Long-Term Care Insurance Act

A Municipality, when providing a Certification of Needed Long-Term Care; a Renewal of Certification of Needed Long-Term Care; a Certification of Change of Category of Condition of Need for Long-Term Care pursuant to the provisions of Article 27, paragraph (7) or Article 30, paragraph (1) as applied mutatis mutandis pursuant to Article 29, paragraph (2), or Article 30, paragraph (1); a Certification of Needed Support; a Renewal of Certification of Needed Support; a Certification of Change of Category of Needed Support Condition pursuant to the provisions of Article 32, paragraph (6) or Article 33-3, paragraph (1) as applied mutatis mutandis pursuant to Article 33-2, paragraph (2), or Article 33-3, paragraph (1); (hereinafter simply referred to as "Certification" in this paragraph) may specify the type of services to be performed for an Insured Person pertaining to said Certification, including In-Home Service pertaining to Allowance for In-Home Long-Term Care Service or Exceptional Allowance for In-Home Long-Term Care Service, Community-Based Service pertaining to Allowance for Community-Based Long-Term Care Service or Exceptional Allowance for Community-Based Long-Term Care Service, Facility Service pertaining to Allowance for Long-Term Care Facility Service or Exceptional Allowance for Long-Term Care Facility Service, Preventive Long-Term Care Service pertaining to Allowance for Preventive Long-Term Care Service or Exceptional Allowance for Preventive Service of Long-Term Care, or Community-Based Service for Preventive Long-Term Care pertaining to Allowance for Community-Based Preventive Long-Term Care Service, or Exceptional Allowance for Community-Based Preventive Service of Long-Term Care, based on the opinionOpinion of the Certification Committee pertaining to the matter listed in Article 27, paragraph (5), item (i) (including a case it is applied mutatis mutandis pursuant to Article 28, paragraph (4), Article 29, paragraph (2), or Article 30, paragraph (2)) or Article 32, paragraph (4), item (i) (including a case it is applied mutatis mutandis pursuant to Article 33, paragraph (4), Article 33-2, paragraph (2), or Article 33-333-2, paragraph (2)). In this case, the Municipality is to enter on notify said Insured Person, pursuant to the Certificateprovisions of Insured Person Order of the Ministry of said Insured Person Health, Labour and Welfare, of the type of services pertaining to said specification including In-Home Service, Community-Based Service, Facility Service, Preventive Long-Term Care Service, or Community-Based Service for Preventive Long-Term Care, together with an entrythe notification pursuant to the provisions of Article 27, paragraph (7), second sentence (including a case it is applied mutatis mutandis pursuant to Article 28, paragraph (4) or, Article 29, paragraph (2)), , or Article 30, paragraph (1), second sentence,2)) or Article 35, paragraph (4), second sentence, or Article 32, paragraph (6), second sentence (including a case it is applied mutatis mutandis pursuant to Article 33, paragraph (4) or, Article 33-2, paragraph (2)), , or Article 33-3, paragraph (1) second sentence, 2)), or Article 35, paragraph (2), second sentence, or paragraph (6), second sentence, pertaining to said Certification.

An Insured Person specified pursuant to the provisions of the preceding paragraph, first sentence, may apply, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, for a change of type of services pertaining to said specification including In-Home Service, Community-Based Service, Facility Service, Preventive Long-Term Care Service, or Community-Based Service for Preventive Long-Term Care.

The In a case when the application as prescribed set forth in the preceding paragraph is to be submitted with the Certificate of Insured Person, a Municipality, pursuant to the provisions of Order of the Ministry of Health, Labour, and Welfare, when it hears the Opinion of the Certification Committee and determines it necessary, may change the type of services pertaining to said specification including In-Home Service, Community-Based Service, Facility Service, Preventive Long-Term Care Service, or Community-Based Service for Preventive Long-Term Care.

InWhen a case when Municipality, with regard to an Insured Person pertaining to the application as set forth in paragraph (2) is submitted, a Municipality, , has changed the type of services pertaining to the specification pursuant to the provisions of Order of the Ministry of Health, Labour, and Welfare, when it hears the opinion of the Certification Committee and determines it necessary, may changeparagraph (1), first sentence, including In-Home Service, Community-Based Service, Facility Service, Preventive Long-Term Care Service, or Community-Based Service for Preventive Long-Term Care pursuant to the typeprovisions of services pertaining the preceding paragraph, it is, pursuant to said specification including In-Home Service, Community-Based Service, Facility Service, Preventive Long-Term Care Service, or Community-Based Service for Preventive Long-Term Carethe provisions of Order of the Ministry of Health, Labour and Welfare, to notify said Insured Person of said result.

