An Insured Person that intends to receive a Certification of Needed Support, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, must submit to a Municipality a written application with the Certificate of Insured Person attached. In this case, said Insured Person may, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, have a Designated In-Home Long-Term Care Support Provider prescribed in Article 46, paragraph (1), a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care or a Facility Covered by Long-Term Care Insurance, as determined by Order of the Ministry of Health, Labour and Welfare, or a community general support center prescribed in Article 115-46, paragraph (1), perform the procedures pertaining to said application on behalf of the Insured Person.
要支援認定を受けようとする被保険者は、厚生労働省令で定めるところにより、申請書に被保険者証を添付して市町村に申請をしなければならない。この場合において、当該被保険者は、厚生労働省令で定めるところにより、第四十六条第一項に規定する指定居宅介護支援事業者、地域密着型介護老人福祉施設若しくは介護保険施設であって厚生労働省令で定めるもの又は第百十五条の四十六第一項に規定する地域包括支援センターに、当該申請に関する手続を代わって行わせることができる。
The provisions of Article 27, paragraphs (2) and (3) apply mutatis mutandis to an investigation pertaining to an application as prescribed in the preceding paragraph, opinions of an attending physician of the Insured Person pertaining to an application as set forth in the same paragraph, and an order for diagnosis to said Insured Person.
A Municipality is to notify the Certification Committee of the result of an investigation as set forth in Article 27, paragraph (2) as applied mutatis mutandis pursuant to the preceding paragraph (in a case when the investigation is entrusted pursuant to the provisions of Article 24-2, paragraph (1), item (ii), including an investigation pertaining to said entrustment), the opinion of an attending physician as set forth in Article 27, paragraph (3) as applied mutatis mutandis pursuant to the preceding paragraph, the result of a diagnosis of a designated physician or its personnel who is a physician, or other matters specified by Order of the Ministry of Health, Labour, and Welfare, and request an examination and judgment pertaining to matters as prescribed in each said item according to the category of Insured Person listed in the following items with regard to the Insured Person pertaining to an application as set forth in paragraph (1):
Primary Insured Person:those who qualify for a Needed Support Condition and Category of Needed Support Condition for which said condition qualifies;
Secondary Insured Person:those who qualify for a Needed Support Condition, a Category of Needed Support Condition for which said condition qualifies, and the physical or mental problem(s) that is the cause of said Needed Support Condition as caused by a Specified Disease.
A Certification Committee, when being requested to perform an examination and judgment pursuant to the provisions of the preceding paragraph, is to act in compliance with standards as determined by the Minister of Health, Labour, and Welfare, examine and judge matters as prescribed in each item of the same paragraph of an Insured Person pertaining to said examination and judgment, and notify the Municipality of said result. In this case, a Certification Committee, when it determines necessary, may state opinions to the Municipality regarding the following matters:
matters of necessary medical care for or support pertaining to domestic home duties for the reduction or prevention of deterioration of a Needed Support Condition of said Insured Person;
当該被保険者の要支援状態の軽減又は悪化の防止のために必要な療養及び家事に係る援助に関する事項
matters that said Insured Person should give heed to regarding the appropriate and effective use, etc. of Designated Preventive Long-Term Care Service prescribed in Article 53, paragraph (1), Designated Community-Based Service for Preventive Long-Term Care prescribed in Article 54-2, paragraph (1), or a Specified Comprehensive Project for Long-Term Care Prevention and Daily Life Support.
第五十三条第一項に規定する指定介護予防サービス若しくは第五十四条の二第一項に規定する指定地域密着型介護予防サービス又は特定介護予防・日常生活支援総合事業の適切かつ有効な利用等に関し当該被保険者が留意すべき事項
The provisions of Article 27, paragraph (6) apply mutatis mutandis to an examination and judgment as prescribed in the first sentence of the preceding paragraph.
A Municipality, when providing Certification of Needed Support based on the results of an examination and judgment of a Certification Committee that is notified pursuant to the provisions of the first sentence of paragraph (4), is to notify the Insured Person pertaining to said Certification of Needed Support of said result. In this case, a Municipality shall enter the following items on the Certificate of Insured Person of said Insured Person and return the Certificate of Insured Person to the Insured Person:
opinions of the Certification Committee pertaining to matters listed in paragraph (4), item (ii).
A Certification of Needed Support becomes effective retroactively on the date that said application was submitted.
要支援認定は、その申請のあった日にさかのぼってその効力を生ずる。
A Municipality, when it is determined that the Insured Person predating the application as set forth in paragraph (1) fails to qualify the Person Requiring Support based on the results of an examination and judgment of a Certification Committee that is notified pursuant to the provisions of the first sentence of paragraph (4), is to notify said Insured Person pertaining of the results, indicating the reasons, and return the Certificate of Insured Person to said Insured Person.
