For many older adults and people with disabilities, the key to remaining independent can be something as simple as a home-delivered meal, a ramp for their homes, or a few hours of respite for a family caregiver. Unfortunately, an often disjointed maze of eligibility criteria, forms, programs, and agencies can prevent even the most determined individuals from obtaining these critical supports. The Administration for Community Living (ACL) has been helping states streamline their processes and implement systems that make it easier for people to learn about—and access—the services they need.
In these “No Wrong Door” systems, multiple state and community agencies coordinate to ensure that regardless of which agency people contact for help, they can access information and one-on-one counseling about the options available across all the agencies and in their communities. The goal is to enable people to make informed decisions based on the full range of available services. The No Wrong Door systems also provide assistance in accessing services, including help in completing applications for various public and private programs.
Last week, ACL awarded nearly $5 million in grants to 13 states to further develop these "No Wrong Door" systems.
“When a bureaucratic maze prevents people from accessing what they need to live in the community, everybody loses,” said ACL Administrator Kathy Greenlee. “These grants will help states and territories better serve older adults and people with disabilities while testing innovative approaches that could be used across the country.”
Each grantee is tackling the issue in a slightly different way. One innovative approach embraced by several grantees is the inclusion of programs that have not traditionally been a part of a No Wrong Door System. For example, Virginia will bring Adult Protective Services programs into its existing No Wrong Door System. Other states are focused on identified the best approach to advancing major changes in their current systems. Colorado, for example, will be implementing “No Wrong Door” pilot projects in three to five areas of the state. They also will develop a long-term strategy for financing and sustaining their “No Wrong Door” System as they move to statewide implementation.
All grantees have demonstrated strong leadership and buy-in from all corners of state government as well as support from the community. Such unity is critical in helping states overcome the obstacles that inevitably arise when revamping vast and long-standing bureaucratic systems.
In Alabama, for example, Gov. Robert Bentley signed an executive order directing multiple state agencies to develop a joint eligibility and enrollment system for all public services and supports that can provide real-time eligibility determinations. Gov. Bentley also directed the state's Medicaid agency to administer the No Wrong Door system. And Alabama has earmarked nearly $1 million to train Medicaid staff state-wide on effectively providing person-centered planning.
All grantees are taking concrete steps to fully incorporate a person-centered planning approach into everything they do. Person-centered planning is directed by the individual seeking services and shifts the role of agency staff from merely determining what services an individual qualifies for to assisting them in identifying and accessing a mix of paid and unpaid services based on their strengths, goals, preferences, and needs.
These grants are part of an ongoing partnership with the Centers for Medicare & Medicaid Services (CMS) and the Veterans Health Administration (VHA) to support state efforts to advance system-wide changes that make it easier for people to remain living in their own homes and communities. Of the 13 states that received current funding, eight (Connecticut, Maryland, Massachusetts, New Hampshire, Oregon, Vermont, Washington, Wisconsin) will continue work begun and funded by ACL in prior years to transform their access systems. The remaining five states (Alabama, Colorado, District of Columbia, Hawaii, Virginia) are launching new initiatives.
About the Administration for Community Living
The Administration for Community Living was created based on a commitment to one fundamental principle—that people with disabilities and older adults should be able to live where they choose, with the people they choose, and fully participate in their communities. A division of the U.S. Department of Health and Human Services, ACL works with other federal agencies, states, tribes, academic and research institutions, and local community networks to ensure access to needed community services, individualized supports, and other forms of assistance that promote self-determination, independence, productivity, and integration and inclusion in all facets of community life.