When a Municipality, with regard to an Insured Person pertaining to the application as set forth in paragraph (2), has changed the type of services pertaining to the specification pursuant to the provisions of paragraph (1), first sentence, including In-Home Service, Community-Based Service, Facility Service, Preventive Long-Term Care Service, or Community-Based Service for Preventive Long-Term Care pursuant to the provisions of the preceding paragraph, it is to notify said Insured Person of said result, enter the type of services, including In-Home Service, Community-Based Service, Facility Service, Preventive Long-Term Care Service, or Community-Based Service for Preventive Long-Term Care after amending the Certificate of Insured Person of said Insured Person, and return the Certificate of Insured Person to the Insured Person.

A prefecture, with regard to affairs pursuant to the provisions of Article 27 to Article 35 and the preceding Article that a Municipality performs, may cooperate regarding technical matters at, through the public aid office it establishes (those offices regarding public aid provided by the Social Welfare Act (Act No. 45 of 1951))) or a health center, it establishes, cooperate regarding technical matters and provide other necessary assistance to a Municipality.

With regard to a Municipality that entrusts examinations and judgments to a prefecture, in a case of applying the provisions of Article 27 (including a case applied mutatis mutandis pursuant to Article 28, paragraph (4), Article 29, paragraph (2), Article 30, paragraph (2), Article 31, paragraph (23) or Article 32, paragraph (5)), Article 30, Article 32 (including a case applied mutatis mutandis pursuant to Article 33, paragraph (4), Article 33-2, paragraph (2), Article 33-3, paragraph (2), or Article 34, paragraph (23)), Article 33-3 orand Article 35 to the preceding Article, the term "Certification Committee" is deemed to be replaced with "Prefectural Certification Committee of Needed Long-Term Care."

payment of an Allowance for Registered Facility Long-Term Care Service Plan;

payment of an Exceptional Allowance for Registered Facility Long-Term Care Service Plan;

When an Insured In-Home Person Requiring Long-Term Care is provided Designated In-Home Service (limited to a case when said Insured In-Home Person Requiring Long-Term Care has notified the Municipality in advance to receive Designated In-Home Long-Term Care Support prescribed in paragraph (1) of the same Article pursuant to the provisions of Article 46, paragraph (4) , and said Designated In-Home Service is subject to said Designated In-Home Long-Term Care Support, a case when said Insured In-Home Person Requiring Long-Term Care has notified the Municipality in advance, that to receive Designated Registered Facility Long-Term Care Support prescribed in paragraph (1) of the same Article pursuant to the provisions of Article 47-2, paragraph (4), and said Designated In-Home Service is subject to said Designated In-Home Registered Facility Long-Term Care Support, and other cases as determined by Order of the Ministry of Health, Labour, and Welfare) by a Designated In-Home Service Provider, the Municipality may pay expenses required for said Designated In-Home Service that said Insured In-Home Person Requiring Long-Term Care should pay to said Designated In-Home Service Provider on behalf of said Insured In-Home Person Requiring Long-Term Care to said Designated In-Home Service Provider within the specified limit of the amount that should be paid to said Insured In-Home Person Requiring Long-Term Care as Allowance for In-Home Long-Term Care Service.

When an Insured Person Requiring Long-Term Care receives Designated Community-Based Service from a Designated Community-Based Service Provider (limited to a case when said Insured Person Requiring Long-Term Care notifies the Municipality regarding the receiving of Designated In-Home Long-Term Care Support prescribed in paragraph (1) of the same Article pursuant to the provisions of Article 46, paragraph (4) in advance, and said Designated Community-Based Service is subject to said Designated In-Home Long-Term Care Support, a case when said Insured Person Requiring Long-Term Care notifies the Municipality regarding the receiving of Designated Registered Facility Long-Term Care Support prescribed in paragraph (1) of the same Article pursuant to the provisions of Article 47-2, paragraph (4) in advance, and said Designated Community-Based Service is subject to said Designated In-Home Registered Facility Long-Term Care Support, or other cases as determined by Order of the Ministry of Health, Labour, and Welfare), the Municipality may pay the expenses required for said Designated Community-Based Service that are to be paid to said Designated Community-Based Service Provider by said Insured Person Requiring Long-Term Care on behalf of said Insured Person Requiring Long-Term Care within the limit of the amount to be paid to said Insured Person Requiring Long-Term Care as an Allowance for Community-Based Long-Term Care Service.

A Municipality, when an Insured In-Home Person Requiring Long-Term Care (excluding a person who receives care in a residence room in a registered Fee-Based Home for the Elderly; the same applies hereinafter in this Article and the following Article) has received, from a person designated by the mayor of said Municipality or the mayor of another Municipality (hereinafter referred to as a "Designated In-Home Long-Term Care Support Provider"), In-Home Long-Term Care Support provided by a Business Office conducting the In-Home Long-Term Care Support Business pertaining to said designation (hereinafter referred to as "Designated In-Home Long-Term Care Support"), pays to said Insured In-Home Person Requiring Long-Term Care an Allowance for In-Home Long-Term Care Service Plan for the expenses required for said Designated In-Home Long-Term Care Support.

