介護保険法
Long-Term Care Insurance Act
平成九年十二月十七日法律第百二十三号
Act No. 123 of December 17, 1997
第一章 総則 (第一条―第八条の二)
Chapter I General Provisions (Articles 1 to 8-2)
第二章 被保険者 (第九条―第十三条)
Chapter II Insured Persons (Articles 9 to 13)
第三章 介護認定審査会 (第十四条―第十七条)
Chapter III Certification Committee of Needed Long-Term Care (Articles 14 to 17)
第四章 保険給付
Chapter IV Insurance Benefits
第一節 通則 (第十八条―第二十六条)
Section 1 General Rules (Articles 18 to 26)
第二節 認定 (第二十七条―第三十九条)
Section 2 Certification (Articles 27 to 39)
第三節 介護給付 (第四十条―第五十一条の三)
Section 3 Long-Term Care Benefits (Articles 40 to 51-3)
第四節 予防給付 (第五十二条―第六十一条の三)
Section 4 Prevention Benefits (Articles 52 to 61-3)
第五節 市町村特別給付 (第六十二条)
Section 5 Municipal Special Benefits (Article 62)
第六節 保険給付の制限等 (第六十三条―第六十九条)
Section 6 Limitation on Insurance Benefits, etc. (Articles 63 to 69)
第五章 介護支援専門員並びに事業者及び施設
Chapter V Long-Term Care Support Specialists, Providers, and Facilities
第一節 介護支援専門員
Section 1 Long-Term Care Support Specialists
第一款 登録等 (第六十九条の二―第六十九条の十)
Subsection 1 Registration, etc. (Articles 69-2 to 69-10)
第二款 登録試験問題作成機関の登録、指定試験実施機関及び指定研修実施機関の指定等 (第六十九条の十一―第六十九条の三十三)
Subsection 2 Registration of an Organization that Prepares Registration Examination Questions, and Appointment of a Designated Testing Agencies and Designated Training Agency (Articles 69-11 to 69-33)
第三款 義務等 (第六十九条の三十四―第六十九条の三十九)
Subsection 3 Obligations, etc. (Articles 69-34 to 69-39)
第二節 指定居宅サービス事業者 (第七十条―第七十八条)
Section 2 Designated In-Home Service Providers (Articles 70 to 78)
第三節 指定地域密着型サービス事業者 (第七十八条の二―第七十八条の十一)
Section 3 Designated Community-Based Service Providers (Articles 78-2 to 78-11)
第四節 指定居宅介護支援事業者 (第七十九条―第八十五条)
Section 4 Designated In-Home Long-Term Care Support Providers (Articles 79 to 85)
第五節 介護保険施設
Section 5 Facilities Covered by Long-Term Care Insurance
第一款 指定介護老人福祉施設 (第八十六条―第九十三条)
Subsection 1 Designated Facilities Covered by Public Aid Providing Long-Term Care to the Elderly (Articles 86 to 93)
第二款 介護老人保健施設 (第九十四条―第百六条)
Subsection 2 Long-Term Care Health Facilities (Articles 94 to 106)
第三款 指定介護療養型医療施設 (第百七条―第百十五条)
Subsection 3 Designated Medical Long-Term Care Sanatoriums (Articles 107 to 115)
第六節 指定介護予防サービス事業者 (第百十五条の二―第百十五条の十)
Section 6 Designated Providers of Preventive Service to Long-Term Care (Articles 115-2 to 115-10)
第七節 指定地域密着型介護予防サービス事業者 (第百十五条の十一―第百十五条の十九)
Section 7 Designated Providers of Community-Based Preventive Service of Long-Term Care (Articles 115-12 to 115-19)
第八節 指定介護予防支援事業者 (第百十五条の二十―第百十五条の二十八)
Section 8 Designated Providers of Support for Prevention of Long-Term Care (Articles 115-20 to 115-28)
第九節 介護サービス情報の公表 (第百十五条の二十九―第百十五条の三十七)
Section 9 Publication of Long-Term Care Service Information (Articles 115-29 to 115-37)
第六章 地域支援事業等 (第百十五条の三十八―第百十五条の四十一)
Chapter VI Community Support Projects, etc. (Articles 115-38 to 115-41)
第七章 介護保険事業計画 (第百十六条―第百二十条)
Chapter VII Insured Long-Term Care Service Plans (Articles 116 to 120)
第八章 費用等
Chapter VIII Expenses, etc.
第一節 費用の負担 (第百二十一条―第百四十六条)
Section 1 Imposition of Expenses (Articles 121 to 146)
第二節 財政安定化基金等 (第百四十七条―第百四十九条)
Section 2 Fiscal Stability Funds (Articles 147 to 149)
第三節 医療保険者の納付金 (第百五十条―第百五十九条)
Section 3 Levies for Medical Insurers (Articles 150 to 159)
第九章 社会保険診療報酬支払基金の介護保険関係業務 (第百六十条―第百七十五条)
Chapter IX Business Related to Insured Long-Term Care for Social Insurance Medical Fee Payment Funds (Articles 160 to 175)
第十章 国民健康保険団体連合会の介護保険事業関係業務 (第百七十六条―第百七十八条)
Chapter X Business Related to a Long-Term Care Insurance Project for the Federation of National Health Insurance Associations (Articles 176 to 178)
第十一章 介護給付費審査委員会 (第百七十九条―第百八十二条)
Chapter XI Examination Committee for Long-Term Care Benefit Expense (Articles 179 to 182)
第十二章 審査請求 (第百八十三条―第百九十六条)
Chapter XII Application for Examination (Articles 183 to 196)
第十三章 雑則 (第百九十七条―第二百四条)
Chapter XIII Miscellaneous Provisions (Articles 197 to 204)
第十四章 罰則 (第二百五条―第二百十五条)
Chapter XIV Penalty Provisions (Articles 205 to 215)
附則
Supplementary Provisions
第一章 総則
Chapter I General Provisions
(目的)
(Purposes)
第一条 この法律は、加齢に伴って生ずる心身の変化に起因する疾病等により要介護状態となり、入浴、排せつ、食事等の介護機能訓練並びに看護及び療養上の管理その他の医療を要する者等について、これらの者が尊厳を保持し、その有する能力に応じ自立した日常生活営むことができるよう、必要な保健医療サービス及び福祉サービスに係る給付を行うため、国民の共同連帯の理念に基づき介護保険制度を設け、その行う保険給付等に関して必要な事を定め、もって国民の保健医療の向上及び福祉増進を図ることを目的とする
Article 1 The purposes of this Act are to improve health and medical care and to enhance the welfare of citizens. With regard to people who are under condition of need for long-term care due to disease, etc., as a result of physical or emotional changes caused by aging, and who require care such as for bathing, bodily waste elimination, meals, etc., and require the functional training, nursing, management of medical treatment, and other medical care, these purposes are to be accomplished by establishing a long-term care insurance system based on the principle of the cooperation of citizens, solidarity, and determining necessary matters concerning related insurance benefits, etc., in order to provide benefits pertaining to necessary health and medical services and public aid services so that these people are able to maintain dignity and an independent daily life routine according to each person's own level of abilities.
(介護保険)
(Long-Term Care Insurance)
第二条 介護保険は、被保険者の要介護状態又は支援状態に関し、必要な保険給付を行うものとする
Article 2 Long-Term Care Insurance shall provide necessary insurance benefits for a Condition of Need for Long-Term Care or for a Needed Support Condition of the insured person.
2 保険給付は、要介護状態又は支援状態の軽減又は悪化の防止資するよう行われるとともに、医療との連携に十分配慮して行われなければならない。
(2) Insurance benefits as set forth in the preceding paragraph shall be provided in order to contribute to reduction or prevention of aggravation of a Condition of Need for Long-Term Care or a Needed Support Condition, and shall be provided with careful attention to cooperation with medical care.
3 第一保険給付は、被保険者の心身の状況、その置かれている環境等に応じて、被保険者選択に基づき、適切な保健医療サービス及び福祉サービスが、多様な事業者又は施設から、総合的かつ効率的に提供されるよう配慮して行われなければならない。
(3) Insurance benefits as set forth in paragraph (1) shall be provided in consideration of the appropriate health and medical services and public aid services that are offered by diverse providers and facilities comprehensively and effectively, according to the physical and mental conditions of the insured person, said person's environment, etc., and based on the preferences of the insured person.
4 第一保険給付の内容及び水準は、被保険者が要介護状態となった場合においても、可能な限り、その居宅において、その有する能力に応じ自立した日常生活営むことができるように配慮されなければならない。
(4) With regard to the contents and level of insurance benefits as set forth in paragraph (1), it shall be considered that said person is able to live an independent daily life according to that person's own abilities in his or her home as much as possible, although said insured person becomes in a Condition of Need for Long-Term Care.
(保険者)
(Insurers)
第三条 市町村及び特別区は、この法律の定めるところにより、介護保険を行うものとする
Article 3 Municipalities and special city wards shall provide Long-Term Care Insurance pursuant to the provisions of this Act.
2 市町村及び特別区は、介護保険に関する収入及び支出について、政令で定めるところにより、特別会計を設けなければならない。
(2) Municipalities and special city wards shall establish a special account for income and expenses regarding Long-Term Care Insurance pursuant to the provisions of Cabinet Orders.
(国民の努力及び義務)
(Citizen's Efforts and Obligations)
第四条 国民は、自ら要介護状態となることを予防するため、加齢に伴って生ずる心身の変化を自覚して常に健康の保持増進に努めるとともに、要介護状態となった場合においても、進んでリハビリテーションその他の適切な保健医療サービス及び福祉サービスを利用することにより、その有する能力維持向上に努めるものとする
Article 4 A citizen shall be aware of his or her physical and mental changes due to aging and shall always strive to maintain and enhance good health in order to prevent becoming in a Condition of Need for Long-Term Care. In a case of becoming in a Condition of Need for Long-Term Care, a citizen shall strive to maintain and improve his or her existing abilities through the willing use of rehabilitation and other appropriate health and medical services and public aid services.
2 国民は、共同連帯の理念に基づき、介護保険事業に要する費用を公平に負担するものとする
(2) Citizens shall be equally subjected to the expenses necessary for an Insured Long-Term Care Project, based on the principle of cooperation and solidarity.
(国及び都道府県の責務)
(Responsibilities of the National and Prefectural Governments)
第五条 は、介護保険事業運営が健全かつ円滑に行われるよう保健医療サービス及び福祉サービスを提供する体制の確保に関する施策その他の必要な各般の措置を講じなければならない。
Article 5 The national government shall undertake measures to ensure the system of providing health and medical services and public aid services, and every other necessary action for the healthy and efficient operation of an Insured Long-Term Care Project.
2 都道府県は、介護保険事業運営が健全かつ円滑に行われるように、必要な助言及び適切な援助しなければならない
(2) Prefectural governments shall provide necessary advice and appropriate support for the healthy and efficient operation of an Insured Long-Term Care Project.
(医療保険者の協力)
(Cooperation of Medical Insurers)
第六条 医療保険者は、介護保険事業が健全かつ円滑に行われるよう協力しなければならない
Article 6 Medical insurers shall cooperate for the healthy and efficient operation of an Insured Long-Term Care Project.
(定義)
(Definitions)
第七条 この法律において「要介護状態」とは、身体又は精神上の障害があるために、入浴、排せつ、食事等の日常生活における基本的な動作の全部又は一部について、厚生労働省令で定める期間にわたり継続して、常時介護を要すると見込まれる状態であって、その介護の必要の程度に応じて厚生労働省令で定める区分(以下「要介護状態区分」という。)のいずれかに該当するもの(要支援状態に該当するものを除く。)をいう。
Article 7 The term "Condition of Need for Long-Term Care" as used in this Act means a condition assumed to require care on a continual and steady basis for the whole or a part of basic movements in daily activities such as bathing, bodily waste elimination, meals, etc., due to physical or mental problems during the period specified by an Ordinance of the Ministry of Health, Labour, and Welfare, and said condition shall conforms to any of the categories stipulated by an Ordinance of the Ministry of Health, Labour, and Welfare according to the degree of needed care (herein referred to as a "Category of Condition of Need for Long-Term Care") (except when said condition is subject to a Needed Support Condition).
2 この法律において「要支援状態」とは、身体若しくは精神上の障害があるために入浴、排せつ、食事等の日常生活における基本的な動作の全部若しくは一部について厚生労働省令で定める期間にわたり継続して常時介護を要する状態の軽減若しくは悪化の防止に特に資する支援を要すると見込まれ、又は身体若しくは精神上の障害があるために厚生労働省令で定める期間にわたり継続して日常生活営むのに支障があると見込まれる状態であって、支援の必要の程度に応じて厚生労働省令で定める区分(以下「要支援状態区分」という。)のいずれかに該当するものをいう。
(2) The term "Needed Support Condition" as used in this Act means a condition assumed to require care on a continual and steady basis during the period specified by an Ordinance of the Ministry of Health, Labour, and Welfare that especially contributes to the reduction or prevention of the aggravation of the condition requiring care for the whole or a part of basic movements in daily activities such as bathing, bodily waste elimination, meals, etc., due to physical or mental problems, or a condition assumed to cause continual difficulties in performing daily activities due to physical or mental problems during the period specified by an Ordinance of the Ministry of Health, Labour, and Welfare, and said condition shall conforms to any category as stipulated by an Ordinance of the Ministry of Health, Labour, and Welfare according to the degree of needed support (herein referred to as "Category of Needed Support Condition").
3 この法律において「要介護者」とは、次の各のいずれかに該当する者をいう。
(3) The term "Person Requiring Long-Term Care" as used in this Act means a person defined by any of the following items:
一 介護状態にある六十五歳以上の者
(i) a person that is in a Condition of Need for Long-Term Care and is the age of 65 or older;
二 介護状態にある四十歳以上六十五歳未満の者であって、その介護状態原因である身体又は精神上の障害が加齢に伴って生ずる心身の変化に起因する疾病であって政令で定めるもの(以下「特定疾病」という。)によって生じたものであるもの
(ii) a person that is in a Condition of Need for Long-Term Care and is the age of 40 to less than the age of 65, and the physical or mental problems that are the causes of said Condition of Need for Long-Term Care are a result of diseases that are caused by the physical or mental changes due to aging, specified by a Cabinet Order (herein referred to as "Specified Disease").
