Article 54-2Payment of an Allowance for Community-Based Preventive Long-Term Care Service
第五十四条の二（地域密着型介護予防サービス費の支給）
A Municipality, when an Insured In-Home Person Requiring Support receives from a person designated by the mayor of said Municipality (including, with regard to a Specified Community-Based Service for Preventive Long-Term Care for an Insured In-Home Person Requiring Support who is an Insured Person to Whom the Domicile Exception Applies (herein referred to as "Insured In-Home Person Requiring Support to Whom the Domicile Exception Applies"), the Municipality Where the Facility Is Located) (herein referred to as "Designated Provider of Community-Based Service for Preventive Long-Term Care") the Community-Based Service for Preventive Long-Term Care (herein referred to as "Designated Community-Based Service for Preventive Long-Term Care") provided by a provider that performs Community-Based Preventive Long-Term Care Business pertaining to said designation (limited to a case when said Insured In-Home Person Requiring Support has notified the Municipality pursuant to the provisions of Article 58, paragraph (4) to receive a Designated Preventive Long-Term Care Support as prescribed in paragraph (1) of the same Article when said Designated Community-Based Service for Preventive Long-Term Care is subject to said Designated Preventive Long-Term Care Support and other matters as determined by Order of the Ministry of Health, Labour and Welfare), pays to said Insured In-Home Person Requiring Support the Allowance for Community-Based Preventive Long-Term Care Service for the expenses required for said Designated Community-Based Service for Preventive Long-Term Care (excluding the expenses necessary to provide meals and other expenses as determined by Order of the Ministry of Health, Labour and Welfare as necessary for daily life; the same applies hereinafter in this Article), however, this provision does not apply to a case when said Insured In-Home Person Requiring Support that has been designated pursuant to the provisions of Article 37, paragraph (1), receives a Community-Based Service for Preventive Long-Term Care other than the type pertaining to said designation.
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予防サービス事業を行う事業所により行われる地域密着型介護予防サービス（以下「指定地域密着型介護予防サービス」という。）を受けたとき（当該居宅要支援被保険者が、第五十八条第四項の規定により同条第一項に規定する指定介護予防支援を受けることにつきあらかじめ市町村に届け出ている場合であって、当該指定地域密着型介護予防サービスが当該指定介護予防支援の対象となっているときその他の厚生労働省令で定めるときに限る。）は、当該居宅要支援被保険者に対し、当該指定地域密着型介護予防サービスに要した費用（食事の提供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。以下この条において同じ。）について、地域密着型介護予防サービス費を支給する。ただし、当該居宅要支援被保険者が、第三十七条第一項の規定による指定を受けている場合において、当該指定に係る種類以外の地域密着型介護予防サービスを受けたときは、この限りでない。
The amount of Allowance for Community-Based Preventive Long-Term Care Service is to be according to the categories of Community-Based Service for Preventive Long-Term Care listed in the following items and the amount as prescribed in said item:
地域密着型介護予防サービス費の額は、次の各号に掲げる地域密着型介護予防サービスの区分に応じ、当該各号に定める額とする。
Preventive Long-Term Care for a Dementia Outpatient:the amount equivalent to 90 percent of the amount calculated after considering the amount of average expenses (excluding the expenses necessary to provide meals and other expenses as determined by Order of the Ministry of Health, Labour, and Welfare as necessary for daily life) that is calculated after considering the content of the Designated Community-Based Preventive Service of Long-Term Care pertaining to Preventive Long-Term Care for a Dementia Outpatient, the area where the provider that performs said Designated Community-Based Preventive Service of Long-Term Care is located, etc., necessary for said Designated Community-Based Preventive Service of Long-Term Care based on the standards provided by the Minister of Health, Labour, and Welfare (when said calculated amount exceeds the actual amount required for said Designated Community-Based Preventive Service of Long-Term Care, the amount of allowance is to be the actual expenses required for said Designated Community-Based Preventive Service of Long-Term Care);
介護予防認知症対応型通所介護 介護予防認知症対応型通所介護に係る指定地域密着型介護予防サービスの内容、当該指定地域密着型介護予防サービスの事業を行う事業所の所在する地域等を勘案して算定される当該指定地域密着型介護予防サービスに要する平均的な費用（食事の提供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。）の額を勘案して厚生労働大臣が定める基準により算定した費用の額（その額が現に当該指定地域密着型介護予防サービスに要した費用の額を超えるときは、当該現に指定地域密着型介護予防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
Multifunctional Preventive Long-Term Care in a Small Group Home, and Preventive Long-Term Care for a Dementia Patient in Communal Living:the amount equivalent to 90 percent of the amount calculated according to type of Community-Based Preventive Service of Long-Term Care, after considering the average expenses (excluding the expenses necessary to provide meals and other expenses as determined by Order of the Ministry of Health, Labour, and Welfare as necessary for daily life) that is calculated after considering the categories of Needed Support Condition, the location of the provider that performs the Designated Community-Based Preventive Service of Long-Term Care Business pertaining to the type of said Community-Based Preventive Service of Long-Term Care, etc., necessary for said Community-Based Preventive Service of Long-Term Care, based on the standards provided by the Minister of Health, Labour, and Welfare (when said calculated amount exceeds the actual expense required for said Designated Community-Based Preventive Service of Long-Term Care, the allowance is to be the actual amount required for said Designated Community-Based Preventive Service of Long-Term Care).