A Municipality, when, among Insured Persons Requiring Long-Term Care, a person who receives care in a residence room in a registered Fee-Based Home for the Elderly (hereinafter referred to as "Insured Person Requiring Long-Term Care in a registered facility" in this Article and the following Article) has received, from a person designated by the mayor of said Municipality or the mayor of another Municipality (hereinafter referred to as a "Designated Registered Facility Long-Term Care Support Provider"), registered facility long-term care support provided by a Business Office conducting the registered facility long-term care support business pertaining to said designation (hereinafter referred to as "Designated Registered Facility Long-Term Care Support"), pays to said Insured Person Requiring Long-Term Care in a registered facility an Allowance for Registered Facility Long-Term Care Service Plan for the expenses required for said Designated Registered Facility Long-Term Care Support.

The amount of Allowance for Registered Facility Long-Term Care Service Plan is to be the amount equivalent to 90 percent of the amount of expenses calculated by standards determined by the Minister of Health, Labour and Welfare after considering the average expenses necessary for Designated Registered Facility Long-Term Care Support, calculated after considering the area, etc., where the provider that performs the business of Designated Registered Facility Long-Term Care Support is located (in a case when said calculated amount exceeds the actual expenses necessary for Designated Registered Facility Long-Term Care Support, the actual expenses necessary for said Designated Registered Facility Long-Term Care Support).

The Minister of Health, Labour and Welfare, when intending to specify the standards prescribed in the preceding paragraph, must hear the opinion of the Social Security Council in advance.

When an Insured Person Requiring Long-Term Care in a registered facility receives Designated Registered Facility Long-Term Care Support from a Designated Registered Facility Long-Term Care Support Provider (limited to a case when said Insured Person Requiring Long-Term Care in a registered facility has notified the Municipality in advance to receive said Designated Registered Facility Long-Term Care Support pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare), the Municipality may pay to said Designated Registered Facility Long-Term Care Support Provider on behalf of said Insured Person Requiring Long-Term Care in a registered facility the expenses required for said Designated Registered Facility Long-Term Care Support that said Insured Person Requiring Long-Term Care in a registered facility should pay to said Designated Registered Facility Long-Term Care Support Provider, within the limit of the amount that should be paid to said Insured Person Requiring Long-Term Care in a registered facility as an Allowance for Registered Facility Long-Term Care Service Plan.

When the payment pursuant to the provisions of the preceding paragraph is made, it is to be deemed that an Allowance for Registered Facility Long-Term Care Service Plan is paid to the Insured Person Requiring Long-Term Care in a registered facility.

A Municipality, when requested to pay an Allowance for Registered Facility Long-Term Care Service Plan by a Designated Registered Facility Long-Term Care Support Provider, is to make the payment after conducting an examination in light of the standards determined by the Minister of Health, Labour and Welfare as set forth in paragraph (2) and the standards concerning the operation of the business of Designated Registered Facility Long-Term Care Support prescribed in Article 85-5, paragraph (2) (limited to the part regarding the handling of Designated Registered Facility Long-Term Care Support).

The provisions of Article 41, paragraph (2), paragraph (3), paragraph (10) and paragraph (11) apply mutatis mutandis to the payment of an Allowance for Registered Facility Long-Term Care Service Plan, and the provisions of paragraph (8) of the same Article apply mutatis mutandis to a Designated Registered Facility Long-Term Care Support Provider, respectively. In this case, the necessary technical replacement of terms in these provisions is provided by a Cabinet Order.

In addition to the provisions of the respective preceding paragraphs, other necessary matters for the payment of an Allowance for Registered Facility Long-Term Care Service Plan and for requesting an Allowance for Registered Facility Long-Term Care Service Plan from a Designated Registered Facility Long-Term Care Support Provider are prescribed by Order of the Ministry of Health, Labour and Welfare.

A Municipality, in the following cases, pays an Exceptional Allowance for Registered Facility Long-Term Care Service Plan to an Insured Person Requiring Long-Term Care in a registered facility:

when the Municipality determines it necessary in a case when an Insured Person Requiring Long-Term Care in a registered facility receives registered facility long-term care support other than Designated Registered Facility Long-Term Care Support or an equivalent service (limited to those provided by a Business Office conducting a business that is found to satisfy, among the number of employees specified by Municipal Ordinance as set forth in Article 85-5, paragraph (1) pertaining to the business of Designated Registered Facility Long-Term Care Support and the standards concerning the operation of the business of Designated Registered Facility Long-Term Care Support prescribed in paragraph (2) of the same Article (referred to as "Standards for the Business of Designated Registered Facility Long-Term Care Support" in the following item), those specified by the Municipal Ordinance of said Municipality; hereinafter referred to as "registered facility long-term care support applicable to standards" in this Article);

when the Municipality determines it necessary in a case when an Insured Person Requiring Long-Term Care in a registered facility receives registered facility long-term care support other than Designated Registered Facility Long-Term Care Support and registered facility long-term care support applicable to standards, or an equivalent service (limited to those provided by a Business Office located in a Specified Area and conducting a business that is found to satisfy, among the Standards for the Business of Designated Registered Facility Long-Term Care Support, those specified by the Municipal Ordinance of said Municipality; hereinafter referred to as "registered facility long-term care support in a Specified Area" in this Article);