4 この法律において「要支援者」とは、次の各のいずれかに該当する者をいう。
(4) The term "Person Requiring Support" as used in this Act means a person defined by any of the following items:
一 支援状態にある六十五歳以上の者
(i) a person that is in a Needed Support Condition and is the age of 65 or older;
二 支援状態にある四十歳以上六十五歳未満の者であって、その支援状態原因である身体又は精神上の障害が特定疾病によって生じたものであるもの
(ii) a person that is in a Needed Support Condition and is the age of 40 to less than the age of 65, and the physical or mental problems that are the cause of said Needed Support Condition are caused by a Specified Disease.
5 この法律において「介護支援専門員」とは、要介護又は支援者(以下「要介護者等」という。)からの相談に応じ、及び介護者等がその心身の状況等に応じ適切な居宅サービス、地域密着型サービス、施設サービス、介護予防サービス又は地域密着型介護予防サービスを利用できるよう市町村、居宅サービス事業を行う者、地域密着型サービス事業を行う者、介護保険施設介護予防サービス事業を行う者、地域密着型介護予防サービス事業を行う者等との連絡調整等を行う者であって、要介護者等が自立した日常生活営むのに必要な援助に関する専門的知識及び技術を有するものとして第六十九の七第一介護支援専門員証の交付を受けたものをいう。
(5) The term "Long-Term Care Support Specialist" as used in this Act means a person that provides consultation to a Person Requiring Long-Term Care or to a Person Requiring Support (herein referred to as a "Person Requiring Long-Term Care, etc.") and communicates with and coordinates Municipalities, a person performing In-Home Services, a person performing Community-Based Service Business, a Facility Covered by Long-Term Care Insurance, a person performing Preventive Long-Term Care Service Business, a person performing Community-Based Preventive Long-Term Care, etc., in order for a Person Requiring Long-Term Care, etc., to be able to use appropriate In-Home Service, Community-Based Service, Facility Service, Preventive Long-Term Care Service, and Community-Based Service for Preventive Long-Term Care according to the mental and physical conditions, etc., of a Person Requiring Long-Term Care, etc., and who received Long-Term Care Support Specialist Certification as set forth in Article 69-7, paragraph (1) as a person possessing professional knowledge and skills regarding necessary support for a Person Requiring Long-Term Care, etc., to live an independent daily life.
6 この法律において「医療保険」とは、次に掲げる法律をいう。
(6) The term "Medical Insurance Acts" as used in this Act means the following acts:
一 健康保険法(大正十一年法律第七十
(i) Health Insurance Act (Act No. 70 of 1992);
二 船員保険法(昭和十四年法律第七十三
(ii) Seaman's Insurance Act (Act No. 73 of 1939);
三 国民健康保険法(昭和三十三年法律第百九十二
(iii) National Health Insurance Act (Act No. 192 of 1958);
四 国家公務員共済組合法(昭和三十三年法律第百二十八
(iv) National Public Servants Mutual Aid Association Act (Act No. 128 of 1958);
五 地方公務員等共済組合法(昭和三十七年法律第百五十二
(v) Local Public Service Mutual Aid Association Act (Act No. 152 of 1962);
六 私立学校教職員共済法(昭和二十八年法律第二百四十五
(vi) Private School Personnel Mutual Aid Association Act (Act No. 245 of 1953).
7 この法律において「医療保険者」とは、医療保険規定により医療に関する給付を行う政府健康保険組合市町村特別区を含む。)、国民健康保険組合共済組合又は日本私立学校振興・共済事業団をいう。
(7) The term "Medical Insurers" as used in this Act means the national government, health insurance societies, municipalities (including special city wards), National Health Insurance Society, mutual aid associations, or Promotion and Mutual Aid Society for Private Schools of Japan that provide medical benefits pursuant to the provisions of Medical Insurance Acts.
8 この法律において「医療保険加入者」とは、次に掲げる者をいう。
(8) The term "Medical Insurance Subscriber" as used in this Act means the following persons:
一 健康保険法規定による被保険者。ただし、同第三第二規定による日雇特例被保険者を除く。
(i) an insured person pursuant to the provisions of the Health Insurance Act, however, provided that it shall not apply to specially-insured day laborers pursuant to the provision of Article 3, paragraph (2) of the same Act;
二 船員保険法規定による被保険者
(ii) an insured person pursuant to the provisions of the Seaman's Insurance Act;
三 国民健康保険法規定による被保険者
(iii) an insured person pursuant to the provisions of the National Health Insurance Act;
四 国家公務員共済組合法又は地方公務員等共済組合法に基づく共済組合組合員
(iv) a member of a mutual aid association pursuant to the National Public Servants Mutual Aid Association Law or the Local Public Care Service Mutual Aid Association Act;
五 私立学校教職員共済法規定による私立学校教職員共済制度の加入者
(v) a subscriber to a Private School Personnel Mutual Aid System pursuant to the provisions of the Private School Personnel Mutual Aid Association Act;
六 健康保険法船員保険法国家公務員共済組合法(他の法律において準用する場合を含む。)又は地方公務員等共済組合法規定による被扶養者。ただし、健康保険法第三第二規定による日雇特例被保険者の同規定による被扶養者を除く。
(vi) an insured person's dependent pursuant to the provisions of the Health Insurance Act, Seaman's Insurance Act, National Public Servants Mutual Aid Association Law (including cases when applied mutatis mutandis pursuant to other Acts), or the Local Public Care Service Mutual Aid Association Act, however, provided that it shall not apply to a dependent pursuant to the provisions of Article 3, paragraph (2) of the Health Insurance Act of a specially-insured day laborer pursuant to the provisions of the same Act;
七 健康保険法第百二十六規定により日雇特例被保険者手帳の交付を受け、その手帳に健康保険印紙をはり付けるべき余白がなくなるに至るまでの間にある者及び規定によるその者の被扶養者。ただし、同第三第二ただし書規定による承認を受けて同規定による日雇特例被保険者とならない期間内にある者及び第百二十六第三規定により当該日雇特例被保険者手帳を返納した者並びに規定によるその者の被扶養者を除く。
(vii) a person that received a specially-insured day laborer certificate book pursuant to the provisions of Article 126 of the Health Insurance Act and within a certain period until the term when all of the blank space for stamps for proof of health insurance of said certificate book are filled, and said dependent pursuant to the provisions of the same Act, however, provided that it shall not apply to a person that is within the period when said person is not a specially-insured day laborer pursuant to the proviso of Article 3, paragraph (2) of the same Act with the approval pursuant to the proviso of the same paragraph, and a person that has returned said specially-insured day laborer certificate book pursuant to the provisions of Article 126, paragraph (3) of the same Act, and said dependent pursuant to the provisions of the same Act.
第八条 この法律において「居宅サービス」とは、訪問介護、訪問入浴介護、訪問看護、訪問リハビリテーション、居宅療養管理指導、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、特定施設入居者生活介護福祉用具貸与及び特定福祉用具販売をいい、「居宅サービス事業」とは、居宅サービスを行う事業をいう。
Article 8 The term "In-Home Service" as used in this Act means Home-Visit Long-Term Care, Home-Visit Bathing Long-Term Care, Home-Visit Nursing, Home-Visit Rehabilitation, Guidance for Management of In-Home Medical Long-Term Care, 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, Rental Service of Equipment for Long-Term Care Covered by Public Aid, and Sale of Specified Equipment Covered by Public Aid. The term "In-Home Service Business" as used in this Act means business performing In-Home Service.
2 この法律において「訪問介護」とは、要介護者であって、居宅(老人福祉法(昭和三十八年法律第百三十三)第二十の六に規定する軽費老ホーム、同第二十九第一規定する有料老ホーム(第十一及び第十九において「有料老ホーム」という。)その他の厚生労働省令で定める施設における居室を含む。以下同じ。)において介護を受けるもの(以下「居宅要介護者」という。)について、その者の居宅において介護福祉その政令で定める者により行われる入浴、排せつ、食事等の介護その他の日常生活上の世話であって、厚生労働省令で定めるもの(夜間対応型訪問介護に該当するものを除く。)をいう。
(2) The term "Home-Visit Long-Term Care" as used in this Act means care service that is for bathing, bodily waste elimination, meals, etc., and for other daily activities provided by long-term care public aid workers and other persons who determined by an Ordinance of the Ministry of Health, Labour, and Welfare (except for care services defined as Home-Visit at Night for Long-Term Care) and which are provided to a Person Requiring Long-Term Care at his or her home (herein referred to as "In-Home Person Requiring Long-Term Care") (including a residence room at a moderate-fee home for the elderly as provided in Article 20-6 of the Public Aid for the Aged Act (Act No. 133 of 1963); a Fee-Based Home for the Elderly as prescribed in Article 29-1 of the same Act (referred to as a "Fee-Based Home for the Elderly" in paragraphs (11) and (19)); and other facilities as determined by an Ordinance of the Ministry of Health, Labour, and Welfare; the same shall apply hereinafter).
3 この法律において「訪問入浴介護」とは、居宅要介護者について、その者の居宅を訪問し、浴槽を提供して行われる入浴の介護をいう。
(3) The term "Home-Visit Bathing Long-Term Care" as used in this Act means care service that provides bathing service and a bathtub to a Person Requiring Long-Term Care by visiting his or her home.
4 この法律において「訪問看護」とは、居宅要介護者(主治の医師がその治療の必要の程度につき厚生労働省令で定める基準適合していると認めたものに限る。)について、その者の居宅において看護師その他厚生労働省令で定める者により行われる療養上の世話又は必要な診療の補助をいう。
(4) The term "Home-Visit Nursing" as used in this Act means medical care or assistance for necessary medical care provided to a Person Requiring Long-Term Care at his or her home (limited to those who are considered by an attending physician to be a person in the degree of need of medical treatment that conforms to standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare) by a nurse or other person as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
5 この法律において「訪問リハビリテーション」とは、居宅要介護者(主治の医師がその治療の必要の程度につき厚生労働省令で定める基準適合していると認めたものに限る。)について、その者の居宅において、その心身の機能維持回復を図り、日常生活の自立を助けるために行われる理学療作業その他必要なリハビリテーションをいう。
(5) The term "Home-Visit Rehabilitation" as used in this Act means physical therapy, occupational therapy, and other necessary rehabilitation that is provided to an In-Home Person Requiring Long-Term Care at his or her home (limited to those who are considered by an attending physician to be a person in the degree of need of medical treatment that conforms to standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare) in order to maintain and recover mental or physical functions and to assist with independently performing daily activities.
6 この法律において「居宅療養管理指導」とは、居宅要介護者について、病院、診療所又は薬局(以下「病院等」という。)の医師、歯科医師、薬剤師その他厚生労働省令で定める者により行われる療養上の管理及び指導であって、厚生労働省令で定めるものをいう。
(6) The term "Guidance for Management of In-Home Medical Long-Term Care" as used in this Act means management and instructions for medical care and as determined by an Ordinance of the Ministry of Health, Labour, and Welfare. Said management and instructions are provided to an In-Home Person Requiring Long-Term Care by a physician, dentist, pharmacist or other personnel as determined by an Ordinance of the Ministry of Health, Labour, and Welfare that are associated with a hospital, clinic, or pharmacy (herein referred to as "Hospital, etc.")
7 この法律において「通所介護」とは、居宅要介護者について、老人福祉法第五の二第三の厚生労働省令で定める施設又は第二十の二の二に規定するデイサービスセンターに通わせ、当該施設において入浴、排せつ、食事等の介護その他の日常生活上の世話であって厚生労働省令で定めるもの及び機能訓練を行うこと(認知症対応型通所介護に該当するものを除く。)をいう。
(7) The term "Outpatient Day Long-Term Care" as used in this Act means care that is for bathing, bodily waste elimination, meals, etc., and other care provided for daily activities and which is provided as defined by an Ordinance of the Ministry of Health, Labour, and Welfare, and functional training (except for care defined as Outpatient Long-Term Care for a Dementia Patient) by having an In-Home Person Requiring Long-Term Care commute to a facility as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 5-2, paragraph (3) of the Public Aid for the Aged Act or a Long-term care Day Service Center as provided in Article 20-2-2 of the same Act.
8 この法律において「通所リハビリテーション」とは、居宅要介護者(主治の医師がその治療の必要の程度につき厚生労働省令で定める基準適合していると認めたものに限る。)について、介護保健施設、病院、診療所その他の厚生労働省令で定める施設に通わせ、当該施設において、その心身の機能維持回復を図り、日常生活の自立を助けるために行われる理学療作業その他必要なリハビリテーションをいう。
(8) The term "Outpatient Rehabilitation" as used in this Act means physical therapy, occupational therapy, and other necessary rehabilitation that is provided to an In-Home Person Requiring Long-Term Care (limited to those who are considered by an attending physician to be a person in the degree of need of medical treatment that conforms to standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare) by having said person commute to a Long-Term Care Health Facility, hospital, clinic, or other facility as determined by an Ordinance of the Ministry of Health, Labour, and Welfare and providing Outpatient Rehabilitation to said facility in order to maintain and recover his or her mental or physical functions and to assist independently performing daily activities.
9 この法律において「短期入所生活介護」とは、居宅要介護者について、老人福祉法第五の二第四の厚生労働省令で定める施設又は第二十の三に規定する短期入所施設に短期間入所させ、当該施設において入浴、排せつ、食事等の介護その他の日常生活上の世話及び機能訓練を行うことをいう。
(9) The term "Short-Term Admission for Daily Life Long-Term Care" as used in this Act means to provide care for bathing, bodily waste elimination, meals, etc., and other care for performing daily activities and to provide functional training for an In-Home Person Requiring Long-Term Care by having said person Short-Term Admission at a facility as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 5-2, paragraph (4) of the Public Aid for the Aged Act or at a Short-Term Admission Facility for the Elderly as provided in Article 20-3 of the same Act.
