Long-Term Care Insurance Act

The purposes of this Act are to improve health and medical care and to enhance the welfare of citizens. With regard to people who are under condition of need for long-term care due to disease, etc., as a result of physical or emotional changes caused by aging, and who require care such as for bathing, bodily waste elimination, meals, etc., and require the functional training, nursing, management of medical treatment, and other medical care, these purposes are to be accomplished by establishing a long-term care insurance system based on the principle of the cooperation of citizens, solidarity, and determining necessary matters concerning related insurance benefits, etc., in order to provide benefits pertaining to necessary health and medical services and public aid services so that these people are able to maintain dignity and an independent daily life routine according to each person's own level of abilities.

Long-Term Care Insurance provides necessary insurance benefits for a Condition of Need for Long-Term Care or for a Needed Support Condition (herein referred to as a "Condition of Need for Long-Term Care, etc.") of the insured person.

Insurance benefits as set forth in the preceding paragraph are provided in order to contribute to reduction or prevention of aggravation of a Condition of Need for Long-Term Care, etc., and must be provided with careful attention to cooperation with medical care.

Insurance benefits as set forth in paragraph (1) must be provided in consideration of the appropriate health and medical services and public aid services that are offered by diverse providers and facilities comprehensively and effectively, according to the physical and mental conditions of the insured person, said person's environment, etc., and based on the preferences of the insured person.

With regard to the contents and level of insurance benefits as set forth in paragraph (1), consideration must be made so that said person is able to live an independent daily life according to that person's own abilities in his or her home as much as possible, although said insured person becomes in a Condition of Need for Long-Term Care.

Municipalities and special city wards shall provide Long-Term Care Insurance pursuant to the provisions of this Act.

Municipalities and special city wards are to establish a special account for income and expenses regarding Long-Term Care Insurance pursuant to the provisions of Cabinet Orders.

A citizen must be aware of his or her physical and mental changes due to aging and shall always strive to maintain and enhance good health in order to prevent becoming in a Condition of Need for Long-Term Care. In a case of becoming in a Condition of Need for Long-Term Care, a citizen is to strive to maintain and improve his or her existing abilities through the willing use of rehabilitation and other appropriate health and medical services and public aid services.

Citizens are to be equally subjected to the expenses necessary for an Insured Long-Term Care Project, based on the principle of cooperation and solidarity.

The national government must undertake measures to ensure the system of providing health and medical services and public aid services, and every other necessary action for the healthy and efficient operation of an Insured Long-Term Care Project.

Prefectural governments must provide necessary advice and appropriate support for the healthy and efficient operation of an Insured Long-Term Care Project.

In providing the advice and assistance set forth in the preceding paragraph, a prefecture must endeavor to promote initiatives that contribute to improving productivity, such as improving the efficiency of operations and improving the quality of Long-Term Care Services at Business Offices or facilities that provide Long-Term Care Services.

The national government and local governments must endeavor to comprehensively promote, while ensuring organic cooperation with measures concerning medical care and housing, measures concerning health and medical services and welfare services pertaining to insurance benefits, measures for preventing a person from falling into a Condition of Need for Long-Term Care, etc. or for reducing or preventing deterioration of a Condition of Need for Long-Term Care, etc., and measures for supporting independent daily life in the community, so that an Insured Person can, to the extent possible, lead an independent daily life in the community in which he or she is accustomed to living, according to his or her abilities.

In comprehensively promoting the measures listed in the preceding paragraph pursuant to the provisions of that paragraph, the national government and local governments must endeavor to ensure organic cooperation with measures concerning the welfare of persons with disabilities and other persons, and must endeavor to contribute to the realization of a community in which local residents respect one another's personalities and individuality, and participate and live together.

The national government and local governments must endeavor to deepen the public's interest in and understanding of Dementia (meaning a condition specified by Cabinet Order in which cognitive function has declined to the extent that daily life is impaired due to Alzheimer's disease or other neurodegenerative diseases, cerebrovascular disease or other diseases; the same applies hereinafter), and to disseminate knowledge about and raise awareness of Dementia so that support for persons with Dementia is provided appropriately.

In order to provide Insured Persons with appropriate health and medical services and welfare services pertaining to Dementia, the national government and local governments must endeavor, in cooperation with research institutions, medical institutions, Long-Term Care Service Providers (meaning Long-Term Care Service Providers prescribed in Article 115-32, paragraph (1)), etc., to promote survey and research on the prevention, diagnosis and treatment of Dementia and on rehabilitation and long-term care methods suited to the physical and mental characteristics of persons with Dementia, and must endeavor to disseminate, utilize and develop the results.

The national government and local governments must endeavor to comprehensively promote measures concerning Dementia, such as developing a support system for persons with Dementia in the community and taking measures necessary to support persons who actually provide care for persons with Dementia and to secure, and improve the quality of, human resources involved in supporting persons with Dementia.

In promoting the measures under the preceding three paragraphs, the national government and local governments must endeavor to give consideration to respecting the wishes of persons with Dementia and their families, and to enable persons with Dementia to live together with other people in the community while maintaining their dignity.

Medical insurers must cooperate for the healthy and efficient operation of an Insured Long-Term Care Project.

The term "Condition of Need for Long-Term Care" as used in this Act means a condition assumed to require care on a continual and steady basis for the whole or a part of basic movements in daily activities such as bathing, bodily waste elimination, meals, etc., due to physical or mental problems during the period specified by Order of the Ministry of Health, Labour, and Welfare, and said condition that conforms to any of the categories stipulated by Order of the Ministry of Health, Labour, and Welfare according to the degree of needed care (herein referred to as a "Category of Condition of Need for Long-Term Care") (except when said condition is subject to a Needed Support Condition).