when the Municipality determines it necessary in a case when an Insured Person Requiring Long-Term Care in a registered facility who is domiciled on an isolated island or other area where it is significantly difficult to secure Designated Registered Facility Long-Term Care Support, registered facility long-term care support applicable to standards, and registered facility long-term care support in a Specified Area, and which qualifies under the standards determined by the Minister of Health, Labour and Welfare, receives registered facility long-term care support other than Designated Registered Facility Long-Term Care Support, registered facility long-term care support applicable to standards, and registered facility long-term care support in a Specified Area, or an equivalent service;

other cases specified by a Cabinet Order.

A Municipality, in establishing a Municipal Ordinance pursuant to the provisions of item (i) of the preceding paragraph, is to establish the following matters in accordance with the standards determined by Order of the Ministry of Health, Labour and Welfare, and is to take into consideration the standards determined by Order of the Ministry of Health, Labour and Welfare for other matters:

standards pertaining to employees engaging in registered facility long-term care support applicable to standards and the number of such employees;

matters concerning the operation of the business of registered facility long-term care support applicable to standards that are closely related to ensuring the appropriate use of services, appropriate treatment and safety of Persons Requiring Long-Term Care who use them, and maintaining confidentiality, etc., and that are specified by Order of the Ministry of Health, Labour and Welfare.

A Municipality, in establishing a Municipal Ordinance pursuant to the provisions of paragraph (1), item (ii), is to establish the matters set forth in item (i) in accordance with the standards determined by Order of the Ministry of Health, Labour and Welfare, taking into account the state of population decline in the areas that fall under the standards determined by Order of the Ministry of Health, Labour and Welfare prescribed in Article 42, paragraph (1), item (iii), the status of employees engaging in registered facility long-term care support, and other circumstances, is to establish the matters set forth in item (ii) in accordance with the standards determined by Order of the Ministry of Health, Labour and Welfare, and is to take into consideration the standards determined by Order of the Ministry of Health, Labour and Welfare for other matters.

standards pertaining to employees engaging in registered facility long-term care support in a Specified Area and the number of such employees;

matters concerning the operation of the business of registered facility long-term care support in a Specified Area that are closely related to ensuring the appropriate use of services, appropriate treatment and safety of Persons Requiring Long-Term Care who use them, and maintaining confidentiality, etc., and that are specified by Order of the Ministry of Health, Labour and Welfare.

The amount of Exceptional Allowance for Registered Facility Long-Term Care Service Plan in the case set forth in paragraph (1), item (i), item (iii) or item (iv) is specified by the Municipality based on the amount equivalent to 90 percent of the amount of expenses calculated, for said registered facility long-term care support or equivalent service, by the standards determined by the Minister of Health, Labour and Welfare as set forth in paragraph (2) of the preceding Article (in a case said calculated amount exceeds the amount of actual expenses of said registered facility long-term care support or equivalent service, the actual expenses required for said registered facility long-term care support or equivalent service).

The amount of Exceptional Allowance for Registered Facility Long-Term Care Service Plan in the case set forth in paragraph (1), item (ii) is specified by the Municipality based on the amount equivalent to 90 percent of the amount of expenses calculated by standards determined by the Minister of Health, Labour and Welfare after considering the average expenses necessary for registered facility long-term care support in a Specified Area, calculated after considering the area, etc., where the provider that performs the business of registered facility long-term care support in a Specified Area is located (in a case when said calculated amount exceeds the actual expenses necessary for registered facility long-term care support in a Specified Area, the actual expenses necessary for said registered facility long-term care support in a Specified Area).

The Minister of Health, Labour and Welfare, when intending to specify the standards prescribed in the preceding paragraph, must hear the opinion of the Social Security Council in advance.

The mayor of a Municipality, when it determines the necessity for payment of an Exceptional Allowance for Registered Facility Long-Term Care Service Plan, may order a person that is or was in charge of the registered facility long-term care support or equivalent service pertaining to said payment (herein referred to as "person, etc. in charge of registered facility long-term care support, etc." in this paragraph) to report, submit or present record books and documents, or appear, or have its personnel question the relevant persons or enter the Business Office pertaining to said payment of said person, etc. in charge of registered facility long-term care support, etc. in order to inspect said books, documents, and other items.

