From the Blog

The first continuing care at home program (CCaH) was established in late 1980s and over the past thirty-five years there have been around 40 programs that started to offer this unique option to older adults. CCaH is also referred to as a continuing care retirement community without walls or life plan community without walls. The concept being that an individual can remain in the comfort of their home and receive the benefits that are offered as part of a life plan community. In most cases, this includes access to amenities on campus such as wellness centers, dining, and life enrichment. It also includes a financial protection aspect like a life care contract or Type A at a life plan community or coverage like a long-term care insurance policy. Members of a CCaH pay an entrance fee and then an ongoing monthly fee and if they ever need care at home or at a facility the program covers the cost of these services.

In the CCaH model, the care or wellness coordinator gets to know each member personally and develops a trusting relationship becoming an advocate for the member’s health care needs. These coordinators assess the member’s health on a regular basis and coordinates all services received by the member, taking the burden off family and other informal supports. The main goals of these programs are to enable a person to age in place, to help maximize functioning, and maintain independence for as long as possible.

The definition in the Code of Maryland Regulations (COMAR) 32.02.02.01 states that a CCaH furnishes services, either directly or by contractual arrangements to the public where: the services include health services and assistance with the maintenance of a subscriber’s dwelling. These health services include medical services, nursing services, assisted living or comprehensive care services in assisted living or comprehensive care facility or assistance with activities of daily living other than provision of meals in a subscriber’s dwelling. The services are offered to individuals 60 years and older and cannot be related to the provider. The services are offered for the life of the subscriber, or excess of 1 year, and have a written agreement that requires a transfer of assets or an entrance fee from the subscriber to the provider. These programs are not long-term care insurance and often work with individuals with an existing policy. Spellman and Townsley (2012) point out that long-term care insurance deals with managing claims and CCaH programs deal with managing care. Most programs are also nonprofit organizations that can expand their mission by offering this model.

Wesley SecureCare is the only CCaH program operating in Maryland. It has been difficult for organizations to bring this model to the market due to Maryland state regulations and substantial financial reserve requirements (funds held to pay for future member care). We are overseen by the Maryland Department of Aging.

Statute: Human Services 10-4 and Regulations: COMAR32.02.02. Maryland has the highest financial reserve requirements and financial monitoring regulations.