Making “No Wrong Door” Work for Multicultural Older People
PICAC Alliance perspective | September 2026
The PICAC Alliance welcomes the growing discussion about a “no wrong door” approach to primary aged care and the recognition that older people should be able to seek support through the people, services and organisations they already know and trust.
The CHSP Alliance position statement proposes multiple entry pathways into CHSP, including through general practitioners, hospital discharge planners, Aboriginal Medical Services, pharmacists, CHSP providers, community organisations and places of worship. It also proposes a more proportionate, relationship-based and “just in time” assessment approach for people seeking preventative and entry-level support.
Reference: CHSP Alliance Position Statement on No Wrong Door (September 2026 PDF)
PICAC Alliance Position Statement
PICAC Alliance supports the development of a more proportionate, relationship-based and accessible primary aged care entry system, including multiple trusted pathways into CHSP.
A “no wrong door” approach has the potential to reduce unnecessary assessment burden, strengthen earlier access to preventative support and reconnect aged care with trusted health, community and local service pathways.
Its success should not be measured only by the number of approved entry points, completed referrals or the speed of registration.
For multicultural older people, every doorway must be able to identify language and communication requirements, support understanding and informed decision-making, arrange qualified interpreters where required, recognise family and community circumstances, and provide a supported handover to an appropriate provider.
The model must also recognise, measure and fund the navigation, communication, cultural brokerage, coordination, partnership-building and follow-up work required to make trusted pathways function.
The practical test is therefore not simply whether an older person can enter the system through more than one door.
The test is whether, through any door, the older person can be heard, understood, appropriately assessed and connected with support that is available, suitable, trusted, affordable and usable.
Reflection Box
“A doorway is not evidence that a pathway exists.”
A pathway exists only when responsibility, communication, capability, provider availability and supported handover connect the first conversation to actual support.
Closing Question
What conditions must exist so that every doorway can recognise, understand and support the person who enters through it?
Why the PICAC Alliance supports this direction
The PICAC Alliance sees significant value in the proposed direction. A centralised gateway does not necessarily produce equitable access. People commonly begin seeking help through existing relationships, including family members, community organisations, bilingual workers, health professionals, faith communities and providers known within their local community.
For many multicultural older people, these relationships are not informal alternatives to the system. They are often the conditions that make entering, understanding and using the system possible.
At the same time, creating more formal entry points will not, by itself, guarantee that every doorway is accessible, culturally safe or capable of leading to appropriate support.
More doors do not automatically produce “no wrong door”.
A workable “no wrong door” model must ensure that every entry point can recognise the person, identify communication requirements, support an informed referral and connect the older person with an appropriate provider able to commence care.
Where the PICAC Alliance sees strong alignment
Primary aged care requires a different access model
The PICAC Alliance agrees that people seeking preventative and lower-intensity CHSP support should not necessarily have to complete the same extensive assessment pathway used for more complex Support at Home or residential care decisions.
Assessment should be proportionate to the decision being made, while maintaining reliable safeguards and clear routes to more comprehensive assessment when needs are complex, uncertain or changing.
The CHSP Alliance’s distinction between a centralised “just in case” assessment and a more responsive “just in time” approach is particularly relevant to services intended to provide earlier support and prevent escalation.
Trusted community pathways matter
The PICAC Alliance agrees that older people frequently seek help from organisations and individuals they already know.
For multicultural older people, these pathways may include:
These actors may help people do more than make initial contact. They may explain aged care, support family conversations, clarify choices, build confidence, identify communication needs and help the person remain connected throughout the pathway.
Trusted NavigationComing soon
Assessment should be relational and ongoing
The PICAC Alliance agrees that assessment should not be treated as a single transaction that definitively captures a person’s circumstances.
Needs may emerge over time. Communication may improve when trust develops. Family and carer capacity may change. Dementia and other conditions may fluctuate or progress. A person may not initially know what support is available or feel able to describe sensitive needs during an unfamiliar assessment.
A relationship-based system should therefore provide:
Assessment Quality Depends on Communication QualityComing soon
CHSP is prevention and community infrastructure
The PICAC Alliance agrees that CHSP should be recognised as more than a lower-cost collection of individual service transactions.
CHSP-funded supports can help sustain:
The PICAC Alliance has specifically highlighted the role of CALD Social Support Groups in reducing isolation, supporting wellbeing and helping prevent premature entry into residential care.
One-size-fits-all pathways do not create equitable outcomes
The CHSP Alliance recognises that the current access model presents particular difficulties for First Nations communities, people who do not speak English, multicultural communities, people living in rural and remote areas, and other older people experiencing vulnerability.