The provisions of Article 24, paragraph (3) apply mutatis mutandis to questions and inspections pursuant to the provisions of the preceding paragraph, and the provisions of paragraph (4) of the same Article apply mutatis mutandis to the authority granted pursuant to the provisions of the preceding paragraph, respectively.

payment of an Allowance for Registered Facility Long-Term Care Service Plan:Article 47-2, paragraph (2);

payment of an Exceptional Allowance for Registered Facility Long-Term Care Service Plan:Article 47-3, paragraph (4) and paragraph (5);

In a case when a Municipality applies the provisions prescribed in the items of paragraph (1) of the preceding Article to a Long-Term Care Benefit listed in said items received by an Insured Person Requiring Long-Term Care for whom the Municipality has found it difficult to pay the necessary expenses for In-Home Service (including equivalent services; the same applies hereinafter in this Article), Community-Based Service (including equivalent services; the same applies hereinafter in this Article), registered facility long-term care support (including equivalent services; the same applies hereinafter in this Article), Facility Service, or Home Modification due to disaster or other special circumstances as determined by Order of the Ministry of Health, Labour and Welfare (excluding a case when the provisions are applied as replaced pursuant to the provisions of that Article), the term "90 percent" in the referenced provisions is deemed to be replaced with "the percentage determined by the Municipality within the range exceeding 90 percent and 100 percent or less".

In a case when a Municipality applies the provisions prescribed in the items of paragraph (1) of the preceding Article to a Long-Term Care Benefit listed in said items received by an Insured Person Requiring Long-Term Care for whom the Municipality has found it difficult to pay the necessary expenses for In-Home Service, Community-Based Service, registered facility long-term care support, Facility Service, or Home Modification due to disaster or other special circumstances as determined by Order of the Ministry of Health, Labour and Welfare (limited to a case when the provisions are applied as replaced pursuant to the provisions of that paragraph), the term "80 percent" in the referenced provisions applied as replaced pursuant to the provisions of that paragraph is deemed to be replaced with "the percentage determined by the Municipality within the range exceeding 80 percent and 100 percent or less".

In a case when a Municipality applies the provisions prescribed in the items of paragraph (1) of the preceding Article to a Long-Term Care Benefit listed in said items received by an Insured Person Requiring Long-Term Care for whom the Municipality has found it difficult to pay the necessary expenses for In-Home Service, Community-Based Service, registered facility long-term care support, Facility Service, or Home Modification due to disaster or other special circumstances as determined by Order of the Ministry of Health, Labour and Welfare (limited to a case when the provisions are applied as replaced pursuant to the provisions of paragraph (2) of that Article), the term "70 percent" in the referenced provisions applied as replaced pursuant to the provisions of paragraph (2) of that Article is deemed to be replaced with "the percentage determined by the Municipality within the range exceeding 70 percent and 100 percent or less".

When the amount obtained by deducting the total amount of the Allowance for In-Home Long-Term Care Service, Exceptional Allowance for In-Home Long-Term Care Service, Allowance for Community-Based Long-Term Care Service, Exceptional Allowance for Community-Based Long-Term Care Service, Allowance for Registered Facility Long-Term Care Service Plan, Exceptional Allowance for Registered Facility Long-Term Care Service, Plan, Allowance for Long-Term Care Facility Service, and Exceptional Allowance for Long-Term Care Facility Service paid for the expenses from the amount calculated as provided by Cabinet Order as the total amount of expenses required for In-Home Service (including equivalent services), Community-Based Service (including equivalent services), registered facility long-term care support (including equivalent services), or Facility Service received by an Insured Person Requiring Long-Term Care (hereinafter referred to as "User Charge for Long-Term Care Service" in paragraph (1) of the following Article) is extremely large, a Municipality pays an Allowance for High-Cost Long-Term Care Service to said Insured Person Requiring Long-Term Care.

In addition to the provisions as set forth in the preceding paragraph, requirements for payment of an Allowance for High-Cost Long-Term Care Service, the amount of said allowance, and other matters necessary for the payment of an Allowance for High-Cost Long-Term Care Service are provided by a Cabinet Order after considering the impact on saidthe household budget due to the burden of the expenses necessary for In-Home Service, Community-Based Service, registered facility long-term care support, or Facility Service.

payment of an Allowance for Registered Facility Preventive Long-Term Care Service Plan;

payment of an Exceptional Allowance for Registered Facility Preventive Long-Term Care Service Plan;

