Long-Term Care Insurance Act

The Minister of Health, Labour and Welfare is to establish Basic Guidelines (hereinafter referred to as "Basic Guidelines") for ensuring the smooth implementation of Insurance Benefits pertaining to the Insured Long-Term Care Project, in line with the comprehensive securing policy prescribed in Article 3, paragraph (1) of the Act on Promotion of Comprehensive Securing of Medical and Long-Term Care in Communities (Act No. 64 of 1989) and the medical information digitization promotion policy prescribed in Article 11-2, paragraph (1) of that Act.

Basic Guidelines are to provide matters as listed in the following:

basic matters for ensuring a system to provide Services Subject to Long-Term Care Benefits, etc., and concerning implementation of a Community Support Project;

for matters that concern the Municipal Insured Long-Term Care Service Plan as set forth in paragraph (1) of the following Article, standards to be considered when determining the prospective service amounts by type of Service Covered by Long-Term Care Benefits, etc., as set forth in paragraph (2), item (i) of the same Article, and matters concerning preparation of a Prefectural Insured Long-Term Care Service Plan as set forth in Article 118, paragraph (1);

matters necessary for ensuring the efficient implementation of Insurance Benefits pertaining to an Insured Long-Term Care Project.

The Minister of Health, Labour, and Welfare must provide Basic Guidelines, and when changing said guidelines, must consult with the Minister for Internal Affairs and Communications and other chairpersons of related administrative organizations.

The Minister of Health, Labour, and Welfare must provide Basic Guidelines and when providing said Guidelines, provide public notice of said Guidelines without delay.

A Municipality, for Basic Guidelines, provide a plan concerning the efficient implementation of Insurance Benefits pertaining to an Insured Long-Term Care Project that is implemented by said Municipality by specifying three years as one project term (hereinafter referred to as "Municipal Insured Long-Term Care Service Plan").

A Municipal Insured Long-Term Care Service Plan is to provide the matters listed as follows:

the total necessary capacity of persons to utilize Communal Daily Long-Term Care for a Dementia Patient, Daily Life Long-Term Care for a Person Admitted to a Community-Based Specified Facility, and Daily Life Long-Term Care for a Person Admitted to a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care in each fiscal year, and other prospective quantity of Service Covered by Long-Term Care Benefits, etc. by type, for each area that is specified by said Municipality as the area where its residents live their daily life by comprehensively taking into consideration geographical conditions, population, transportation and other social conditions, the status of development of facilities for providing Service Covered by Long-Term Care Benefits, etc., and other conditions;

the prospective quantity of Community Support Projects in each fiscal year;

matters concerning measures that a Municipality is to undertake regarding support for independent daily life of Insured Persons in the community, prevention of falling into a Condition of Need for Long-Term Care, etc., or reduction or prevention of deterioration of a Condition of Need for Long-Term Care, etc., and ensuring the appropriateness of the expenses required for Long-Term Care Benefit, etc.;

matters concerning the targets for the matters listed in the preceding item.

A Municipal Insured Long-Term Care Service Plan is to endeavor to provide for the following matters, in addition to the matters listed in the items of the preceding paragraph:

measures for securing the total necessary capacity of persons to utilize services as set forth in item (i) of the preceding paragraph and other prospective volume by type of Service Covered by Long-Term Care Benefits, etc.;

the amount of cost necessary for a Community Support Project in each fiscal year and measures for ensuring the prospective volume of a Community Support Project;

medium- to long-term estimates of the quantity by type of Service Covered by Long-Term Care Benefits, etc., the amount of funding required for Insurance Benefits, the quantity of Community Support Projects, the amount of funding required for Community Support Projects, and the level of insurance premiums;

matters concerning initiatives in collaboration with the prefecture that contribute to securing and improving the quality of Long-Term Care Support Specialists and other persons engaged in Service Covered by Long-Term Care Benefits, etc. and Community Support Projects;

matters concerning initiatives in collaboration with the prefecture that contribute to improving productivity, such as improving the efficiency of operations at Business Offices or facilities for the provision of Service Covered by Long-Term Care Benefits, etc. or the implementation of Community Support Projects, and improving the quality of Long-Term Care Service;

matters concerning a project for ensuring cooperation among organizations that are a Designated In-Home Service Provider, Designated Community-Based Service Provider, and Designated In-Home Long-Term Care Support Provider and concerning other projects for promoting the efficient provision of Service Covered by Long-Term Care Benefits, etc., (limited to those pertaining to Long-Term Care Benefits);

matters concerning a project for ensuring cooperation among organizations that are a Designated Provider of Preventive Long-Term Care Service, Designated Provider of Community-Based Service for Preventive Long-Term Care, and Designated Provider of Support for Prevention of Long-Term Care and other projects for promoting the efficient provision of Service Covered by Long-Term Care Benefits, etc., (limited to those pertaining to Prevention Benefits) and efficient implementation of a Community Support Project;

