Long-Term Care Insurance Act

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

The Minister of Health, Labour, and Welfare, when it intends to provide standards as prescribed in the items of the preceding paragraph, must hear opinions of the Social Security Council in advance.

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

When the expenses are paid pursuant to the provisions of the preceding paragraph, it is to be deemed that an Allowance for Preventive Long-Term Care Service Plan is paid to said Insured In-Home Person Requiring Support.

A Municipality, when a Designated Preventive Long-Term Care Support Provider requests an Allowance for Preventive Long-Term Care Service Plan, is to pay 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 Preventive Long-Term Care Support as prescribed in Article 115-24, paragraph (2), and standards concerning the management of the business of Designated Preventive Long-Term Care Support (limited to the part concerning the handling of Designated 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 Preventive Long-Term Care Service Plan and the provisions of paragraph (8) of the same Article apply mutatis mutandis to a Designated Provider of Preventive Support of Long-Term Care. In this case, the necessary technical replacement of terms in these provisions is provided by a Cabinet Order.

In addition to those provisions as prescribed in each of the preceding paragraphs, other necessary matters payment of an Allowance for Preventive Long-Term Care Service Plan and the request of an Allowance for Preventive Long-Term Care Service Plan by a Designated Provider of Preventive Support of Long-Term Care are to be as determined by Order of the Ministry of Health, Labour, and Welfare.

A Municipality, in the following cases, pay an Exceptional Allowance for Preventive Long-Term Care Service Plan to an Insured In-Home Person Requiring Support:

when a Municipality determines it necessary in a case when an Insured In-Home Person Requiring Support receives Preventive Long-Term Care Support other than Designated Preventive Long-Term Care Support, or any service equivalent thereto, that is provided by a Business Office conducting a business that is found to satisfy, among the standards determined by Municipal Ordinance as set forth in Article 115-24, paragraph (1) pertaining to the business of Designated Preventive Long-Term Care Support and the number of employees determined by Municipal Ordinance as set forth in the same paragraph, and the standards concerning effective support methods for Prevention of Long-Term Care pertaining to Designated 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 Preventive Long-Term Care Support (referred to as "Standards for the Business of Designated Preventive Long-Term Care Support" in the following item), those determined by Municipal Ordinance (hereinafter referred to as "Preventive Long-Term Care Support Applicable to Standards" in this Article);

when a Municipality determines it necessary in a case when an Insured In-Home Person Requiring Support receives Preventive Long-Term Care Support other than Designated Preventive Long-Term Care Support and Preventive Long-Term Care Support Applicable to Standards, or any service equivalent thereto, that is provided by a Business Office conducting a business that is located in a Specified Area and is found to satisfy those of the Standards for the Business of Designated Preventive Long-Term Care Support that are specified by Municipal Ordinance (hereinafter referred to as "Preventive Long-Term Care Support in a Specified Area" in this Article);

when a Municipality determines it necessary in a case when an Insured In-Home Person Requiring Support who is domiciled on an isolated island or other location where it is significantly difficult to secure Designated Preventive Long-Term Care Support, Preventive Long-Term Care Support Applicable to Standards and Preventive Long-Term Care Support in a Specified Area, and which falls under the standards as determined by the Minister of Health, Labour and Welfare, receives Preventive Long-Term Care Support other than Designated Preventive Long-Term Care Support, Preventive Long-Term Care Support Applicable to Standards and Preventive Long-Term Care Support in a Specified Area, or service equivalent thereto;

when otherwise provided by a Cabinet Order.

A Municipality, in establishing the 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:

the standards concerning the employees that engage in Preventive Long-Term Care Support Applicable to Standards and the number of said employees;

matters concerning the management of the business of 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 the provisions of paragraph (1), item (ii), is to establish the matters listed in item (i) in accordance with the standards specified by Order of the Ministry of Health, Labour and Welfare, taking into consideration the status of population decline in areas that fall under the standards specified by Order of the Ministry of Health, Labour and Welfare prescribed in Article 42, paragraph (1), item (iii), the status of employees engaging in Preventive Long-Term Care Support and other circumstances; is to establish the matters listed in item (ii) in accordance with the standards specified by Order of the Ministry of Health, Labour and Welfare; and is to take into consideration the standards specified by Order of the Ministry of Health, Labour and Welfare for other matters.

standards pertaining to employees engaging in Preventive Long-Term Care Support in a Specified Area and the number of such employees;

matters concerning the operation of the business of Preventive 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 Support 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 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 a Municipality based on the expenses calculated by standards determined by the Minister of Health, Labour and Welfare as set forth in paragraph (2) of the preceding Article for said Preventive Long-Term Care Support or equivalent service (in a case said calculated amount exceeds the amount of actual expenses of said Preventive Long-Term Care Support or equivalent service, the base amount is to be the actual expenses required for said Preventive Long-Term Care Support or equivalent service).

The amount of Exceptional Allowance for Preventive Long-Term Care Service Plan in the case listed in paragraph (1), item (ii) is specified by a Municipality based on the amount of expenses calculated according to the standards determined by the Minister of Health, Labour and Welfare after taking into consideration the average expenses required for Preventive Long-Term Care Support in a Specified Area, calculated by taking into consideration the area, etc., where the Business Offices conducting the business of Preventive Long-Term Care Support in a Specified Area are located (if that amount exceeds the actual expenses required for said Preventive Long-Term Care Support in a Specified Area, the amount of those actual expenses).

The Minister of Health, Labour and Welfare, when intending to determine the standards referred to 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 for the payment of an Exceptional Allowance for Preventive Long-Term Care Service Plan, may order a person that is or has been in charge of the Preventive Long-Term Care Support or equivalent service pertaining to said payment (herein referred to as "Person, etc., in Charge of Preventive Long-Term Care Support, etc." in this paragraph) to report, to submit or present record books and documents, or to appear, or may direct its personnel to question the relevant persons or to enter the Business Office of said Person, etc., in Charge of Preventive Long-Term Care Support, etc., pertaining to said payment and inspect the record books and documents, and other items.

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