Val_5-16-09-portraitVal J. Halamandaris: A Journey from the Coal Mines to Capitol Hill

Halamandaris means “wall breaker” in Greek. It’s a great name for a man who knocked down so many barriers to care for others. He didn’t do it through brute force, though he was a big guy who played football in his youth. He did it by harnessing the power of law, the strength of words, and the might of association to his dream of a caring society.

Val believed in “leading through caring,” as he wrote some years ago in CARING magazine. Great leaders succeed, he proposed, because they possess three qualities. They have “the intellect to develop good ideas and to fashion solutions.” They have “the ability to communicate their ideas in written form.” And they have “the empathy or heart to feel what people need.”

Val could have been describing himself. He had all these attributes in spades and always used them to help society’s weakest members. His inner compass steered him this way because it was his path to self-fulfillment. No matter what challenges we face in life, Val told us, we should use them to do something positive. “Every human life has intrinsic value,” he said, “and beyond that, people should be valued not by what they own, but by what they have done for others.”

This caring credo was summed up in the golden rule, Val explained, and embraced by thinkers throughout the ages. Aristotle said the essence of life was “to serve others and to do good.” Confucius considered compassion the core of human interaction and said, “What you do not want done to yourself, do not do to others.” More recently, former Vice President Hubert H. Humphrey restated this timeless rule in the context of civil rights. “The moral test of good government,” Humphrey proposed, “is how it treats those who are in the dawn of life, the children; those who are in the twilight of life, the aged; and those who are in the shadows of life, the sick, the needy, and the handicapped.”

Val drew these words from Humphrey, and added them to his ongoing collection of memorable quotes, now published in two stirring books. It’s an interest he acquired from his father, who once collected bulging scrapbooks of quotations. As Val learned after his father’s death, the quotations had a central theme — the universal message of caring. This, too, was a lifelong passion Val acquired from his dad as a small-town youth back in Carbon County, Utah.

Val’s father was a coal miner who didn’t have the chance to attend school beyond eighth grade. Poverty and the demands of family life stopped him from becoming a scholar. He didn’t have much time to read books, but he knew volumes about caring. He showed it by working the graveyard shift in the coal mines and holding a second job to scrape up college tuition for his two sons. The law was his passion, and his dream was for Val to become a lawyer. He tried to point him in this direction by bringing him and his brother, Bill, to watch cases in court.

The two boys saw a lot of squabbling in court, but they got a different picture of life at home. “We grew up in a multicultural society where everybody was comfortable with everybody else, where we were constantly reminded of the goodness of people,” Val recalled. “We were shown the importance of doing things for others day in and day out.”

Val loved this caring community, but he also dreamed of venturing forth and doing great things in the world. Unfortunately, his options were limited because all of his father’s sacrifices did not add up to the cost of college tuition. “Nobody ever got out of Carbon County,” Val explained. “If your grandfather was a coal miner and your father was a coal miner, you were a coal miner, too.”

Val decided his path to fame and fortune lay in playing football and earning an athletic scholarship to college. His great size and strength fed his hopes of triumph on the football field, but this idea went up in smoke when he injured his back during a game. Val was left with chronic pain, but he didn’t let it interfere with his mission to serve others. Val’s enormous strength of will always allowed him to transcend his personal concerns, just as it did at the time of this early letdown. With his father’s encouragement, he joined the debate team and became a national star. This led to him being elected student body president and outstanding student in the state, achievements that soon opened a door to the outside world.

Val escaped Carbon because someone saw his potential and cared enough to help him. His journey from the coal mines to Capitol Hill began when he came to Washington with the American Legion Boys Nation program. While he was there, he met Senator Frank Moss of Utah, a kind man who would become Val’s friend and mentor, as well as NAHC’s senior counsel. Moss was so impressed with the young miner’s son that he persuaded him to go to George Washington University and gave him a job in his office to help pay his tuition.

“If it hadn’t been for Senator Moss, I’d still be out there digging coal or planting crops,” Val once remarked. Instead, he devoted himself to his studies with the intellectual rigor that remained his trademark. He admitted that “sometimes, I was in so much pain that the simple acts of combing my hair and walking up and down stairs were sheer agony.” But he “managed both work and school by mentally blocking the pain.” When time allowed, he loved going to the Library of Congress where he asked the scholars around him for their take on philosophical questions.

“I was interested in what made people tick,” Val reminisced. “What were the values that sustained them? What were the components of their internal compass, which guided them through their lives?” These questions haunted him through college and into law school at Catholic University.

