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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.

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Recent Initiatives

Transforming State LTSS Access Programs and Functions into a No Wrong Door System for All Populations and All Payers

The U.S. Administration for Community Living along with the Centers for Medicare & Medicaid Services and the Veterans Health Administration is pleased to announce awards to 25 states to develop state plans to transform their multiple access functions to long-term services and supports (LTSS) into a single No Wrong Door (NWD) system for all populations and all payers.

Using these awards, each state grantee will develop a plan to create a single statewide NWD access system to LTSS for all populations and all payers that meet the state’s unique needs and circumstances. The NWD system will make it easy for people of all ages, disabilities and income levels to learn about and access the services and supports they need.

For these purposes, "all populations" means everyone, regardless of age, income, or disability and "all payers" means any state administered program that provides LTSS to the people that will be served by the NWD System. States will design systems that will best organize and operate the various NWD functions.

It is expected that states will better integrate, and in some cases, restructure and strengthen, their existing ADRC and/or Balancing Incentive Program NWD programs and other state administered LTSS access programs. This would be accomplished in order to realize the joint vision across Administration for Community Living, Centers for Medicare & Medicaid Services and the Veterans Health Administration vision of each state having a single NWD System that is a fully integrated for all populations.

States will define the roles and responsibilities of all agencies or organizations involved in performing NWD System functions and ensure that all of the functions are carried out in a coordinated, high-quality manner. States will examine ways that NWD System activities (e.g., Person Centered Counseling, the Preliminary Functional Assessment) can be provided by a broad array of local agencies and organizations. The four key functions within a state’s No Wrong Door System are:

  • Public Outreach and Coordination with Key Referral Sources
  • Person Centered Counseling (PCC)
  • Streamlined Access to Public LTSS Programs, and
  • State Governance and Administration

From past work, it is clear that no one agency or network has the capacity, expertise, or authority to effectively carry out all the NWD System functions for all of the different populations that will be served. It is expected that multiple agencies and organizations at the state and local level will be formally involved in the operations of a state’s NWD System in order for the NWD System to be effective.

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Summary of Funding Opportunity Announcement

Most states have already developed programs that help consumers understand and access their LTSS options using various federal grants and authorities. These include Aging and Disability Resource Center grants, Money Follows the Person grant funding, and the Balancing Incentive Program. Building upon these efforts, the funds being made available under this funding announcement will support a state-led 12-month planning process to identify the key actions the state will need to take to move forward with the development and implementation of a single NWD System. Various state agencies will be involved as full partners in leading this planning process, including State Medicaid Agencies; State Units on Aging; state agencies that serve or represent the interests of individuals with physical, intellectual, and developmental disabilities; and the state authorities administering mental health services.

In addition, the planning process will incorporate meaningful input from key stakeholders including consumers; their advocates; Area Agencies on Aging; Centers for Independent Living; local Medicaid agencies; local organizations that serve or represent the interests of individuals with physical disabilities, individuals with intellectual and developmental disabilities, and individuals with mental/behavioral health needs; Veteran Service Organizations; as well as service providers and other relevant public and private entities. In short, this funding opportunity is designed to ensure that states will meaningfully include persons who use LTSS in all aspects of the planning process.

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List of Awardees
STATE Applicant Agency Lead Agency or Agencies Award Amount
Alabama Alabama Medicaid Agency Alabama Medicaid Agency $217,401
Colorado Colorado Department of Health Care Policy & Financing Colorado Department of Health Care Policy & Financing $223,600
District of Columbia District of Columbia Department on Disability Services Department of Health Care Finance, Department of Behavioral Health, Department on Disability Services, DC Office on Aging, Department on Human Services, and Office of Veterans Affairs $225,000
Florida Florida Department of Elder Affairs Florida Department of Elder Affairs $166,536
Georgia Division of Aging Services, Georgia Department of Human Services Division of Aging Services $224,694
Guam Division of Senior Citizens Department of Integrated Services for Individuals with Disabilities, Guam Behavioral Health & Wellness Center, and Department of Public Health & Social Services $100,000
Hawaii Executive Office of the State of Hawaii Governor’s Office of Healthcare Transformation $225,000
Idaho Idaho Commission on Aging Idaho Commission on Aging $185,603
Illinois Illinois Department on Aging Illinois Department on Aging $225,000
Indiana Indiana Family & Social Services Administration Division of Aging, Division of Mental Health & Addiction, Office of Medicaid Policy & Planning, and Division of Disability & Rehabilitative Services $225,000
Iowa Iowa Department on Aging Iowa Department on Aging $225,000
Kentucky Kentucky Cabinet for Health & Family Services Office of Health Policy $225,000
Louisiana Governor's Office of Elderly Affairs Governor's Office of Elderly Affairs $225,000
Michigan Office of Services to the Aging Office of Services to the Aging $225,000
Minnesota Minnesota Board on Aging Minnesota Board on Aging $225,000
Mississippi Mississippi Department of Human Services Mississippi Department of Human Services $225,000
Nevada Aging & Disability Services Division Aging & Disability Services Division $224,227
North Carolina North Carolina Department of Health & Human Services Division of Medical Assistance $224,173
Oklahoma Oklahoma Department of Human Services Division of Aging Services $225,000
Pennsylvania Pennsylvania Department of Aging Department of Aging's Link to Aging & Disability Resources $222,954
Rhode Island Executive Office of Health and Human Services Executive Office of Health and Human Services $225,000
Tennessee Tennessee Commission on Aging & Disability Tennessee Commission on Aging & Disability $173,218
Texas Texas Department of Aging & Disability Services Department of Aging & Disability Services $225,000
Virginia Virginia Department for Aging & Rehabilitative Services Department for Aging & Rehabilitative Services $224,830
West Virginia Bureau of Senior Services Bureau of Senior Services $215,500

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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.

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Last Modified: 10/3/2014