10 この法律において「短期入所療養介護」とは、居宅要介護者(その治療の必要の程度につき厚生労働省令で定めるものに限る。)について、介護保健施設介護療養型医療施設その他の厚生労働省令で定める施設に短期間入所させ、当該施設において看護、医学的管理の下における介護及び機能訓練その他必要な医療並びに日常生活上の世話を行うことをいう。
(10) The term "Short-Term Admission for Recuperation" as used in this Act means to provide nursing, long-term care and functional training under control of medical management, or other necessary medical treatment, or to provide care for performing daily activities to an In-Home Person Requiring Long-Term Care (limited to persons with the degree of necessity for medical treatment that conforms with standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare) by having said person Short-Term Admission at a Long-Term Care Health Facility, Sanatorium Medical Facility for the Elderly Requiring Long-Term Care or other facility as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
11 この法律において「特定施設」とは、有料老ホームその他厚生労働省令で定める施設であって、第十九規定する地域密着型特定施設でないものをいい、「特定施設入居者生活介護」とは、特定施設に入居している要介護者について、当該特定施設提供するサービスの内容、これを担当する者その他厚生労働省令で定める事を定めた計画に基づき行われる入浴、排せつ、食事等の介護その他の日常生活上の世話であって厚生労働省令で定めるもの、機能訓練及び療養上の世話をいう。
(11) The term "Specified Facility" as used in this Act means a Fee-Based Home for the Elderly or other facility as determined by an Ordinance of the Ministry of Health, Labour, and Welfare that is not a Community-Based Specified Facility as provided in this Article, paragraph (19) of this Act. The term "Daily Life Long-Term Care Admitted to a Specified Facility" as used in this Act means care for bathing, bodily waste elimination, meals, etc., and other care for performing daily activities that is as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, functional training, and medical care. Said care is provided to a Person Requiring Long-Term Care who is staying in a Specified Facility and is based on a plan which stipulates the content of services to be provided by said Specified Facility, the personnel in charge of the services, and other items as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
12 この法律において「福祉用具貸与」とは、居宅要介護者について福祉用具(心身の機能が低下し日常生活営むのに支障がある要介護者等の日常生活上の便宜を図るための用具及び介護者等の機能訓練のための用具であって、要介護者等の日常生活の自立を助けるためのものをいう。次並びに第十二及び第十三において同じ。)のうち厚生労働大臣が定めるものの政令で定めるところにより行われる貸与をいう。
(12) The term "Rental Service of Equipment for Long-Term Care Covered by Public Aid" as used in this Act means the rental of equipment covered by public aid undertaken pursuant to provisions of a Cabinet Order of those types of equipment as determined by the Minister of Health, Labour, and Welfare among equipment covered by public aid for an In-Home Person Requiring Long-Term Care (equipment for the convenience of performing daily activities by a Person Requiring Long-Term Care, etc., whose physical or mental functions are underactive and that cause problems with performing daily activities, equipment to assist an Insured Person Requiring Long-Term Care, etc., independently performing daily activities and equipment for functional training or an Insured Person Requiring Long-Term Care, etc.,; the same shall apply in the following paragraph (13), and to the following Article, paragraph (12) and paragraph (13) of this Act).
13 この法律において「特定福祉用具販売」とは、居宅要介護者について福祉用具のうち入浴又は排せつの用に供するものその他の厚生労働大臣が定めるもの(以下「特定福祉用具」という。)の政令で定めるところにより行われる販売をいう。
(13) The term "Sale of Specified Equipment Covered by Public Aid" as used in this Act means the sale, undertaken pursuant to provisions of a Cabinet Order, of equipment covered by public aid among equipment provided for use in bathing or bodily waste elimination and other items provided by the Minister of Health, Labour, and Welfare (herein referred to as "Specified Equipment Covered by Public Aid") to an In-Home Person Requiring Long-Term Care.
14 この法律において「地域密着型サービス」とは、夜間対応型訪問介護認知症対応型通所介護、小規模機能型居宅介護認知症対応型共同生活介護地域密着型特定施設入居者生活介護及び地域密着型介護福祉施設入所者生活介護をいい、「地域密着型サービス事業」とは、地域密着型サービスを行う事業をいう。
(14) The term "Community-Based Service" as used in this Act means Home-Visit at Night for Long-Term Care, Outpatient Long-Term Care for a Dementia Patient, Multifunctional Long-Term Care in a Small Group Home, Communal Daily Long-Term Care for a Dementia Patient, Daily Life Long-Term Care for a Person Admitted to a Community-Based Specified Facility, and Admission to a Community-Based Facility for Preventive Daily Long-Term Care of the Elderly Covered by Public Aid. The term "Community-Based Service Business" as used in this Act means a business that provides Community-Based Service.
15 この法律において「夜間対応型訪問介護」とは、居宅要介護者について、夜間において、定期的な巡回訪問により、又は通報を受け、その者の居宅において介護福祉その他第二政令で定める者により行われる入浴、排せつ、食事等の介護その他の日常生活上の世話であって、厚生労働省令で定めるものをいう。
(15) The term "Home-Visit at Night for Long-Term Care" as used in this Act means care provided for bathing, bodily waste elimination, meals, etc., and for other daily activities that are as determined by an Ordinance of the Ministry of Health, Labour, and Welfare. Said care is provided to an In-Home Person Requiring Long-Term Care at his or her home by a long-term care public aid worker or other personnel specified by a Cabinet Order and as set forth in paragraph (2) of this Article, according to periodic night visits or as requested during the night.
16 この法律において「認知症対応型通所介護」とは、居宅要介護者であって、脳血管疾患、アルツハイマー病その他の要因に基づく脳の器質的な変化により日常生活に支障が生じる程度にまで記憶機能及びその他の認知機能が低下した状態(以下「認知症」という。)であるものについて、老人福祉法第五の二第三の厚生労働省令で定める施設又は第二十の二の二に規定するデイサービスセンターに通わせ、当該施設において入浴、排せつ、食事等の介護その他の日常生活上の世話であって厚生労働省令で定めるもの及び機能訓練を行うことをいう。
(16) The term "Outpatient Long-Term Care for a Dementia Patient" as used in this Act means to provide care for bathing, bodily waste elimination, meals, etc., and for other daily activities as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, and functional training for an In-Home Person Requiring Long-Term Care who is in the condition that memory functions and other cognitive functions have become underactive as far as causing disorder with performing daily activities due to organic changes of the brain that are caused by cerebral vascular disease, Alzheimer's disease, or other factors (herein referred to as "Dementia"). This is accomplished by having said person commute to a facility as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 5-2, paragraph (3) of the Public Aid for the Aged Act or Long-Term Care Day Service Centers for the elderly as provided in Article 20-2-2 of the same Act.
17 この法律において「小規模機能型居宅介護」とは、居宅要介護者について、その者の心身の状況、その置かれている環境等に応じて、その者の選択に基づき、その者の居宅において、又は厚生労働省令で定めるサービスの拠点に通わせ、若しくは期間宿泊させ、当該拠点において、入浴、排せつ、食事等の介護その他の日常生活上の世話であって厚生労働省令で定めるもの及び機能訓練を行うことをいう。
(17) The term "Multifunctional Long-Term Care in a Small Group Home" as used in this Act means to provide care for bathing, bodily waste elimination, meals, etc., and for other daily activities as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, and functional training to an In-Home Person Requiring Long-Term Care at his or her home, or said bases of services as determined by an Ordinance of the Ministry of Health, Labour, and Welfare by having the person commute daily to a location or stay for short-term at said bases, according to the person's mental and physical condition, surroundings, etc., and based on his or her preference.
18 この法律において「認知症対応型共同生活介護」とは、要介護者であって認知症であるもの(その者の認知症の原因となる疾患が急性の状態にある者を除く。)について、その共同生活営むべき住居において、入浴、排せつ、食事等の介護その他の日常生活上の世話及び機能訓練を行うことをいう。
(18) The term "Communal Daily Long-Term Care for a Dementia Patient" as used in this Act means to provide care for bathing, bodily waste elimination, meals, etc., and for other daily activities, and functional training for a Person Requiring Long-Term Care who is suffering from Dementia (except for a person with the cause of Dementia being an acute disease), at a residence where the person lives communally.
19 この法律において「地域密着型特定施設入居者生活介護」とは、有料老ホームその他第十一の厚生労働省令で定める施設であって、その入居者が要介護者、その配偶者その他厚生労働省令で定める者に限られるもの(以下「介護専用型特定施設」という。)のうち、その入居定員が二十九以下であるもの(以下このにおいて「地域密着型特定施設」という。)に入居している要介護者について、当該地域密着型特定施設提供するサービスの内容、これを担当する者その他厚生労働省令で定める事を定めた計画に基づき行われる入浴、排せつ、食事等の介護その他の日常生活上の世話であって厚生労働省令で定めるもの、機能訓練及び療養上の世話をいう。
(19) The term "Daily Life Long-Term Care for a Person Admitted to a Community-Based Specified Facility" as used in this Act means to provide care for bathing, bodily waste elimination, meals, etc., and for other daily activities as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, functional training and medical care based on a plan that stipulates the content of services to be provided by said Community-Based Specified Facility, the personnel in charge of the services, and other items as determined by an Ordinance of the Ministry of Health, Labour, and Welfare. This service is provided to a Person Requiring Long-Term Care who is staying in a Fee-Based Home for the Elderly and other facilities as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in paragraph (11) of this Article and for which the capacity of the fixed number of said residents is twenty-nine (29) or less (hereinafter referred to as "Community-Based Specified Facility"), among facilities for which residents are limited to a Person Requiring Long-Term Care, said person's spouse, and other personnel as determined by an Ordinance of the Ministry of Health, Labour, and Welfare (herein referred to as a "Specialized Long-Term Care Specified Facility").
20 この法律において「地域密着型介護福祉施設」とは、老人福祉法第二十の五に規定する特別養護老ホーム(入所定員が二十九以下であるものに限る。以下このにおいて同じ。)であって、当該特別養護老ホームに入所する要介護者に対し、地域密着型施設サービス計画地域密着型介護福祉施設に入所している要介護者について、当該施設提供するサービスの内容、これを担当する者その他厚生労働省令で定める事を定めた計画をいう。以下このにおいて同じ。)に基づいて、入浴、排せつ、食事等の介護その他の日常生活上の世話、機能訓練、健康管理及び療養上の世話を行うことを目的とする施設をいい、「地域密着型介護福祉施設入所者生活介護」とは、地域密着型介護福祉施設に入所する要介護者に対し、地域密着型施設サービス計画に基づいて行われる入浴、排せつ、食事等の介護その他の日常生活上の世話、機能訓練、健康管理及び療養上の世話をいう。
(20) The term "Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care" as used in this Act means an Intensive Care Home for the Elderly (limited to facilities for which the capacity of residents is twenty-nine (29) or less; the same shall apply hereinafter in this paragraph) provided in Article 20-5 of the Public Aid for the Aged Act that aims to provide care for bathing, bodily waste elimination, meals, etc., and for other daily activities, functional training, health management, and medical care to a Person Requiring Long-Term Care who is staying in said Intensive Care Home for the Elderly based on a Community-Based Facility Service Plan (one that provides the content of services provided to a Person Requiring Long-Term Care who is staying in a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care by said facility, the personnel in charge of said services, and other items as determined by an Ordinance of the Ministry of Health, Labour, and Welfare; the same shall apply hereinafter in this paragraph). The term "Admission to a Community-Based Facility for Preventive Daily Long-Term Care of the Elderly Covered by Public Aid" as used in this Act means to provide care for bathing, bodily waste elimination, meals, etc., and for other daily activities, functional training, health management, and medical care to a Person Requiring Long-Term Care who is staying in a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care, based on a Community-Based Facility Service Plan.
21 この法律において「居宅介護支援」とは、居宅要介護者が第四十一第一規定する指定居宅サービス又は特例居宅介護サービス費に係る居宅サービス若しくはこれに相当するサービス、第四十二の二第一規定する指定地域密着型サービス又は特例地域密着型介護サービス費に係る地域密着型サービス若しくはこれに相当するサービス及びその他の居宅において日常生活営むために必要な保健医療サービス又は福祉サービス(以下このにおいて「指定居宅サービス等」という。)の適切な利用等をすることができるよう、当該居宅要介護者の依頼を受けて、その心身の状況、その置かれている環境当該居宅要介護及びその家族の希望等を勘案し、利用する指定居宅サービス等の種類及び内容、これを担当する者その他厚生労働省令で定める事を定めた計画(以下この、第百十五の三十八第一第五及びにおいて「居宅サービス計画」という。)を作成するとともに、当該居宅サービス計画に基づく指定居宅サービス等の提供が確保されるよう、第四十一第一規定する指定居宅サービス事業者、第四十二の二第一規定する指定地域密着型サービス事業者その他の者との連絡調整その他の便宜の提供を行い、並びに当該居宅要介護者が地域密着型介護福祉施設又は介護保険施設への入所を要する場合にあっては、地域密着型介護福祉施設又は介護保険施設への紹介その他の便宜の提供を行うことをいい、「居宅介護支援事業」とは、居宅介護支援を行う事業をいう。
(21) The term "In-Home Long-Term Care Support" as used in this Act means to establish a plan (herein referred to as an "In-Home Service Plan" in this paragraph, Article 115-38, paragraph (1), item (v), and the appended table to this Act) that provides the types and contents of Designated In-Home Service, etc. (herein referred to as "Designated In-Home Service, etc." in this paragraph), the personnel in charge of said services to be used by an In-Home Person Requiring Long-Term Care, and other items as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, at the request of said Person Requiring Long-Term Care and in consideration of his or her mental and physical condition, surroundings, and the person's and his or her family's preferences, etc., in order for an In-Home Person Requiring Long-Term Care to be able to use appropriately the Designated In-Home Service as prescribed in Article 41, paragraph (1) of this Act, In-Home Service related to Exceptional Allowance for In-Home Long-Term Care Service or equivalent services, Designated Community-Based Service as prescribed in Article 42-2, paragraph (1) of this Act, Community-Based Service related to Exceptional Allowance for Community-Based Long-Term Care Service or equivalent services, and other necessary health and medical services or public aid services for performing daily activities at home (hereinafter referred to as "Designated In-Home Service, etc." in this paragraph); the term also means to provide communication and coordination among Designated Providers of In-Home Long-Term Care as prescribed in Article 41, paragraph (1) of this Act, Designated Community-Based Service Provider as prescribed in Article 42-2, paragraph (1) of this Act and other person and to provide other conveniences in order to ensure provision of the Designated In-Home Service, etc., based on said In-Home Service Plan, and in a case when said In-Home Person Requiring Long-Term Care requires admission to a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care or a Facility Providing Insured Long-Term Care, the term means to introduce a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care or Facility Providing Insured Long-Term Care and to provide other conveniences. The term "Designated In-Home Long-Term Care Support Business" as used in this Act means a business to provide In-Home Long-Term Care Support.
