Public Assistance Act

The purpose of this Act is for the State to guarantee a minimum standard of living as well as to promote self-support for all citizens who are in living in poverty by providing the necessary public assistance according to the level of poverty, based on the principles prescribed in Article 25 of the Constitution of Japan.

All citizens may receive public assistance under this Act (hereinafter referred to as "public assistance") in a nondiscriminatory and equal manner as long as they satisfy the requirements prescribed by this Act.

The minimum standard of living guaranteed by this Act shall be where a person is able to maintain a wholesome and cultured standard of living.

①Public assistance shall be provided based on a requirement that a person who is living in poverty shall utilize his/her assets, abilities and every other thing available to him/her for maintaining a minimum standard of living.

②Any support given by a person responsible for support prescribed by the Civil Code (Act No. 89 of 1896) and any assistance prescribed by any other Act shall be provided in precedence to public assistance under this Act.

③The provisions of the preceding two paragraphs shall not preclude the provision of necessary public assistance in the case where there are urgent circumstances.

What is provided for in the preceding four Articles are fundamental principles of this Act based on which all interpretations and the operation of this Act shall be made.

①The term "public assistance recipient" as used in this Act means a person who currently receives public assistance.

②The term "person requiring public assistance" is a person who requires public assistance regardless of whether he/she currently receives public assistance.

③The term "public assistance benefit" as used in this Act means the money and/or goods furnished or lent as public assistance.

④The term "performance in money" as used in this Act means to provide public assistance by furnishing or lending money.

⑤The term "performance in kind" as used in this Act means to provide public assistance by furnishing or lending goods, furnishing medical care, providing services or any other means other than by providing performance in money.

The provision of public assistance shall start based on an application filed by a person requiring public assistance, a person responsible for his/her support or any other relative living together; provided, however, that necessary public assistance may be provided without an application therefore when a person requiring public assistance is under urgent circumstances.

①Public assistance shall be provided, based on the level of the demand of a person requiring public assistance, which has been measured according to the standard specified by the Minister of Health, Labour and Welfare, to the extent that makes up the shortfall thereof that cannot be satisfied by the money or goods possessed by said person.

②The standard set forth in the preceding paragraph shall be one that sufficiently satisfies but shall not exceed the demand pertaining to a minimum standard of living, taking into consideration the age, sex, household composition and location of the person requiring public assistance and any other necessary circumstances according to the type of public assistance.

Public assistance shall be provided effectively and appropriately by taking into consideration the differences between the actual needs of individuals or households, such as the age, sex and health conditions of the person requiring assistance.

The need for and extent of public assistance shall be determined on a household basis ; provided, however, that, if this is difficult, such determination may be made on an individual basis.

①The type of public assistance shall be as follows:

②The assistance set forth in the items of the preceding paragraph shall be provided singly or in combination according to the needs of the person requiring public assistance.

Livelihood assistance shall be provided within the scope of the following matters to a person who is unable to maintain a minimum standard of living due to poverty:

Education assistance shall be provided within the scope of the following matters to a person who is unable to maintain a minimum standard of living due to poverty:

Housing assistance shall be provided within the scope of the following matters to a person who is unable to maintain a minimum standard of living due to poverty:

Medical assistance shall be provided within the scope of the following matters to a person who is unable to maintain a minimum standard of living due to poverty:

①Long-term care assistance shall be provided within the scope of the matters listed in items (i) to (iv) and item (ix) to a person requiring long-term care (which means a person requiring long-term care prescribed in Article 7, paragraph (3) of the Long-Term Care Insurance Act [Act No. 123 of 1997]; the same shall apply in paragraph (3)) who is unable to maintain a minimum standard of living due to poverty, shall be provided within the scope of the matters listed in items (v) to (ix) to a person requiring support (which means a person requiring support prescribed in paragraph (4) of the same Article; the same shall apply hereinafter in this paragraph and paragraph (6)) who is unable to maintain a minimum standard of living due to poverty, and shall be provided within the scope of the matters listed in items (viii) and (ix) to a person equivalent to an Insured In-Home Person Requiring Support, etc. (which means an Insured In-Home Person Requiring Support, etc. prescribed in Article 115-45, paragraph (1), item (i) of that Act) who is unable to maintain a minimum standard of living due to poverty (excluding persons requiring support):

②In-home care services prescribed in item (i) of the preceding paragraph means home-visit care services prescribed in Article 8, paragraph (2) of the Long-Term Care Insurance Act, home-visit bathing services prescribed in paragraph (3) of the same Article, home-visit nursing prescribed in paragraph (4) of the same Article, home-visit rehabilitation prescribed in paragraph (5) of the same Article, in-home medical care management counseling prescribed in paragraph (6) of the same Article, day care services prescribed in paragraph (7) of the same Article, day rehabilitation prescribed in paragraph (8) of the same Article, short-stay care services prescribed in paragraph (9) of the same Article, short-stay medical care prescribed in paragraph (10) of the same Article, care services provided in specified facilities prescribed in paragraph (11) of the same Article, lending of welfare equipment prescribed in paragraph (12) of the same Article, Periodic Patrol and On-Demand Home-Visit Long-Term Care and Nursing prescribed in paragraph (15) of the same Article, nighttime home-visit care services prescribed in paragraph (16) of the same Article, Community-Based Outpatient Day Long-Term Care prescribed in paragraph (17) of the same Article, day care services for the elderly with dementia prescribed in paragraph (18) of the same Article, small-scale and multifunctional in-home care services prescribed in paragraph (19) of the same Article, care services provided in group homes for the elderly with dementia prescribed in paragraph (20) of the same Article, care services provided in community-based specified facilities prescribed in paragraph (21) of the same Article, and combined service prescribed in paragraph (23) of the same Article, and any services equivalent thereto.

③An in-home care support plan prescribed in paragraph (1), item (i) means a plan which, for the purpose of allowing a person requiring long-term care who leads his/her life at home to use, etc. appropriately in-home care services and any other health and medical services and welfare services that are necessary for leading a daily life at home (hereinafter referred to as "in-home care services, etc." in this paragraph), specifies such matters as the types and contents of the in-home care services, etc. to be used by said person requiring long-term care.

④Facility care services prescribed in paragraph (1), item (iv) means care services provided at community-based long-term care welfare facilities for the elderly prescribed in Article 8, paragraph (22) of the Long-Term Care Insurance Act, long-term care welfare facility services prescribed in paragraph (27) of the same Article, long-term care health facility services prescribed in paragraph (28) of the same Article and service at an integrated facility for medical and long-term care prescribed in paragraph (29) of the same Article.

⑤Care prevention services prescribed in paragraph (1), item (v) means home-visit bathing services for care prevention prescribed in Article 8-2, paragraph (2) of the Long-Term Care Insurance Act, home-visit nursing for care prevention prescribed in paragraph (3) of the same Article, home-visit rehabilitation for care prevention prescribed in paragraph (4) of the same Article, in-home medical care management counseling for care prevention prescribed in paragraph (5) of the same Article, day rehabilitation for care prevention prescribed in paragraph (6) of the same Article, short-stay care services for care prevention prescribed in paragraph (7) of the same Article, short-stay medical care for care prevention prescribed in paragraph (8) of the same Article, care services for care prevention provided in specified facilities prescribed in paragraph (9) of the same Article, lending of welfare equipment for care prevention prescribed in paragraph (10) of the same Article, day care services for the elderly with dementia for care prevention prescribed in paragraph (13) of the same Article, small-scale and multifunctional in-home care services for care prevention prescribed in paragraph (14) of the same Article, and care services for care prevention provided in group homes for the elderly with dementia prescribed in paragraph (15) of the same Article, and any services equivalent thereto.