介護予防小規模多機能型居宅介護及び介護予防認知症対応型共同生活介護 これらの地域密着型介護予防サービスの種類ごとに、要支援状態区分、当該地域密着型介護予防サービスの種類に係る指定地域密着型介護予防サービスの事業を行う事業所の所在する地域等を勘案して算定される当該指定地域密着型介護予防サービスに要する平均的な費用（食事の提供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。）の額を勘案して厚生労働大臣が定める基準により算定した費用の額（その額が現に当該指定地域密着型介護予防サービスに要した費用の額を超えるときは、当該現に指定地域密着型介護予防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
The Minister of Health, Labour, and Welfare, when it intends to provide standards as prescribed in each item of the preceding paragraph, hear opinions of Social Security Council in advance.
厚生労働大臣は、前項各号の基準を定めようとするときは、あらかじめ社会保障審議会の意見を聴かなければならない。
A Municipality may, notwithstanding the provisions of each item of paragraph (2), set the amount determined by said Municipality (or, for the amount of an Allowance for Community-Based Preventive Long-Term Care Service (limited to that pertaining to a Specified Community-Based Service for Preventive Long-Term Care) for an Insured In-Home Person Requiring Support to Whom the Domicile Exception Applies who has received a Designated Community-Based Service for Preventive Long-Term Care from a Designated Provider of Community-Based Service for Preventive Long-Term Care designated by the mayor of the Municipality Where the Facility Is Located under the main clause of paragraph (1), the Municipality Where the Facility Is Located), within the limit of the amount calculated according to standards determined by the Minister of Health, Labour and Welfare after considering the type of Community-Based Service for Preventive Long-Term Care and other circumstances, in place of the amount of the Allowance for Community-Based Preventive Long-Term Care Service prescribed in each item of that paragraph, as the amount of the Allowance for Community-Based Preventive Long-Term Care Service in said Municipality.
市町村は、第二項各号の規定にかかわらず、地域密着型介護予防サービスの種類その他の事情を勘案して厚生労働大臣が定める基準により算定した額を限度として、同項各号に定める地域密着型介護予防サービス費の額に代えて、当該市町村（施設所在市町村の長が第一項本文の指定をした指定地域密着型介護予防サービス事業者から指定地域密着型介護予防サービスを受けた住所地特例適用居宅要支援被保険者に係る地域密着型介護予防サービス費（特定地域密着型介護予防サービスに係るものに限る。）の額にあっては、施設所在市町村）が定める額を、当該市町村における地域密着型介護予防サービス費の額とすることができる。
A Municipality, when it intends to determine the amount of Allowance for Community-Based Preventive Long-Term Care Service in said Municipality as prescribed in the preceding paragraph, must reflect the opinions of Insured Persons of Long-Term Care Insurance undertaken by said Municipality and other relevant persons, and take necessary measures in order to promote the use of knowledge of persons with relevant knowledge and experience, in advance.
When an Insured In-Home Person Requiring Support receives Designated Preventive Service of Long-Term Care from a Designated Provider of Community-Based Preventive Service of Long-Term Care, a Municipality may pay the expense required for said Designated Preventive Service of Long-Term Care that said Insured In-Home Person Requiring Support should pay to said Designated Provider of a Preventive Service to Long-Term Care, to said Designated Provider of a Preventive Service to Long-Term Care on behalf of said Insured In-Home Person Requiring Support within the limit of the amount to be paid to said Insured In-Home Person Requiring Support as an Allowance for Preventive Long-Term Care Service.