A Municipality, when an Insured Person who has received a Certification of Needed Support and receives support at home (hereinafter referred to as an "Insured In-Home Person Requiring Support") has received, from a person designated by the prefectural governor (hereinafter referred to as a "Designated Provider of Preventive Long-Term Care Service"), Preventive Long-Term Care Service provided by a Business Office conducting the Preventive Long-Term Care Service Business pertaining to said designation (hereinafter referred to as "Designated Preventive Long-Term Care Service") (limited to a case when said Insured In-Home Person Requiring Support has notified a Municipality in advance, pursuant to the provisions of Article 58, paragraph (4), of receiving Designated Preventive Long-Term Care Support prescribed in paragraph (1) of the same Article and said Designated Preventive Long-Term Care Service is subject to said Designated Preventive Long-Term Care Support, a case when said Insured In-Home Person Requiring Support has notified a Municipality in advance, pursuant to the provisions of Article 59-2, paragraph (4), of receiving Designated Registered Facility Preventive Long-Term Care Support prescribed in paragraph (1) of the same Article and said Designated Preventive Long-Term Care Service is subject to said Designated Registered Facility Preventive Long-Term Care Support, or other cases specified by Order of the Ministry of Health, Labour and Welfare), pays to said Insured In-Home Person Requiring Support an Allowance for Preventive Long-Term Care Service for the expenses required for said Designated Preventive Long-Term Care Service (excluding the expenses required to purchase Specified Equipment for Preventive Long-Term Care Covered by Public Aid and, with regard to the expenses required for Outpatient Rehabilitation for Preventive Long-Term Care, Short-Term Admission for Daily Preventive Long-Term Care, Short-Term Admission for Recuperation for Preventive Long-Term Care, and Daily Preventive Long-Term Care Admitted to a Specified Facility, the expenses necessary to provide meals, stay and other expenses necessary for daily life as determined by Order of the Ministry of Health, Labour and Welfare; the same applies hereinafter in this Article); provided, however, that this does not apply when said Insured In-Home Person Requiring Support, in a case where he or she has been issued a designation pursuant to the provisions of Article 37, paragraph (1), receives Preventive Long-Term Care Service other than the type pertaining to said designation.

A Municipality, when an Insured In-Home Person Requiring Support receives from a person designated by the mayor of said Municipality (including, with regard to a Specified Community-Based Service for Preventive Long-Term Care for an Insured In-Home Person Requiring Support who is an Insured Person to Whom the Domicile Exception Applies (herein referred to as "Insured In-Home Person Requiring Support to Whom the Domicile Exception Applies"), the Municipality Where the Facility Is Located) (herein referred to as "Designated Provider of Community-Based Service for Preventive Long-Term Care") the Community-Based Service for Preventive Long-Term Care (herein referred to as "Designated Community-Based Service for Preventive Long-Term Care") provided by a provider that performs Community-Based Preventive Long-Term Care Business pertaining to said designation (limited to a case when said Insured In-Home Person Requiring Support has notified the Municipality pursuant to the provisions of Article 58, paragraph (4) to receive a Designated Preventive Long-Term Care Support as prescribed in paragraph (1) of the same Article and said Designated Community-Based Service for Preventive Long-Term Care is subject to said Designated Preventive Long-Term Care Support, a case when said Insured In-Home Person Requiring Support has notified the Municipality pursuant to the provisions of Article 59-2, paragraph (4) to receive Designated Registered Facility Preventive Long-Term Care Support as prescribed in paragraph (1) of the same Article whenand said Designated Community-Based Service for Preventive Long-Term Care is subject to said Designated Registered Facility Preventive Long-Term Care Support, and other matterscases as determined by Order of the Ministry of Health, Labour and Welfare), pays to said Insured In-Home Person Requiring Support the Allowance for Community-Based Preventive Long-Term Care Service for the expenses required for said Designated Community-Based Service for Preventive Long-Term Care (excluding the expenses necessary to provide meals and other expenses as determined by Order of the Ministry of Health, Labour and Welfare as necessary for daily life; the same applies hereinafter in this Article), however, this provision does not apply to a case when said Insured In-Home Person Requiring Support that has been designated pursuant to the provisions of Article 37, paragraph (1), receives a Community-Based Service for Preventive Long-Term Care other than the type pertaining to said designation.

A Municipality, when an Insured In-Home Person Requiring Support (excluding a person who receives support in a residence room in a registered Fee-Based Home for the Elderly; the same applies hereinafter in this Article and the following Article) receives from a person designated by the mayor of said Municipality (or, for Preventive Long-Term Care Support for an Insured In-Home Person Requiring Support to Whom the Domicile Exception Applies, the Municipality Where the Facility Is Located) (herein referred to as "Designated Preventive Long-Term Care Support Provider") the Preventive Long-Term Care Support provided by a provider that performs the Preventive Long-Term Care Support Business pertaining to said designation (herein referred to as "Designated Preventive Long-Term Care Support"), pays to said Insured In-Home Person Requiring Support an Allowance for Preventive Long-Term Care Service Plan for the expenses required for said Designated Preventive Long-Term Care Support.

A Municipality, when an Insured Person who has received Certification of Needed Support and who receives support in a residence room in a registered Fee-Based Home for the Elderly (hereinafter in this Article and the following Article referred to as "insured Person Requiring Support in a registered facility") receives from a person designated by the mayor of said Municipality (or, for registered facility Preventive Long-Term Care Support for an Insured In-Home Person Requiring Support to Whom the Domicile Exception Applies, the Municipality Where the Facility Is Located) (herein referred to as "Designated Registered Facility Preventive Long-Term Care Support Provider") the registered facility Preventive Long-Term Care Support provided by a provider that performs the registered facility Preventive Long-Term Care Support Business pertaining to said designation (herein referred to as "Designated Registered Facility Preventive Long-Term Care Support"), pays to said insured Person Requiring Support in a registered facility an Allowance for Registered Facility Preventive Long-Term Care Service Plan for the expenses required for said Designated Registered Facility Preventive Long-Term Care Support.