⑥A care prevention support plan prescribed in paragraph (1), items (v) and (viii) means a plan which, for the purpose of allowing a person requiring support who leads his/her life at home to use, etc. appropriately care prevention services and any other health and medical services and welfare services that contribute to relieving or preventing from worsening the conditions where, due to physical or mental disabilities, said person requires constant care with regard to all or part of the basic activities of daily life such as bathing, excretion and eating or has trouble leading his/her daily life (hereinafter referred to as "care prevention services, etc." in this paragraph), specifies such matters as the types and contents of the care prevention services, etc. to be used by said person requiring support, and which has been prepared by any person specified by an Order of the Ministry of Health, Labour and Welfare set forth in Article 8-2, paragraph (16) of the Long-Term Care Insurance Act from among the employees of a community general support center prescribed in Article 115-46, paragraph (1) of the Long-Term Care Insurance Act and the workers of an office that provides Designated In-Home Long-Term Care Support prescribed in Article 46, paragraph (1) of that Act.

⑦Care prevention and daily life support prescribed in paragraph (1), item (viii) means support equivalent to support through the category 1 home-visit project prescribed in Article 115-45, paragraph (1), item (i), (a) of the Long-Term Care Insurance Act, the category 1 day service project prescribed in (b) of that item and the category 1 daily life support project prescribed in (c) of that item.

Maternity assistance shall be provided within the scope of the following matters to a person who is unable to maintain a minimum standard of living due to poverty:

Occupational assistance shall be provided within the scope of the following matters to a person who is unable to or is likely to become unable to maintain a minimum standard of living due to poverty; provided, however, that this shall be limited to the case where such provision is likely to be able to increase the income of said person or promote the self-support for said person:

①Funeral assistance shall be provided within the scope of the following matters to a person who is unable to maintain a minimum standard of living due to poverty:

②In any of the following cases, if there is a person who intends to conduct the funeral, funeral assistance set forth in the items of the preceding paragraph may be provided to said person:

①A prefectural governor, a city mayor, or a mayor of a town or village managing an office concerning welfare (hereinafter referred to as a "welfare office") prescribed in the Social Welfare Act (Act No. 45 of 1951) (a city mayor and such mayor of a town or village shall be collectively referred to as a "municipal mayor") shall decide on and implement public assistance, pursuant to the provisions of this Act, for the following persons:

②Even when the place of residence of a person requiring public assistance is clear, if said person is under urgent circumstances, public assistance for said person shall be provided by the prefectural governor or the municipal mayor managing the welfare office having jurisdiction over the current location of said person, notwithstanding the provisions of the preceding paragraph, until the urgent circumstances cease to exist.

③In the case of having a public assistance recipient admitted into a relief facility, a rehabilitation facility or any other appropriate facility, or entrusting such admission to any such facility, or entrusting nursing care to the home of a private individual pursuant to the proviso to Article 30, paragraph (1), the person who should provide public assistance to said person while said admission or entrustment remains valid shall be decided based on the place of residence or the current location of said person prior to said admission or entrustment.

④The person who should provide public assistance pursuant to the provisions of the preceding three paragraphs (hereinafter referred to as the "public assistance administrator") may delegate all or a part of the affairs concerning decisions about and implementation of public assistance, but only to an administrative agency under his/her management.

⑤A public assistance administrator shall not be precluded from entrusting a part of the affairs concerning decisions about and implementation of public assistance to another public assistance administrator pursuant to the provisions of a Cabinet Order.

⑥The mayor of a town or village without a welfare office (hereinafter referred to as the "mayor of a town or village") shall provide the necessary public assistance, as emergency treatment, to a person requiring public assistance within the district of that town or village who is in such a state that he/she cannot be left unattended due to particularly urgent circumstances.

⑦The mayor of a town or village shall carry out the following matters in order to ensure the appropriate execution of public assistance affairs conducted by the public assistance administrator or the head of the welfare office (hereinafter referred to as the "welfare office director"):

A prefectural governor may delegate a part of his/her authority prescribed by this Act to an administrative agency under his/her management.

A social welfare officer prescribed in the Social Welfare Act shall assist in the execution of the affairs of a prefectural governor or a municipal mayor with regard to the enforcement of this Act.

A welfare commissioner prescribed in the Welfare Commissioners Act (Act No. 198 of 1948) shall assist in the execution of the affairs of a municipal mayor, welfare office director or social welfare officer with regard to the enforcement of this Act.

①The Minister of Health, Labour and Welfare shall have an official he/she has designated conduct an audit of the affairs concerning the enforcement of this Act carried out by a prefectural governor or municipal mayor, and a prefectural governor shall have an official he/she has designated conduct an audit of the affairs concerning the enforcement of this Act carried out by a municipal mayor.

②An official designated pursuant to the provisions of the preceding paragraph may make a request for the submission of materials or the provision of a statement of explanation that he/she finds necessary or give an instruction that he/she finds necessary to a prefectural governor or municipal mayor.

③The qualification of an official to be designated pursuant to the provisions of paragraph (1) shall be specified by a Cabinet Order.

①A person applying for the commencement of public assistance must submit to the public assistance administrator, as provided by Order of the Ministry of Health, Labour and Welfare, a written application stating the following matters; provided, however, that this does not apply where there are special circumstances that make it impossible to prepare the written application:

②Documents specified by Order of the Ministry of Health, Labour and Welfare as necessary for deciding the need for and the type, extent and method of public assistance for the person requiring public assistance must be attached to the written application under the preceding paragraph; provided, however, that this does not apply where there are special circumstances that make it impossible to attach the documents.

③A public assistance administrator shall, where an application for the commencement of public assistance has been filed, decide on the need for and the type, extent and method of public assistance, and notify the applicant of the result in writing.

④The document under the preceding paragraph shall state the reason for the decision.

⑤The notice under paragraph (3) shall be given within fourteen days from the date on which an application has been filed; provided, however, that said period may be extended to thirty days in the case where an investigation on the state of the assets and income of persons responsible for support takes time or there is any other special reason.

⑥Where, pursuant to the proviso to the preceding paragraph, a public assistance administrator has not given the notice under paragraph (3) within the period prescribed in the main clause of the preceding paragraph, the public assistance administrator must clearly indicate the reason in the document under paragraph (3).

⑦When an applicant does not receive the notice under paragraph (3) within thirty days from the filing of an application for public assistance, he/she may deem that the public assistance administrator has dismissed the application.

⑧Where it is found that a known person responsible for support has not performed the obligation of support under the provisions of the Civil Code, a public assistance administrator that intends to make a decision on the commencement of public assistance must, as provided by Order of the Ministry of Health, Labour and Welfare, notify that person responsible for support in advance, in writing, of the matters specified by Order of the Ministry of Health, Labour and Welfare; provided, however, that this does not apply in a case specified by Order of the Ministry of Health, Labour and Welfare as one in which it is not appropriate to give the notice in advance.

⑨The provisions of paragraphs (1) to (7) shall apply mutatis mutandis to an application for a change to public assistance by a person prescribed in Article 7.

⑩An application for the commencement of or a change to public assistance may also be filed through the mayor of a town or village. In the case where the mayor of a town or village has received an application, he/she shall send said application to the public assistance administrator together with a document stating the presence or absence of any person responsible for support of the person requiring public assistance, the state of assets and income, and any other matters that would serve as a reference when making a decision concerning public assistance, within five days.

①A public assistance administrator shall, when a person requiring public assistance is under urgent circumstances, decide promptly on the type, extent and method of public assistance and commence public assistance ex officio.

②A public assistance administrator shall constantly investigate the status of the standard of living of a public assistance recipient, and when he/she finds a need for a change to the public assistance, he/she shall decide promptly on said change ex officio and notify the public assistance recipient of the result in writing. The provisions of paragraph (4) of the preceding Article shall apply mutatis mutandis to this case.

