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Public Engagement Strategies Redefine “No Wrong Door” in Maryland

For over ten years Maryland has refined its NWD/ADRC initiative, known as Maryland Access Points (MAP). The term “Maryland Access Point” was chosen to remove any semblance of preferences for “aging” or “disability” being first in the name, as Maryland wanted its NWD/ADRC to be seen as access points for all individuals needing LTSS. Starting in 2008, Maryland formally initiated its branding process and hired a consultant to construct a marketing plan for consumers and providers that eliminated system fragmentation, increased awareness of LTSS, and focused on prevention of crises. The state launched a toll free number in August 2014 and a new website in February 2015. Read more about Maryland’s Promising Innovations.



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What are No Wrong Door (NWD) Systems?


Many individuals and their families find locating and accessing the right long term services and supports (LTSS) a daunting task. Individuals frequently find themselves confronted with a bewildering maze of organizations and bureaucratic requirements often during a crisis. This can lead to decisions to purchase less optimal and more expensive than necessary LTSS options, including decisions to use nursing facility care that can quickly result in exhausting an individual’s financial resources. The No Wrong Door (NWD) System, including Aging and Disability Resource Centers (ADRC), represents a collaborative effort of the U.S. Administration for Community Living (ACL), the Centers for Medicare & Medicaid Services (CMS), and the Veterans Health Administration (VHA), to support state efforts to streamline access to LTSS options for all populations and all payers. In a “No Wrong Door” entry system, multiple agencies retain responsibility for their respective services while coordinating with each other to integrate access to those services through a single, standardized entry process administered and overseen by a coordinating entity. A No Wrong Door System can provide information and assistance to individuals needing either public or private resources, professionals seeking assistance on behalf of their clients, and individuals planning for their future long term care needs.


State and local leaders can learn more about building capacity for No Wrong Door Systems by using the No Wrong Door National Key Elements. We have also highlighted certain components of No Wrong Door Systems in a series of Promising Practices that showcase states that have developed or are working to develop NWD Systems.


Arrow I: Public Outreach and Coordination with Key Referral Sources Level 1. Schools, Family Members & Friends, Individuals, Local Non-Profits, LTSS Providers; Level 2. 1-800 #'s/211, Acute Care Systems, VA Medical Center, Nursing Homes; Level 2.a Local l&R Programs, Hospitals, Veteran Directed HCBS, MFP/ Section Q.Arrow 2: Person Centered CounselingTitle: Person Centered Counseling Process – Assists with any immediate LTSS needs, conducts conversation to confirm who should be part of process, and identifies goals, strengths and preferences. Comprehensive review of private resources and informal supports. Facilitates informed choice of available options and the development of the Person Centered Plan. Facilitates implementation of the plan by linking individuals to private pay resources, and if applicable, in applying for public LTSS programs and follow-up. As needed, facilitates diversion from nursing homes, transition from nursing home to home, transition from hospital to home, and transition from post-secondary school to post-secondary life.Arrow 3: Streamlined Eligibility to Public ProgramsTitle: Improving the Efficiency and Effectiveness of LTSS Eligibility Process Across Multiple Public Programs – Leverages Person Centered Counseling staff to use information from the person centered plan to help individuals’ complete applications for public LTSS program(s) and to help them through the entire eligibility process. Continually identifies ways to improve the efficiency and effectiveness of the eligibility determination processes across the multiple LTSS programs administered by the state, while also creating a more expeditious and seamless process for consumers and their families.Arrow 4: State Governance and Administration – Title: State Leadership, Management and Oversight – Must include support from the Governor and involvement from State Medicaid Agency, State Agencies Administering programs for Aging, Intellectual and Developmental Disabilities, Physical Disabilities and Mental/Behavioral Health. Must involve input from external stakeholders, including consumers and their families, on the design, implementation, and operation of the system. Responsible for designating the agencies and organizations that will play a formal role in carrying out the NWD system. Will use NWD System as a vehicle for making its overall LTSS System more consumer-driven and cost-effective.






Created by: system last modification: Friday 06 of May, 2016 [16:16:24 UTC] by kevinhy

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