The provisions of Article 27, paragraph (10) to (12) apply mutatis mutandis to an application as set forth in paragraph (1) and the action for said application.
第二十七条第十項から第十二項までの規定は、第一項の申請及び当該申請に対する処分について準用する。
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(Community General Support Center)
A community general support center is a facility that aims to provide comprehensive support for improvement of health and medical care and promotion of public aid of local residents…
地域包括支援センターは、第一号介護予防支援事業(居宅要支援被保険者に係るものを除く。)及び第百十五条の四十五第二項第一号から第六号までに掲げる事業(以下「包括的支援事業」という。)その他厚生労働省令で定める事業を実施し、地域住民の心身の健康の保持及び生活の安定のために必要な援助を行うことにより…
Open this provision(Designated and Entrusted Juridical Person for Municipal Affairs)
affairs pertaining to an inspection pursuant to the provisions of Article 27, paragraph (2) (including a case when applied mutatis mutandis pursuant to Article 28, paragraph (4), Article 29…
第二十七条第二項(第二十八条第四項、第二十九条第二項、第三十条第二項、第三十一条第二項及び第三十二条第二項(第三十三条第四項、第三十三条の二第二項、第三十三条の三第二項及び第三十四条第二項において準用する場合を含む。)において準用する場合を含む。)の規定による調査に関する事務
Open this provision(Certification of Needed Long-Term Care)
A Municipality may dismiss an application submitted pursuant to paragraph (1) when the Insured Person pertaining to the application as set forth in paragraph (1) fails to respond to an investigation…
市町村は、第一項の申請に係る被保険者が、正当な理由なしに、第二項の規定による調査(第二十四条の二第一項第二号の規定により委託された場合にあっては、当該委託に係る調査を含む。)に応じないとき、又は第三項ただし書の規定による診断命令に従わないときは、第一項の申請を却下することができる。
Open this provision(Certification of Needed Long-Term Care)
Action for an application as set forth in paragraph (1) must be performed within thirty (30) days from the date of submission of said application, however…
第一項の申請に対する処分は、当該申請のあった日から三十日以内にしなければならない。ただし、当該申請に係る被保険者の心身の状況の調査に日時を要する等特別な理由がある場合には、当該申請のあった日から三十日以内に、当該被保険者に対し…
Open this provision(Certification of Needed Long-Term Care)
In a case when the action for an application as set forth in paragraph (1) has not been executed within thirty (30) days from the date of submission of said application or the notification as set…
第一項の申請をした日から三十日以内に当該申請に対する処分がされないとき、若しくは前項ただし書の通知がないとき、又は処理見込期間が経過した日までに当該申請に対する処分がされないときは、当該申請に係る被保険者は、市町村が当該申請を却下したものとみなすことができる。
Open this provision(Certification of Needed Long-Term Care)
A Municipality, when the application as prescribed in the preceding paragraph is submitted, direct its personnel to interview said Insured Person pertaining to said application and investigate the…
市町村は、前項の申請があったときは、当該職員をして、当該申請に係る被保険者に面接させ、その心身の状況、その置かれている環境その他厚生労働省令で定める事項について調査をさせるものとする。この場合において、市町村は、当該被保険者が遠隔の地に居所を有するときは、当該調査を他の市町村に嘱託することができる。
Open this provision(Certification of Needed Long-Term Care)
A Municipality, when the application as prescribed in paragraph (1) is submitted, request an attending physician of the Insured Person pertaining to said application for opinions regarding the status…
市町村は、第一項の申請があったときは、当該申請に係る被保険者の主治の医師に対し、当該被保険者の身体上又は精神上の障害の原因である疾病又は負傷の状況等につき意見を求めるものとする。
Open this provision(Certification of Needed Long-Term Care)
A Certification Committee may, when it determines it necessary in an examination or judgment referred to in the first sentence of the preceding paragraph…
認定審査会は、前項前段の審査及び判定をするに当たって必要があると認めるときは、当該審査及び判定に係る被保険者、その家族、第三項の主治の医師その他の関係者の意見を聴くことができる。
Open this provision(Certification of Needed Support)
An Insured Person that intends to receive a Certification of Needed Support, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare…
要支援認定を受けようとする被保険者は、厚生労働省令で定めるところにより、申請書に被保険者証を添付して市町村に申請をしなければならない。この場合において、当該被保険者は、厚生労働省令で定めるところにより、第四十六条第一項に規定する指定居宅介護支援事業者…
Open this provision(Certification of Needed Support)
The provisions of Article 27, paragraphs (2) and (3) apply mutatis mutandis to an investigation pertaining to an application as prescribed in the preceding paragraph…