His future seemed set after he received the highest mark in his tax class at law school. The teacher who taught the class was impressed, just like Senator Moss, and helped Val get a job with the IRS. “I was going to be a tax lawyer and become a multimillionaire by age 35,” Val explained.

Attractive as this future might have seemed, it didn’t feel quite right to Val. He realized he wanted to help people, and looked on law as the “ultimate form of public service.” He asked himself, “How could I use my time and talents to help the greatest number of people?” He knew “I could handle one case and help that person or bring a class action that helped many people. But for the investment of the same amount of time and energy, I could help pass a law which would benefit all Americans.”

He would have the chance to do so when Senator Moss asked him to postpone his job with the IRS for a few months, and help him investigate abuses in nursing homes. The few months turned into 20 years after Moss offered him a post on the Senate Aging Committee. When Moss left Congress, Val continued his work on Capitol Hill by becoming counsel to Congressman Claude Pepper’s House Select Committee on Aging.

As a congressional investigator, Val let Pepper and Moss decide policy, level charges, and appear in the spotlight. But he became a power behind the scenes. When long-term care legislation was developed, Val had a hand in writing it. When a congressman made a speech, attentive listeners could hear the echoes of Val’s voice. Most importantly, Val was the guy who did the research, managed the investigations, and dug up the dirt before Congress wrote the laws.

Val was a crusader devoted to battling corruption and tackling the nation’s toughest scandals. He fought even harder as he learned more about the shady operators and slick politicians, who tried to profit by ripping off the Medicare system, running squalid nursing homes, or peddling worthless “Medigap” insurance. He was a sleuth, who had occasion to play a bum, a young doctor, a mental defective, and a crooked nursing home operator in the course of his career. He was also a vigilant fact-finder, whose office was crowded with newspaper clippings, reports, old investigative memos, and thank-you letters chronicling his fight for the aged.

He saw the reality of their suffering by going out into the field himself. In 1970, his investigation of nursing homes fires in Marietta, Ohio, and Chicago, Illinois, led him to discover that the owner of the Chicago homes was spending only 52 cents per patient each day for food. Work he helped launch in 1971 snowballed into a major investigation of Florida’s elderly housing market and revealed the rot of corruption in the Florida statehouse.

We shouldn’t forget his investigation of fraud and abuse among clinical laboratories. It resulted in national hearings, a major report, and subsequent corrective legislation. During the probe, Val led teams of investigators into five states and documented that kickbacks were a common practice among clinical laboratories. When his team set up a storefront doctor’s office in Chicago, dozens of lab owners quickly offered kickbacks up to 55 percent for steering Medicare business their way. The tidal wave of responses that flowed in led Val to exclaim, “It was incredible, simply incredible!”

Equally mind-boggling were the findings that emerged when Val, Moss, and other investigators took to the streets to see, first-hand, the operation of “Medicaid mills.” The sleuths had all taken complete physical exams and were pronounced in perfect health. But when they visited Medicaid mills in New York, California, Michigan, and New Jersey seeking treatment for “a cold,” they received bushel baskets of prescriptions for nonexistent ailments. The Medicaid doctors found evidence of heart murmurs, faulty vision, muscle spasms, flat feet, depression, weak ankles, tennis elbow, bunions, kidney disorders, and bladder infections.

Thankfully, Val didn’t suffer from any of these scourges. At the same time, he didn’t exactly cut an imposing figure in the exam room. For this undercover operation, he posed as a skid-row bum, wore a full beard, and walked with the aid of a cane, as you can see from photos in old magazines. Decked out in rags, he came to the attention of a group of hoodlums, who nearly beat him to a pulp as he waited for Moss outside a squalid Medicaid mill in a tough part of Brooklyn. Val’s cloak-and-dagger techniques sometimes put him in danger, but he confessed, “I do like the electricity, the risks, and the danger.” Besides, his undercover sleuthing helped Congress conclude that 25 percent of the federal money spent for Medicaid was being ripped off.

Val enjoyed “doing a hit” — as Hill investigators liked to put it — on the Medicaid mills, but his real moment of truth came when he conducted a major probe of the nursing home industry. His visits to homes showed him old people lying in filth and festering with deep sores that went right to the bone. He persuaded some 50 nursing home attendants to talk to him about “things that happen to old people that defy the imagination.”