③The mayor of a town or village shall, when a person requiring public assistance is in such a state that he/she cannot be left unattended due to particularly urgent circumstances, provide promptly the public assistance prescribed in Article 19, paragraph (6) ex officio.

A public assistance administrator shall, when a public assistance recipient no longer needs public assistance, decide promptly on the suspension or abolition of the public assistance, and notify the public assistance recipient of the result in writing. The same shall apply in the case of suspending or abolishing public assistance pursuant to the provisions of Article 28, paragraph (5) or Article 62, paragraph (3).

①A public assistance administrator may give a public assistance recipient any guidance or instruction that is necessary for maintaining or improving the recipient's standard of living or for achieving the purpose of public assistance.

②The guidance or instruction under the preceding paragraph shall respect the freedom of the public assistance recipient and be limited to the minimum extent necessary.

③The provisions of paragraph (1) shall not be interpreted as those that may force a public assistance recipient to receive guidance or instruction against his/her will.

In addition to the employment support programme for public assistance recipients prescribed in Article 55-7, paragraph (1), the health management support programme for public assistance recipients prescribed in Article 55-8, paragraph (1), the career path support programme for children prescribed in Article 55-10, paragraph (1), item (i), the employment preparation support programme for public assistance recipients prescribed in item (ii) of the same paragraph, the household finance improvement support programme for public assistance recipients prescribed in item (iii) of the same paragraph and the community living support programme for public assistance recipients prescribed in item (iv) of the same paragraph, a public assistance administrator may, when requested by a person requiring public assistance, respond to consultation from the person requiring public assistance and give necessary advice in order to promote self-support for the person requiring public assistance.

①A public assistance administrator may organize a meeting (hereinafter referred to as the "coordination meeting" in this Article) composed of relevant bodies that carry out work relating to support for public assistance recipients in the community, such as welfare, employment, education and housing, persons entrusted pursuant to Article 55-7, paragraph (2) (including where applied mutatis mutandis pursuant to Article 55-8, paragraph (3) and Article 55-10, paragraph (2)), organizations related to that support, persons engaged in duties related to that support, and other persons whom the public assistance administrator has found to be related to support for public assistance recipients (hereinafter referred to as "relevant bodies, etc." in this Article).

②The coordination meeting is to exchange information necessary for promoting self-support for public assistance recipients and to examine the support structure necessary for public assistance recipients to lead daily life and social life in the community.

③When the coordination meeting finds it necessary in order to exchange and examine the information prescribed in the preceding paragraph, it may request relevant bodies, etc. to provide materials or information concerning public assistance recipients, to state their opinions, and to give other necessary cooperation.

④When requested pursuant to the provisions of the preceding paragraph, relevant bodies, etc. are to make efforts to cooperate with the request.

⑤When a support conference prescribed in Article 9, paragraph (1) of the Act on Self-Reliance Support for Persons in Need (Act No. 105 of 2013) or a support conference prescribed in Article 106-6, paragraph (1) of the Social Welfare Act has been organized in the prefecture, city, or town or village establishing a welfare office in which the coordination meeting is organized, the coordination meeting is to make efforts to coordinate with those conferences for the smooth implementation of support for public assistance recipients.

⑥A person engaged or formerly engaged in the affairs of the coordination meeting must not, without a justifiable reason, divulge any secret learned in relation to the affairs of the coordination meeting.

⑦In addition to what is provided for in the preceding paragraphs, matters necessary for the organization and operation of the coordination meeting are to be specified by the coordination meeting.

①When a public assistance administrator finds it necessary for deciding on or implementing public assistance or for the enforcement of the provisions of Article 77 or Article 78 (excluding paragraph (3) of Article 78; the same applies in the following paragraph and paragraph (1) of the following Article), it may, in order to investigate the state of the assets and income, health conditions or any other matters of a person requiring public assistance, in accordance with the provisions of an Order of the Ministry of Health, Labour and Welfare, request a report from said person requiring public assistance, or have a relevant official enter the place of residence of said person requiring public assistance and investigate these matters, or order said person requiring public assistance to have a medical examination from a doctor or a dentist designated by the public assistance administrator.

②When a public assistance administrator finds it necessary for deciding on or implementing public assistance or for the enforcement of the provisions of Article 77 or Article 78, it may, in order to investigate the contents of the written application for commencement of or change to public assistance and the documents attached thereto, in accordance with the provisions of an Order of the Ministry of Health, Labour and Welfare, request a report from a person responsible for the support of the person requiring public assistance or any other relative living together, or from a person who was, at the time of the application for commencement of or change to public assistance, the person requiring public assistance or one of those persons.

③A relevant official who conducts on-site investigations pursuant to the provisions of paragraph (1) shall carry his/her identification and present it when requested to do so by a person concerned, pursuant to the provisions of an Order of the Ministry of Health, Labour and Welfare.

④The authority for on-site inspections under the provisions of paragraph (1) shall not be interpreted as that granted for criminal investigation.

⑤A public assistance administrator may, when a person requiring public assistance has failed to make a report, has made a false report, has refused, obstructed or avoided an on-site investigation, or has failed to follow an order to have a medical examination from a doctor or dentist, under the provisions of paragraph (1), dismiss an application for the commencement of or a change to the public assistance or may change, suspend or abolish the public assistance.

①When a public assistance administrator or a welfare office director finds it necessary for deciding on or implementing public assistance or for the enforcement of the provisions of Article 77 or Article 78, it may, with regard to the matters specified in each of the following items for the person listed in that item, request a government agency, the Japan Pension Service or the mutual aid associations, etc. prescribed in Article 3, paragraph (2) of the National Pension Act (Act No. 141 of 1959) (referred to as "mutual aid associations, etc." in the following paragraph) to allow inspection of necessary documents or to provide materials, or request a report from a bank, a trust company, the employer of a person listed in each of the following items, or any other person concerned.

②The head of a government agency listed in the left hand column of Appended Table 1, the Japan Pension Service or the mutual aid associations, etc. are to, when requested pursuant to the provisions of the preceding paragraph by a public assistance administrator or a welfare office director with regard to the information listed in the right hand column of that table respectively, promptly allow inspection of documents in which that information is written or recorded, or provide materials.

The provisions of Chapter 3 (excluding Articles 12 and 14) of the Administrative Procedure Act (Act No. 88 of 1993) shall not apply to any disposition under the provisions of this Chapter.

①Livelihood assistance shall be provided at the home of a public assistance recipient; provided, however, that, when this method cannot be used, when it is difficult to achieve the purpose of public assistance by this method, or when the public assistance recipient has so desired, public assistance may be provided by having the public assistance recipient admitted into a relief facility, a rehabilitation facility, a residential facility for daily living support (meaning a facility used for the project prescribed in Article 2, paragraph (3), item (viii) of the Social Welfare Act or any other facility that a prefectural governor has found to satisfy the requirements specified by Order of the Ministry of Health, Labour and Welfare as necessary for the provision of support in daily life to public assistance recipients; the same applies in Article 62, paragraph (1) and Article 70, item (i), (c)) or any other appropriate facility, or entrusting such admission into any such facility, or entrusting nursing care to the home of a private individual.

②The provisions of the proviso to the preceding paragraph shall not be interpreted as those that are able to force admission into a facility or provision of nursing care against the will of a public assistance recipient.

③A public assistance administrator may, in the case where a person who has parental authority or is a guardian for a public assistance recipient fails to exercise his/her rights appropriately, take one of the measures under the proviso to paragraph (1) by obtaining the permission of a family court, even if said person objects to it.