22 この法律において「介護保険施設」とは、第四十八第一第一規定する指定介護福祉施設介護保健施設及び第三規定する指定介護療養型医療施設をいう。
(22) The term "Facility Covered by Long-Term Care Insurance" as used in this Act means a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly or a Long-Term Care Health Facility as prescribed in Article 48, paragraph (1), item (i) of this Act, and a Designated Medical Long-Term Care Sanatorium as prescribed in item (iii) of the same paragraph.
23 この法律において「施設サービス」とは、介護福祉施設サービス、介護保健施設サービス及び介護療養施設サービスをいい、「施設サービス計画」とは、介護福祉施設介護保健施設又は介護療養型医療施設に入所している要介護者について、これらの施設提供するサービスの内容、これを担当する者その他厚生労働省令で定める事を定めた計画をいう。
(23) The term "Facility Service" as used in this Act means a Facility Service for Long-Term Care Covered by Public Aid, Long-Term Care Health Facility Service, or Sanatorium Long-Term Care Service. The term "Facility Service Plan" as used in this Act means a plan for a Person Requiring Long-Term Care staying at a Designated Facility Covered by Public Aid Providing Long-Term Care to the Elderly, a Long-Term Care Health Facility, or a Sanatorium Medical Facility for the Elderly Requiring Long-Term Care that stipulates the content of services provided by said facilities, the personnel in charge of said services, and other items as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
24 この法律において「介護福祉施設」とは、老人福祉法第二十の五に規定する特別養護老ホーム(入所定員が三十以上であるものに限る。以下このにおいて同じ。)であって、当該特別養護老ホームに入所する要介護者に対し、施設サービス計画に基づいて、入浴、排せつ、食事等の介護その他の日常生活上の世話、機能訓練、健康管理及び療養上の世話を行うことを目的とする施設をいい、「介護福祉施設サービス」とは、介護福祉施設に入所する要介護者に対し、施設サービス計画に基づいて行われる入浴、排せつ、食事等の介護その他の日常生活上の世話、機能訓練、健康管理及び療養上の世話をいう。
(24) The term "Facility Covered by Public Aid Providing Long-Term Care to the Elderly" as used in this Act means an Intensive Care Home for the Elderly provided in Article 20-5 of the Public Aid for the Aged Act (limited to a facility with a capacity of thirty (30) residents or more; the same shall apply hereinafter in this paragraph). The purpose of said facility is to provide care for bathing, bodily waste elimination, meals, etc., and for other daily activities, functional training, health management, and medical care to a Person Requiring Long-Term Care who is staying in said Intensive Care Home for the Elderly based on a Facility Service Plan. The term "Facility Service for Long-Term Care Covered by Public Aid" as used in this Act means care that is provided based on a Facility Service Plan for bathing, bodily waste elimination, meals, etc., and for other daily activities, functional training, health management, and medical care to a Person Requiring Long-Term Care who is staying in said Facility Covered by Public Aid Providing Long-Term Care to the Elderly.
25 この法律において「介護保健施設」とは、要介護者(その治療の必要の程度につき厚生労働省令で定めるものに限る。以下このにおいて同じ。)に対し、施設サービス計画に基づいて、看護、医学的管理の下における介護及び機能訓練その他必要な医療並びに日常生活上の世話を行うことを目的とする施設として、第九十四第一都道府県知事許可を受けたものをいい、「介護保健施設サービス」とは、介護保健施設に入所する要介護者に対し、施設サービス計画に基づいて行われる看護、医学的管理の下における介護及び機能訓練その他必要な医療並びに日常生活上の世話をいう。
(25) The term "Long-Term Care Health Facility" as used in this Act means a facility which has obtained permission from the prefectural governor as set forth in Article 94, paragraph (1) of this Act as a facility with the purpose of providing nursing, care and functional training under control of medical management, and other necessary care for medical treatment and daily activities to a Person Requiring Long-Term Care (limited to persons whose degree of necessity for medical treatment conforms with standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare; the same shall apply hereinafter in this paragraph) based on a Facility Service Plan. The term "Long-Term Care Health Facility Service" as used in this Act means nursing, care and functional training under control of medical management, and other necessary care for medical treatment and daily activities for a Person Requiring Long-Term Care who is staying in a Long-Term Care Health Facility, based on a Facility Service Plan.
26 この法律において「介護療養型医療施設」とは、療養病床等(医療法(昭和二十三年法律第二百五)第七第二第四規定する療養病床のうち要介護者の心身の特性に応じた適切な看護が行われるものとして政令で定めるもの又は療養病床以外の病院の病床のうち認知症である要介護者の心身の特性に応じた適切な看護が行われるものとして政令で定めるものをいう。以下同じ。)を有する病院又は診療所であって、当該療養病床等に入院する要介護者(その治療の必要の程度につき厚生労働省令で定めるものに限る。以下このにおいて同じ。)に対し、施設サービス計画に基づいて、療養上の管理、看護、医学的管理の下における介護その他の世話及び機能訓練その他必要な医療を行うことを目的とする施設をいい、「介護療養施設サービス」とは、介護療養型医療施設の療養病床等に入院する要介護者に対し、施設サービス計画に基づいて行われる療養上の管理、看護、医学的管理の下における介護その他の世話及び機能訓練その他必要な医療をいう。
(26) The term "Sanatorium Medical Facility for the Elderly Requiring Long-Term Care as used in this Act means a facility such as a hospital or clinic that maintains a sanatorium ward or other beds ("Sanatorium Ward, etc.") that are specified by a Cabinet Order to provide appropriate nursing services according to the mental and physical characteristics of a Person Requiring Long-Term Care among Sanatorium Ward, etc., as prescribed in Article 7, paragraph (2) item (iv) of the Medical Care Act (Act No. 205, 1948), or beds which are specified by a Cabinet Order to provide appropriate nursing services according to the mental and physical characteristics of a Person Requiring Long-Term Care with Dementia among beds other than those for Long-Term Care Beds in the hospital; the same shall apply hereinafter), and with the purpose of providing medical care management, nursing, long-term care and other care under medical management, functional training, and other necessary medical care to a Person Requiring Long-Term Care who is in said bed for long-term care, etc., (limited to a person with the degree of need for medical treatment that conforms with standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare; the same shall apply hereinafter in this paragraph), based on a Facility Service Plan. The term "Sanatorium Long-Term Care Service" as used in this Act means medical care management, nursing, long-term care under medical management, and other care, functional training, and other necessary medical care provided to a Person Requiring Long-Term Care who is in a Sanatorium Ward, etc., for long-term care of a Sanatorium Medical Facility for the Elderly Requiring Long-Term Care based on a Facility Service Plan.
第八条の二 この法律において「介護予防サービス」とは、介護予防訪問介護介護予防訪問入浴介護介護予防訪問看護、介護予防訪問リハビリテーション、介護予防居宅療養管理指導介護予防通所介護介護予防通所リハビリテーション、介護予防短期入所生活介護介護予防短期入所療養介護介護予防特定施設入居者生活介護介護予防福祉用具貸与及び特定介護予防福祉用具販売をいい、「介護予防サービス事業」とは、介護予防サービスを行う事業をいう。
Article 8-2 The term "Preventive Long-Term Care Service" as used in this Act means Home-Visit Service for Preventive Long-Term Care, Home-Visit Bathing Service for Preventive Long-Term Care, Home-Visit Nursing Service for Preventive Long-Term Care, Home-Visit Rehabilitation Service for Preventive Long-Term Care, Management and Guidance for In-Home Medical Service for Preventive Long-Term Care, other Outpatient Preventive Long-Term Care, Outpatient Rehabilitation for Preventive Long-Term Care, Short-Term Admission for Daily Preventive Long-Term Care, Short-Term Admission for Recuperation for Preventive Long-Term Care, Daily Preventive Long-Term Care Admitted to a Specified Facility, Rental of Specified Equipment for Preventive Long-Term Care Covered by Public Aid, and the Sale of Specified Equipment for Preventive Long-Term Care Covered by Public Aid. The term "Preventive Long-Term Care Service Business" as used in this Act means a business that provides Preventive Long-Term Care Service.
2 この法律において「介護予防訪問介護」とは、要支援者であって、居宅において支援を受けるもの(以下「居宅要支援者」という。)について、その者の居宅において、その介護予防身体又は精神上の障害があるために入浴、排せつ、食事等の日常生活における基本的な動作の全部若しくは一部について常時介護を要し、又は日常生活営むのに支障がある状態の軽減又は悪化の防止をいう。以下同じ。)を目的として、介護福祉その政令で定める者により、厚生労働省令で定める期間にわたり行われる入浴、排せつ、食事等の介護その他の日常生活上の支援であって、厚生労働省令で定めるものをいう。
(2) The term "Home-Visit Service for Preventive Long-Term Care" as used in this Act means support for bathing, bodily waste elimination, meals, etc., and for other daily activities as determined by an Ordinance of the Ministry of Health, Labour, and Welfare. Said support is provided to a Person Requiring Support who receives support (herein referred to as a "Person Requiring In-Home Support"), at his or her home for the purpose of prevention of long-term care (reduction or prevention of deterioration of conditions for which a person requires continuous care for the whole or a part of basic movements during daily activities, such as bathing, bodily waste elimination, meals, etc., or a person that has difficulty performing daily activities due to physical or mental disabilities; the same shall apply herein) by a long-term care public aid worker or other personnel as provided by a Cabinet Order and for the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
3 この法律において「介護予防訪問入浴介護」とは、居宅要支援者について、その介護予防目的として、厚生労働省令で定める場合に、その者の居宅を訪問し、厚生労働省令で定める期間にわたり浴槽を提供して行われる入浴の介護をいう。
(3) The term "Home-Visit Bathing Service for Preventive Long-Term Care" as used in this Act means bathing care provided to a Person Requiring In-Home Support with the purpose of preventing the long-term care of said person by visiting said person at his or her home and providing a bathing tub for the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
4 この法律において「介護予防訪問看護」とは、居宅要支援者(主治の医師がその治療の必要の程度につき厚生労働省令で定める基準適合していると認めたものに限る。)について、その者の居宅において、その介護予防目的として、看護師その他厚生労働省令で定める者により、厚生労働省令で定める期間にわたり行われる療養上の世話又は必要な診療の補助をいう。
(4) The term "Home-Visit Nursing Service for Preventive Long-Term Care" as used in this Act means medical care or assistance of a necessary medical care provided to a Person Requiring In-Home Support (limited to a person that is considered by an attending physician to be a person with the degree of need for medical treatment that conforms to standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare) at his or her home for the purpose of prevention of long-term care, and by a nurse or other personnel as determined by an Ordinance of the Ministry of Health, Labour, and Welfare and for the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
5 この法律において「介護予防訪問リハビリテーション」とは、居宅要支援者(主治の医師がその治療の必要の程度につき厚生労働省令で定める基準適合していると認めたものに限る。)について、その者の居宅において、その介護予防目的として、厚生労働省令で定める期間にわたり行われる理学療作業その他必要なリハビリテーションをいう。
(5) The term "Home-Visit Rehabilitation Service for Preventive Long-Term Care" as used in this Act means physical therapy, occupational therapy, and other necessary rehabilitation provided to a Person Requiring In-Home Support (limited to a person that is considered by an attending physician to be a person with the degree of need for medical treatment that conforms to standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare) at his or her home for the purpose of prevention of long-term care and for the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
6 この法律において「介護予防居宅療養管理指導」とは、居宅要支援者について、その介護予防目的として、病院等の医師、歯科医師、薬剤師その他厚生労働省令で定める者により行われる療養上の管理及び指導であって、厚生労働省令で定めるものをいう。
(6) The term "Management and Guidance for In-Home Medical Service for Preventive Long-Term Care" as used in this Act means management and guidance for medical care that is stipulated by an Ordinance of the Ministry of Health, Labour, and Welfare and said management and guidance for medical care is provided to a Person Requiring In-Home Support for the purpose of prevention of long-term care, and by a physician in a Hospital, etc., dentist, pharmacist, or other personnel as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
7 この法律において「介護予防通所介護」とは、居宅要支援者について、その介護予防目的として、老人福祉法第五の二第三の厚生労働省令で定める施設又は第二十の二の二に規定するデイサービスセンターに通わせ、当該施設において、厚生労働省令で定める期間にわたり、入浴、排せつ、食事等の介護その他の日常生活上の支援であって厚生労働省令で定めるもの及び機能訓練を行うこと(介護予防認知症対応型通所介護に該当するものを除く。)をいう。
(7) The term "Outpatient Preventive Long-Term Care" as used in this Act means care for bathing, bodily waste elimination, meals, etc., and other support for daily activities as determined by an Ordinance of the Ministry of Health, Labour, and Welfare and performing functional training (except that which is defined as Preventive Long-Term Care for a Dementia Outpatient) that is provided to a Person Requiring In-Home Support for the purpose of prevention of long-term care by having said person commute to a facility as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 5-2, paragraph (3) of the Public Aid for the Aged Act, or a Long-Term Care Day Service Center as provided in Article 20-2-2 of the same Act, at said facility and for the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
8 この法律において「介護予防通所リハビリテーション」とは、居宅要支援者(主治の医師がその治療の必要の程度につき厚生労働省令で定める基準適合していると認めたものに限る。)について、介護保健施設、病院、診療所その他の厚生労働省令で定める施設に通わせ、当該施設において、その介護予防目的として、厚生労働省令で定める期間にわたり行われる理学療作業その他必要なリハビリテーションをいう。
(8) The term "Outpatient Rehabilitation for Preventive Long-Term Care" as used in this Act means physical therapy, occupational therapy, and other necessary rehabilitation provided to a Person Requiring In-Home Support (limited to a person that is considered by an attending physician to be a person with the degree of need for medical treatment that conforms to standards as determined by an Ordinance of the Ministry of Health, Labour, and Welfare) by having said person commute to a Long-Term Care Health Facility, hospital, clinic, or other facility as determined by an Ordinance of the Ministry of Health, Labour, and Welfare at said facility for the purpose of prevention of long-term care for the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
9 この法律において「介護予防短期入所生活介護」とは、居宅要支援者について、老人福祉法第五の二第四の厚生労働省令で定める施設又は第二十の三に規定する短期入所施設に短期間入所させ、その介護予防目的として、厚生労働省令で定める期間にわたり、当該施設において入浴、排せつ、食事等の介護その他の日常生活上の支援及び機能訓練を行うことをいう。
(9) The term "Short-Term Admission for Daily Preventive Long-Term Care" as used in this Act means to provide care for bathing, bodily waste elimination, meals, etc., support for other daily activities, and functional training to a Person Requiring In-Home Support by having said person stay for a short-term in a facility as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 5-2, paragraph (4) of the Public Aid for the Aged Act, or in a Short-Term Admission Facility for the Elderly as provided in Article 20-3 of the same Act, for the purpose of prevention of long-term care for the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare at said facility.