matters concerning support for independent daily life in the community of Insured Persons who have Dementia, matters concerning organic coordination with measures concerning education, community development, and employment and other related measures, and other matters concerning the comprehensive promotion of measures concerning Dementia;

the total capacity of residents of each of the Fee-Based Homes for the Elderly for which notification has been made pursuant to the provisions of Article 29, paragraph (1) of the Act on Social Welfare for the Elderly and the registered housing prescribed in Article 7, paragraph (5) of the Act on Securement of Stable Supply of Elderly Persons' Housing (Act No. 26 of 2001) (referred to as "registered housing" in paragraph (3), item (vii) of the following Article), in each area referred to in item (i) of the preceding paragraph (limited to that pertaining to those that have not received the designation under the main clause of Article 41, paragraph (1), the main clause of Article 42-2, paragraph (1), or the main clause of Article 53, paragraph (1) as a Business Office conducting the business of daily life long-term care for a person admitted to a Specified Facility, Daily Life Long-Term Care for a Person Admitted to a Community-Based Specified Facility, or Daily Preventive Long-Term Care Admitted to a Specified Facility; the same applies in paragraph (3), item (vii) of the following Article);

matters concerning the integrated implementation of Community Support Projects with health services for the elderly and National Health Insurance health services, matters concerning cooperation with medical care for Insured In-Home Persons Requiring Long-Term Care and Insured In-Home Persons Requiring Support and other medical care, matters concerning cooperation with measures concerning housing for the elderly, and other matters necessary for supporting independent daily life of Insured Persons in the community.

A Municipal Insured Long-Term Care Service Plan must be prepared by taking into consideration the outlook for changes in the population structure, the number of Persons Requiring Long-Term Care, etc., in the area of said Municipality, the intentions of Persons Requiring Long-Term Care, etc. concerning use of the Service Covered by Long-Term Care Benefits, etc., and other conditions.

A Municipality is to endeavor to prepare a Municipal Insured Long-Term Care Service Plan by accurately ascertaining the physical and mental conditions of Insured Persons, the environments in which they are placed, and other circumstances in each area specified by said Municipality pursuant to the provisions of paragraph (2), item (i), analyzing information on the status of implementation of the Insured Long-Term Care Project, such as the results published pursuant to the provisions of Article 118-2, paragraph (1), taking into consideration said circumstances and the results of said analysis, and giving consideration to the results of the consultation under the provisions of Article 30-18-5, paragraph (1) of the Medical Care Act (limited to those pertaining to the matters listed in item (iv) of that paragraph).

A Municipality, in preparing a Municipal Insured Long-Term Care Service Plan, is to bear in mind the importance of the effective and efficient provision of medical care and long-term care that takes into account the physical, mental, and social characteristics accompanying the aging of residents.

A Municipal Insured Long-Term Care Service Plan must be prepared in conjunction with a Municipal Welfare Plan for the Elderly as prescribed in Article 20-8, paragraph (1) of the Act on Social Welfare for the Elderly.

A Municipality is to conduct a survey and analysis of the status of implementation of the measures prescribed in paragraph (2), item (iii) and the status of achievement of the targets prescribed in item (iv) of that paragraph, and evaluate the performance of the Municipal Insured Long-Term Care Service Plan.

A Municipality is to endeavor to publish the results of the evaluation under the preceding paragraph and is to report them to the prefectural governor.

A Municipal Insured Long-Term Care Service Plan must be one for which consistency has been ensured with the municipal plan prescribed in Article 5, paragraph (1) of the Act on Promotion of Comprehensive Securing of Medical and Long-Term Care in Communities.

A Municipal Insured Long-Term Care Service Plan must maintain harmony and balance with a Municipal Community Welfare Plan as prescribed in Article 107, paragraph (1) of the Social Welfare Act, a municipal plan for securing stable housing for the elderly as prescribed in Article 4-2, paragraph (1) of the Act on Securement of Stable Supply of Elderly Persons' Housing, and other plans pursuant to the provisions of Acts that provide matters concerning health, medical care, welfare, or housing of Persons Requiring Long-Term Care, etc.

A Municipality, when providing or changing a Municipal Insured Long-Term Care Service Plan, is to undertake the necessary measures in advance in order to reflect the opinions of Insured Persons.

A Municipality, when providing or changing a Municipal Insured Long-Term Care Service Plan (limited to the portion pertaining to the matters listed in paragraph (2), items (i) and (ii)), must hear opinions of the prefecture in advance.

A Municipality, when providing or changing a Municipal Insured Long-Term Care Service Plan, must submit said Plan to the prefectural governor without delay.