①Livelihood assistance shall be provided by way of performance in money; provided, however, that when this method cannot be used, when it is not appropriate to use this method, or when it is necessary in order to achieve the purpose of public assistance, livelihood assistance may be provided by way of performance in kind.

②The public assistance benefit for livelihood assistance shall be provided in advance to the extent of one month's worth; provided, however, that when it is difficult to use this method, the public assistance benefit may be provided in advance in excess of one month's worth.

③The public assistance benefit in the case of providing livelihood assistance at home shall be calculated on a household basis and shall be delivered to the householder or a person equivalent thereto; provided, however, that if it is difficult to use this method, the public assistance benefit may be delivered to the public assistance recipient on an individual basis.

④In the case of providing livelihood assistance to a public assistance recipient who receives facility care services (meaning the facility care services prescribed in Article 15-2, paragraph (4); the same applies hereinafter) at a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care (meaning a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care prescribed in Article 8, paragraph (22) of the Long-Term Care Insurance Act; the same applies hereinafter), a Facility Covered by Public Aid Providing Long-Term Care to the Elderly (meaning a Facility Covered by Public Aid Providing Long-Term Care to the Elderly prescribed in paragraph (27) of that Article; the same applies hereinafter), a long-term care health facility (meaning a long-term care health facility prescribed in paragraph (28) of that Article; the same applies hereinafter) or an integrated facility for medical and long-term care (meaning an integrated facility for medical and long-term care prescribed in paragraph (29) of that Article; the same applies hereinafter) that has been designated pursuant to the provisions of Article 54-2, paragraph (1) (including one that is deemed to have received the designation under paragraph (1) of that Article pursuant to the provisions of the main clause of paragraph (2) of that Article), if it is not appropriate to deliver the public assistance benefit to a person prescribed in the preceding paragraph or if it is necessary for achieving the purpose of public assistance, the public assistance benefit may be delivered to the head of said Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care or Facility Covered by Public Aid Providing Long-Term Care to the Elderly, or to the manager of said long-term care health facility or integrated facility for medical and long-term care, notwithstanding the provisions of the preceding paragraph.

⑤The public assistance benefit in the case of providing livelihood assistance pursuant to the provisions of the proviso to paragraph (1) of the preceding Article shall be delivered to the public assistance recipient, the head of the facility, or the person to whom nursing care has been entrusted.

①Education assistance shall be provided by way of performance in money; provided, however, that when this method cannot be used, when it is not appropriate to use this method, or when it is necessary in order to achieve the purpose of public assistance, education assistance may be provided by way of performance in kind.

②The public assistance benefit for education assistance shall be delivered to the public assistance recipient, a person who has parental authority over the public assistance recipient or is a guardian of a public assistance recipient who is a minor, or the head of the school which the public assistance recipient attends.

①Housing assistance shall be provided by way of performance in money; provided, however, that when this method cannot be used, when it is not appropriate to use this method, or when it is necessary in order to achieve the purpose of public assistance, housing assistance may be provided by way of performance in kind.

②Out of the housing assistance, residence as performance in kind shall be provided by having the public assistance recipient use a facility providing accommodation or by entrusting such actions to a facility providing accommodation.

③The provisions of Article 30, paragraph (2) shall apply mutatis mutandis to the case under the preceding paragraph.

④The public assistance benefit for housing assistance shall be delivered to the householder or a person equivalent thereto.

①Medical assistance shall be provided by way of performance in kind; provided, however, that when this method cannot be used, when it is not appropriate to use this method, or when it is necessary in order to achieve the purpose of public assistance, medical assistance may be provided by way of performance in money.

②Out of the performance in kind prescribed in the preceding paragraph, medical care shall be furnished by having the public assistance recipient use a medical facility for persons requiring public assistance or by entrusting such actions to a medical facility for persons requiring public assistance or a medical institution that has been designated pursuant to the provisions of Article 49 (hereinafter referred to as a "designated medical care provider").

③Of the furnishing of medical care prescribed in the preceding paragraph, for that which a doctor or dentist in charge of medical care has found, based on medical knowledge, can be provided with a generic drug (meaning, among pharmaceuticals that have received authorization for manufacturing and marketing under Article 14 or Article 19-2 of the Act on Securing Quality, Efficacy and Safety of Products Including Pharmaceuticals and Medical Devices (Act No. 145 of 1960), those found to be identical in active ingredient, quantity, directions for use, dosage, indications and effects to the pharmaceuticals listed in the items of Article 14-4, paragraph (1) of that Act and specified by Order of the Ministry of Health, Labour and Welfare; the same applies hereafter in this paragraph), the furnishing is, in principle, to be made with generic drugs.

④Of the furnishing of medical care prescribed in paragraph (2), the extent of the treatment that may be provided by an amma-massage practitioner, acupuncturist, moxa-cauterist or judo therapist (hereinafter referred to as a "practitioner") pursuant to the provisions of the Act on Amma-Massage Practitioners, Acupuncturists, and Moxa-cauterists, etc. (Act No. 217 of 1947) or the Judo Therapists Act (Act No. 19 of 1970) shall not be precluded from being furnished by way of entrusting said treatment to a practitioner who has been designated pursuant to the provisions of Article 55, paragraph (1).

⑤When a public assistance recipient receives, out of the furnishing of medical care prescribed in paragraph (2), that which is provided by entrusting it to a designated medical care provider, the public assistance recipient is to, in accordance with the provisions of an Order of the Ministry of Health, Labour and Welfare, receive confirmation from that designated medical care provider, by electronic eligibility confirmation or any other method specified by Order of the Ministry of Health, Labour and Welfare, that the person is a public assistance recipient receiving medical assistance.

⑥"Electronic eligibility confirmation" in the preceding paragraph means, for a public assistance recipient, to make an inquiry to a public assistance administrator about information concerning the public assistance recipient's eligibility to receive medical assistance (including information necessary for claiming the costs of the furnishing of medical care), by a method of transmitting an electronic certificate for user certification (meaning the electronic certificate for user certification prescribed in Article 22, paragraph (1) of the Act on Certification Business of the Japan Agency for Local Authority Information Systems in Relation to Electronic Signatures, etc. (Act No. 153 of 2002)) recorded on an Individual Number Card (meaning the Individual Number Card prescribed in Article 2, paragraph (7) of the Act on the Use of Numbers to Identify a Specific Individual in Administrative Procedures (Act No. 27 of 2013)) or by any other method specified by Order of the Ministry of Health, Labour and Welfare, to receive a response from the public assistance administrator by a method using an electronic data processing system or any other method using information and communications technology and provide that information to the medical care provider that is to furnish the medical care, and to receive confirmation from that medical care provider that the person is a public assistance recipient receiving medical assistance.

⑦In the case where there are urgent circumstances or other unavoidable circumstances, a public assistance recipient may be furnished with medical care by a medical institution that has not been designated or be furnished with treatment by a practitioner who has not been designated, notwithstanding the provisions of paragraphs (2) and (4).

⑧The public assistance benefit for medical assistance shall be delivered to the public assistance recipient.

①Long-term care assistance shall be provided by way of performance in kind; provided, however, that when this method cannot be used, when it is not appropriate to use this method, or when it is necessary in order to achieve the purpose of public assistance, long-term care assistance may be provided by way of performance in money.