Val responded in 1974 by issuing a 1,000 page report called Nursing Home Care in the United States: Failure of Public Policy. The blistering tome cited abuses ranging from outright crimes — “the smothering to death of a patient, who was obviously in a coma and taking too long to die” — to poor food quality, unsanitary conditions, and a shameful lack of doctor involvement. These findings were so horrifying that they led 25 states to launch their own investigations. In New York alone, more than 150 nursing home operators and owners were indicted for fraud, patient abuse, and financial manipulation — and that was just the tip of the iceberg. The plight of seniors reached the general public after Val’s findings made national headlines, and Val was interviewed on both 60 Minutes and 20/20.

Millions of viewers cringed at the horrors that lurked in nursing homes, but Val was not through shaking things up. He also went on to offer specific advice to nursing home administrators on how to avoid problems. In 1977, he collaborated with Senator Moss on Too Old, Too Sick, Too Bad: Nursing Homes in America. This authoritative book traced the origins of nursing home abuse to the lack of a national policy for the infirm elderly. Together with Moss, Val issued a clarion call for a federal law, as well as reforms in regulatory and fiscal rules.

Val got results, as anyone can tell from his extensive legislative achievements. He helped write the Medicare and Medicaid Home Health Benefit into law, guided the first Medicare Hospice Bill through Congress, and helped create federal minimum standards for nursing homes. He established the Office of the Inspector General in the Department of Health & Human Services. And he helped the National Institutes of Health create both the National Institutes of Aging and the National Institute on Arthritis.

These accomplishments drew on an intimate knowledge of society’s dark side. Val had seen human suffering, and he had seen greed. The sight of these things turned some investigators into cynics, but Val remained an idealist. “My feeling,” he once said, “is that there’s so much fraud and corruption out there, you can’t ever get it all.” He also knew that “if you don’t cut down the weeds, they’ll cover everything up.”

Val saw a few more weeds through his work with association lobbyists. As the contact for many associations, he recognized the positive — and the negative — aspects of these groups. “They were often accused of having narrow self-interests and of grabbing with both hands,” he remembered. “I wanted to have a part in changing and transforming associations so people can see how much good they can do. I decided that if I ever had anything to do with a trade association, we would speak out on issues that were not directly in our own interests, but spoke to our values.”

Val was looking for an industry with ethical standards. He believed he had found it after his first experience of a home care visit. “I went on my first home care visit in 1963, guided by a nurse with the Visiting Nurse Society of New York. You would think I had discovered the Holy Grail,” he chuckled in recalling his youthful fervor. “I came back and told the senators that I had found a better way of caring for the aged and infirm than to place them in institutions. This is what led to the inclusion of home health care in Medicare, which I helped push into law in 1965, and to the Medicaid home care benefit, the federal minimum standards for nursing homes, and the Medicare hospice benefit.”

Val’s belief that home health care was the “cleanest” industry would endure through the rest of his congressional career. In his years of muckraking on Capitol Hill, he learned that only six people in home health care had ever been indicted for fraud. His admiration also went out to the many home care workers, who lived up to his high ideals of service. “Think about the kind of person who would work as a nurse, and go out to urban combat zones to provide home care to those who are sick, dying, or disabled,” he marveled. “You really have to care about people to do that.”

Val had found his constituency, and he would get his chance to represent it in 1982. This was the year he was selected as president of the newly formed National Association for Home Care & Hospice. When he took the post, Val committed himself to three ideals that would make NAHC a model in the association world: community service, close interaction with members of Congress, and community outreach. The goal he set himself at the time was “to have the values of the home care and hospice community visited on America at large.”

It would be a struggle, he knew, because “we are all involved in the last great civil rights battle.” The outcome, he explained, rested on “how America chose to care for those who are old, frail, and disabled.” He had seen that “our rhetoric in the U.S. speaks of care and concern until the end of their days, but the reality looks more like neglect and abandon.” Contrast this to the concern the great classical societies had shown their seniors, and the call to arms rang even more clearly. “We believe,” he concluded, “that seniors must be revered and cared for as much as they cared for us as children.”

This belief consumed Val from his first days at NAHC, a time when there was no hospice program and expenditures for home care were minute. In the 35 years since then, he did all in his power to improve care for aged and infirm Americans. By serving as an advocate for hospice and home care, he helped give these senior citizens the care that often means the difference between life and death.

This is because Val brought home care and hospice from the shadows into the mainstream of health care. Under his direction, NAHC helped raise public awareness and acceptance of home care and hospice from 10 to more than 80 percent of the U.S. public. Today, expenditures for these programs make up the fastest-growing part of the health care economy and have reached about $100 billion. Nowadays, the number of people cared for each year in home care and hospice exceeds the number cared for in hospitals and nursing homes.

