Skip Navigation

Center for Disability and Aging Policy (CDAP)

Office of Integrated Programs

Aging & Disability Resource Centers Program/No Wrong Door System

Find a Local ADRC

The Purpose of the Program and How it Works

The No Wrong Door System comprised of Aging and Disability Resource Centers (ADRC), a collaborative effort of ACL (formerly Administration on Aging), the Centers for Medicare & Medicaid Services (CMS), and now the Veterans Health Administration (VHA), supports state efforts to streamline access to long-term services and support (LTSS) options for older adults and individuals with disabilities. NWD systems simplify access to LTSS, and are a key component to LTSS systems reform.

NWD systems are designed to serve as highly visible and trusted places available in every community across the country where people of all ages, incomes and disabilities go to get information and one-on-one person-centered counseling on the full range of LTSS options. Nationally, NWD systems have taken important steps towards meeting ACL and CMS’s vision by:
  • Creating a person-centered, community-based environment that promotes independence and dignity for individuals
  • Providing easy access to information and one-on-one counseling to assist consumers in exploring a full range of long-term support options
  • Providing resources and services that support the needs of family caregivers

Finding the right services can be a daunting task for individuals and their family members. The current LTSS system involves numerous funding streams, and is administered by multiple federal, state and local agencies using complex, fragmented, and often duplicative intake, assessment and eligibility processes. There are more and more options for services and supports, in home, residential, and institutional settings. Individuals trying to access the multitude of new LTSS frequently find themselves confronted with a maze of agencies, organizations and bureaucratic requirements at a time when they may be vulnerable or in crisis. These issues frequently lead to use of the most expensive forms of care, including institutional care such as nursing homes or extended hospitalization, and can cause a person to quickly exhaust their own resources.

NWD systems provide information and assistance not only to individuals needing either public or private resources, but also to professionals seeking assistance on behalf of their clients and to individuals planning for their future long-term care needs. NWD systems also serve as the entry point to publicly administered long-term supports, including those funded under Medicaid, the Older Americans Act, Veterans Health Administration, and state revenue programs.

To date, ACL has funded 54 out of 56 states and territories to implement NWD activities. Nationwide 530 local NWD  systems are in place actively serving older adults and persons with disabilities. Since the inception of the program, NWD systems have responded to over 25 million contacts helping answer questions related to health and long-term services and supports.

Back to top

Recent Initiatives

In 2012, the Veteran Health Administration (VHA) partnered with ACL and Centers for Medicare & Medicaid Services (CMS) to fund an opportunity specifically designed to help support states in pursuing and developing sustainability strategies for a statewide Options Counseling Program in conjunction with their health systems transformation. States were eligible to apply for The Enhanced Options Counseling Program (Part A) or Sustainability Program Expansion Supplemental (Part B).

The Enhanced Options Counseling Program (Part A)

The Enhanced Options Counseling Program funded states will serve as high-performing national models for providing LTSS options counseling to all state residents with LTSS needs.

A high performing program is designed specifically to help individuals and their family caregivers access the right services at the right time in the right setting. It will have capacity to serve people of all ages, disabilities and income levels, including individuals interested in planning for or able to pay for their LTSS needs. It will also streamline eligibility determinations for people appropriate for public LTSS programs and increase access to lower cost community-based alternatives that can help avoid institutional care and preserve personal resources. States will use their NWD System as a key tool for rebalancing their LTSS systems and for making their systems more person-centered, more efficient, and more supportive of community living.

Goals and Outcomes

The long-term outcome for Part A awarded states will be documented by increases in community-living and quality of life for state residents as well as a more effective use of public resources, especially as people access lower cost alternatives to institutional care. This will be accomplished by the states over a three year project period by:

