave me valuable knowledge about the progression of the dying process, and they were simply extraordinary at a time of great need. I only wish that I had pursued this option earlier so that a couple of futile hospital admissions could have been avoided.

There is no doubt that hospice provides a valuable service to patients and their families. It is also important to note that hospice saves the Medicare program numerous expenses related to the provision of futile care at the end of life. Our medical delivery system is programmed to provide an overwhelming number of health care services up to the very last minute of life. Hospice offers a better alternative to those pointless hospital stays that are so disturbing for elderly patients.

Yet for some reason, it seems like CMS has set its sights on making life extremely difficult for hospices. In the course of the current year, CMS has demanded that hospices begin posting all pharmacy and infusion charges to patient bills on April 1, coordinate prescriptions with patients’ Part D carriers on May 1, complete an OASIS-like patient assessment form called HIS on July 1, contend with a completely new Medicare payment system on October 1, fulfill requirements for a complex cost report for years after October 1 and new standardized patient satisfaction surveys on January 1. It seems like the plan is to tie up a wonderful and necessary program that actually saves money with an endless burden of more paperwork.

Of course, CMS has not made any provisions for the costs of collecting and submitting all of these items, making this another one of those unfunded Medicare mandates we are all too familiar with in health care. The logic of what CMS is thinking completely escapes me, and a couple of questions come to mind. Why would they try to disable a viable program? Don’t they recognize that all this paperwork only reduces the resources available to serve patients like my dad?

At my father’s gravesite, the Army sent two soldiers in full dress uniform to play taps and present me with a carefully folded ceremonial flag. As they handed it to me, they said, “On behalf of the president of the United States, a grateful nation gives its thanks for your father’s service.” I’ll never forget those words, and I would like to paraphrase them in closing. On behalf of a grateful son, I give thanks for the services of hospice. May hospice providers survive the current nightmare of paperwork and keep giving their valuable services to many more.


Walter W. Borginis III, CPA, CGMA, MBA is executive  vice president  for finance and administration and CFO of the Visiting Nurse Association of Greater Philadelphia. He serves as treasurer of the NAHC board and chairman of its finance committee.  He is also on the boards of the HHFMA, Voluntary Nonprofit Home Care Association of America, and Hospice Association of America. He can be reached at

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