As America ages, states are facing a pivotal challenge: How to support older adults, people with disabilities, and their caregivers in ways that are coordinated, person-centered, and sustainable. Two major movements address this challenge: No Wrong Door systems and Multisector Plans for Aging (MPAs).
At first glance, they may seem like separate melodies. But in reality, they are deeply connected and increasingly, their success depends on each other.
The No Wrong Door system concept began over 20 years ago as network of state agencies and community-based organizations that help people access supports by coordinating entry points. Essentially, a No Wrong Door system makes it easier for people to get the services they need (i.e. such as home care, disability services, and Medicaid programs) regardless of which agency or organization they first contact for help.
Multisector Plans for Aging emerged more recently as statewide strategies that bring together government, business, philanthropy, and community voices around a shared 10-year vision for aging well. States use MPAs to set measurable goals across housing, transportation, workforce, health equity, and caregiving, treating aging not as a single agency’s job but as a responsibility shared across the whole of state government.
If the two initiatives harmonize, they have the potential to transform how states support aging and disability populations.
The Shared Songbook: Making Systems Work for People
Anyone who has tried to navigate aging and disability services knows the experience can feel fragmented and overwhelming. Housing assistance is in one place. Caregiving support is somewhere else. Transportation, nutrition, healthcare, Medicaid, social services, and behavioral health often operate independently. Older adults, people with disabilities and family caregivers are left to connect the dots themselves.
No Wrong Door systems were created to solve this navigation problem. Through state governance, local Aging and Disability Resource Centers (ADRCs), person-centered counseling, and coordinated eligibility and referral systems, the No Wrong Door vision aims to ensure people can find the right help without being bounced between agencies.
In many ways, No Wrong Door systems are the “rhythm section” of a band that provides the steady beat and driving force to keep the MPA’s various goals moving forward.
MPAs start from the same premise, recognizing that healthy aging across the lifespan depends on much more than healthcare. States developing MPAs are also bringing together leaders from transportation, housing, workforce, public health, Medicaid, technology, philanthropy, and community organizations to create coordinated strategies for aging populations.
A typical MPA lays out a multi-year roadmap with concrete goals and measurable targets. States have organized these plans around themes like housing choices across the lifespan, caregiving infrastructure, workforce development for direct care, transportation access, and combating isolation. What distinguishes an MPA from a state plan on aging is the “multisector” commitment: agencies that don’t traditionally see themselves as aging-focused—labor, housing, finance, transportation—sign on to specific deliverables.
Both movements are trying to answer the same question: How do we build systems around people instead of forcing people to navigate systems?
Why Strong No Wrong Door Systems and MPAs Are Essential to Each Other
Many MPAs are ambitious by design. They include goals related to housing stability, caregiving, economic security, social connection, dementia readiness, and equitable access to care. For implementation, states need infrastructure capable of turning plans into real experiences for residents. That is where No Wrong Door systems become indispensable.
The No Wrong Door vision strives to build coordinated aging and disability networks that have:
- Trusted community entry points
- Trained person-centered counselors to support navigation
- Cross-agency referral relationships
- Consumer data and insight
- Expertise serving complex populations
- Operational knowledge of service gaps
In many ways, No Wrong Door systems are the “rhythm section” of a band that provides the steady beat and driving force to keep the MPA’s various goals moving forward. If No Wrong Door is the rhythm section, MPAs are the arrangement, deciding which instruments come in when, and toward a comprehensive symphony. For example, if an MPA includes a goal to reduce caregiver burden, No Wrong Door organizations are often the people helping caregivers connect to respite programs, benefits counseling, and support services. If a state wants to improve equitable access to home- and community-based services, No Wrong Door systems already interact directly with populations experiencing barriers and No Wrong Door governing bodies design plans to make the system more seamless for people trying to access services.
MPAs give No Wrong Door systems state-level momentum that can justify bigger investments in data infrastructure, workforce, and cross-agency authority underscoring the work of a No Wrong Door governing body. At the same time, the operational backbone of coordinated access systems ensures that MPAs are rooted in the daily realities of residents.
Despite their natural alignment, No Wrong Door leaders and MPA leaders do not always work closely together. Sometimes this happens because the initiatives originated in different agencies. In other cases, MPAs are developed at high policy levels while the key organizations involved in access remain operational programs focused on day-to-day service delivery and lack coordinated leadership to drive the No Wrong Door vision.
There are actionable ways MPA and No Wrong Door initiatives can work together to leverage momentum and maximize success. To truly align these efforts, states should move beyond informal coordination and create intentional structures for partnership.
How to Harmonize
1. Assembling a Full Ensemble: Collaborate to Build Cross-Sector Partnerships
Both MPA and No Wrong Door initiatives must engage a broad spectrum of stakeholders to affect lasting change. It makes sense to leverage these groups for both purposes. The No Wrong Door Key Elements articulates a vision that the No Wrong Door governing body at a minimum should include the state Medicaid agency, the state unit on aging, the state agencies that serve or represent the interests of individuals with physical disabilities, intellectual and developmental disabilities, and the state authorities administering mental health services. Healthcare, CBOs, foundations, advocacy groups and others also contribute to the development and sustainability of No Wrong Door systems.