  1. Strengthening the capacity to serve people of all ages, income levels and disabilities by adopting a “No Wrong Door” approach that operationally involves a wide array of community agencies and organizations so it can effectively serve a broad range of populations, including at a minimum, older adults, people with disabilities of all ages, people with physical, intellectual and developmental disabilities (ID/DD), and family caregivers.
  2. Developing financially sustainable ADRC models that includes revenue from multiple public programs (including Medicaid, Medicare, the Older Americans Act, the VHA and other programs) to cover expenses associated with such tasks as:
    • Outreach
    • Screening/assessing individuals’ need for LTSS
    • Working with individuals and their families to develop service plans
    • Linking individuals to needed services, helping individuals to use self-directed service models
    • Assisting individuals in determining their eligibility for public programs
  3. Aligning data collection and reporting methods across LTSS payers within a state to minimize administrative burden and support continuous quality improvement. The funded states will participate in development of a NWD system management tool which will document the impact of Options Counseling Programs on the quality of life and well-being of individuals and families, and the utilization and cost of LTSS and health care services.
Part A State Awards
Connecticut $694,000
Maryland $700,000
Massachusetts $700,000
New Hampshire $700,000
Oregon $700,000
Vermont $700,000
Washington $700,000
Wisconsin $699,757

Back to top

Sustainability Program Expansion Supplemental Program (Part B)

ACL designed this funding opportunity to help support states in pursuing and developing sustainability strategies for Options Counseling Programs in conjunction with their health systems transformation and funding from the Center for Medicare and Medicaid (CMS) and Veteran Health Administration (VHA). Under this opportunity, states will continue to work toward developing a high performing statewide Options Counseling Program as outlined in their own statewide NWD development/expansion plans and as described in the 2012 ACL, CMS, VHA Funding Opportunity.

Goals and Outcomes

States receiving awards will seek to achieve the following two key sustainability goals as part of this funding opportunity:

  1. Strengthening the capacity of the Options Counseling Program to serve people of all ages, income levels and disabilities by adopting a “No Wrong Door” approach that operationally involves a wide array of community agencies and organizations so it can effectively serve a broad range of populations; and
  2. Developing financially sustainable NWD models that includes revenue from multiple public programs (including Medicaid, Medicare, the Older Americans Act, and the Veterans Health Administration and other programs)

Based on the experience to-date with NWD systems across the nation, and the importance of having an infrastructure that can effectively reach and serve different populations with unique LTSS needs as well as different ethnic and cultural groups, ACL is encouraging funded states to adopt a “No Wrong Door” (NWD) approach to implementing their Options Counseling Programs. The NWD approach operationally involves a wide array of agencies and organizations so it can effectively reach and serve a broad range of populations, including older adults, individuals with physical disabilities of all ages, individuals with intellectual and developmental disabilities, as well as individuals who can pay for their own services.

Part B State Awards
Alabama $199,758
Alaska $199,757
Arizona $199,460
Arkansas $182,772
California $202,443
Colorado $199,496
Delaware $199,741
Georgia $197,759
Florida $183,545
Hawaii $181,021
Idaho $199,759
Illinois $202,443
Indiana $202,443
Iowa $199,758
Kentucky $177,758
Maine $199,758
Michigan $199,500
Minnesota $199,750
Montana $195,958
Nebraska $194,000
Nevada $199,150
New Jersey $118,295
New Mexico $199,758
North Carolina $174,995
Ohio $194,724
Oklahoma $199,745
Rhode Island $199,759
South Carolina $193,508
South Dakota $173,419
Tennessee $194,306
Texas $198,161
Utah $199,758
Virginia $199,776
West Virginia $174,000
Washington DC $202,443
Guam $194,745

Back to top

ADRC Program Resources and Useful Links

ADRC Technical Assistance Exchange (TAE)
Sponsored by ACL, the ADRC TAE website provides training and technical assistance to states working on NWD systems. The ADRC TAE website includes summary information on state efforts, a variety of resources related to the development and implementation of NWD systems, and provides a forum for peer-to-peer information exchange on policy and program issues. In partnership with ACL, the ADRC TAE provides direct technical assistance to states and communities as they develop, implement and evaluate their NWD systems.

Find a Local NWD System
This resource on the ADRC-TAE website allows consumers to find contact information for local NWD systems in their area.

VD-HCBS Portal
This portal on the ADRC-TAE website features resources and information for VD-HCBS grantees and others serving Veterans.

ADRC-TAE Newsletter
This weekly newsletter includes important NWD announcements as well as news, resources, and upcoming events of interest to NWD stakeholders. Please register for the newsletter if you wish to receive it.

Back to top

Last Modified: 4/16/2014