The PICAC Alliance agrees with this recognition and adds that equity requires more than allowing different communities to use different entry points.
It requires the system to resource the communication, navigation, workforce and service-delivery capability that makes those pathways function in practice.
Rights → Implementation Conditions → Delivery → OutcomesComing soon
What the PICAC Alliance adds
A multiple-door model will only create equitable access when the following six implementation conditions are made visible, measured and funded.
Explore the six implementation conditions:
A trusted doorway is not necessarily an accessible doorway
A community organisation, GP practice, faith organisation or CHSP provider may be trusted by the older person but may not automatically have:
A “no wrong door” model must therefore distinguish between: “A place a person trusts” and “A trusted, equipped and connected pathway into care”.
Both matter.
Language identification is not enough
Every doorway should be capable of identifying:
The ability to hold a basic conversation in English is not evidence that a person can:
Speaking a language, reading it, understanding institutional information and using a complex system are related capabilities, but they are not the same capability.
CALD Implementation Test for Reasonable Pricing
Why Language Access Is Not EnoughComing soon
Related implementation tool: CALD Implementation Test for Reasonable Pricing — examines whether interpreter use, additional communication time, family coordination and other conditions required for meaningful communication are visible and sustainable within pricing frameworks.
Referral is not the same as supported handover
A referral should not be considered successful merely because information was sent or a telephone number was provided.
A supported handover may require:
The pathway should be measured through to service commencement, not only referral completion.
CALD Implementation Test for Reasonable Pricing
Additional care-management capacity is required to support explanation, navigation, interpreter use, family-supported decision-making and follow-through.
Related implementation tool: CALD Implementation Test for Reasonable Pricing — tests whether the communication, navigation, coordination and follow-up required for supported handover are recognised within pricing and implementation frameworks.
Provider availability is part of access
A “no wrong door” approach cannot succeed if all doors eventually lead to an unavailable service.
The system must recognise CALD micro-markets in which provider capacity may be constrained by:
PICAC Alliance has argued that specialised CALD services can appear expensive or inefficient when pricing and reporting systems fail to recognise the different conditions under which these services operate.
Family involvement must be visible, chosen and supported
Family members often help older people:
This involvement should not be assumed to be unlimited, stable or available.
A “no wrong door” system should identify:
Family assistance should complement formal communication access. It should not replace qualified interpreters in clinical, legal, safeguarding, consent, financial or other consequential conversations.
Who Supports the Supporter?Coming soon
Community organisations require resourcing, not only recognition
The CHSP Alliance model appropriately identifies community organisations and places of worship as possible entry points.
However, trusted community organisations cannot be expected to absorb additional responsibilities for:
without appropriate funding, governance, training, technology and ongoing support.
If these functions are necessary to make the pathway work, they should be recognised as implementation infrastructure and funded accordingly.
CALD Implementation Test for Reasonable Pricing
This submission outlines PICAC Alliance proposals for increased investment in culturally responsive aged care, including expanded PICAC capacity building, support for small CALD organisations and CHSP services, continued Sector Support and Development, and additional resources for culturally safe communication, interpreting and service navigation.
Related implementation tool: CALD Implementation Test for Reasonable Pricing — tests whether trusted navigation, community outreach, cultural brokerage, family coordination and other implementation work are recognised, measured and sustainably funded.
CALD Implementation Test for “No Wrong Door”
Assess any proposed entry doorway against these eight core domains:
- Recognition
- Communication
- Understanding and Decision-Making
- Eligibility and Assessment Integrity
- Supported Handover
- Provider and CALD Micro-Market Capability
- Service Commencement and Continued Use
- Data, Accountability and Learning
Recommended Related PICAC Alliance Evidence & Tools
PICAC Alliance Submission to the Inquiry into the Support at Home Program (July 2026 PDF)
Primary evidence addressing CALD micro-markets, Social Support Groups as prevention infrastructure, interpreter and care-management time, navigation, service agreements, and assessment integrity.
PICAC Alliance Submission to IHACPA
Evidence concerning interpreter-supported communication, additional assessment and communication time, representative cost collection and the pricing of culturally responsive care.
CALD Implementation Test for Reasonable Pricing
Companion implementation test on price transparency, hidden cultural cost drivers and sustainable CALD service delivery.
PICAC Alliance Submission on the Transition from CHSP to Support at Home (January 2026 PDF)
Supporting evidence on small CALD organisations, Social Support Groups and thin-market conditions.
Forthcoming tools: Trusted Navigation • Why Language Access Is Not Enough • Assessment Quality Depends on Communication Quality • Rights → Implementation Conditions → Delivery → Outcomes • Who Supports the Supporter?