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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

Proposed Rule Change by Department of Labor Would Harm the Frail Elderly and Adversely Impact Home Care Workers, the Businesses that Employ Them and the Government Programs that Allow Aging at Home

Survey of over 1,500 home care companies predicts major issues for the industry and consumers
January 30, 2012 03:15 PM


For additional information:

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

January 30, 2012 (Washington D.C.) - The Private Duty Homecare Association of America (PDHCA) and the National Private Duty Association (NPDA) today released the results of a national survey of home care agencies on the impact of the U.S. Department of Labor's (DoL) proposed rule which effectively eliminates the companionship services’ overtime exemption in private pay home care and live-in services. The survey results demonstrate the negative consequences which would occur for employed caregivers, the clients/patients they serve, and the home care companies if the exemption is eliminated.

The greatest negative impact on clients/patients reported by respondents is the loss of continuity of care brought on by the need to assign multiple caregivers to control overtime costs. A common belief is that clients are then driven into the underground economy, hiring workers "under the table" where quality control and oversight that an agency worker provides is lost, exposing the elder client to greater chances of abuse, fraud and inconsistency in care.

The DoL proposal has the potential to cut employed caregiver hours and compensation by imposing unaffordable overtime pay on the voluntary hours they work in excess of 40 per week. In addition to losing continuity of care, the cost for care will also increase. The survey indicates that 81.8 percent of companies expect to increase their private pay billing charges with 23.7 percent anticipating a need to scale back their availability of care. These expectations are warranted as 45.2 percent of companies currently required to pay overtime under state laws have increased their charges and 10.4 percent reduced care access.

Shelle Womble, Chairman of PDHCA commented, "As an industry we believe that eliminating the companionship exemption will force many seniors and people with disabilities into assisted living or institutional care because of the increased cost of in-home care. It will increase federal spending by adding cost to in-home care provided through federal programs, and by increasing utilization of government-funded institutional care."

Kevin D. Turner, Executive Director of NPDA, stated, “One of the consistent findings referenced by agencies was restricting or expecting to restrict overtime hoursfor employees. So, instead of making more money through overtime wages, the average home care worker will simply work for multiple agencies to get the hours they want to work in a week. This makes it harder for the home care employee who will have to match total hours desired with piecing together schedules that will also include additional expenses for travel to more locations.”

The predominant impact on the employed caregivers is the restriction in working hours. Nearly 63 percent of the respondents currently obligated to pay overtime under state law report that they restrict overtime hours. More than 86 percent of the companies that will face a new overtime requirement if the proposed rule takes effect report that they will restrict the hours worked by staff to prevent overtime costs.

Over 93 percent of the home care companies reported an expectation of a moderate to significant increase in business costs. This mirrors the actual experiences of companies with a current overtime requirement where nearly 69 percent report moderate to significant business cost increases. The primary cost increases are in human resources, 67.4 percent expected/38.2 percent actual, and staff training costs, 67.9 percent expected/38.3 percent actual.

Some of the potential tactics and adjustments that companies are or will make as a result of the ruling, should it be put into place, include cutbacks on employee benefits and pay increases, withdrawal from Medicaid services, terminating live-in care, and reduction of current base pay of personal care workers.

The full survey report is available here.

The survey was conducted in December 2011 as a joint project between the Private Duty Homecare Association (PDHCA), an affiliate of the National Association for Home Care & Hospice (NAHC) and the National Private Duty Association (NPDA). Nearly 1500 responses from home care companies in all 50 states, the District of Columbia, U.S. Virgin Islands, and Puerto Rico were received.


The Private Duty Homecare Association (PDHCA) was established by the National Association for Home Care & Hospice (NAHC). It is a trade association of home care providers dedicated to providing an array of home care services, including non-medical and supportive services to the aged, infirm, or disabled client to help maintain safety and independence at home, wherever home is. PDHCA focuses on providing valuable information and education to its members as well as educating consumers as to the options to remain at home with home care. The focus of member services is in consumer education, industry advocacy and agency support. PDHCA is designed to answer all the questions that private duty home care providers may have regarding their businesses and practices. Please visit PDHCA on the web at, on Twitter @PDHCA or

About NPDA

The National Private Duty Association (NPDA) is the nation's first association for providers of private duty home care, which includes non-medical home care services. The NPDA is the recognized resource for information and definition of private duty home care practice, supported by a strong national membership of providers. The NPDA currently represents more than 1,200 member organizations throughout the United States that provide private pay in-home care services for the elderly and disabled. For more information about the National Private Duty Association visit or call (317) 663-3637.




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