These gains are a tribute to Val’s genius for leadership and his grasp of the political process. After starting with five people, he built a top-flight staff of 65. He helped unify the home care industry, which was once represented by five national organizations, four of which merged to form NAHC. And membership now includes all 33,000 home care agencies in the nation.

Under Val’s firm baton, these groups became a single voice that still resonates through the halls of power. NAHC has had dazzling success in Congress, where it enjoys the support of conservatives and liberals alike. In 2004, Val was selected to make a keynote speech before the National Governors Association. His eloquent address convinced the governors to name long- term care as our nation’s number-one problem and point to home care as our best solution.

Fortunately, home care is up to the challenges posed by the aging of America. This is largely because Val worked relentlessly to preserve the high standards that first attracted him to the industry. Val always urged providers to remember that people come first. “We need to have an obsession with customer satisfaction, an obsession with the quality of our product, an obsession with the well-being of our employees.” Furthermore, he added, “home health care providers need a connectedness with the community. We are a group that goes out of its way to help other people.”

Home care and hospice providers might sometimes feel overwhelmed by the demands of this mission. But Val’s words and acts provided them with constant encouragement and guidance. Val helped them cope with the emotional toll of a profession in which death is a constant specter. He waged war against any legislation that made it harder for them to fully serve the needy. And he always urged home care to reach for the stars. “You are the heirs to the caring people,” Val once said to 7,000 providers who gathered in Chicago for NAHC’s annual meeting. “You have the power to love and move mountains,” he told the sea of faces that drank in his poignant words of empowerment.

Val managed to move a few mountains himself by using the power of the law to help people. In 1983, he established the Center for Health Care Law at NAHC. The center handles up to 100 pro bono cases per year, and hasn’t lost one of them yet. It has also brought a number of high-profile lawsuits that preserved access to quality, cost-effective care. “Its record of advocacy and success in righting wrongs and restoring justice is second to none,” Val proudly observed.

As the voice of NAHC, he pleaded the case for equity in public debate over health care policy. He was part of a 34-member panel appointed by former President Clinton to draft a bill of rights for health care consumers and assess the need for federal government to regulate private health insurance plans. He was also one of the prominent individuals who marked the eighth anniversary of the Americans with Disabilities Act by signing a Universal Declaration of Empowerment and Unity for People with Disabilities and Senior Citizens.

Val noted at the time that the declaration signified a commitment among the elderly, disability, and home care communities to oppose government efforts to “create divisions between senior citizens, people with disabilities, and the home industry, and to exploit these divisions as an excuse for their failure to provide sufficient resources for the elderly and people with disabilities to live independently in their homes and communities.”

These groups had suffered as a result of government indifference, he pointed out. At the same time, he realized they were also victims of a broader apathy that deadened society as a whole. In modern culture, “loving had become a tortured and misapplied word,” he lamented. Even worse, we had lost track of the central truth that “caring is the great secret of the universe.” He decided to set a new path for future generations by founding the Caring Institute.

Val first had the idea for the institute in 1985. This was the year that Mother Teresa visited Washington, DC, to accept an award from NAHC. In discussions about the visit, she wrote that she had heard of Val and looked forward to meeting him. “I was staggered by that,” Val recalled. “Mother Teresa was the ultimate rock star in terms of whom I wanted to meet.”

When they met, Mother Teresa gave Val his mission. “The poverty of the spirit in the United States and the western world is much greater than the poverty of the body in India and Africa,” she told him. “Do something about it.”

Her words challenged Val. After spending so many years tracking down fraud and abuse, he began using his investigative skills to look for good in the world. In the course of his search, he became concerned over the rampant materialism he saw around him. “I looked at society,” he said, “and thought the problem was that we valued people by how much money they had.”

Val believed the attention paid to celebrities made Americans even greedier. The millions of people who selflessly served others received far less attention. As a society, we ignored Joseph Campbell’s lucid insight that “a celebrity serves himself or herself. A hero goes out and redeems society.” Val decided to set an example for the next generation by finding these unsung heroes and honoring them. “Children model the behavior they see, so I knew we had to give them examples.”

Val acted on this conviction three decades ago when he created the Caring Institute. The new institute was a response to an unanswered need in society, as he explained. “We see an America hungry for affirmation of the fact that one person can make a difference. We will search for genuine heroes and heroines, particularly those who have overcome disability, pain, or suffering in order to serve others.”

It was clear that this quest struck a chord after the institute issued a widespread call for nominees. “We got such an avalanche of responses,” Val recalled. “It took a couple of years to open them.” And they’re still pouring in from a broad range of sponsors. They send thousands of nominations each year when it’s time to award America’s most caring people.