10 この法律において「介護予防短期入所療養介護」とは、居宅要支援者(その治療の必要の程度につき厚生労働省令で定めるものに限る。)について、介護保健施設介護療養型医療施設その他の厚生労働省令で定める施設に短期間入所させ、その介護予防目的として、厚生労働省令で定める期間にわたり、当該施設において看護、医学的管理の下における介護及び機能訓練その他必要な医療並びに日常生活上の支援を行うことをいう。
(10) The term "Short-Term Admission for Recuperation for Preventive Long-Term Care" as used in this Act means to provide nursing, long-term care, functional training and other necessary care for medical treatment under control of medical management, and support for daily activities to a Person Requiring In-Home Support (limited to a person with the degree of need for medical treatment that conforms with an Ordinance of the Ministry of Health, Labour, and Welfare) by having the person stay for a short-term in a Long-Term Care Health Facility, a Sanatorium Medical Facility for the Elderly Requiring Long-Term Care or other facility as determined by an Ordinance of the Ministry of Health, Labour, and Welfare for the purpose of prevention of long-term care for the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare at said facility.
11 この法律において「介護予防特定施設入居者生活介護」とは、特定施設介護専用型特定施設を除く。)に入居している要支援者について、その介護予防目的として、当該特定施設提供するサービスの内容、これを担当する者その他厚生労働省令で定める事を定めた計画に基づき行われる入浴、排せつ、食事等の介護その他の日常生活上の支援であって厚生労働省令で定めるもの、機能訓練及び療養上の世話をいう。
(11) The term "Daily Preventive Long-Term Care Admitted to a Specified Facility" as used in this Act means care for bathing, bodily waste elimination, meals, etc., and support for other daily activities as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, functional training, and medical care that is provided to a Person Requiring Support who is staying in a Specified Facility (except for a Specialized Long-Term Care Specified Facility) for the purpose of prevention of long-term care, and based on a plan for providing services of specified content by said Specified Facility, the personnel in charge of said services, and other items as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
12 この法律において「介護予防福祉用具貸与」とは、居宅要支援者について福祉用具のうちその介護予防資するものとして厚生労働大臣が定めるものの政令で定めるところにより行われる貸与をいう。
(12) The term "Equipment Rental for Preventive Long-Term Care Covered by Public Aid" as used in this Act means a rental of equipment undertaken for a Person Requiring In-Home Support pursuant to the provisions of a Cabinet Order for equipment covered by public aid that is specified by the Minister of Health, Labour, and Welfare as equipment contributing to the prevention of long-term care to a Person Requiring In-Home Support among equipment covered by public aid.
13 この法律において「特定介護予防福祉用具販売」とは、居宅要支援者について福祉用具のうちその介護予防資するものであって入浴又は排せつの用に供するものその他の厚生労働大臣が定めるもの(以下「特定介護予防福祉用具」という。)の政令で定めるところにより行われる販売をいう。
(13) The term "Sale of Specified Equipment for Preventive Long-Term Care Covered by Public Aid" as used in this Act means sales undertaken for a Person Requiring In-Home Support pursuant to the provisions of a Cabinet Order of equipment covered by public aid that contributes to the prevention of long-term care that is provided for use in bathing or bodily waste elimination, as specified by the Ministry of Health, Labour, and Welfare, among equipment covered by public aid (herein referred to as "Specified Equipment for Preventive Long-Term Care Covered by Public Aid").
14 この法律において「地域密着型介護予防サービス」とは、介護予防認知症対応型通所介護介護予防規模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をいい、「地域密着型介護予防サービス事業」とは、地域密着型介護予防サービスを行う事業をいう。
(14) The term "Community-Based Service for Preventive Long-Term Care" as used in this Act means Preventive Long-Term Care for a Dementia Outpatient, Multifunctional Preventive Long-Term Care in a Small Group Home, and Preventive Long-Term Care for a Dementia Patient in Communal Living. The term "Community-Based Preventive Long-Term Care Business" as used in this Act means a business that provides Community-Based Service for Preventive Long-Term Care.
15 この法律において「介護予防認知症対応型通所介護」とは、居宅要支援者であって、認知症であるものについて、その介護予防目的として、老人福祉法第五の二第三の厚生労働省令で定める施設又は第二十の二の二に規定するデイサービスセンターに通わせ、当該施設において、厚生労働省令で定める期間にわたり、入浴、排せつ、食事等の介護その他の日常生活上の支援であって厚生労働省令で定めるもの及び機能訓練を行うことをいう。
(15) The term "Preventive Long-Term Care for a Dementia Outpatient" as used in this Act means to provide care for bathing, bodily waste elimination, meals, etc., and support for other daily activities as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, and functional training to a Person Requiring In-Home Support who is suffering from Dementia, for the purpose of prevention of long-term care by having the person commute to a facility as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in Article 5-2, paragraph (3) of the Public Aid for the Aged Act or a Long-Term Care Day Service Center as provided in Article 20-2-2 of the same Act, at said facility and for the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
16 この法律において「介護予防規模機能型居宅介護」とは、居宅要支援者について、その者の心身の状況、その置かれている環境等に応じて、その者の選択に基づき、その者の居宅において、又は厚生労働省令で定めるサービスの拠点に通わせ、若しくは期間宿泊させ、当該拠点において、その介護予防目的として、入浴、排せつ、食事等の介護その他の日常生活上の支援であって厚生労働省令で定めるもの及び機能訓練を行うことをいう。
(16) The term "Multifunctional Preventive Long-Term Care in a Small Group Home" as used in this Act means to provide care for bathing, bodily waste elimination, meals, etc., and support for other daily activities as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, and functional training to a Person Requiring In-Home Support according to the mental and physical conditions of said person and according to the environment, etc., of said person based on the preferences of said person at his or her home or at a base of service as determined by an Ordinance of the Ministry of Health, Labour, and Welfare by having the person commute daily or stay for a short-term for the purpose of prevention of long-term care.
17 この法律において「介護予防認知症対応型共同生活介護」とは、要支援者(厚生労働省令で定める要支援状態区分に該当する状態である者に限る。)であって認知症であるもの(その者の認知症の原因となる疾患が急性の状態にある者を除く。)について、その共同生活営むべき住居において、その介護予防目的として、入浴、排せつ、食事等の介護その他の日常生活上の支援及び機能訓練を行うことをいう。
(17) The term "Preventive Long-Term Care for a Dementia Patient in Communal Living" as used in this Act means to provide care for bathing, bodily waste elimination, meals, etc., support for other activities, and functional training to a Person Requiring Support (limited to a person that corresponds to a Category of Needed Support Condition as determined by an Ordinance of the Ministry of Health, Labour, and Welfare) who are suffering from Dementia (except for a person that cause of Dementia is an acute disease) at a residence where the person lives communally and for the purpose of prevention of long-term care.
18 この法律において「介護予防支援」とは、居宅要支援者が第五十三第一規定する指定介護予防サービス又は特例介護予防サービス費に係る介護予防サービス若しくはこれに相当するサービス、第五十四の二第一規定する指定地域密着型介護予防サービス又は特例地域密着型介護予防サービス費に係る地域密着型介護予防サービス若しくはこれに相当するサービス及びその他の介護予防資する保健医療サービス又は福祉サービス(以下このにおいて「指定介護予防サービス等」という。)の適切な利用等をすることができるよう、第百十五の三十九第一規定する地域包括支援センターの職員のうち厚生労働省令で定める者が、当該居宅要支援者の依頼を受けて、その心身の状況、その置かれている環境当該居宅要支援及びその家族の希望等を勘案し、利用する指定介護予防サービス等の種類及び内容、これを担当する者その他厚生労働省令で定める事を定めた計画(以下この及びにおいて「介護予防サービス計画」という。)を作成するとともに、当該介護予防サービス計画に基づく指定介護予防サービス等の提供が確保されるよう、第五十三第一規定する指定介護予防サービス事業者、第五十四の二第一規定する指定地域密着型介護予防サービス事業者その他の者との連絡調整その他の便宜の提供を行うことをいい、「介護予防支援事業」とは、介護予防支援を行う事業をいう。
(18) The term "Preventive Long-Term Care Support" as used in this Act means that a person as determined by an Ordinance of the Ministry of Health, Labour, and Welfare among the personnel of a community general support center as prescribed in Article 115-39, paragraph (1) of this Act, with regard to a Person Requiring In-Home Support, considers said a Person's mental and physical condition, the present environment of said Person, the preferences, etc., of said Person Requiring In-Home Support and those of his or her family according to the request of said Person Requiring In-Home Support, and establishes a plan that stipulates the type and content of a Designated Provider of a Preventive Service to Long-Term Care Service, etc., that said Person will use, the personnel in charge of said services, and other items as determined by an Ordinance of the Ministry of Health, Labour, and Welfare (herein referred to as "Preventive Long-Term Care Service Plan" in this paragraph and the appended table) in order for the Person Requiring In-Home Support to be able to use appropriately those services as prescribed in Article 53, paragraph (1) of this Act that are of a Designated Preventive Long-Term Care Service, Preventive Long-Term Care Service pertaining to Exceptional Allowance for Preventive Service of Long-Term Care or services equivalent to said service, those services as prescribed in Article 54-2, paragraph (1) that are Designated Community-Based Preventive Service of Long-Term Care, Community-Based Service for Preventive Long-Term Care pertaining to Exceptional Allowance for Community-Based Preventive Service of Long-Term Care, or equivalent services to said service, or other health and medical services or public aid services contributing to prevention of long-term care (herein referred to as "Designated Preventive Long-Term Care Service, etc.") and that said personnel provide liaison and coordination among those who are a Designated Provider of a Preventive Service to Long-Term Care prescribed in Article 53, paragraph (1) of this Act, those who are a Designated Person Providing Community-Based Preventive Service of Long-Term Care as prescribed in Article 54-2, paragraph (1), and other personnel, and other convenience in order to ensure the provision of the Designated Preventive Long-Term Care Service, etc., based on said Preventive Long-Term Care Service Plan. The term "Preventive Long-Term Care Support Business" as used in this Act means a business that provides a Preventive Long-Term Care Support.
第二章 被保険者
Chapter II Insured Persons
(被保険者)
(Insured Person)
第九条 次の各のいずれかに該当する者は、市町村又は特別区(以下単に「市町村」という。)が行う介護保険被保険者とする
Article 9 A person that corresponds to any of the following items shall be an Insured Person of Long-Term Care for the Aged Insurance provided by a municipality or special city ward (herein referred to simply as "Municipality"):
一 市町村区域内に住所を有する六十五歳以上の者(以下「第一被保険者」という。)
(i) a person that is domiciled in the Municipality and is 65 years of age or more (herein referred to as "Primary Insured Person");
二 市町村区域内に住所を有する四十歳以上六十五歳未満の医療保険加入者(以下「第二被保険者」という。)
(ii) a person insured by medical insurance that is domiciled in the Municipality and is 40 years of age or more but less than 65 years of age (herein referred to as "Secondary Insured Person").
(資格取得の時期)
(Time of Acquisition of Qualifications)
第十条 規定による当該市町村が行う介護保険被保険者は、次の各のいずれかに該当するに至った日から、その資格取得する
Article 10 An Insured Person by Long-Term Care Insurance as provided by a Municipality pursuant to the provisions of the preceding Article shall acquire said eligibility on the date when said Person first corresponds to any of the following items:
一 当該市町村区域内に住所を有する医療保険加入者が四十歳に達したとき。
(i) when a Medical Insurance Subscriber who is domiciled in said Municipality becomes 40 years of age;
二 四十歳以上六十五歳未満の医療保険加入者又は六十五歳以上の者が当該市町村区域内に住所を有するに至ったとき。
(ii) when a Medical Insurance Subscriber who is 40 years of age or more but less than 65 years of age acquires domicile in said Municipality;
三 当該市町村区域内に住所を有する四十歳以上六十五歳未満の者が医療保険加入者となったとき。
(iii) when a person that is domiciled in said Municipality and is 40 years of age or more but less than 65 years of age becomes a Medical Insurance Subscriber;
四 当該市町村区域内に住所を有する者(医療保険加入者を除く。)が六十五歳に達したとき。
(iv) when a person that is domiciled in said Municipality (other than a Medical Insurance Subscriber) becomes 65 years of age.
(資格喪失の時期)
(Time of Loss of Qualification)
第十一条 第九規定による当該市町村が行う介護保険被保険者は、当該市町村区域内に住所を有しなくなった日の翌日から、その資格を喪失する。ただし、当該市町村区域内に住所を有しなくなった日に他の市町村区域内に住所を有するに至ったときは、その日から、その資格を喪失する。
Article 11 An Insured Person by Long-Term Care Insurance provided by said Municipality pursuant to the provisions of Article 9 of this Act shall lose said qualification from the day following the date when said person fails to have domicile in said Municipality, however, provided that said person shall lose this qualification on said date when the person fails to have domicile in said Municipality and obtains domicile in another Municipality on the same day.
