No Wrong Door in North Carolina: Connecting Services for WNC and Beyond
Image Credit: Benis Arapovic
Making The Connection Between Services and Needs
For many people across North Carolina, and especially in Western North Carolina (WNC), finding help can feel like navigating a maze. Whether someone is seeking support for aging in place, disability services, caregiving, housing stability, or recovery, the system often requires knocking on multiple doors before finding the right one.
The No Wrong Door (NWD) framework was created to address this challenge. Guided by the Administration for Community Living (ACL), No Wrong Door is not a single program, technology platform, or intake system. Instead, it is a framework that helps states align governance, outreach, counseling, and access points so individuals can more easily find and receive Long-Term Services and Supports (LTSS).
Understanding LTSS
LTSS refers to services and supports that help older adults and people with disabilities live safely and independently over time. These include home and community-based services, personal care, transportation, caregiver supports, nutrition services, and related social supports.
The need for better coordination across North Carolina is no surprise: According to AARP’s LTSS State Scorecard, North Carolina currently ranks 41st nationally. This ranking reflects long-standing challenges related to access, navigation, and system integration, particularly for rural and mountain communities like those in WNC.
Strategies For Connection
The federal No Wrong Door framework outlines four core strategy areas.
The first is governance. States are encouraged to establish a governing body that brings together agencies responsible for aging, disability, health, and human services. North Carolina has already established such a governing body, creating a structure for cross-agency collaboration. This governing body is not only central to No Wrong Door efforts but is also identified as a key player in other statewide initiatives. Connecting with North Carolina’s Multisector Plan on Aging, the statewide action plan that explicitly incorporates No Wrong Door principles and recognizes the governing body as an important coordinating partner. This alignment helps integrate a No Wrong Door movement as part of a broader strategy to improve how the state supports aging, disability, and caregiving across the lifespan.
The second strategy area is public outreach. People need to know where to start when they need help. This includes clear, consistent messaging and entry points that work across regions and populations at the moment they need it, whether through our hospital systems, clinics, or the front desks of service providers of other critical needs like food and transportation..
The third area is person-centered counseling. Rather than focusing solely on only one program's eligibility, No Wrong Door emphasizes helping individuals understand all of their options, clarify their goals, and make informed choices that reflect their needs and values.
The fourth strategy is streamlining access to services. This involves reducing duplication, improving referrals, and making it easier for people to move between programs without having to retell their story at every step.
North Carolina already has several upstream services that align with these strategies. Platforms such as NCCARE360’s self-service tool, 211, and the Area Agencies on Aging play important roles in connecting people to LTSS-related resources. While these platforms are not the No Wrong Door system itself, they are part of the NC system that supports LTSS and some examples of where coordination and shared infrastructure can support smoother access across the state.
No Wrong Door in action
Western North Carolina, in particular, has a strong history of local innovation and collaboration. Many organizations in the region are already operating in ways that reflect No Wrong Door principles, even without formal NWD designation.
One example worth noting is a program in Franklin that uses the name “No Wrong Door” to support individuals navigating mental health and substance use recovery. While this local program is not affiliated with the federal No Wrong Door framework or North Carolina’s state NWD initiative, it appears to be addressing similar challenges around navigation, coordination, and person-centered support. Its work highlights how the underlying needs that No Wrong Door seeks to address are being felt and responded to at the community level and connecting services across the state too would open the door to significantly better outcomes for our communities. (Learn more about Macon County’s “No Wrong Door for Support and Recovery” program here.)
North Carolina has also seen a partial demonstration of coordinated service delivery through the Healthy Opportunities Pilot. Although limited to Medicaid recipients, the pilot showed how health care and social services can be better aligned to address non-medical needs such as food, housing, and transportation AND save the state, insurers, and individuals money through these clinically-driven interventions.
Looking ahead, Medicaid Administrative Claiming may offer an opportunity for LTSS organizations across the state, including those in WNC. Applying for MAC has been a useful approach in other states that helped fund coordination, outreach, and networking activities that organizations are often already performing, supporting sustainability without requiring entirely new systems.
Bringing it all together
No Wrong Door is about reducing fragmentation, not replacing existing services. Many upstream services already reflect this vision, including NCCARE360’s self-service tool, 211, and Area Agencies on Aging. Whether looking at tighter relationships between providers, IT innovations, or tapping into funding that can support work already being done through Medicaid Administrative Claiming, LTSS organizations in our state are poised to make big improvements for our communities.
For a state ranked 41st nationally on Long-Term Services and Supports, and for regions like Western North Carolina where access challenges are magnified by geography and workforce constraints, the framework offers a path toward better alignment and clearer entry points.
Resources
Learn more
To learn more about how No Wrong Door is taking shape in North Carolina, listen to our podcast episode featuring longtime No Wrong Door consultant, Christina Neill Bowen, Catherine Zontine of the Lewin Group, and North Carolina’s current No Wrong Door grant program manager, Taylor Paré,. They share insights on what NWD means, and some of the ways our region and state can move forward.
Get engaged
For organizations, providers, and partners interested in helping shape this work, No Wrong Door offers an opportunity to align statewide efforts and improve the experiences of North Carolinians navigating LTSS. Those interested in sharing regional perspectives, strengthening referral pathways, or learning more about participation in the Governing Body or statewide coordination efforts are encouraged to reach out to Taylor Paré (tpare@unca.edu) or learn more at ACL’s NWD site.
Disclaimer
This content was developed by the WNC Health Policy Initiative in consultation with people and organizations with connections to the health of people of Western North Carolina. Individual or organizational opinions, findings, conclusions, or recommendations are those of the relevant author(s)/interviewee(s) and do not necessarily reflect the view of the WNC Health Policy Initiative or its host institutions of the University of North Carolina Asheville (UNCA), Mountain Area Health Education Center (MAHEC) or our funders.