No Wrong Door Implementation Grant | Department of Health Care Policy and Financing

NWD Implementation Grant Update

No Wrong Door (NWD) is a federally funded grant opportunity administered by the Centers for Medicare and Medicaid (CMS), the Administration for Community Living (ACL), and the Department of Veterans Affairs (VA). This project concluded for Colorado in 2019.
The project represented a statewide collaboration between the Department of Health Care Policy & Financing (HCPF), the Department of Human Services (CDHS), and the Department of Labor and Employment (CDLE).
The overarching goal of the project was to streamline access to Long-Term Services and Supports (LTSS) for all people in need regardless of age, disability or pay source

Colorado implemented a project that leveraged pilot sites to identify system barriers and best practices to streamline access to community-based resources. Four pilot sites from different regions of the state were identified through a competitive application process.
Each pilot site provided a final report and presentation to HCPF, outlining the successes and challenges faced within the respective projects.
The pilot sites that participated in the effort were:
- Colorado Access (serving Adams, Arapahoe, Denver, and Douglas counties)
- Larimer County Department of Human Services
- San Juan Basin Area Agency on Aging (serving Archuleta, Dolores, La Plata, Montezuma, and San Juan counties)
- Senior Resource Development (serving Pueblo County)

The federal NWD initiative identifies the following areas of focus:
- Information, Referral, and Awareness
- Person-Centered Counseling
- Streamlined Eligibility
- Person-Centered Transition Support
- Individual Populations, Partnerships, and Stakeholder Involvement
- Quality Assurance and Continuous Improvement
The four pilot sites each developed unique and creative local solutions to streamline access to LTSS for all people in need regardless of age, disability, or pay source. Pilot sites were charged with creating a “one-stop-shop” among local resources. Solutions focused on person-centered practices that would bridge the gap between resources; wherein a person directs their own care and determines how their story is to be shared.
Pilot sites were successful in identifying the importance and value of collaboration and communication. Each site approached the barriers differently but presented unique solutions to information sharing and collaboration between community organizations.

Through work with the pilot sites, the need for centralized communication and oversight emerged as a consistent barrier.
The HCPF's Office of Community Living is in the process of implementing a Person-Centered Assessment and Support Planning process. The process will be supported by the new Care and Case Management system that streamlines access to LTSS using a singular assessment tool.
The tool is designed to improve automation and communication between systems such that members are able to navigate the system and direct their care with greater ease.
Further Case Management Redesign (CMRD) will evaluate how oversight of these functions needs to evolve to improve the members’ experience.

Aging and Disability Resource Centers (ADRC) were key partners in the NWD project. Through a collaborative effort that involved HCPF and CDHS, Medicaid Administrative Claiming (MAC) was authorized for ADRCs statewide, bolstering the support provided to Medicaid-eligible members.
This process continues to be managed by the collaboration between HCPF and CDHS.

No Wrong Door (NWD) implementation included meetings of a NWD Planning Advisory Group in the spring of 2015, followed by five public regional forums on the No Wrong Door Implementation Plan, held around the state during October and November 2015.