2 第二被保険者は、医療保険加入者でなくなった日から、その資格を喪失する。
(2) A Secondary Insured Person shall lose this qualification on the date when said person becomes a non-Medical Insurance Subscriber.
(届出等)
(Notifications, etc.)
第十二条 第一被保険者は、厚生労働省令で定めるところにより、被保険者資格取得及び喪失に関する事その他必要な事市町村に届け出なければならない。ただし、第十第四に該当するに至ったことにより被保険者資格取得した場合(厚生労働省令で定める場合を除く。)については、この限りでない。
Article 12 A Primary Insured Person shall notify the Municipality of matters regarding acquisition and loss of qualification of Insured Person status and other necessary matters pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, however, provided that this provision shall not apply to a case when the Primary Insured Person acquired the qualification of an Insured Person due to becoming subject to Article 10, item (iv) of this Act (except for a case pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare).
2 第一被保険者の属する世帯の世帯主は、その世帯に属する第一被保険者に代わって、当該第一被保険者に係る規定による届出することができる
(2) The householder of said family in which a Primary Insured Person resides may provide the notification pursuant to the provisions of the preceding paragraph regarding said Primary Insured Person on behalf of a Primary Insured Person that resides in the household.
3 被保険者は、市町村に対し、当該被保険者に係る被保険者証の交付を求めることができる。
(3) An Insured Person may request the Municipality to issue a Certificate of Insured Person pertaining to said Insured Person.
4 被保険者は、その資格を喪失したときは、厚生労働省令で定めるところにより、速やかに被保険者証を返還しなければならない
(4) An Insured Person shall return the Certificate of Insured Person pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare when said Person no longer meets said qualifications.
5 住民基本台帳法(昭和四十二年法律第八十一)第二十二から第二十四まで又は第二十五規定による届出があったとき(当該届出に係る書面に同第二十八の二の規定による付記がされたときに限る。)は、その届出と同一の事由に基づく第一本文規定による届出があったものとみなす
(5) When a notification is issued pursuant to the provisions of Articles 22 to 24, or Article 25 of the Basic Resident Registration Act (Act No. 81 of 1967) (limited to a case when a supplementary note is appended to the document pertaining to said notification pursuant to the provisions of Article 28-2 of the same Act), it shall be deemed as a notification pursuant to the main clause of paragraph (1) based on the same reason for said notification.
6 前各規定するもののほか、被保険者に関する届出及び被保険者証に関して必要な事は、厚生労働省令で定める。
(6) In addition to the provisions as prescribed in each of the preceding paragraphs of this Article, necessary matters for notification pertaining to an Insured Person and that pertaining to the Certificate of Insured Person shall be as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
(住所地特例対象施設に入所又は入居中の被保険者の特例)
(Domicile Exception of an Insured Person that is Admitted to or has been a Resident of a Facility Subject to Domicile Exception)
第十三条 次に掲げる施設(以下「住所地特例対象施設」という。)に入所又は入居(以下このにおいて「入所等」という。)をすることにより当該住所地特例対象施設の所在する場所に住所を変更したと認められる被保険者(第三に掲げる施設に入所することにより当該施設の所在する場所に住所を変更したと認められる被保険者にあっては、老人福祉法第十一第一第一規定による入所措置がとられた者に限る。以下このにおいて「住所地特例対象被保険者」という。)であって、当該住所地特例対象施設に入所等をした際他の市町村当該住所地特例対象施設が所在する市町村以外の市町村をいう。)の区域内に住所を有していたと認められるものは、第九規定にかかわらず、当該他の市町村が行う介護保険被保険者とする。ただし、二以上の住所地特例対象施設に継続して入所等をしている住所地特例対象被保険者であって、現に入所等をしている住所地特例対象施設(以下この及びにおいて「現入所施設」という。)に入所等をする直前に入所等をしていた住所地特例対象施設(以下このにおいて「直前入所施設」という。)及び現入所施設のそれぞれに入所等をすることにより直前入所施設及び現入所施設のそれぞれの所在する場所に順次住所を変更したと認められるもの(次において「特定継続入所被保険者」という。)については、この限りでない。
Article 13 An Insured Person for whom it is determined that his or her domicile has changed to a location of one of the following facilities (herein referred to as "Facility Subject to Domicile Exception") and is located by admission or residence (herein referred to as "Admission, etc.") in said Facility Subject to Domicile Exception (an Insured Person for whom it is determined that his or her domicile has changed to a location where said Facility is located by moving into said Facility as listed in item (iii) is limited to a person for whom the admission measures are pursuant to the provisions of Article 11, paragraph (1), item (i) of the Public Aid for the Aged Act; hereinafter referred to as "Insured Person Subject to Domicile Exception" in this Article) and for whom it is determined to have had domicile in another Municipality (a Municipality other than the Municipality where said Facility Subject to Domicile Exception is located) at the time of moving in for Admission, etc., at said Facility Subject to Domicile Exception, shall be an Insured Person of Long-Term Care Insurance provided by said other Municipality of prior domicile, notwithstanding the provisions of Article 9; however, provided that this provision shall not apply to an Insured Person Subject to Domicile Exception who moved in for Admission, etc., into two or more of a said Facility Subject to Domicile Exception, and said Person is determined to have moved consecutively from one said Facility Subject to Domicile Exception in which said Insured Person was admitted immediately prior to the said Facility Subject to Domicile Exception where said Insured Person is currently residing for Admission, etc. (herein referred to as the "Facility of First Prior Admission of an Insured Person" in this paragraph) into a Facility Subject to Domicile Exception in which said Insured Person is currently residing (herein referred to as the "Facility of Current Admission of an Insured Person" in this paragraph and the following paragraph) (collectively herein referred to as "Specified Continuous Admission of an Insured Person" in the following paragraph):
一 介護保険施設
(i) Facility Covered by Long-Term Care Insurance;
二 特定施設
(ii) Specified Facility;
三 老人福祉法第二十の四に規定する養護老ホーム
(iii) a Care Facility for the Elderly as provided in Article 20-4 of the Public Aid for the Aged Act.
2 特定継続入所被保険者のうち、次の各に掲げるものは、第九規定にかかわらず、当該に定める市町村が行う介護保険被保険者とする
(2) A person described in any of the following items that corresponds to the conditions of a Specified Continuous Admission of an Insured Person shall be an Insured Person of Long-Term Care Insurance of the Municipality as prescribed respectively in the following items, notwithstanding the provisions of Article 9:
一 継続して入所等をしている二以上の住所地特例対象施設のそれぞれに入所等をすることによりそれぞれの住所地特例対象施設の所在する場所に順次住所を変更したと認められる住所地特例対象被保険者であって、当該二以上の住所地特例対象施設のうち最初の住所地特例対象施設に入所等をした際他の市町村(現入所施設が所在する市町村以外の市町村をいう。)の区域内に住所を有していたと認められるもの 当該他の市町村
(i) an Insured Person Subject to Domicile Exception for whom it is determined to have changed his or her domicile consecutively from one location where a Facility Subject to Domicile Exception is located to another such Facility by moving in for Admission, etc., at two or more of a Facility Subject to Domicile Exception, where in each said Facility the Insured Person moved in for Admission, etc., continuously, and is considered to have had domicile in another Municipality (a Municipality other than the Municipality where the Facility of Current Admission of an Insured Person is located) when said Insured Person moved in for Admission, etc., at said Facility of First Prior Admission of an Insured Person, from among two or more of a said Facility Subject to Domicile Exception, said other Municipality;
二 継続して入所等をしている二以上の住所地特例対象施設のうち一の住所地特例対象施設から継続して他の住所地特例対象施設に入所等をすること(以下このにおいて「継続入所等」という。)により当該一の住所地特例対象施設の所在する場所以外の場所から当該他の住所地特例対象施設の所在する場所への住所の変更(以下このにおいて「特定住所変更」という。)を行ったと認められる住所地特例対象被保険者であって、最後に行った特定住所変更に係る継続入所等の際他の市町村(現入所施設が所在する市町村以外の市町村をいう。)の区域内に住所を有していたと認められるもの 当該他の市町村
(ii) an Insured Person Subject to Domicile Exception for whom it is determined to have changed domicile from a location other than where one of a Facility Subject to Domicile Exception is located to a place where another said Facility Subject to Domicile Exception is located (herein referred to as "Change of Specified Domicile" in this item) by moving in for continuous Admission, etc., from one of two or more of a said Facility Subject to Domicile Exception where the Insured Person continues Admission, etc., to another said Facility Subject to Domicile Exception (herein referred to as "Continuous Admission, etc." in this item), and is considered to have had a domicile in another Municipality (a Municipality other than the Municipality where the Facility of Current Admission of an Insured Person is located) when moving in for Continuous Admission, etc., pertaining to a Change of Specified Domicile for the most recent occurrence, said other Municipality.
3 住所地特例対象被保険者が入所等をしている住所地特例対象施設は、当該住所地特例対象施設の所在する市町村及び当該住所地特例対象被保険者に対し介護保険を行う市町村に、必要な協力しなければならない
(3) A Facility Subject to Domicile Exception where an Insured Person Subject to Domicile Exception is in Admission, etc., shall provide the necessary cooperation to the Municipality where said Facility Subject to Domicile Exception is located and is the Municipality that provides Long-Term Care Insurance to said Insured Person Subject to Domicile Exception.
第三章 介護認定審査会
Chapter III Certification Committee of Needed Long-Term Care
(介護認定審査会)
(Certification Committee of Needed Long-Term Care)
第十四条 第三十八第二規定する審査判定業務を行わせるため、市町村介護認定審査会(以下「認定審査会」という。)を置く。
Article 14 A Certification Committee of Needed Long-Term Care (herein referred to as "Certification Committee") shall be established in a Municipality in order to perform the examination and determination as prescribed in Article 38, paragraph (2) of this Act.
(委員)
(Certification Committee Members)
第十五条 認定審査会委員の定数は、政令で定める基準に従い条例で定める数とする
Article 15 The fixed number of Certification Committee members shall be the number specified by prefectural ordinance in accordance with standards specified by a Cabinet Order.
2 委員は、要介護者等の保健、医療又は福祉に関する学識経験を有する者のうちから、市町村長特別区にあっては、区長。以下同じ。)が任命する
(2) Certification Committee members shall be appointed by the mayor of a Municipality (or the ward mayor, for special city wards; the same shall apply hereinafter) and shall be a person with relevant knowledge and experience pertaining to health care, medical care, or for the administration of public aid of an Insured Person Requiring Long-Term Care, etc.
(共同設置の支援)
(Support for Co-Establishment)
第十六条 都道府県は、認定審査会について地方自治法(昭和二十二年法律第六十七)第二百五十二の七第一規定による共同設置をしようとする市町村の求めに応じ、市町村相互間における必要な調整を行うことができる。
Article 16 A prefecture may perform the necessary coordination among Municipalities according to a request from a Municipality that intends to co-establish a Certification Committee pursuant to Article 252-7, paragraph (1) of the Local Autonomy Act (Act No. 67 of 1947).
2 都道府県は、認定審査会を共同設置した市町村に対し、その円滑な運営が確保されるように必要な技術的な助言その他の援助することができる
(2) A prefecture may provide to Municipalities that have co-established a Certification Committee the technical advice and other support necessary for ensuring its efficient operation.
(政令への委任規定)
(Provisions Pertaining to Delegation of a Cabinet Order)
第十七条 この法律に定めるもののほか、認定審査会に関し必要な事は、政令で定める。
Article 17 In addition to the provisions of this Act, necessary matters pertaining to a Certification Committee shall be provided by a Cabinet Order.
第四章 保険給付
Chapter IV Insurance Benefits
第一節 通則
Section 1 General Rules
(保険給付の種類)
(Types of Insurance Benefits)
第十八条 この法律による保険給付は、次に掲げる保険給付とする
Article 18 Insurance benefits provided by this Act shall be the following insurance benefits:
一 被保険者の要介護状態に関する保険給付(以下「介護給付」という。)
(i) insurance benefits pertaining to the Condition of Need for Long-Term Care of an Insured Person (hereinafter referred to as "Long-Term Care Benefit");
二 被保険者の要支援状態に関する保険給付(以下「予防給付」という。)
(ii) insurance benefits pertaining to the Needed Support Condition of an Insured Person (herein referred to as "Prevention Benefit");
三 前二に掲げるもののほか、要介護状態又は支援状態の軽減又は悪化の防止資する保険給付として条例で定めるもの(第五において「市町村特別給付」という。)
(iii) in addition to the provisions of the preceding two items, insurance benefits provided by a municipal ordinance as insurance benefits that contribute to the reduction or prevention of deterioration of a Condition of Need for Long-Term Care or a Needed Support Condition (herein referred to as "Municipal Special Benefit" in Section V).
(市町村の認定)
(Certification by a Municipality)
第十九条 介護給付を受けようとする被保険者は、要介護者に該当すること及びその該当する要介護状態区分について、市町村の認定(以下「要介護認定」という。)を受けなければならない。
Article 19 An Insured Person that intends to receive a Long-Term Care Benefit shall obtain certification by a Municipality pertaining to the fact that said Insured Person qualifies as a Person Requiring Long-Term Care and as to the Category of Condition of Need for Long-Term Care for which said Insured Person qualifies (herein referred to as "Certification of Needed Long-Term Care").
2 予防給付を受けようとする被保険者は、要支援者に該当すること及びその該当する要支援状態区分について、市町村の認定(以下「要支援認定」という。)を受けなければならない。
(2) An Insured Person that intends to receive a Prevention Benefit shall obtain certification by a Municipality pertaining to the fact that said Insured Person qualifies as a Person Requiring Support and as to the Category of Needed Support Condition for which said Insured Person qualifies (herein referred to as "Certification of Needed Support").