第二十七条第二項及び第三項の規定は、前項の申請に係る調査並びに同項の申請に係る被保険者の主治の医師の意見及び当該被保険者に対する診断命令について準用する。
Open this provision(Certification of Needed Support)
A Municipality is to notify the Certification Committee of the result of an investigation as set forth in Article 27, paragraph (2) as applied mutatis mutandis pursuant to the preceding paragraph…
市町村は、前項において準用する第二十七条第二項の調査(第二十四条の二第一項第二号の規定により委託された場合にあっては、当該委託に係る調査を含む。)の結果、前項において準用する第二十七条第三項の主治の医師の意見又は指定する医師若しくは当該職員で医師であるものの診断の結果その他厚生労働省令で定める事項を認定審査会に通知し…
Open this provision(Certification of Needed Support)
A Certification Committee, when being requested to perform an examination and judgment pursuant to the provisions of the preceding paragraph, is to act in compliance with standards as determined by…
認定審査会は、前項の規定により審査及び判定を求められたときは、厚生労働大臣が定める基準に従い、当該審査及び判定に係る被保険者について、同項各号に規定する事項に関し審査及び判定を行い、その結果を市町村に通知するものとする。
Open this provision(Certification of Needed Support)
matters that said Insured Person should give heed to regarding the appropriate and effective use, etc. of Designated Preventive Long-Term Care Service prescribed in Article 53, paragraph (1)…
第五十三条第一項に規定する指定介護予防サービス若しくは第五十四条の二第一項に規定する指定地域密着型介護予防サービス又は特定介護予防・日常生活支援総合事業の適切かつ有効な利用等に関し当該被保険者が留意すべき事項
Open this provision(Payment of an Allowance for In-Home Long-Term Care Service Plan)
A Municipality, when an Insured In-Home Person Requiring Long-Term Care has received, from a person designated by the mayor of said Municipality or the mayor of another Municipality…
市町村は、居宅要介護被保険者が、当該市町村の長又は他の市町村の長が指定する者(以下「指定居宅介護支援事業者」という。)から当該指定に係る居宅介護支援事業を行う事業所により行われる居宅介護支援(以下「指定居宅介護支援」という。)を受けたときは、当該居宅要介護被保険者に対し、当該指定居宅介護支援に要した費用について…
Open this provision(Payment of an Allowance for Preventive Long-Term Care Service)
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…
市町村は、要支援認定を受けた被保険者のうち居宅において支援を受けるもの(以下「居宅要支援被保険者」という。)が、都道府県知事が指定する者(以下「指定介護予防サービス事業者」という。)から当該指定に係る介護予防サービス事業を行う事業所により行われる介護予防サービス(以下「指定介護予防サービス」という。)を受けたとき(当…
Open this provision(Payment of an Allowance for Community-Based Preventive Long-Term Care Service)
A Municipality, when an Insured In-Home Person Requiring Support receives from a person designated by the mayor of said Municipality…
市町村は、居宅要支援被保険者が、当該市町村(住所地特例適用被保険者である居宅要支援被保険者(以下「住所地特例適用居宅要支援被保険者」という。)に係る特定地域密着型介護予防サービスにあっては、施設所在市町村を含む。)の長が指定する者(以下「指定地域密着型介護予防サービス事業者」という。)から当該指定に係る地域密着型介護…
Open this provisionNeeded Support Condition
「要支援状態」
A condition in which a person, because of a physical or mental disability, is expected, continuously over a period a Ministry of Health, Labour and Welfare Order (厚生労働省令) sets, to need support that particularly helps ease, or keep from worsening, a state of needing constant care with all or some of the basic actions of daily life such as bathing, toileting and eating, or to have difficulty carrying on daily life, and which falls in one of the categories by degree of need for support that Order sets (要支援状態区分).
Defined inArticle 7, paragraph (2)· applies throughout the law
Category of Needed Support Condition
「要支援状態区分」
Each of the categories, set by a Ministry of Health, Labour and Welfare Order (厚生労働省令) according to how much support a person needs, one of which a condition needing support (要支援状態) must fall in (Article 7, paragraph (2)).
Short name set inArticle 7, paragraph (2)
Specified Disease
「特定疾病」
An illness, specified by Cabinet Order (政令), caused by the physical and mental changes that come with ageing; a person aged 40 to 64 counts as a person requiring long-term care (要介護者) or support (要支援者) only where the disability behind their condition arose from one of these (Article 7, paragraphs (3) and (4)).