居宅要支援被保険者が指定地域密着型介護予防サービス事業者から指定地域密着型介護予防サービスを受けたときは、市町村は、当該居宅要支援被保険者が当該指定地域密着型介護予防サービス事業者に支払うべき当該指定地域密着型介護予防サービスに要した費用について、地域密着型介護予防サービス費として当該居宅要支援被保険者に対し支給すべき額の限度において、当該居宅要支援被保険者に代わり、当該指定地域密着型介護予防サービス事業者に支払うことができる。
When the cost is paid pursuant to the provisions of the preceding paragraph, it is to be deemed that an Allowance for Community-Based Preventive Long-Term Care Service is paid to said Insured In-Home Person Requiring Support.
A Municipality, when a Designated Provider of Community-Based Service for Preventive Long-Term Care requests an Allowance for Community-Based Preventive Long-Term Care Service, is to pay said allowance after conducting an examination according to the standards provided by the Minister of Health, Labour and Welfare as set forth in each item of paragraph (2) or the amount determined by the Municipality (or, for a request for an Allowance for Community-Based Preventive Long-Term Care Service (limited to that pertaining to a Specified Community-Based Service for Preventive Long-Term Care) for an Insured In-Home Person Requiring Support to Whom the Domicile Exception Applies who has received a Designated Community-Based Service for Preventive Long-Term Care from a Designated Provider of Community-Based Service for Preventive Long-Term Care designated by the mayor of the Municipality Where the Facility Is Located under the main clause of paragraph (1), the Municipality Where the Facility Is Located) pursuant to the provisions of paragraph (4), and the standards concerning effective support methods for Prevention of Long-Term Care pertaining to a Designated Community-Based Service for Preventive Long-Term Care and the standards concerning the facilities and management of the business of Designated Community-Based Service for Preventive Long-Term Care (limited to the part concerning the handling of Designated Community-Based Service for Preventive Long-Term Care) that are determined by the Municipality (or, for a request for an Allowance for Community-Based Preventive Long-Term Care Service (limited to that pertaining to a Specified Community-Based Service for Preventive Long-Term Care) for an Insured In-Home Person Requiring Support to Whom the Domicile Exception Applies who has received a Designated Community-Based Service for Preventive Long-Term Care from a Designated Provider of Community-Based Service for Preventive Long-Term Care designated by the mayor of the Municipality Where the Facility Is Located under the main clause of paragraph (1), the Municipality Where the Facility Is Located) pursuant to the provisions of Article 115-14, paragraph (2) or paragraph (5).
市町村は、指定地域密着型介護予防サービス事業者から地域密着型介護予防サービス費の請求があったときは、第二項各号の厚生労働大臣が定める基準又は第四項の規定により市町村（施設所在市町村の長が第一項本文の指定をした指定地域密着型介護予防サービス事業者から指定地域密着型介護予防サービスを受けた住所地特例適用居宅要支援被保険者に係る地域密着型介護予防サービス費（特定地域密着型介護予防サービスに係るものに限る。）の請求にあっては、施設所在市町村）が定める額並びに第百十五条の十四第二項又は第五項の規定により市町村（施設所在市町村の長が第一項本文の指定をした指定地域密着型介護予防サービス事業者から指定地域密着型介護予防サービスを受けた住所地特例適用居宅要支援被保険者に係る地域密着型介護予防サービス費（特定地域密着型介護予防サービスに係るものに限る。）の請求にあっては、施設所在市町村）が定める指定地域密着型介護予防サービスに係る介護予防のための効果的な支援の方法に関する基準及び指定地域密着型介護予防サービスの事業の設備及び運営に関する基準（指定地域密着型介護予防サービスの取扱いに関する部分に限る。）に照らして審査した上、支払うものとする。
The provisions of Article 41, paragraph (2), paragraph (3), paragraph (10) and paragraph (11) apply mutatis mutandis to the payment of an Allowance for Community-Based Preventive Long-Term Care Service and the provisions of paragraph (8) of the same Article apply mutatis mutandis to a Designated Service Provider of Community-Based Preventive Approach in Long-Term Care. In this case, the necessary technical replacement of terms in these provisions is provided by a Cabinet Order.
In addition to the provisions as prescribed in the preceding paragraphs, other necessary matters payment of an Allowance for Community-Based Preventive Long-Term Care Service and for requests of Allowance for Community-Based Preventive Long-Term Care Service by a Designated Provider of Community-Based Service for Preventive Long-Term Care is to be provided by Order of the Ministry of Health, Labour, and Welfare.
前各項に規定するもののほか、地域密着型介護予防サービス費の支給及び指定地域密着型介護予防サービス事業者の地域密着型介護予防サービス費の請求に関して必要な事項は、厚生労働省令で定める。
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