The amount of the Allowance for Registered Facility Preventive Long-Term Care Service Plan is to be an amount equivalent to 90 percent of the amount of expenses calculated by standards determined by the Minister of Health, Labour and Welfare after considering the average expenses required for Designated Registered Facility Preventive Long-Term Care Support, which are calculated after considering the area, etc., where the provider that performs the business of Designated Registered Facility Preventive Long-Term Care Support is located (if said calculated amount exceeds the actual expenses required for said Designated Registered Facility Preventive Long-Term Care Support, the amount of expenses is to be the actual expenses required for said Designated Registered Facility Preventive Long-Term Care Support).

The Minister of Health, Labour and Welfare, when intending to specify the standards in the preceding paragraph, must hear the opinion of the Social Security Council in advance.

When an insured Person Requiring Support in a registered facility receives Designated Registered Facility Preventive Long-Term Care Support from a Designated Registered Facility Preventive Long-Term Care Support Provider (limited to the case where said insured Person Requiring Support in a registered facility has notified the Municipality in advance, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, of receiving said Designated Registered Facility Preventive Long-Term Care Support), the Municipality may, on behalf of said insured Person Requiring Support in a registered facility, pay to said Designated Registered Facility Preventive Long-Term Care Support Provider, within the limit of the amount to be paid to said insured Person Requiring Support in a registered facility as an Allowance for Registered Facility Preventive Long-Term Care Service Plan, the expenses required for said Designated Registered Facility Preventive Long-Term Care Support that said insured Person Requiring Support in a registered facility should pay to said Designated Registered Facility Preventive Long-Term Care Support Provider.

When payment is made pursuant to the provisions of the preceding paragraph, it is to be deemed that an Allowance for Registered Facility Preventive Long-Term Care Service Plan has been paid to the insured Person Requiring Support in a registered facility.

A Municipality, when a Designated Registered Facility Preventive Long-Term Care Support Provider requests an Allowance for Registered Facility Preventive Long-Term Care Service Plan, pays said allowance after conducting an examination according to standards determined by the Minister of Health, Labour and Welfare as set forth in paragraph (2), standards concerning effective support methods for Prevention of Long-Term Care pertaining to Designated Registered Facility Preventive Long-Term Care Support as prescribed in Article 115-31-4, paragraph (2), and standards concerning management of the business of Designated Registered Facility Preventive Long-Term Care Support (limited to the part concerning the handling of Designated Registered Facility Preventive Long-Term Care Support).

The provisions of Article 41, paragraph (2), paragraph (3), paragraph (10) and paragraph (11) apply mutatis mutandis to the payment of an Allowance for Registered Facility Preventive Long-Term Care Service Plan, and the provisions of paragraph (8) of the same Article apply mutatis mutandis to a Designated Registered Facility Preventive Long-Term Care Support Provider, respectively. In this case, the necessary technical replacement of terms in these provisions is provided by a Cabinet Order.

In addition to what is prescribed in the respective preceding paragraphs, necessary matters concerning the payment of an Allowance for Registered Facility Preventive Long-Term Care Service Plan and the request for an Allowance for Registered Facility Preventive Long-Term Care Service Plan by a Designated Registered Facility Preventive Long-Term Care Support Provider are to be prescribed by Order of the Ministry of Health, Labour and Welfare.

A Municipality, in the following cases, pays an Exceptional Allowance for Registered Facility Preventive Long-Term Care Service Plan to an insured Person Requiring Support in a registered facility:

when the Municipality determines it necessary in a case where an insured Person Requiring Support in a registered facility receives registered facility Preventive Long-Term Care Support other than Designated Registered Facility Preventive Long-Term Care Support, or an equivalent service, that is provided by a Business Office conducting a business found to satisfy, among the standards specified by Municipal Ordinance as set forth in Article 115-31-4, paragraph (1) pertaining to the business of Designated Registered Facility Preventive Long-Term Care Support, the number of employees specified by Municipal Ordinance as set forth in the same paragraph, and the standards concerning effective methods of support for Prevention of Long-Term Care pertaining to Designated Registered Facility Preventive Long-Term Care Support as prescribed in paragraph (2) of the same Article and the standards concerning the management of the business of Designated Registered Facility Preventive Long-Term Care Support (herein referred to as "Standards for the Business of Designated Registered Facility Preventive Long-Term Care Support" in the following item), those specified by Municipal Ordinance (herein referred to as "registered facility Preventive Long-Term Care Support applicable to standards" in this Article);

when the Municipality determines it necessary in a case where an insured Person Requiring Support in a registered facility receives registered facility Preventive Long-Term Care Support other than Designated Registered Facility Preventive Long-Term Care Support and registered facility Preventive Long-Term Care Support applicable to standards, or an equivalent service, that is located in a Specified Area and provided by a Business Office conducting a business found to satisfy those among the Standards for the Business of Designated Registered Facility Preventive Long-Term Care Support that are specified by Municipal Ordinance (herein referred to as "registered facility Preventive Long-Term Care Support in a Specified Area" in this Article);