For MPAs, stakeholder engagement occurs throughout development and implementation and is key to ensuring plans are person-centered and reflective of the needs and preferences of older adults. An MPA is developed and implemented with broad stakeholder engagement, including input from aging/disability stakeholders, as well as stakeholders who may not traditionally focus on aging, such as housing agencies, transportation leaders, workforce officials, health systems, and private-sector partners. Including nontraditional partners ensures that the MPA incorporates a range of perspectives and helps partners see themselves reflected in the plan.
North Carolina’s No Wrong Door governing body serves as an MPA subgroup focused on “Referrals and Access to Care.” They are working to create a unified referral system so caregivers receive tailored and accurate information, referrals, and access to long-term services and supports no matter which “door” they walk through. It will also work to enhance NC211 and NCCARE360 as comprehensive resources for older adults and people with disabilities to obtain information and connect to needed services, such as housing, health care, food, transportation, and life-long learning resources.
2. Securing the Conductor: Engage Executive-Level Support
Governors and state leadership are increasingly backing MPAs as statewide priorities. States that have strong No Wrong Door access systems also have Governor or legislative support. This visibility can help strengthen political support for investments in coordinated access infrastructure and consumer navigation systems. Leadership is central to Maryland’s No Wrong Door strategy. The state is integrating its multisector plan for aging, Longevity Ready Maryland (LRM), into the core of its service delivery infrastructure. At the center of this approach is Maryland Access Point (MAP), the state’s No Wrong Door system, which serves as a streamlined gateway for older adults, people with disabilities, and caregivers seeking services and supports. By aligning governance, care transitions, technology, and caregiver supports, the state is building a more connected system of access to services and supports.
3. Writing Access into the Score: Create Specific MPA Goal Related to Streamlined Access
Many states struggle with duplicative assessments, disconnected eligibility systems, and fragmented consumer experiences.
MPAs create opportunities to align systems more intentionally and grow No Wrong Door systems. States can use discretionary federal grant funding they get for implementing the National Strategy to Support Family Caregivers or No Wrong Door systems to support aligned MPA goals. MPAs are one of the only vehicles that can put access and navigation on equal footing with housing, transportation, and workforce goals—sectors that don’t typically fund or prioritize a No Wrong Door system on their own. When streamlined access becomes a named MPA goal, it can unlock cross-sector funding and political attention that a No Wrong Door system, on its own, might struggle to generate.
No Wrong Door systems and MPAs are strongest when they operate not as separate initiatives, but as complementary voices singing from the same songbook about transformation.
Oklahoma’s MPA, Aging Our Way, included No Wrong Door as one of the 13 goals in the plan. “Goal 2: Oklahoma’s No Wrong Door system makes it easy for older adults to find and receive the services, resources and support they need, including Person-Centered Options Counseling.” As part of this goal the plan details two pathways— “create a network of certified No Wrong Door navigators” or person-centered counselors and “create a central website for older Oklahomans and caregivers to access services and support.” As a way of sustaining person-centered counseling long-term, the state unit on aging is working with the state Medicaid agency to expand on Medicaid Administrative Claiming.
4. Tuning the Performance with Real-Time Feedback: Use No Wrong Door Data to Inform MPA Priorities
No Wrong Door systems often collect valuable information about unmet needs, referral trends, service gaps, and barriers faced by residents. This data can help MPAs prioritize investments and identify inequities across regions or populations. Recent efforts by Tennessee to increase No Wrong Door system governance and the state Medicaid agency’s development of an MPA sparked the merger of Department of Intellectual and Developmental Disabilities and the Tennessee Commission on Aging and Disability to form a new state agency called the Department of Disability and Aging. The Tennessee No Wrong Door governing body will lead implementation of the MPA which includes a dashboard to track progress incorporating data from the states access system across populations.
5. Building the Concert Hall’s Infrastructure: Invest in Shared Technology and Infrastructure
Integrated referral systems, shared data platforms, and interoperable eligibility tools can support both initiatives simultaneously. Technology investments should be designed around the consumer experience, not agency boundaries.
6. Performing a Unified Anthem: Build a Common Narrative
Both movements benefit from telling a unified story:
- Aging policy is not just about older adults.
- Coordinated systems benefit families, caregivers, healthcare systems, employers, and communities.
- Navigation support is a core part of equitable access.
When leaders communicate this shared vision clearly, it becomes easier to build bipartisan support and cross-sector momentum.
Missouri’s MPA had a dedicated section on their recent No Wrong Door efforts to map Missouri’s LTSS landscape, identify access gaps, and pilot solutions to improve person-centered access statewide. This resulted in a plan to strengthen interagency collaboration, operational coordination, and person-centered access which aligns with their MPA.
The Crescendo Ahead
No Wrong Door systems and MPAs are strongest when they operate not as separate initiatives, but as complementary voices singing from the same songbook about transformation. Together, they can help states move from fragmented programs to truly person-centered systems—where people do not need to understand government structures to get the support they need. This is the ultimate crescendo of our work: a state where every door is the right door, and behind every door is a commitment to helping every resident age well with dignity and support.
Christina Neill Bowen, MSW, LISCW has operated her consulting practice in aging, disability, and caregiving for over 25 years.
Amy Herr, MHS, PMP, is senior director of Health Policy for the nonprofit, nonpartisan West Health Policy Center.
Photo credit: Shutterstock/AT Global
While every state maintains a system for accessing aging and disability services, these systems vary significantly in their sophistication and alignment with the national No Wrong Door vision. They often operate under the unique state-specific names, such as LA Answers, Maryland Access Point, or MI Options. Currently, 14 states have MPAs with several more in the planning state, as shown in the map.