Short name set inArticle 7, paragraph (3), item (ii)
Person Requiring Support
「要支援者」
A person in a condition needing support (要支援状態) who is aged 65 or over, or aged 40 to 64 where the physical or mental disability causing it arose from a specified disease (特定疾病).
Defined inArticle 7, paragraph (4)· applies throughout the law
Specified Comprehensive Project for Long-Term Care Prevention and Daily Life Supportmachine translation
「特定介護予防・日常生活支援総合事業」
The category 1 home-visit projects (第一号訪問事業), day service projects (第一号通所事業) and daily life support projects (第一号生活支援事業) of Article 115-45, paragraph (1), item (i), (a) to (c).
Defined inArticle 7, paragraph (5)
Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Caremachine translation
「地域密着型介護老人福祉施設」
An intensive care home for the elderly (特別養護老人ホーム) under Article 20-5 of the Act on Social Welfare for the Elderly with 29 or fewer places, whose purpose is to give the people requiring long-term care (要介護者) admitted to it — limited to those in a care-need category a Ministry of Health, Labour and Welfare Order (厚生労働省令) sets or otherwise unable to live at home as such an Order provides — bathing, toileting, eating and other daily-life care, functional training, health management and care in the course of medical treatment under a community-based facility service plan (地域密着型施設サービス計画).
Defined inArticle 8, paragraph (22)· applies throughout the law
Facility Covered by Long-Term Care Insurancemachine translation
「介護保険施設」
A designated facility covered by public aid providing long-term care to the elderly (指定介護老人福祉施設) under Article 48, paragraph (1), item (i), a long-term care health facility (介護老人保健施設) or an integrated facility for medical and long-term care (介護医療院).
Defined inArticle 8, paragraph (25)· applies throughout the law
Municipality
「市町村」
A city, town or village, together with a special ward (特別区): the bodies that run long-term care insurance (介護保険) under this Act, whose insured persons Article 9 names.
Short name set inArticle 9, paragraph (1)
Primary Insured Person
「第一号被保険者」
A person aged 65 or over who has a domicile in the municipality's area (Article 9, item (i)). Residents of certain facilities for persons with disabilities, and others a Ministry of Health, Labour and Welfare Order names, are kept out of the insurance for the time being by Article 11, paragraph (1) of the Act for Enforcement of the Long-Term Care Insurance Act.
Short name set inArticle 9, paragraph (1), item (i)
Secondary Insured Person
「第二号被保険者」
A person aged 40 to 64 who has a domicile in the municipality's area and is a medical insurance subscriber (医療保険加入者) (Article 9, item (ii)). Residents of certain facilities for persons with disabilities, and others a Ministry of Health, Labour and Welfare Order names, are kept out of the insurance for the time being by Article 11, paragraph (1) of the Act for Enforcement of the Long-Term Care Insurance Act.
Short name set inArticle 9, paragraph (1), item (ii)
Certification Committee
「認定審査会」
The Certification Committee of Needed Long-Term Care (介護認定審査会) that each municipality sets up to examine and judge cases for certification of needed long-term care or support, the work Articles 27 to 35 and 37 give it (審査判定業務, Article 38, paragraph (2)).
Short name set inArticle 14, paragraph (1)
Certification of Needed Support
「要支援認定」
A municipality's certification that an insured person who wants prevention benefits (予防給付) is a person requiring support (要支援者), and of the category of need for support (要支援状態区分) the person falls in (Article 19, paragraph (2)).
Short name set inArticle 19, paragraph (2)
Designated In-Home Long-Term Care Support Providermachine translation
「指定居宅介護支援事業者」
A person the mayor of a municipality, or of another municipality, designates under Article 46, paragraph (1) to provide in-home long-term care support (居宅介護支援) at a business office covered by the designation.
Short name set inArticle 46, paragraph (1)
Designated Preventive Long-Term Care Servicemachine translation
「指定介護予防サービス」
A service to prevent long-term care (介護予防サービス) provided by a business a prefectural governor has designated (指定介護予防サービス事業者), at its place of business covered by the designation, as Article 53, paragraph (1) of the Long-Term Care Insurance Act provides.
Short name set inArticle 53, paragraph (1)
Designated Community-Based Service for Preventive Long-Term Caremachine translation
「指定地域密着型介護予防サービス」
A community-based preventive long-term care service (地域密着型介護予防サービス) provided by a person the mayor of a municipality has designated (指定地域密着型介護予防サービス事業者), at a business office covered by the designation, for which the municipality pays community-based preventive long-term care service allowances (地域密着型介護予防サービス費) (Article 54-2, paragraph (1)).
Short name set inArticle 54-2, paragraph (1)