Community Services for the Older Adult: Access and Payment Systems


While most people prefer to live their final years in the familiar setting of their homes with their families and in their communities, most of the state and federal funding has been directed to caring for people in institutions. Participate in this module to learn the types of home and community based services available through federal and state programs. This module will enable you to assist older adults and their families in accessing those programs locally.

Author Information

Michael Gelder, MPH
Michael Gelder and Associates
Adjunct Assistant Professor
School of Public Health
Department of Human Development
University of Illinois at Chicago
Adjunct Assistant Professor
School of Education and Social Policy
Northwestern University

Susan Altfeld, PhD, MA (SW)
Clinical Assistant Professor
Community Health Sciences
Center for Research on Health and Aging
Associate Dean for Academic Affairs
School of Public Health
Co-Investigator, ENGAGE-IL
University of Illinois at Chicago

Authors Bio:
Michael A. Gelder is recognized as a driver of change and manager of complex processes necessary for health system transformation. His expertise was achieved over 40 years working to improve access, quality and affordability of health care and community-based long-term care for underserved populations, including fifteen years at top-levels of state and local governments.

Mr. Gelder currently consults on projects leading to development of integrated delivery systems linked to community based services, population health, and other drivers to achieve improved health, higher quality and more cost-effective care. He is an adjunct professor at Northwestern University College of Medicine and University of Illinois Chicago, teaching courses in the US health system and health policy to undergraduate and graduate MD and MPH students.

Michael Gelder served as senior health policy advisor to Illinois Governor Pat Quinn from June 2009 to January 2015. He advised the governor on all policy matters pertaining to implementing the Affordable Care Act, state health system transformation, Medicaid managed care, nursing home safety, long-term care rebalancing, and the state’s health information exchange. Mr. Gelder was instrumental in negotiating consent decrees to bring Illinois into compliance with the Olmstead decree for older adults, people with serious mental illness and other disabilities.

Mr. Gelder previously served as Director and Deputy Director for the Illinois Department on Aging, managing approximately $1 billion for state and federal programs to help older adults receive the support and services needed to live safely in the community and avoid unnecessary and unwanted nursing home placement.

For 25 years prior to joining state government in 2003, Mr. Gelder was principal of a consulting firm that provided technical assistance, advocacy, and policy analysis to improve access, delivery, and quality of health care for under-served populations. From 1997 to 2009, Mr. Gelder served as an elected village trustee in Skokie, Illinois.

Mr. Gelder holds a master’s degree in health administration from Washington University, St. Louis and a bachelor’s degree in business administration from Michigan State University.

Dr. Susan Altfeld has been on the faculty of the University of Illinois at Chicago School of Public Health since 2005 where she is currently the Associate Dean for Academic Affairs. She received her master’s degree in social work from the University of Chicago School of Social Service Administration and a Ph.D. in Public Health from the University of Illinois at Chicago. Dr. Altfeld has worked in both health care and social work settings as a clinician, instructor, consultant and researcher. Her research interests include family caregiving throughout the life cycle, transitional care and evaluation of community-based interventions.

Valerie Gruss PhD, APN, CNP-BC
Associate Professor
College of Nursing
Director, ENGAGE-IL
University of Illinois at Chicago

Memoona Hasnain MD, MHPE, PhD
Professor and Associate Department Head, Faculty Development & Research
College of Medicine,
Department of Family Medicine
Co-Director, ENGAGE-IL
University of Illinois at Chicago

Expert Interviewee:
Michael Gelder, MPH
Michael Gelder and Associates
Adjunct Assistant Professor
School of Public Health
Department of Human Development
University of Illinois at Chicago
Adjunct Assistant Professor
School of Education and Social Policy
Northwestern University

Module Information

Duration: 30 minutes
Format: Video Stream & pdfs

Module Guide and Handout
Resources & References
Continuing Education Credit Information

In support of patient care, Rush University Medical Center is accredited by the American Nurses Credentialing Center (ANCC), the Accreditation Council for Pharmacy Education (ACPE), and the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing education for the healthcare team.

Rush University Medical Center designates this live activity for a maximum of (0.5) AMA PRA Category 1 Credit(s)™. Physicians should claim only credit commensurate with the extent of their participation in the activity.

This activity is being presented without bias and without commercial support.

ANCC Credit Designation – Nurses
The maximum number of hours awarded for this CE activity is 0.5 contact hours.

Rush University is an approved provider for physical therapy (216.000272), occupational therapy, respiratory therapy, social work (159.001203), nutrition, speech-audiology, and psychology by the Illinois Department of Professional Regulation. Rush University designates this live activity for (0.5) Continuing Education credit(s).

Rush University Medical Center designates this knowledge based CPE activity for 0.5 contact hours for pharmacists.

Learning Objectives

Upon completion of this module, learners will be able to:

Identify national programs that support older adults in the community
Describe the overall system of care available through federal and state programs and how older adults and their families can access those programs locally
Discuss variations in long-term supports and services and how they are financed

Technical Support / Contact Info

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