When Missouri released “Aging with Dignity: Missouri’s Master Plan on Aging” in February 2026, it joined a growing number of states using cross-agency, cross-sector plans to better coordinate policies and services for older adults. The plan grew out of mounting recognition that Missouri’s aging population was growing, yet its infrastructure and services were underequipped to effectively support these residents. Early efforts from states like California and Texas helped show what a statewide multisector plan for aging (MPA) could look like, and advocates in Missouri’s aging network helped build momentum for the effort. Many states that have a multisector plan for aging may call it by different names, such as Longevity Ready Maryland, Age Strong Vermont or All Ages, All Stages North Carolina. In January 2023, the Missouri Department of Health and Senior Services began conversations with then-Gov. Mike Parsons, which led to an executive order directing the state to develop an MPA.
Missouri’s experience offers a useful example of how ample lead time, broad engagement, and cross-sector collaboration can shape a statewide strategy for aging.
Launching the Work Through Executive Action
Parson’s executive order authorized Missouri to begin developing its MPA and, notably, provided nearly three years to complete the work. That longer timeline gave the state room to be deliberate about how to develop the plan, including substantial input from community stakeholders.
Missouri’s experience offers a useful example of how ample lead time, broad engagement, and cross-sector collaboration can shape a statewide strategy for aging.
The executive order also required each state department to designate a representative to contribute to the development and implementation of the plan. This requirement helped reinforce for state leaders that aging policy touches nearly every part of the government, not aging services alone.
Following the executive order, Mindy Ulstad, chief of the Bureau of Senior Programs, led the work to identify initial key priority areas for the MPA. These priority areas helped inform the composition of the advisory council for the plan, including state department leads, and shape subcommittees comprised of community members and subject matter experts to guide plan development. Together, their work identified seven key focus areas for their MPA:
(1) daily life and employment;
(2) family caregivers;
(3) housing and aging in place;
(4) long-term services and supports;
(5) safety and security;
(6) transportation and mobility; and
(7) whole-person health.
Extensive community and stakeholder engagement was central to the process. More than 10,000 Missourians contributed through town halls, subcommittee and advisory council participation, and responses to a statewide needs assessment survey. This level of participation would not have been possible without strong partnerships with the state’s Area Agencies on Aging, along with the support of philanthropic foundations and expert consultants. Missouri also participated in the Center for Health Care Strategies’ Multisector Plan for Aging Learning Collaborative, which gave the state an opportunity to connect with other states developing MPAs.
Amid developing the plan, Missouri welcomed a new administration, Gov. Mike Kehoe, and a new Health and Senior Services Director, Sarah Willson. Through the transition, the MPA team worked with Director Willson and Gov. Kehoe to keep them abreast of the MPA activities and to ensure support for the plan remained strong. Early plan progress, such as collaboration on transportation access and No Wrong Door efforts, helped sustain support for the plan across administrations.
Moving from Plan to Implementation
Once Missouri published its MPA, the state restructured its advisory council and subcommittees to better support implementation. The advisory council now includes more people with lived experience, while subcommittees have more state department representatives. At the same time, participation remains open to anyone who is interested.
Missouri is already seeing the benefits of developing an MPA. State agencies have become more aware of how aging impacts their work and are collaborating in ways they had not before.
Like other states, Missouri worked to prioritize its actions based on complexity and what could be accomplished in the first year. The state is starting with action steps that do not necessarily require funding or legislative authority, as those items will need more time to implement. An annual report will serve to update stakeholders each year on plan progress and goals for the coming year. Missouri is also working on a website that will share information on local implementation efforts, a data dashboard, and connect to the state’s No Wrong Door initiative. The state would like to make county-level profiles available to can track key measures and plan progress at the local level.
Missouri is already seeing the benefits of developing an MPA. State agencies have become more aware of how aging impacts their work and are collaborating in ways they had not before. The plan has also helped people who may not yet think of themselves as aging recognize that longevity planning begins well before older adulthood, including through retirement planning or caregiving responsibilities.
For Ulstad, one of the clearest lessons is the importance of having dedicated staff time, and in some cases consultant support, to manage this work. She also pointed to the value of sharing responsibility with other state leaders and partners, such as academic institutions, to make the MPA sustainable. Ulstad also said Missouri’s three-year development timeline allowed time to engage people with lived experience and ensure their priorities were reflected in the MPA. “The plan should be made up by the people living in the state,” she said. That emphasis on community engagement, and collaboration across state agencies and external partners, has led to an MPA that is designed to support all Missourians as they age with dignity, now and in the future.
Valerie Flores, MGS, is a program officer at the Center for Health Care Strategies.
Thank you to Mindy Ulstad, Chief of the Bureau of Senior Programs, Missouri Department of Health and Senior Services, for her contributions to this blog post.
Photo credit: Shutterstock/PeopleImages