(他の法令による給付との調整)
(Coordination with Benefits Provided by Other Laws and Regulations)
第二十条 介護給付又は予防給付(以下「介護給付等」という。)は、当該介護状態又は支援状態(以下「要介護状態等」という。)につき、労働者災害補償保険法(昭和二十二年法律第五十)の規定による療養補償給付若しくは療養給付その他の法令に基づく給付であって政令で定めるもののうち介護給付等に相当するものを受けることができるときは政令で定める限度において、又は当該政令で定める給付以外の給付であって若しくは地方公共団体の負担において介護給付等に相当するものが行われたときはその限度において、行わない。
Article 20 A Long-Term Care Benefit or Prevention Benefit (herein referred to as "Long-Term Care Benefit, etc.") with regard to said Condition of Need for Long-Term Care or Needed Support Condition (herein referred to as "Condition of Need for Long-Term Care, etc.") shall not be provided within the limit provided by a Cabinet Order when a benefit equivalent to a Long-Term Care Benefit, etc., can be received from among benefits that is a medical compensation benefit pursuant to the provisions of the Worker Accident Compensation Insurance Act (Act No. 50 of 1947), a medical benefit, or other benefits based on laws and regulations and provided by a Cabinet Order, or within said limit when benefits other than those provided by said a Cabinet Order and those benefits equivalent to a Long-Term Care Benefit, etc., are granted under the covered expenses of a plan of the national government or a local government.
(損害賠償請求権)
(Right to Claim Compensation for Damages)
第二十一条 市町村は、給付事由が第三者行為によって生じた場合において、保険給付を行ったときは、その給付価額限度において、被保険者第三者に対して有する損害賠償請求権取得する
Article 21 When the basis for benefit claim is caused by the act of a third party and a Municipality provides insurance benefits, the Municipality shall obtain the right to claim compensation for the damages which an Insured Person holds against the third party within the limit of the amount of said benefit.
2 前項に規定する場合において保険給付を受けるべき者が第三者から同一の事由について損害賠償を受けたときは、市町村は、その価額限度において、保険給付を行う責めを免れる。
(2) In a case as prescribed in the preceding paragraph, when a person to be granted an insurance benefit receives compensation for damages for the same reason from a third party, a Municipality shall not be responsible for payment of said insurance benefit within the limit of the compensation amount.
3 市町村は、第一規定により取得した請求権に係る損害賠償金の徴収又は収納の事務を国民健康保険法第四十五第五規定する国民健康保険団体連合会(以下「連合会」という。)であって厚生労働省令で定めるものに委託することができる
(3) A Municipality may entrust affairs of the collection or receipt of compensation for damages pertaining to the claim of right obtained pursuant to the provisions of paragraph (1) of this Article to the Federation of National Health Insurance Associations as prescribed in Article 45, paragraph (5) of the National Health Insurance Act (herein referred to as "Association") as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
(不正利得の徴収等)
(Collection, etc., of Fraudulent Gain)
第二十二条 偽りその他不正の行為によって保険給付を受けた者があるときは、市町村は、その者からその給付価額の全部又は一部を徴収することができる
Article 22 In a case when a person receives an insurance benefit by deception or other wrongful act, a Municipality may collect in whole or a portion of said benefit amount from said person.
2 前項に規定する場合において、訪問看護、訪問リハビリテーション、通所リハビリテーション若しくは短期入所療養介護又は介護予防訪問看護、介護予防訪問リハビリテーション、介護予防通所リハビリテーション若しくは介護予防短期入所療養介護についてその治療の必要の程度につき診断する医師その他居宅サービス若しくはこれに相当するサービス、施設サービス又は介護予防サービス若しくはこれに相当するサービスに従事する医師又は歯科医師が、市町村提出されるべき診断書虚偽の記載をしたため、その保険給付が行われたものであるときは、市町村は、当該医師又は歯科医師に対し、保険給付を受けた者に連帯して徴収金を納付すべきことを命ずることができる。
(2) In a case as prescribed in the preceding paragraph, with regard to Home-Visit Nursing, Home-Visit Rehabilitation, Outpatient Rehabilitation, Short-Term Admission for Recuperation, Home-Visit Nursing Service for Preventive Long-Term Care, Home-Visit Rehabilitation Service for Preventive Long-Term Care, Outpatient Rehabilitation for Preventive Long-Term Care, Short-Term Admission for Recuperation for Preventive Long-Term Care, when an insurance benefit for said services is granted because a physician who diagnoses the degree of necessity of said treatment or another physician or dentist who engages in In-Home Long-Term Care or equivalent services, Facility Service, Preventive Long-Term Care Service or equivalent services, has made a false entry on the medical certification which is to be submitted to a Municipality, the Municipality may order said physician or dentist to pay the levy as prescribed by the above paragraph jointly and severally with the person that received the insurance benefit.
3 市町村は、第四十一第一規定する指定居宅サービス事業者、第四十二の二第一規定する指定地域密着型サービス事業者、第四十六第一規定する指定居宅介護支援事業者介護保険施設、第五十三第一規定する指定介護予防サービス事業者、第五十四の二第一規定する指定地域密着型介護予防サービス事業者又は第五十八第一規定する指定介護予防支援事業者(以下このにおいて「指定居宅サービス事業者等」という。)が、偽りその他不正の行為により第四十一第六、第四十二の二第六、第四十六第四、第四十八第四、第五十一の二第四、第五十三第四、第五十四の二第六、第五十八第四又は第六十一の二第四規定による支払を受けたときは、当該指定居宅サービス事業者等に対し、その支払った額につき返還させるほか、その返還させる額に百分の四十を乗じて得た額を支払わせることができる。
(3) When a Designated In-Home Service Provider as prescribed in Article 41, paragraph (1) of this Act; a Designated Community-Based Service Provider as prescribed in Article 42-2, paragraph (1); a Designated In-Home Long-Term Care Support Provider as prescribed in Article 46, paragraph (1); a Facility Covered by Long-Term Care Insurance; a Designated Provider of a Preventive Service to Long-Term Care as prescribed in Article 53, paragraph (1); a Designated Provider of Community-Based Preventive Service of Long-Term Care as prescribed in Article 54-2, paragraph (1); or a Designated Provider of Support for Prevention of Long-Term Care as prescribed in Article 58, paragraph (1) (hereinafter collectively referred to as "Designated In-Home Service Provider, etc." in this paragraph) receives a payment pursuant to the provisions of Article 41, paragraph (6), Article 42-2, paragraph (6), Article 46, paragraph (4), Article 48, paragraph (4), Article 51-2, paragraph (4), Article 53, paragraph (4), Article 54-2, paragraph (6), Article 58, paragraph (4), or Article 61-2, paragraph (4) by deception or other wrongful act, a Municipality may require said Designated In-Home Service Provider, etc., to return the amount paid, or to pay the amount obtained by multiplying 40 percent of the principal amount to be returned.
(文書の提出等)
(Submission, etc., of Documents)
第二十三条 市町村は、保険給付に関して必要があると認めるときは、当該保険給付を受ける者若しくは当該保険給付に係る居宅サービス等(居宅サービス(これに相当するサービスを含む。)、地域密着型サービス(これに相当するサービスを含む。)、居宅介護支援(これに相当するサービスを含む。)、施設サービス、介護予防サービス(これに相当するサービスを含む。)、地域密着型介護予防サービス(これに相当するサービスを含む。)若しくは介護予防支援(これに相当するサービスを含む。)をいう。以下同じ。)を担当する者若しくは保険給付に係る第四十五第一規定する住宅改修を行う者又はこれらの者であった者(第二十四の二第一第一において「照会等対象者」という。)に対し、文書その他の件の提出若しくは提示を求め、若しくは依頼し、又は当該職員に質問若しくは照会をさせることができる。
Article 23 A Municipality may, when it determines necessity with regard to an insurance benefit, demand or request submission or presentation of documents and other items, or direct its personnel to ask questions and inquiries to a person that receives said insurance benefit, a person that is in charge of In-Home Service, etc. pertaining to said insurance benefit (which means In-Home Service (including equivalent services), Community-Based Service (including equivalent services), In-Home Long-Term Care Support (including equivalent services), Facility Service, Preventive Long-Term Care Service (including equivalent services), Community-Based Service for Preventive Long-Term Care (including equivalent services), or a Preventive Long-Term Care Support (including equivalent services); the same shall apply hereinafter) , or a person that provides a house modification for in-home care as prescribed in Article 45, paragraph (1) which pertains to an insurance benefit, or a person that was said person (hereinafter referred to as "Person, etc., Subject to Inquiry").
(帳簿書類の提示等)
(Presentation, etc., of Record Books and Documents)
第二十四条 厚生労働大臣又は都道府県知事は、介護給付等(居宅介護住宅改修費の支給及び介護予防住宅改修費の支給を除く。次及び第二百八において同じ。)に関して必要があると認めるときは、居宅サービス等を行った者又はこれを使用する者に対し、その行った居宅サービス等に関し、報告若しくは当該居宅サービス等の提供の記録帳簿書類その他の件の提示を命じ、又は当該職員に質問させることができる。
Article 24 The Minister of Health, Labour, and Welfare or a prefectural governor may, when it is determined that it is necessary as pertaining to a Long-Term Care Benefit, etc. (except for payments of an Allowance for Home Modification for In-Home Long-Term Care and an Allowance for Preventive Long-Term Care Home Modification; the same shall apply in the following paragraph and Article 208), order a person that has provided In-Home Service, etc., or employees of said Services, etc., to report and provide records of said In-Home Service, etc., to present record books and documents, and other items, and direct personnel to ask questions concerning the In-Home Service, etc., provided by said person.
2 厚生労働大臣又は都道府県知事は、必要があると認めるときは、介護給付等を受けた被保険者又は被保険者であった者に対し、当該介護給付に係る居宅サービス等(以下「介護給付等対象サービス」という。)の内容に関し、報告を命じ、又は当該職員に質問させることができる。
(2) The Minister of Health, Labour, and Welfare or a prefectural governor, when it is determined that it is necessary, may order an Insured Person that received a Long-Term Care Benefit, etc., and a person that was the Insured Person to report and direct its personnel to ask questions concerning the content of the In-Home Service, etc., pertaining to said Long-Term Care Benefit, etc. (herein referred to as "Service Covered by Long-Term Care Benefits, etc.").
3 前二規定による質問を行う場合においては、当該職員は、その身分を示す証明書を携帯し、かつ関係人請求があるときは、これを提示しなければならない
(3) In a case of asking questions pursuant to the provisions of the preceding two paragraphs, said personnel shall carry identification and shall present the same if required by the relevant person to be questioned.
4 第一及び第二規定による権限は、犯罪捜査のために認められたものと解釈してはならない
(4) The authority granted pursuant to the provisions of paragraphs (1) and (2) shall not be construed as an approval of a criminal investigation.
(指定市町村事務受託法人)
(Designated and Entrusted Juridical Person for Municipal Affairs)
第二十四条の二 市町村は、次に掲げる事務の一部を、法人であって厚生労働省令で定める要件に該当し、当該事務を適正に実施することができると認められるものとして都道府県知事指定するもの(以下このにおいて「指定市町村事務受託法人」という。)に委託することができる
Article 24-2 A Municipality may entrust a portion of the following affairs to a juridical person that qualifies as per the requirements as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, and is designated by a prefectural governor as a person that can perform said affairs appropriately (herein referred to as "Designated and Entrusted Juridical Person for Municipal Affairs" in this Article):
一 第二十三規定する事務(照会等対象者の選定に係るものを除く。)
(i) affairs as prescribed in Article 23 of this Act (except for affairs pertaining to the selection of a Person Subject to an Inquiry, etc.);
二 第二十七第二(第二十八第四、第二十九第二、第三十第二、第三十一第二及び第三十二第二(第三十三第四、第三十三の二第二、第三十三の三第二及び第三十四第二において準用する場合を含む。)において準用する場合を含む。)の規定による調査に関する事務
(ii) affairs pertaining to an inspection pursuant to the provisions of Article 27, paragraph (2) (including a case when applied mutatis mutandis pursuant to Article 28, paragraph (4), Article 29, paragraph (2), Article 30, paragraph (2), Article 31, paragraph (2), and Article 32, paragraph (2) (including a case when applied mutatis mutandis pursuant to Article 33, paragraph (4), Article 33-2, paragraph (2), Article 33-3, paragraph (2), and Article 34, paragraph (2)));
三 その他厚生労働省令で定める事務
(iii) other affairs as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
2 指定市町村事務受託法人は、前第二の事務を行うときは、介護支援専門員その他厚生労働省令で定める者に当該委託に係る調査を行わせるものとする
(2) A Designated and Entrusted Juridical Person for Municipal Affairs, when performing affairs as set forth in item (ii) of the preceding paragraph, shall assign a Long-Term Care Support Specialist or other person as determined by an Ordinance of the Ministry of Health, Labour, and Welfare to implement the inspection pertaining to said entrustment.
3 指定市町村事務受託法人役員若しくは職員(前介護支援専門員その他厚生労働省令で定める者を含む。次において同じ。)又はこれらの職にあった者は、正当な理由なしに、当該委託事務に関して知り得た秘密を漏らしてはならない
(3) An Officer or personnel of a Designated and Entrusted Juridical Person for Municipal Affairs (including a Long-Term Care Support Specialist or other person as determined by an Ordinance of the Ministry of Health, Labour, and Welfare as set forth in the preceding paragraph; the same shall apply in the following paragraph) or a person that held that position shall not divulge any confidential information learned pertaining to said entrusted affairs without a justifiable reason.
4 指定市町村事務受託法人役員又は職員で、当該委託事務に従事するものは、刑法(明治四十年法律第四十五その他の罰則適用については、法令により公務に従事する職員とみなす
(4) An Officer or personnel of a Designated and Entrusted Juridical Person for Municipal Affairs who engage in said entrusted affairs shall be deemed as personnel engaged in public service pursuant to the provisions of laws and regulations with regard to the application of the Penal Code (Act No. 45 of 1907) and other penal provisions.
5 市町村は、第一規定により事務を委託したときは、厚生労働省令で定めるところにより、その旨を公示しなければならない
(5) A Municipality, when entrusting affairs pursuant to the provisions of paragraph (1), shall issue public notice of this effect pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare.
6 前各に定めるもののほか、指定市町村事務受託法人に関し必要な事は、政令で定める。
(6) In addition to the provisions as prescribed in each of the preceding paragraphs of this Article, other necessary matters pertaining to a Designated and Entrusted Juridical Person for Municipal Affairs shall be as prescribed by a Cabinet Order.
(受給権の保護)
(Protection of Right to Benefit)
第二十五条 保険給付を受ける権利は、譲り渡し、担保に供し、又は差し押さえることができない。
Article 25 The right to receive an insurance benefit may not be transferred, pledged as collateral, or levied.