The Caring Institute presented its first National Caring Awards in 1988. Then, as now, the recipients have always been a diverse lot. They’ve ranged from Jimmy and Rosalyn Carter to Hannah Hawkins, who opens her home and heart to nearly 100 inner-city kids each day. Father Theodore Hesburgh, Notre Dame’s great former president, is among their number. So is Pope Francis, for his work on behalf of the environment and the poor, along with Mother Mary Ann Wright, whose lack of schooling doesn’t stop her from feeding thousands of hungry people each day. The winners include business magnates, community activists, social workers, and clergy as poor as those they help.

The Caring Awards recognize caring across the spectrum of society. So do the Young Adult Caring Awards, first instituted in 1992. The honorees who receive the award each year show that there are many ways to make a difference, no matter how young you are. Some work with the homeless; others organize AIDS awareness projects. Many help sick kids, and yet others make different contributions to their community.

Every year the Caring Institute brings the winners together for a ceremony in honor of their service to humanity. They each receive a crystal angel award which symbolizes the divine spirit of caring. Their portraits and biographies also hang in the Caring Hall of Fame, located in the first Washington, DC, home of the great abolitionist Frederick Douglass. NAHC bought the home from the Smithsonian in 1989 and opened it to the public. Anyone is welcome to visit this charming building in the heart of our nation’s capital and learn about the award winners or see a collection of Douglass memorabilia.

The Frederick Douglass Museum is a concrete embodiment of Val’s mission. Equally important is the caring community that he created. The Caring Institute gives award winners the chance to network among themselves, and it offers concerned people a forum to come together in service to others. As an old crime fighter, Val came up with his own unique response to the Mafia. “The bad guys are organized; that’s why we call it ‘organized crime,’” Val explained. “But the good guys aren’t, and I think we ought to be, so we can plan and plot together on spreading the goodness.”

The Caring Institute urges us all to heed the call to service, as Val always did. In the course of his career, he used his legal skills to break through the walls of indifference and greed that confine our seniors to lives of suffering and isolation. “Integrity, justice, and hope” are NAHC’s founding principles, as well as Val’s battle cry in his long-standing war on behalf of the ill and disabled. He urged us all to join “a great army of freedom” by providing service to others. Health care is one front of this war because he knew “there is no kind of service more necessary and important.”

The “me society” was a second and even more crucial aspect of Val’s crusade. Val wanted to tear down the culture of selfishness and teach young people to think more about others. Like so many among us, they have forgotten the true purpose of life is to serve others and do good, an axiom of the world’s great religions. Jesus, Muhammad, and Confucius, Val reminded us, have revealed that “caring is in one way or another the ultimate cosmic answer to the cosmic questions” humanity asks in its endless search for meaning.

Caring is also the source of our nation’s power and prestige, Alexis de Tocqueville observed in his classic work Democracy in America. In the 1830s, the young Frenchman toured the U.S., where he had a piercing insight on the national character. The achievements of the new democracy, he thought, came from a caring sense of community. “America is great because America is good,” he wrote over a century ago. “When it ceases to be good,” he warned, “it will no longer be great.”

Val’s vision was a return to national greatness by creating a society in which “people are valued by what they have done for others, not by what they own.” Perhaps then, he dreamed, “we can make America again what it always was: the most caring and thus the greatest nation on the face of the earth.” Achieving this goal meant breaking through the greatest wall of all. But Halamandaris, as we have said, means wall breaker — and Val always strived to live up to his name.

Another of his long-held hopes was to see his great hero, Mother Teresa, declared a saint. This wish came true in the last year of his life, when he and his wife, Kathleen, were invited to witness Teresa’s canonization in Rome. It was an experience that thrilled him as he joined over 120,000 people in St. Peter’s Square. “We were a few among many,” he recalled after coming home, “but we were treated like rock stars because we represent home care and hospice. We stood about 100 feet from the altar on a high balcony as we witnessed a mass in which Pope Francis praised Mother for her charitable work. We will, of course, never forget the moment when he officially proclaimed Mother to be Saint Teresa of Calcutta as the crowd broke into applause and many were moved to tears. These sights and sounds are forever blazed in our minds.”

So are our memories of Val. And as NAHC forges ahead, we will continue to honor the legacy he left behind. There will be new battles to wage in both Congress and the courts. Home care and hospice will face new demands as our country continues to age. And NAHC will need to change in some ways to meet the challenges ahead. Still, we will remain faithful to Val’s lifelong cause: to break down the walls that keep America’s weakest members from getting the care they deserve.