②Out of the performance in kind prescribed in the preceding paragraph, in-home care services (meaning the in-home care services prescribed in Article 15-2, paragraph (2); the same applies hereinafter), the furnishing of welfare equipment, facility care services, care prevention services (meaning the care prevention services prescribed in paragraph (5) of that Article; the same applies hereinafter), the furnishing of welfare equipment for care prevention, and care prevention and daily life support (meaning the care prevention and daily life support prescribed in paragraph (7) of that Article; the same applies in Article 54-2, paragraph (1)) shall be provided by way of entrusting such assistance to a long-term care provider (which means a person who provides in-home care services as his/her business, a person who prepares in-home care support plans (meaning the in-home care support plans prescribed in Article 15-2, paragraph (3); the same applies in Article 54-2, paragraph (1) and Appended Table 2) as his/her business, a person who sells specified welfare equipment prescribed in Article 8, paragraph (13) of the Long-Term Care Insurance Act as his/her business (referred to as a "specified welfare equipment dealer" in Article 54-2, paragraph (1) and Appended Table 2), a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care, a Facility Covered by Public Aid Providing Long-Term Care to the Elderly, a long-term care health facility and an integrated facility for medical and long-term care, a person who provides care prevention services as his/her business, a person who prepares care prevention support plans (meaning the care prevention support plans prescribed in Article 15-2, paragraph (6); the same applies in Article 54-2, paragraph (1) and Appended Table 2) as his/her business, a person who sells specified welfare equipment for care prevention prescribed in Article 8-2, paragraph (11) of that Act as his/her business (referred to as a "specified care prevention welfare equipment dealer" in Article 54-2, paragraph (1) and Appended Table 2), and a care prevention and daily life support provider (meaning a person who conducts, as his/her business, a category 1 project prescribed in Article 115-45, paragraph (1), item (i) of that Act; the same applies hereinafter); the same applies hereinafter) who has been designated pursuant to the provisions of Article 54-2, paragraph (1) (including one that is deemed to have received the designation under paragraph (1) of that Article pursuant to the provisions of the main clause of paragraph (2) of that Article).

③The provisions of paragraphs (7) and (8) of the preceding Article apply mutatis mutandis to long-term care assistance.

①Maternity assistance shall be provided by way of performance in money; provided, however, that when this method cannot be used, when it is not appropriate to use this method, or when it is necessary in order to achieve the purpose of public assistance, maternity assistance may be provided by way of performance in kind.

②Out of the performance in kind prescribed in the proviso to the preceding paragraph, the furnishing of midwifery shall be provided by way of entrusting such midwifery to a midwife who has been designated pursuant to the provisions of Article 55, paragraph (1).

③The provisions of paragraphs (7) and (8) of Article 34 shall apply mutatis mutandis to maternity assistance.

①Occupational assistance shall be provided by way of performance in money; provided, however, that when this method cannot be used, when it is not appropriate to use this method, or when it is necessary in order to achieve the purpose of public assistance, occupational assistance may be provided by way of performance in kind.

②Out of performance in kind prescribed in the proviso to the preceding paragraph, use of a facility necessary for the employment and provision of the skills necessary for occupational assistance shall be provided by having the person requiring public assistance use a vocational facility or any other facility aimed at training, or by entrusting such assistance to such a facility.

③The public assistance benefit for occupational assistance shall be delivered to the public assistance recipient; provided however, that the public assistance benefit necessary for the use of a facility or the provision of skills may be delivered to the head of a vocational facility.

①Funeral assistance shall be provided by way of performance in money; provided, however, that when this method cannot be used, when it is not appropriate to use this method, or when it is necessary in order to achieve the purpose of public assistance, funeral assistance may be provided by way of performance in kind.

②The public assistance benefit for funeral assistance shall be delivered to the person conducting the funeral.

Out of the public assistance benefit delivered to the householder or a person equivalent thereto pursuant to the provisions of the main clause of Article 31, paragraph (3) or Article 33, paragraph (4), the public assistance benefit delivered to the public assistance recipient pursuant to the provisions of the proviso to Article 31, paragraph (3), Article 31, paragraph (5), Article 34, paragraph (8) (including the cases where it is applied mutatis mutandis pursuant to Article 34-2, paragraph (3) or Article 35, paragraph (3)) or Article 36, paragraph (3), the public assistance benefit delivered to the public assistance recipient, a person who has parental authority over the public assistance recipient, or a guardian of a public assistance recipient who is a minor, pursuant to the provisions of Article 32, paragraph (2) (hereinafter referred to in this Article as "public assistance benefit for educational assistance"), or the public assistance benefit delivered to the person conducting the funeral pursuant to the provisions of paragraph (2) of the preceding Article, a public assistance administrator may, when it is necessary for achieving the purpose of public assistance, pay the money equivalent to the amount of the premium for long-term care insurance (which means the premium prescribed in Article 129, paragraph (1) of the Long-Term Care Insurance Act) and any other expenses to be paid by the public assistance recipient (including, in the case of public assistance benefit for educational assistance, a person who has parental authority over the public assistance recipient or a guardian of a public assistance recipient who is a minor; the same applies hereinafter in this Article) that is specified by a Cabinet Order to a person specified by a Cabinet Order in lieu of the public assistance recipient. In this case, when said payment has been made, it shall be deemed that the public assistance benefit has been delivered to the person to whom delivery should be made pursuant to these provisions.

①The types of public assistance facilities shall be as follows:

②A relief facility shall be a facility aimed at providing livelihood assistance by admitting persons requiring public assistance who have difficulty leading their daily lives due to serious physical or mental disabilities.

③A rehabilitation facility shall be a facility aimed at providing livelihood assistance by admitting persons requiring public assistance who need nursing care and livelihood guidance due to physical or mental reasons.

④A medical facility for persons requiring public assistance shall be a facility aimed at furnishing medical care to persons requiring public assistance who need medical care.

⑤A vocational facility shall be a facility aimed at promoting the self-support for persons requiring public assistance whose ability to work is limited due to physical or mental reasons or due to household circumstances, by providing them with the necessary opportunities and assistance for employment or the acquisition of skills.

⑥A facility providing accommodation shall be a facility aimed at providing housing assistance to the households of persons requiring public assistance who have no home.

①A prefecture must establish standards for the equipment and operation of public assistance facilities by Prefectural Ordinance.

②In establishing the Prefectural Ordinance under the preceding paragraph, a prefecture is to establish the matters listed in items (i) to (iii) in accordance with the standards specified by Order of the Ministry of Health, Labour and Welfare, establish the matters listed in item (iv) with the standards specified by Order of the Ministry of Health, Labour and Welfare as the standard, and take into consideration the standards specified by Order of the Ministry of Health, Labour and Welfare for other matters.

③The founder of a public assistance facility must comply with the standards under paragraph (1).

①A prefecture may establish public assistance facilities.

②When a municipality or a local incorporated administrative agency (which means a local incorporated administrative agency prescribed in Article 2, paragraph (1) of the Local Incorporated Administrative Agency Act [Act No. 118 of 2003]; the same shall apply hereinafter) intends to establish a public assistance facility, it shall notify the prefectural governor of the matters specified by an Ordinance of the Ministry of Health, Labour and Welfare in advance.

③A prefecture, municipality or local incorporated administrative agency that has established a public assistance facility may abolish said public assistance facility or downsize or suspend the operations of said public assistance facility as long as it does not impede the public assistance for the currently admitted public assistance recipients.

④The establishment and abolition of a public assistance facility by a prefecture or municipality shall be prescribed by an ordinance.

①A public assistance facility may only be established by a social welfare juridical person or the Japanese Red Cross Society, apart from a prefecture, municipality and local incorporated administrative agency.

②When a social welfare juridical person or the Japanese Red Cross Society intends to establish a public assistance facility, it shall submit a written application stating the following matters to the prefectural governor and obtain his/her approval in advance:

③In the case where an application for approval under the preceding paragraph has been filed, the prefectural governor shall grant approval if the facility complies with the following standards in addition to the standards prescribed in Article 39, paragraph (1):

④When granting the approval under paragraph (1), the prefectural governor may limit the duration of said public assistance facility or attach conditions that are found to be necessary for achieving the purpose of public assistance.

