Article 42Payment of an Exceptional Allowance for In-Home Long-Term Care Service
第四十二条（特例居宅介護サービス費の支給）
A Municipality pays an Exceptional Allowance for In-Home Long-Term Care Service to an Insured In-Home Person Requiring Long-Term Care in the following cases:
when a Municipality determines it necessary in a case when an Insured In-Home Person Requiring Long-Term Care receives Designated In-Home Service prior to the date said Certification of Needed Long-Term Care becomes effective due to an emergency or other compelling reason;
when a Municipality determines it necessary in a case when an Insured In-Home Person Requiring Long-Term Care receives In-Home Service other than Designated In-Home Service or service equivalent to said services (limited to those provided by a Business Office conducting a business that is found to satisfy the standards specified by Prefectural Ordinance as set forth in Article 74, paragraph (1) pertaining to the business of Designated In-Home Service, the number of employees specified by Prefectural Ordinance as set forth in the same paragraph, and, among the standards concerning facilities and management of the business of Designated In-Home Service prescribed in paragraph (2) of the same Article, those specified by Prefectural Ordinance; herein referred to as "In-Home Service Applicable to Standards" in the following item and the following paragraph);
when a Municipality determines it necessary in a case when an Insured In-Home Person Requiring Long-Term Care who is domiciled on an isolated island or other area where it is significantly difficult to secure Designated In-Home Service and In-Home Service Applicable to Standards and is in a location that qualifies with the standards as determined by the Minister of Health, Labour, and Welfare, receives In-Home Service other than Designated In-Home Service or In-Home Service Applicable to Standards, or services equivalent to those services;
指定居宅サービス及び基準該当居宅サービスの確保が著しく困難である離島その他の地域であって厚生労働大臣が定める基準に該当するものに住所を有する居宅要介護被保険者が、指定居宅サービス及び基準該当居宅サービス以外の居宅サービス又はこれに相当するサービスを受けた場合において、必要があると認めるとき。
when provided by a Cabinet Order.
その他政令で定めるとき。
A prefecture, in establishing the Prefectural Ordinance set forth in item (ii) of the preceding paragraph, is to establish the matters listed in items (i) through (iii) in accordance with the standards specified by Order of the Ministry of Health, Labour and Welfare, is to establish the matters listed in item (iv) using the standards specified by Order of the Ministry of Health, Labour and Welfare as the standard, and is to take into consideration the standards specified by Order of the Ministry of Health, Labour and Welfare for other matters.
都道府県が前項第二号の条例を定めるに当たっては、第一号から第三号までに掲げる事項については厚生労働省令で定める基準に従い定めるものとし、第四号に掲げる事項については厚生労働省令で定める基準を標準として定めるものとし、その他の事項については厚生労働省令で定める基準を参酌するものとする。
standards pertaining to employees engaging in In-Home Service Applicable to Standards and the number of such employees;
基準該当居宅サービスに従事する従業者に係る基準及び当該従業者の員数
the floor area of residence rooms pertaining to the business of In-Home Service Applicable to Standards;
基準該当居宅サービスの事業に係る居室の床面積
matters concerning the operation of the business of In-Home Service Applicable to Standards that are closely related to ensuring the appropriate use of services, appropriate treatment and safety of Persons Requiring Long-Term Care who use them, and maintaining confidentiality, etc., and that are specified by Order of the Ministry of Health, Labour and Welfare;
基準該当居宅サービスの事業の運営に関する事項であって、利用する要介護者のサービスの適切な利用、適切な処遇及び安全の確保並びに秘密の保持等に密接に関連するものとして厚生労働省令で定めるもの
the maximum number of users pertaining to the business of In-Home Service Applicable to Standards.
基準該当居宅サービスの事業に係る利用定員
The amount of Exceptional Allowance for In-Home Long-Term Care Service is to be specified by a Municipality with regard to said In-Home Service or services equivalent to said service based on an amount equivalent to 90 percent of the expenses calculated by standards determined by the Minister of Health, Labour, and Welfare as prescribed in each item of the preceding Article, paragraph (4) (but shall be the actual expenses required for said In-Home Service or service equivalent to said services when said calculated standard amount exceeds the actual expenses required for said In-Home Service or service equivalent to said services (except for purchases of Specified Equipment Covered by Public Aid; with regard to expenses necessary for Outpatient Day Long-Term Care, Outpatient Rehabilitation, Short-Term Admission for Daily Life Long-Term Care, Short-Term Admission for Recuperation, Daily Life Long-Term Care Admitted to a Specified Facility, excluding expenses necessary to provide meals, residence, other expenses, other expenses necessary for daily life as determined by Order of the Ministry of Health, Labour, and Welfare)).
特例居宅介護サービス費の額は、当該居宅サービス又はこれに相当するサービスについて前条第四項各号の厚生労働大臣が定める基準により算定した費用の額（その額が現に当該居宅サービス又はこれに相当するサービスに要した費用（特定福祉用具の購入に要した費用を除き、通所介護、通所リハビリテーション、短期入所生活介護、短期入所療養介護及び特定施設入居者生活介護並びにこれらに相当するサービスに要した費用については、食事の提供に要する費用、滞在に要する費用その他の日常生活に要する費用として厚生労働省令で定める費用を除く。）の額を超えるときは、当該現に居宅サービス又はこれに相当するサービスに要した費用の額とする。）の百分の九十に相当する額を基準として、市町村が定める。
A Municipality, when it determines the necessity for payment of an Exceptional Allowance for In-Home Long-Term Care Service, may order a person that has been in charge of the In-Home Service pertaining to said payment or equivalent service (herein referred to as "Person, etc., in Charge of In-Home Service, etc." in this paragraph) to report, submit, or present record books and documents, appear before, or direct its personnel to question the relevant person and enter the Business Office of the service provider of said Person, etc., in Charge of In-Home Service, etc., pertaining to said payment in order to inspect said equipment, record books and documents, and other items.
市町村長は、特例居宅介護サービス費の支給に関して必要があると認めるときは、当該支給に係る居宅サービス若しくはこれに相当するサービスを担当する者若しくは担当した者（以下この項において「居宅サービス等を担当する者等」という。）に対し、報告若しくは帳簿書類の提出若しくは提示を命じ、若しくは出頭を求め、又は当該職員に関係者に対して質問させ、若しくは当該居宅サービス等を担当する者等の当該支給に係る事業所に立ち入り、その設備若しくは帳簿書類その他の物件を検査させることができる。
The provisions of Article 24, paragraph (3) apply mutatis mutandis to questions or inspections as prescribed in the preceding paragraph, and the provisions of paragraph (4) of the same Article apply mutatis mutandis to the authority granted as prescribed in the preceding paragraph.
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