The term "Needed Support Condition" as used in this Act means a condition assumed to require care on a continual and steady basis during the period specified by Order of the Ministry of Health, Labour, and Welfare that especially contributes to the reduction or prevention of the aggravation of the condition requiring care for the whole or a part of basic movements in daily activities such as bathing, bodily waste elimination, meals, etc., due to physical or mental problems, or a condition assumed to cause continual difficulties in performing daily activities due to physical or mental problems during the period specified by Order of the Ministry of Health, Labour, and Welfare, and said condition that conforms to any category as stipulated by Order of the Ministry of Health, Labour, and Welfare according to the degree of needed support (herein referred to as "Category of Needed Support Condition").

The term "Person Requiring Long-Term Care" as used in this Act means a person defined by any of the following items:

a person that is in a Condition of Need for Long-Term Care and is the age of 65 or older;

a person that is in a Condition of Need for Long-Term Care and is the age of 40 to less than the age of 65, and the physical or mental problems that are the causes of said Condition of Need for Long-Term Care are a result of diseases that are caused by the physical or mental changes due to aging, specified by a Cabinet Order (herein referred to as "Specified Disease").

The term "Person Requiring Support" as used in this Act means a person defined by any of the following items:

a person that is in a Needed Support Condition and is the age of 65 or older;

a person that is in a Needed Support Condition and is the age of 40 to less than the age of 65, and the physical or mental problems that are the cause of said Needed Support Condition are caused by a Specified Disease.

The term "Long-Term Care Support Specialist" as used in this Act means a person that provides consultation to a Person Requiring Long-Term Care or to a Person Requiring Support (herein referred to as a "Person Requiring Long-Term Care, etc."), and communicates with and coordinates Municipalities, a person performing In-Home Service Business, a person performing Community-Based Service Business, a Facility Covered by Long-Term Care Insurance, a person performing Preventive Long-Term Care Service Business, a person performing Community-Based Preventive Long-Term Care Business, a person performing a Specified Comprehensive Project for Long-Term Care Prevention and Daily Life Support, etc., in order for a Person Requiring Long-Term Care, etc., to be able to use appropriate In-Home Service, Community-Based Service, Facility Service, Preventive Long-Term Care Service or Community-Based Service for Preventive Long-Term Care, or a Specified Comprehensive Project for Long-Term Care Prevention and Daily Life Support (meaning the category 1 home-visit project prescribed in Article 115-45, paragraph (1), item (i), (a), the category 1 outpatient project prescribed in (b) of that item, or the category 1 daily life support project prescribed in (c) of that item; the same applies hereinafter) according to the mental and physical conditions, etc., of a Person Requiring Long-Term Care, etc., and who received Long-Term Care Support Specialist Certification as set forth in Article 69-7, paragraph (1) as a person possessing professional knowledge and skills regarding support necessary for a Person Requiring Long-Term Care, etc., to live an independent daily life.

The term "Medical Insurance Acts" as used in this Act means the following acts:

Health Insurance Act (Act No. 70 of 1922);

Seaman's Insurance Act (Act No. 73 of 1939);

National Health Insurance Act (Act No. 192 of 1958);

National Public Servants Mutual Aid Association Act (Act No. 128 of 1958);

Local Public Service Mutual Aid Association Act (Act No. 152 of 1962);

Private School Personnel Mutual Aid Association Act (Act No. 245 of 1953).

The term "medical insurer" as used in this Act means the Japan Health Insurance Association, health insurance societies, prefectures and Municipalities (including special city wards), National Health Insurance Societies, mutual aid Associations, or the Promotion and Mutual Aid Society for Private Schools of Japan that provide medical benefits pursuant to the provisions of the Medical Insurance Acts.

The term "Medical Insurance Subscriber" as used in this Act means the following persons:

an insured person pursuant to the provisions of the Health Insurance Act, however, provided that this does not apply to specially-insured day laborers pursuant to the provision of Article 3, paragraph (2) of the same Act;

an insured person pursuant to the provisions of the Seaman's Insurance Act;

an insured person pursuant to the provisions of the National Health Insurance Act;

a member of a mutual aid association pursuant to the National Public Servants Mutual Aid Association Act or the Local Public Service Mutual Aid Association Act;

a subscriber to a Private School Personnel Mutual Aid System pursuant to the provisions of the Private School Personnel Mutual Aid Association Act;

an insured person's dependent pursuant to the provisions of the Health Insurance Act, Seaman's Insurance Act, National Public Servants Mutual Aid Association Act (including cases when applied mutatis mutandis pursuant to other Acts), or the Local Public Service Mutual Aid Association Act, however, provided that this does not apply to a dependent pursuant to the provisions of Article 3, paragraph (2) of the Health Insurance Act of a specially-insured day laborer pursuant to the provisions of the same Act;

a person that received a specially-insured day laborer certificate book pursuant to the provisions of Article 126 of the Health Insurance Act and within a certain period until the term when all of the blank space for stamps for proof of health insurance of said certificate book are filled, and said dependent pursuant to the provisions of the same Act, however, provided that this does not apply to a person that is within the period when said person is not a specially-insured day laborer pursuant to the provision of Article 3, paragraph (2) of the same Act with the approval pursuant to the proviso of the same paragraph, and a person that has returned said specially-insured day laborer certificate book pursuant to the provisions of Article 126, paragraph (3) of the same Act, and said dependent pursuant to the provisions of the same Act.

The term "social insurance Acts" as used in this Act means the following Acts:

This Act;

The Acts listed in the items of paragraph (6) (excluding item (iv));

Employees' Pension Insurance Act (Act No. 115 of 1954);

National Pension Act (Act No. 141 of 1959).