⑤When a social welfare juridical person or the Japanese Red Cross Society that has obtained the approval under paragraph (2) intends to change any of the matters listed in item (i) or items (iii) to (viii) of the same paragraph, it shall obtain the approval of the prefectural governor in advance. In the case where an application for said approval has been filed, the provisions of paragraph (3) shall apply mutatis mutandis.

When a social welfare juridical person or the Japanese Red Cross Society intends to suspend the operations of or abolish a public assistance facility, it shall obtain the approval of the prefectural governor in advance with regard to the time of the suspension or abolition, by clarifying the reasons therefor, the measures to be taken for the currently admitted public assistance recipients, and the method of disposing of property, and refunding the remainder of grants or subsidies that have been delivered pursuant to the provisions of Article 70, Article 72 or Article 74, if any.

①A prefectural governor shall give the necessary guidance with regard to the administration of public assistance facilities.

②A municipal mayor shall assist in the guidance under the preceding paragraph given to a public assistance facility established by a social welfare juridical person or the Japanese Red Cross Society.

①A prefectural governor may order the manager of a public assistance facility to report on the state of its operations or accounting or any other matters that are found to be necessary, or have a relevant official enter the facility, have him/her request the manager to allow the inspection of and provide a statement of explanation with regard to the equipment as well as accounting documents, medical records and any other books and documents (including electromagnetic records [which mean records prepared in an electronic form, magnetic form or any other form that cannot be recognized by human senses, and which are provided for use in information processing by computers] in the case where electromagnetic records have been prepared or preserved in lieu of the preparation or preservation of such books and documents; the same shall apply hereinafter), or have him/her carry out an inspection thereof.

②The provisions of Article 28, paragraphs (3) and (4) shall apply mutatis mutandis to an on-site inspection under the provisions of the preceding paragraph.

①When any of the following grounds exist, the Minister of Health, Labour and Welfare may order a prefectural governor, and a prefectural governor may order a municipality or a local incorporated administrative agency to improve the equipment or administration of a public assistance facility or to abolish a public assistance facility:

②When any of the following grounds exist, a prefectural governor may order a social welfare juridical person or the Japanese Red Cross Society to improve the equipment or administration of the public assistance facility or rescind the approval under Article 41, paragraph (2):

③Notice under Article 15, paragraph (1) or Article 30 of the Administrative Procedure Act pertaining to a disposition under the provisions of the preceding paragraph shall be given by fourteen days prior to the date of the hearing or the deadline of the submission of a written statement of explanation (in the case of granting an opportunity for explanation by oral presentation, the date and time of the presentation).

④When a prefectural governor has given notice under Article 15, paragraph (1) of the Administrative Procedure Act pertaining to rescission of the approval under the provisions of paragraph (2), he/she shall publicly notify the date and place of the hearing.

⑤Proceedings on the date of the hearing pertaining to rescission of the approval under the provisions of paragraph (2) shall be conducted openly.

①The founder of a public assistance facility shall stipulate management rules clearly indicating the following matters, prior to the commencement of the operations:

②When a person other than a prefecture has stipulated the management rules under the preceding paragraph, he/she shall promptly notify them to the prefectural governor. The same shall apply when such person intends to change the management rules that have been notified.

③When a prefectural governor finds that the contents of the management rules that have been notified pursuant to the provisions of the preceding paragraph are not appropriate for achieving the purpose of public assistance for persons using said facility, he/she may order changes to said management rules.

①When a public assistance facility has received an entrustment for the purpose of public assistance from a public assistance administrator, it may not refuse the entrustment without justifiable grounds.

②A public assistance facility may not give discriminatory or preferential treatment depending on race, beliefs, social status or family status when admitting or treating a person requiring public assistance.

③A public assistance facility shall not force a person using the facility to participate in a religious act, celebration, ceremony or event.

④A public assistance facility shall not refuse an on-site inspection carried out by a relevant official pursuant to the provisions of Article 44.

①The head of a public assistance facility shall constantly endeavor to achieve an improvement in the standards of living and rehabilitation of persons using the facility.

②The head of a public assistance facility may provide necessary guidance to persons using the facility in accordance with the management rules.

③A prefectural governor may restrain or prohibit the guidance under the preceding paragraph if he/she finds it necessary.

④When the head of a public assistance facility finds that there are grounds requiring a change to or suspension or discontinuance of public assistance with regard to a public assistance recipient using the facility, he/she shall promptly notify this to the public assistance administrator.

The Minister of Health, Labour and Welfare shall designate the providers in charge of the medical care for medical assistance under this Act with regard to hospitals or clinics, or pharmacies, established by the State, and a prefectural governor shall designate such providers with regard to any other hospitals or clinics (including institutions that are specified by a Cabinet Order as being equivalent to such hospitals or clinics), or pharmacies.

①The designation under the preceding Article by the Minister of Health, Labour and Welfare is to be made upon application by the establisher of a hospital or clinic, or of a pharmacy, as provided by Order of the Ministry of Health, Labour and Welfare.

②In the case where an application under the preceding paragraph has been filed, the Minister of Health, Labour and Welfare must not make the designation under the preceding Article if any of the following items applies:

③In the case where an application under paragraph (1) has been filed, the Minister of Health, Labour and Welfare may refrain from making the designation under the preceding Article if the hospital or clinic, or pharmacy, pertaining to the application falls under any of the following items:

④The provisions of the preceding three paragraphs apply mutatis mutandis to the designation under the preceding Article by a prefectural governor. In this case, the term "clinic" in paragraph (1) is deemed to be replaced with "clinic (including those specified by the Cabinet Order referred to in the preceding Article; the same applies in the following paragraph and paragraph (3))", and the term "or a pharmacy providing services covered by health insurance" in paragraph (2), item (i) is deemed to be replaced with "or a pharmacy providing services covered by health insurance, or an office or facility specified by Order of the Ministry of Health, Labour and Welfare".

①The designation under Article 49 loses its effect upon the lapse of the period unless it is renewed every six years.

②In the case where an application for renewal under the preceding paragraph has been filed, if the disposition on the application has not been made by the day of expiry of the period under that paragraph (hereinafter referred to in this Article as the "validity period of designation"), the previous designation remains in force even after the expiry of the validity period of designation until the disposition is made.

③In a case as set forth in the preceding paragraph, when the designation is renewed, the validity period of designation is to be from the date following the date of expiry of the prior validity period of designation.

④The provisions of the preceding Article and Article 68, paragraph (2) of the Health Insurance Act apply mutatis mutandis to the renewal of the designation under paragraph (1). In this case, necessary technical replacement of terms is to be specified by Cabinet Order.

①A designated medical care provider shall provide medical care to public assistance recipients considerately and meticulously, in accordance with the rules provided by the Minister of Health, Labour and Welfare.

②A designated medical care provider shall follow any guidance provided by the Minister of Health, Labour and Welfare or a prefectural governor with regard to medical care for public assistance recipients.

A designated medical care provider shall, when there has been a change to the name of said designated medical care provider or any other matters specified by an Ordinance of the Ministry of Health, Labour and Welfare, or when having discontinued, suspended or resumed the operations of said designated medical care provider, notify the Minister of Health, Labour and Welfare or prefectural governor who has made the designation under Article 49 to that effect within ten days, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour and Welfare.

①A designated medical care provider may decline the designation by giving advance notice of thirty days or more.

②When a designated medical care provider falls under any of the following items, the Minister of Health, Labour and Welfare, in the case of a medical care provider designated by the Minister of Health, Labour and Welfare, and a prefectural governor, in the case of a medical care provider designated by a prefectural governor, may rescind the designation or suspend the whole or part of the effect of the designation for a specified period:

①The medical treatment policy and the medical treatment fees of a designated medical care provider shall be in accordance with the medical treatment policy and the medical treatment fees of the National Health Insurance.