when the Municipality determines it necessary in a case where an insured Person Requiring Support in a registered facility who is domiciled on an isolated island or in another area where it is significantly difficult to secure Designated Registered Facility Preventive Long-Term Care Support, registered facility Preventive Long-Term Care Support applicable to standards and registered facility Preventive Long-Term Care Support in a Specified Area, and which falls under the standards determined by the Minister of Health, Labour and Welfare, receives registered facility Preventive Long-Term Care Support or an equivalent service other than Designated Registered Facility Preventive Long-Term Care Support, registered facility Preventive Long-Term Care Support applicable to standards and registered facility Preventive Long-Term Care Support in a Specified Area;

any other case provided by Cabinet Order.

A Municipality, in establishing a Municipal Ordinance pursuant to item (i) of the preceding paragraph, is to establish the following matters in accordance with the standards determined by Order of the Ministry of Health, Labour and Welfare, and is to take into consideration the standards determined by Order of the Ministry of Health, Labour and Welfare for other matters:

the standards concerning the employees that engage in registered facility Preventive Long-Term Care Support applicable to standards and the number of said employees;

matters concerning the management of the business of registered facility Preventive Long-Term Care Support applicable to standards that are determined by Order of the Ministry of Health, Labour and Welfare as being closely related to the appropriate use of services by Persons Requiring Support who use them, appropriate treatment, ensuring of safety, and maintenance of confidentiality, etc.

A Municipality, in establishing a Municipal Ordinance pursuant to paragraph (1), item (ii), is to establish the matters listed in item (i) in accordance with the standards determined by Order of the Ministry of Health, Labour and Welfare after taking into consideration the state of population decline in areas that fall under the standards determined by Order of the Ministry of Health, Labour and Welfare prescribed in Article 42, paragraph (1), item (iii), the state of employees that engage in registered facility Preventive Long-Term Care Support, and other circumstances, is to establish the matters listed in item (ii) in accordance with the standards determined by Order of the Ministry of Health, Labour and Welfare, and is to take into consideration the standards determined by Order of the Ministry of Health, Labour and Welfare for other matters:

the standards concerning the employees that engage in registered facility Preventive Long-Term Care Support in a Specified Area and the number of said employees;

matters concerning the management of the business of registered facility Preventive Long-Term Care Support in a Specified Area that are determined by Order of the Ministry of Health, Labour and Welfare as being closely related to the appropriate use of services by Persons Requiring Support who use them, appropriate treatment, ensuring of safety, and maintenance of confidentiality, etc.

The amount of the Exceptional Allowance for Registered Facility Preventive Long-Term Care Service Plan in the cases listed in paragraph (1), item (i), item (iii) or item (iv) is to be specified by the Municipality based on an amount equivalent to 90 percent of the expenses calculated by the standards determined by the Minister of Health, Labour and Welfare as set forth in paragraph (2) of the preceding Article for said registered facility Preventive Long-Term Care Support or equivalent service (if said calculated amount exceeds the actual expenses required for said registered facility Preventive Long-Term Care Support or equivalent service, the actual expenses required for said registered facility Preventive Long-Term Care Support or equivalent service).

The amount of the Exceptional Allowance for Registered Facility Preventive Long-Term Care Service Plan in the case listed in paragraph (1), item (ii) is to be specified by the Municipality based on an amount equivalent to 90 percent of the amount of expenses calculated by standards determined by the Minister of Health, Labour and Welfare after considering the average expenses required for registered facility Preventive Long-Term Care Support in a Specified Area, which are calculated after considering the area, etc., where the provider that performs the business of registered facility Preventive Long-Term Care Support in a Specified Area is located (if said calculated amount exceeds the actual expenses required for said registered facility Preventive Long-Term Care Support in a Specified Area, the actual expenses required for said registered facility Preventive Long-Term Care Support in a Specified Area).

The Minister of Health, Labour and Welfare, when intending to specify the standards in the preceding paragraph, must hear the opinion of the Social Security Council in advance.

The mayor of a Municipality, when he or she determines it necessary in relation to the payment of an Exceptional Allowance for Registered Facility Preventive Long-Term Care Service Plan, may order a person that is or was in charge of the registered facility Preventive Long-Term Care Support or equivalent service pertaining to said payment (herein referred to as "person, etc. in charge of registered facility Preventive Long-Term Care Support, etc." in this paragraph) to report, to submit or present record books and documents, or to appear, or direct its personnel to question relevant persons, or to enter the Business Office pertaining to said payment of said person, etc. in charge of registered facility Preventive Long-Term Care Support, etc. and inspect the record books and documents and other items there.

The provisions of Article 24, paragraph (3) apply mutatis mutandis to questions or inspections pursuant to the provisions of the preceding paragraph, and the provisions of paragraph (4) of the same Article apply mutatis mutandis to the authority granted pursuant to the provisions of the preceding paragraph, respectively.