This Act comes into effect as of April 1, 2000; provided, however, that the provisions set forth in the following items come into effect as of the day specified in the relevant item.

With regard to the long-term care insurance system, taking into consideration the state of the system for providing health care services and welfare services for Persons Requiring Long-Term Care, etc., the state of expenses required for Insurance Benefits, trends in the burden on the people, socioeconomic conditions, etc., and paying attention to measures concerning the welfare of persons with disabilities, consistency with the medical insurance system, etc., and the efficient operation of Insured Long-Term Care Projects conducted by Municipalities, a review is to be conducted of the whole of the system, with five years after the enforcement of this Act as a target, including the scope of Insured Persons and persons eligible to receive Insurance Benefits, the content and level of Insurance Benefits, and the manner of bearing insurance premiums and Levies (including insurance premiums (including National Health Insurance tax collected pursuant to the provisions of the Local Tax Act) or contributions collected pursuant to the provisions of the Medical Insurance Acts for appropriation to their payment), and necessary measures such as revision are to be taken based on the results.

The government is, after the enforcement of this Act, when it finds it necessary in consideration of trends in the expenses required for Insurance Benefits, the state of the burden of insurance premiums, etc., to conduct a review of the proportion of Long-Term Care Benefit, etc. in the expenses required for In-Home Service, Facility Service, etc., and take required measures based on the results.

The government is, when 10 years have elapsed after the enforcement of this Act, to conduct a review of the state of enforcement of the provisions of Chapter V, and take necessary measures based on the results.

The government, in conducting a review pursuant to the provisions of the preceding three Articles, must give full consideration to the opinions on matters pertaining to the review, when such opinions have been submitted by a local government or other relevant person.

①The state may, for the time being, within the scope of the budget, lend to local governments, interest-free, a part of the funds to be appropriated to the expenses required for the development of Long-Term Care Health Facilities that fall under Article 2, paragraph (1), item (ii) of the Act on Special Measures Concerning Promotion of Social Infrastructure Development Through Use of Proceeds from Sale of the Stock of Nippon Telegraph and Telephone Corporation (Act No. 86 of 1987; hereinafter referred to as the "Social Infrastructure Development Special Measures Act").

②The state may, for the time being, within the scope of the budget, lend interest-free to prefectures or Designated Cities, etc., a part of the funds to be appropriated to the expenses that the prefecture or Designated City, etc. subsidizes to a medical juridical person, a social welfare juridical person, or any other person determined by the Minister of Health, Labour and Welfare, as set forth in Article 94, paragraph (3), item (i), with regard to the development of Long-Term Care Health Facilities that fall under Article 2, paragraph (1), item (ii) of the Social Infrastructure Development Special Measures Act.

③The repayment period of the loans by the state under the preceding two paragraphs is a period specified by Cabinet Order within five years (including a deferment period of two years or less).

④In addition to what is provided for in the preceding paragraph, the method of repayment of the loans under the provisions of paragraphs (1) and (2), the advance of the repayment deadline, and other matters necessary for repayment are specified by Cabinet Order.

⑤The state, when it has made a loan to a local government pursuant to the provisions of paragraph (1) or (2), is to provide a subsidy in an amount equivalent to the loan for the development of the facility that is the subject of the loan, and the subsidy is to be provided by paying an amount equivalent to the repayment of the loan at the time of repayment of the loan.

⑥In the application of the provisions of the preceding paragraph to the case where a local government has repaid an interest-free loan received pursuant to the provisions of paragraph (1) or (2) before the repayment deadline determined based on the provisions of paragraphs (3) and (4) (excluding the cases specified by Cabinet Order), the repayment is deemed to have been made at the time the repayment deadline arrives.

The Minister of Health, Labour and Welfare, in establishing the Basic Guidelines, is to give appropriate consideration to an increase in the capacity of residents of integrated facilities for medical and long-term care and other facilities specified by Order of the Ministry of Health, Labour and Welfare, so that the conversion of beds prescribed in Article 2 of the Supplementary Provisions of the Act on Assurance of Medical Care for Elderly People is carried out smoothly, from the viewpoint of ensuring the appropriateness of expenses required for medical care and securing high-quality and effective Long-Term Care Service.

①An Insured Person who is found to have changed domicile to the location of a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly by being admitted to that Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly, and who is found to have had a domicile in another Municipality (a Municipality other than the Municipality where that Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly is located) when admitted to that Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly, is, even in the case where that Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly has become a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care (limited to one that has received the designation under the main clause of Article 42-2, paragraph (1) with regard to a Business Office conducting the business of Daily Life Long-Term Care for a Person Admitted to a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care; hereinafter in this Article referred to as a "converted Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care") due to a decrease in the capacity of residents, while continuously admitted to that converted Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care, to be an Insured Person of Long-Term Care Insurance conducted by that other Municipality, notwithstanding the provisions of Article 9; provided, however, that this does not apply to an Insured Person who had continuously moved in for Admission, etc. at two or more Facilities Subject to Domicile Exception including a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly that has become a converted Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care (hereinafter in this Article referred to as a "former Facility Covered by Public Aid Providing Long-Term Care to the Elderly") (limited to a person who is continuously admitted to that converted Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care), and who is found to have changed domicile consecutively to the location of each of the Facility Subject to Domicile Exception at which Admission, etc. was made immediately before admission to that former Facility Covered by Public Aid Providing Long-Term Care to the Elderly (hereinafter in this paragraph referred to as the "facility of immediately preceding admission") and the former Facility Covered by Public Aid Providing Long-Term Care to the Elderly, by moving in for Admission, etc. at each of the facility of immediately preceding admission and the former Facility Covered by Public Aid Providing Long-Term Care to the Elderly (referred to as an "insured person in specified continuous admission" in the following paragraph).

②Among insured persons in specified continuous admission, those set forth in the following items are Insured Persons of Long-Term Care Insurance conducted by the Municipality specified in each of those items, notwithstanding the provisions of Article 9:

③With regard to an Insured Person subject to the application of the provisions of the preceding two paragraphs, Article 13 is applied by deeming a converted Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care to be a Facility Subject to Domicile Exception.

①The provisions of Article 107, Article 108, and Article 110 through Article 112 of the Medical Care Act apply mutatis mutandis to Long-Term Care Health Facilities and integrated facilities for medical and long-term care. In this case, the necessary technical replacement of terms in these provisions is provided by Cabinet Order.

②With regard to the application of the provisions of Article 105 and Article 114-8, for the time being, the phrase "and Article 104, paragraph (1)" in Article 105 is deemed to be replaced with ", Article 104, paragraph (1) and Article 111 of the same Act as applied mutatis mutandis pursuant to Article 10, paragraph (1) of the Supplementary Provisions", and the phrase "and Article 114-6, paragraph (1)" in Article 114-8 is deemed to be replaced with ", Article 114-6, paragraph (1) and Article 111 of the same Act as applied mutatis mutandis pursuant to Article 10, paragraph (1) of the Supplementary Provisions".