②In the case where the medical treatment policy and the medical treatment fees prescribed in the preceding paragraph cannot be adopted or are considered inappropriate, the medical treatment policy and the medical treatment fees shall be in accordance with the rules provided by the Minister of Health, Labour and Welfare.

①A prefectural governor may examine the contents of medical treatment provided by and the claims for medical treatment fees made by a designated medical care provider as needed and decide the amount of the medical treatment fees that the designated medical care provider may claim pursuant to the provisions of the preceding Article.

②A designated medical care provider shall follow the decision under the preceding paragraph made by a prefectural governor.

③When a prefectural governor decides on the amount of medical treatment fees that a designated medical care provider may claim pursuant to the provisions of paragraph (1), he/she shall hear the opinion of an examination committee prescribed in the Act on the Medical Information Infrastructure and Medical Fee Examination and Payment Organization (Act No. 129 of 1948) or an examination organ related to medical care that has been specified by Cabinet Order.

④A prefecture, city, or a town or village with a welfare office may entrust affairs concerning the payment of medical treatment fees to designated medical care providers to the Medical Information Infrastructure and Medical Fee Examination and Payment Organization or a person specified by an Order of the Ministry of Health, Labour and Welfare.

⑤No request for review may be made with regard to a decision on the amount of the medical treatment fees under the provisions of paragraph (1).

①A prefectural governor (the Minister of Health, Labour and Welfare or a prefectural governor, in the case of a designated medical care provider designated by the Minister of Health, Labour and Welfare) may, when finding it necessary with regard to medical assistance, order a designated medical care provider, or a person who was the establisher, administrator, doctor, pharmacist or other worker of a designated medical care provider (hereinafter in this paragraph referred to as a "former establisher, etc."), to report on matters found necessary or to submit or present clinical records, books and documents or other articles, request the establisher, administrator, doctor, pharmacist or other worker of a designated medical care provider (including a former establisher, etc.) to appear, or have a relevant official question persons concerned, or inspect on-site at the designated medical care provider its equipment or clinical records, books and documents or other articles.

②The provisions of Article 28, paragraphs (3) and (4) shall apply mutatis mutandis to an inspection under the provisions of the preceding paragraph.

①The Minister of Health, Labour and Welfare shall designate providers in charge of in-home care services, preparation of in-home care support plans, furnishing of welfare equipment, facility care services, care prevention services, preparation of care prevention support plans, furnishing of welfare equipment for care prevention, or furnishing of care prevention and daily life support for long-term care assistance under this Act with regard to Community-Based Facilities for the Elderly Covered by Public Aid Requiring Long-Term Care, Facilities Covered by Public Aid Providing Long-Term Care to the Elderly, long-term care health facilities or integrated facilities for medical and long-term care established by the State, and a prefectural governor shall designate such providers with regard to any other Community-Based Facilities for the Elderly Covered by Public Aid Requiring Long-Term Care, Facilities Covered by Public Aid Providing Long-Term Care to the Elderly, long-term care health facilities or integrated facilities for medical and long-term care, persons who provide in-home care services as their business or persons who prepare in-home care support plans as their business, specified welfare equipment dealers, persons who provide care prevention services as their business or persons who prepare care prevention support plans as their business, specified care prevention welfare equipment dealers or care prevention and daily life support providers.

②When, for a long-term care provider, the designation or permission listed in the second column of Appended Table 2 has been given in accordance with the type of long-term care provider listed in the first column of that table, that long-term care provider is deemed to have received the designation under the preceding paragraph at the time of that designation or permission; provided, however, that this does not apply where that long-term care provider (excluding a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care and a Facility Covered by Public Aid Providing Long-Term Care to the Elderly) has, in advance and in accordance with the provisions of an Order of the Ministry of Health, Labour and Welfare, made a separate notification.

③In the case of a long-term care provider designated pursuant to the provisions of paragraph (1) that has received the designation or permission listed in the second column of Appended Table 2 (including one deemed to have received the designation under paragraph (1) pursuant to the provisions of the main clause of the preceding paragraph; hereinafter referred to as a "designated long-term care provider under Appended Table 2" in this paragraph, the following paragraph and paragraph (7)), the designation under paragraph (1) ceases to be effective when that designated long-term care provider under Appended Table 2 falls under a case listed in the third column of that table.

④The designation under paragraph (1) pertaining to a designated long-term care provider under Appended Table 2 is suspended in effect (limited to the part for which the effect of the designation or permission under the provision of the Long-Term Care Insurance Act listed in the same column has been suspended, in each case) for the period in which that designated long-term care provider under Appended Table 2 falls under a case listed in the fourth column of Appended Table 2.

⑤The provisions of Article 49-2 (excluding paragraph (2), item (i)) apply mutatis mutandis to the designation under paragraph (1) (excluding that pertaining to a care prevention and daily life support provider), and the provisions of Article 50 to the preceding Article apply mutatis mutandis to a long-term care provider designated pursuant to the provisions of paragraph (1) (including one deemed to have received the designation under paragraph (1) pursuant to the provisions of the main clause of paragraph (2), and excluding a care prevention and daily life support provider that received the designation under paragraph (1) (including one deemed to have received the designation under paragraph (1) pursuant to the provisions of the main clause of paragraph (2))). In this case, the term "designated medical care provider" in Article 50, paragraph (1) is deemed to be replaced with "a long-term care provider designated pursuant to the provisions of Article 54-2, paragraph (1) (including one deemed to have received the designation under paragraph (1) of that Article pursuant to the provisions of the main clause of paragraph (2) of that Article, and excluding a care prevention and daily life support provider that received the designation under paragraph (1) of that Article (including one deemed to have received the designation under paragraph (1) of that Article pursuant to the provisions of the main clause of paragraph (2) of that Article); hereinafter referred to as a "designated long-term care provider" in this Chapter)", the term "designated medical care provider" in paragraph (2) of that Article and Article 50-2 with "designated long-term care provider", the term "designated medical care provider" in Article 51, paragraph (1) with "designated long-term care provider (excluding those pertaining to a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care and a Facility Covered by Public Aid Providing Long-Term Care to the Elderly)", the term "designated medical care provider" in paragraph (2) of that Article, Article 52, paragraph (1) and Article 53, paragraphs (1) to (3) with "designated long-term care provider", the phrase "an examination committee prescribed in the Act on the Medical Information Infrastructure and Medical Fee Examination and Payment Organization (Act No. 129 of 1948) or an examination organ related to medical care that has been specified by Cabinet Order" in paragraph (3) of that Article with "an examination committee for Long-Term Care Benefit expenses, etc. prescribed in the Long-Term Care Insurance Act", the term "designated medical care provider" in paragraph (4) of that Article with "designated long-term care provider" and the phrase "the Medical Information Infrastructure and Medical Fee Examination and Payment Organization or a person specified by an Order of the Ministry of Health, Labour and Welfare" in that paragraph with "the Federation of National Health Insurance Associations", and the term "designated medical care provider" in paragraph (1) of the preceding Article with "designated long-term care provider", and necessary technical replacement of terms is to be specified by Cabinet Order.

⑥The provisions of Article 49-2, paragraphs (1) and (3) apply mutatis mutandis to the designation under paragraph (1) (limited to that pertaining to a care prevention and daily life support provider), and the provisions of Article 50, Article 50-2, Article 51 (excluding paragraph (2), items (i), (viii) and (x)), and Article 52 to the preceding Article apply mutatis mutandis to a long-term care provider designated pursuant to the provisions of paragraph (1) (limited to a care prevention and daily life support provider that received the designation under paragraph (1) (including one deemed to have received the designation under paragraph (1) pursuant to the provisions of the main clause of paragraph (2))). In this case, the phrase "the Minister of Health, Labour and Welfare" in Article 49-2, paragraphs (1) and (3) is deemed to be replaced with "a prefectural governor", the term "designated medical care provider" in Article 50, paragraph (1) with "a long-term care provider designated pursuant to the provisions of Article 54-2, paragraph (1) (limited to a care prevention and daily life support provider that received the designation under paragraph (1) of that Article (including one deemed to have received the designation under paragraph (1) of that Article pursuant to the provisions of the main clause of paragraph (2) of that Article); hereinafter referred to as a "designated long-term care provider" in this Chapter)", the term "designated medical care provider" in paragraph (2) of that Article and Article 50-2 with "designated long-term care provider", the phrase "the Minister of Health, Labour and Welfare or a prefectural governor" in paragraph (2) of Article 50 with "a prefectural governor" and the phrase "the Minister of Health, Labour and Welfare or prefectural governor" in Article 50-2 with "the prefectural governor", the term "designated medical care provider" in Article 51, paragraph (1) with "designated long-term care provider", the phrase "designated medical care provider falls under any of the following" in paragraph (2) of that Article with "designated long-term care provider falls under any of the following" and the phrase "the Minister of Health, Labour and Welfare, in the case of a medical care provider designated by the Minister of Health, Labour and Welfare, and a prefectural governor, in the case of a medical care provider designated by a prefectural governor" in that paragraph with "a prefectural governor", the term "designated medical care provider" in items (ii) to (vii) and (ix) of that paragraph, Article 52, paragraph (1) and Article 53, paragraphs (1) to (3) with "designated long-term care provider", the phrase "an examination committee prescribed in the Act on the Medical Information Infrastructure and Medical Fee Examination and Payment Organization (Act No. 129 of 1948) or an examination organ related to medical care that has been specified by Cabinet Order" in paragraph (3) of that Article with "an examination committee for Long-Term Care Benefit expenses, etc. prescribed in the Long-Term Care Insurance Act", the term "designated medical care provider" in paragraph (4) of that Article with "designated long-term care provider" and the phrase "the Medical Information Infrastructure and Medical Fee Examination and Payment Organization or a person specified by an Order of the Ministry of Health, Labour and Welfare" in that paragraph with "the Federation of National Health Insurance Associations", the phrase "A prefectural governor (the Minister of Health, Labour and Welfare or a prefectural governor, in the case of a designated medical care provider designated by the Minister of Health, Labour and Welfare)" in paragraph (1) of the preceding Article with "A prefectural governor", the phrase "designated medical care provider, or a person who was the establisher, administrator, doctor, pharmacist or other worker of a designated medical care provider" in that paragraph with "designated long-term care provider, or a person who was the establisher, administrator, doctor, pharmacist or other worker of a designated long-term care provider", the phrase "articles, request the establisher, administrator, doctor, pharmacist or other worker of a designated medical care provider" in that paragraph with "articles, request the establisher, administrator, doctor, pharmacist or other worker of a designated long-term care provider", and the phrase "the designated medical care provider" in that paragraph with "the designated long-term care provider", and necessary technical replacement of terms is to be specified by Cabinet Order.

⑦When a notification listed in the fifth column of Appended Table 2 has been made for a designated long-term care provider under Appended Table 2, a notification is deemed to have been made, based on those of the grounds pertaining to that notification that correspond to the grounds for notification under the provisions of Article 50-2 as applied mutatis mutandis pursuant to paragraph (5).

①A prefectural governor shall designate, from among midwives or amma-massage practitioners, acupuncturists, moxa-cauterists or judo therapists, providers in charge of midwifery for maternity assistance under this Act or treatment for medical assistance under this Act.

②The provisions of Article 49-2, paragraph (1), paragraph (2) (excluding item (i), the proviso to item (iv), and items (vii) and (ix)) and paragraph (3) apply mutatis mutandis to the designation under the preceding paragraph, and the provisions of Article 50, Article 50-2, Article 51 (excluding paragraph (2), item (iv), the proviso to item (vi), and item (x)) and Article 54 apply mutatis mutandis to a midwife or an amma-massage practitioner, acupuncturist, moxa-cauterist or judo therapist who has received the designation under the preceding paragraph. In this case, the phrase "the Minister of Health, Labour and Welfare" in Article 49-2, paragraphs (1) and (2) is deemed to be replaced with "a prefectural governor", the phrase "a person whose designation has been rescinded pursuant to Article 51, paragraph (2) and for whom five years have not elapsed from the date of the rescission (including a person who was, within 60 days before the date on which the notice under Article 15 of the Administrative Procedure Act pertaining to the disposition of the rescission was given, the administrator of the hospital or clinic, or pharmacy, whose designation was rescinded, and for whom five years have not elapsed from the date of the rescission)" in item (iv) of that paragraph with "a person whose designation has been rescinded pursuant to Article 51, paragraph (2) and for whom five years have not elapsed from the date of the rescission", the phrase "the Minister of Health, Labour and Welfare" in paragraph (3) of that Article with "a prefectural governor", the term "designated medical care provider" in Article 50, paragraph (1) with "a midwife or an amma-massage practitioner, acupuncturist, moxa-cauterist or judo therapist who has been designated pursuant to the provisions of Article 55, paragraph (1) (hereinafter referred to in this Chapter as a "designated midwifery provider" or "designated treatment provider", respectively)", the term "designated medical care provider" in paragraph (2) of that Article with "designated midwifery provider or designated treatment provider" and the phrase "the Minister of Health, Labour and Welfare or a prefectural governor" in that paragraph with "a prefectural governor", the phrase "A designated medical care provider" in Article 50-2 with "A designated midwifery provider or designated treatment provider", the phrase "said designated medical care provider" in that Article with "said designated midwifery provider or designated treatment provider" and the phrase "the Minister of Health, Labour and Welfare or prefectural governor" in that Article with "the prefectural governor", the term "designated medical care provider" in Article 51, paragraph (1) with "designated midwifery provider or designated treatment provider", the phrase "designated medical care provider falls under any of the following" in paragraph (2) of that Article with "designated midwifery provider or designated treatment provider falls under any of the following", the phrase "the Minister of Health, Labour and Welfare, in the case of a medical care provider designated by the Minister of Health, Labour and Welfare, and a prefectural governor, in the case of a medical care provider designated by a prefectural governor" in that paragraph with "a prefectural governor", the term "designated medical care provider" in paragraph (2), items (i) to (iii) and (v) of that Article with "designated midwifery provider or designated treatment provider", the phrase "an establisher or a worker of a designated medical care provider" in item (vi) of that paragraph with "a designated midwifery provider or designated treatment provider", the term "designated medical care provider" in items (vii) to (ix) of that paragraph with "designated midwifery provider or designated treatment provider", the phrase "A prefectural governor (the Minister of Health, Labour and Welfare or a prefectural governor, in the case of a designated medical care provider designated by the Minister of Health, Labour and Welfare)" in Article 54, paragraph (1) with "A prefectural governor", the phrases "a designated medical care provider, or a person who was the establisher, administrator, doctor, pharmacist or other worker of a designated medical care provider (hereinafter in this paragraph referred to as a 'former establisher, etc.')" and "the establisher, administrator, doctor, pharmacist or other worker of a designated medical care provider (including a former establisher, etc.)" in that paragraph with "a designated midwifery provider, a designated treatment provider, or a person who was either of these", and the phrase "the designated medical care provider" in that paragraph with "the designated midwifery provider or designated treatment provider", and necessary technical replacement of terms is to be specified by Cabinet Order.