(租税その他の公課の禁止)
(Prohibition of Taxation and Other Public Dues)
第二十六条 その他の公課は、保険給付として支給を受けた金品標準として、課することができない
Article 26 Taxation and other public dues may not be imposed by establishing money or goods that are provided as an insurance benefit as a standard.
第二節 認定
Section 2 Certification
(要介護認定)
(Certification of Needed Long-Term Care)
第二十七条 介護認定を受けようとする被保険者は、厚生労働省令で定めるところにより、申請書被保険者証を添付して市町村申請しなければならない。この場合において、当該被保険者は、厚生労働省令で定めるところにより、第四十六第一規定する指定居宅介護支援事業者地域密着型介護福祉施設若しくは介護保険施設であって厚生労働省令で定めるもの又は第百十五の三十九第一規定する地域包括支援センターに、当該申請に関する手続を代わって行わせることができる。
Article 27 An Insured Person that intends to obtain a Certification of Needed Long-Term Care, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, shall submit an application with attachment of Certificate of Insured Person to a Municipality. In this case, said Insured Person, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, may have a Designated In-Home Long-Term Care Support Provider as prescribed in Article 46, paragraph (1), a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care, or a Facility Covered by Long-Term Care Insurance, and those which are determined by an Ordinance of the Ministry of Health, Labour, and Welfare, or a community general support center as prescribed in Article 115-39, paragraph (1) implement procedures pertaining to said application on behalf of said Insured Person.
2 市町村は、前申請があったときは、当該職員をして、当該申請に係る被保険者に面接させ、その心身の状況、その置かれている環境その他厚生労働省令で定める事について調査をさせるものとする。この場合において、市町村は、当該被保険者遠隔の地居所を有するときは、当該調査を他の市町村嘱託することができる
(2) A Municipality shall, when the application as prescribed in the preceding paragraph is submitted, direct its personnel to interview said Insured Person pertaining to said application and investigate the mental and physical condition and surroundings of said Insured Person, and other matters as determined by an Ordinance of the Ministry of Health, Labour, and Welfare. In this case, the Municipality may, when said Insured Person has a residence in a remote place, commission said investigation to another Municipality.
3 市町村は、第一申請があったときは、当該申請に係る被保険者の主治の医師に対し、当該被保険者身体又は精神上の障害の原因である疾病又は負傷の状況等につき意見を求めるものとする。ただし、当該被保険者に係る主治の医師がないときその当該意見を求めることが困難なときは、市町村は、当該被保険者に対して、その指定する医師又は当該職員で医師であるものの診断を受けるべきことを命ずることができる。
(3) A Municipality shall, when the application as prescribed in paragraph (1) is submitted, request an attending physician of the Insured Person pertaining to said application for opinions regarding the status of illness or injury that is the cause of the physical or mental problems of said Insured Person, however, provided that the Municipality may, when there is no attending physician of the Insured Person pertaining to said application, or it is difficult to request for said opinion, etc., order said Insured Person to obtain the diagnosis of a designated physician or from the Municipality's personnel who is a physician.
4 市町村は、第二の調査(第二十四の二第一第二規定により委託された場合にあっては、当該委託に係る調査を含む。)の結果、前の主治の医師の意見又は指定する医師若しくは当該職員で医師であるものの診断の結果その他厚生労働省令で定める事を認定審査会通知し、第一申請に係る被保険者について、次の各に掲げる被保険者の区分に応じ、当該に定める事に関し審査及び判定を求めるものとする
(4) A Municipality shall notify the relevant Certification Committee of the result of the investigation as set forth in paragraph (2) (in a case of entrustment pursuant to the provisions of Article 24-2, paragraph (1), item (ii), including an investigation pertaining to said entrustment) of the opinion of the attending physician as prescribed in the preceding paragraph, the result of a diagnosis by the designated physician or its personnel who is a physician, and other matters as specified by an Ordinance of the Ministry of Health, Labour, and Welfare, and request an examination and judgment pertaining to matters as prescribed in each said item according to the Category of the Insured Person as listed in the following items with regard to the Insured Person pertaining to an application as prescribed in paragraph (1):
一 第一被保険者 要介護状態に該当すること及びその該当する要介護状態区分
(i) Primary Insured Person: those who qualify with a Condition of Need for Long-Term Care and Category of Condition of Need for Long-Term Care that said condition is subject to;
二 第二被保険者 要介護状態に該当すること、その該当する要介護状態区分及びその介護状態原因である身体又は精神上の障害が特定疾病によって生じたものであること。
(ii) Secondary Insured Person: those who qualify with a Condition of Need for Long-Term Care and Category of Condition of Need for Long-Term Care that said condition is subject to, and the physical or mental problems causing said Condition of Need for Long-Term Care is caused by a Specified Disease.
5 認定審査会は、前項の規定により審査及び判定を求められたときは、厚生労働大臣が定める基準に従い、当該審査及び判定に係る被保険者について、同規定するに関し審査及び判定を行い、その結果を市町村通知するものとする。この場合において、認定審査会は、必要があると認めるときは、次に掲げる事項について、市町村意見を述べることができる。
(5) A Certification Committee shall, when being requested to conduct an examination and provide judgment pursuant to the provisions of the preceding paragraph, act in compliance with standards as determined by the Minister of Health, Labour, and Welfare, examine and judge matters as prescribed in each item of the same paragraph of the Insured Person pertaining to said examination and judgment, and notify said result to the Municipality. In this case, a Certification Committee may, when it determines it necessary, state opinions to the Municipality regarding the matters listed as follows:
一 当該被保険者の要介護状態の軽減又は悪化の防止のために必要な療養に関する事
(i) matters concerning the necessary medical care for the reduction or prevention of deterioration of the Condition of Need for Long-Term Care of said Insured Person;
二 第四十一第一規定する指定居宅サービス、第四十二の二第一規定する指定地域密着型サービス又は第四十八第一規定する指定施設サービス等の適切かつ有効利用等に関し当該被保険者が留意すべき事
(ii) matters that said Insured Person shall heed for the appropriate and effective use of a Designated In-Home Service as prescribed in Article 41, paragraph (1) of this Act, a Designated Community-Based Service as prescribed in Article 42-2, paragraph (1), or a Designated Facility Service, etc., as prescribed in Article 48, paragraph (1).
6 認定審査会は、前前段審査及び判定をするに当たって必要があると認めるときは、当該審査及び判定に係る被保険者その家族、第三の主治の医師その他の関係者意見を聴くことができる。
(6) A Certification Committee may, when it determines it necessary in an examination or judgment referred to in the first sentence of the preceding paragraph, hear opinions of the Insured Person pertaining to said examination and judgment, said Person's family members, the attending physician as set forth in paragraph (3), and other relevant persons.
7 市町村は、第五前段規定により通知された認定審査会審査及び判定の結果に基づき、要介護認定をしたときは、その結果を当該介護認定に係る被保険者通知しなければならない。この場合において、市町村は、次に掲げる事項当該被保険者被保険者証に記載し、これを返付するものとする
(7) A Municipality, when providing a Certification of Needed Long-Term Care based on the results of an examination and judgment of a Certification Committee as notified pursuant to the provisions of the first sentence of paragraph (5), shall notify the Insured Person pertaining to said Certification of Needed Long-Term Care of said result. In this case, the Municipality shall enter the following items on the Certificate of Insured Person of said Insured Person and return the Certificate of Insured Person to the Insured Person:
一 該当する要介護状態区分
(i) applicable Category of Condition of Need for Long-Term Care;
二 第五第二に掲げる事項に係る認定審査会意見
(ii) opinions of the Certification Committee pertaining to the matters listed in paragraph (5), item (ii).
8 介護認定は、その申請のあった日にさかのぼってその効力を生ずる。
(8) A Certification of Needed Long-Term Care shall become effective retroactively on the date that said application was submitted.
9 市町村は、第五前段規定により通知された認定審査会審査及び判定の結果に基づき、要介護者に該当しないと認めたときは、理由を付して、その旨を第一申請に係る被保険者通知するとともに、当該被保険者被保険者証を返付するものとする
(9) A Municipality, when it determined the Insured Person pertaining to the application as set forth in paragraph (1) fails to be qualified as a Person Requiring Long-Term Care based on the results of an examination and judgment of a Certification Committee as notified pursuant to the provisions of the first sentence of paragraph (5), shall notify said Insured Person of that effect, indicating the reason(s), and return the Certificate of Insured Person of said Insured Person.
10 市町村は、第一申請に係る被保険者が、正当な理由なしに、第二規定による調査(第二十四の二第一第二規定により委託された場合にあっては、当該委託に係る調査を含む。)に応じないとき、又は第三ただし書規定による診断命令に従わないときは、第一申請却下することができる
(10) A Municipality may dismiss an application submitted pursuant to paragraph (1) when the Insured Person pertaining to the application as set forth in paragraph (1) fails to respond to an investigation pursuant to the provisions of paragraph (2) (in a case of entrustment pursuant to the provisions of Article 24-2, paragraph (1), item (ii), an investigation pertaining to said entrustment shall be included) without a justifiable reason or when said Insured Person fails to comply with an order for a diagnosis pursuant to the provisions of the proviso of paragraph (3).
11 第一申請に対する処分は、当該申請のあった日から三十日以内にしなければならない。ただし、当該申請に係る被保険者の心身の状況の調査に日時を要する等特別な理由がある場合には、当該申請のあった日から三十日以内に、当該被保険者に対し、当該申請に対する処分をするためになお要する期間(次において「処理見込期間」という。)及びその理由を通知し、これを延期することができる
(11) Action for an application as set forth in paragraph (1) shall be performed within thirty (30) days from the date of submission of said application, however, provided that in a case that there are special reasons that an investigation of the mental or physical conditions of the Insured Person pertaining to said application may require additional hours or days, etc., said action for the matter may be postponed after notifying said Insured Person of the additional period necessary for the action for said application (herein referred to as the "Prospective Processing Period" in the following paragraph) and said reasons within thirty (30) days from the date of submission of said application.
12 第一申請をした日から三十日以内に当該申請に対する処分がされないとき、若しくはただし書通知がないとき、又は処理見込期間経過した日までに当該申請に対する処分がされないときは、当該申請に係る被保険者は、市町村当該申請却下したものとみなすことができる。
(12) In a case when the action for an application as set forth in paragraph (1) has not been executed within thirty (30) days from the date of submission of said application or the notification as set forth in the proviso of the preceding paragraph has not been issued, or when the action for said application has not been executed by the date that the Prospective Processing Period expires, the Insured Person pertaining to said application may deem that the Municipality has dismissed said application.
(要介護認定の更新)
(Renewal of Certification of Needed Long-Term Care)
第二十八条 介護認定は、要介護状態区分に応じて厚生労働省令で定める期間(以下このにおいて「有効期間」という。)内に限り、その効力を有する。
Article 28 A Certification of Needed Long-Term Care shall be effective according to the Category of Condition of Need for Long-Term Care during the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare (herein referred to as the "Effective Period" in this Article).
2 介護認定を受けた被保険者は、有効期間の満了後においても要介護状態に該当すると見込まれるときは、厚生労働省令で定めるところにより、市町村に対し、当該介護認定の更新(以下「要介護更新認定」という。)の申請することができる
(2) An Insured Person that is issued a Certification of Needed Long-Term Care, when he or she is expected to be in a Condition of Need for Long-Term Care although after the expiry of the Effective Period, may apply to the Municipality for an application of renewal of said Certification of Needed Long-Term Care (herein referred to as a "Renewal of Certification of Needed Long-Term Care") pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare.
3 申請することができる被保険者が、災害そのやむを得ない理由により当該申請に係る介護認定の有効期間の満了前に当該申請をすることができなかったときは、当該被保険者は、その理由のやんだ日から一月以内に限り、要介護更新認定の申請することができる
(3) In a case when an Insured Person that may apply for the renewal application as set forth in the preceding paragraph was not able to apply for said renewal application prior to the expiry of the Effective Period of Certification of Needed Long-Term Care pertaining to said application due to a disaster or other compelling reason, said Insured Person may apply for a Renewal of Certification of Needed Long-Term Care within one month following the date on which said reason for delay is no longer valid.
4 (第八を除く。)の規定は、前二申請及び当該申請に係る介護更新認定について準用する。この場合において、同規定に関し必要な技術的読替えは、政令で定める。
(4) The provisions of the preceding Article (except paragraph (8)) shall apply mutatis mutandis to an application as set forth in the preceding two paragraphs and to an application for Renewal of Certification of Needed Long-Term Care pertaining to said application. In this case, the necessary technical replacement of terms used in the provisions of the same Article shall be provided by a Cabinet Order.
5 市町村は、前において準用する第二の調査を第四十六第一規定する指定居宅介護支援事業者地域密着型介護福祉施設介護保険施設その他の厚生労働省令で定める事業者若しくは施設(以下このにおいて「指定居宅介護支援事業者等」という。)又は介護支援専門員であって厚生労働省令で定めるものに委託することができる
(5) A Municipality may entrust an investigation as set forth in the preceding Article, paragraph (2), as applied mutatis mutandis pursuant to the preceding paragraph, to a Designated In-Home Long-Term Care Support Provider as prescribed in Article 46, paragraph (1), a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care, a Facility Covered by Long-Term Care Insurance, other providers or facilities as determined by an Ordinance of the Ministry of Health, Labour, and Welfare (herein referred to as "Designated In-Home Long-Term Care Support Provider, etc." in this Article), or to a Long-Term Care Support Specialist as determined by an Ordinance of the Ministry of Health, Labour, and Welfare.
6 前項の規定により委託を受けた指定居宅介護支援事業者等は、介護支援専門員その他厚生労働省令で定める者に当該委託に係る調査を行わせるものとする
(6) A Designated In-Home Long-Term Care Support Provider, etc., entrusted pursuant to the provisions of the preceding paragraph shall direct a Long-Term Care Support Specialist or other person as determined by an Ordinance of the Ministry of Health, Labour, and Welfare to perform an investigation pertaining to said entrustment.
7 第五規定により委託を受けた指定居宅介護支援事業者等(その者が法人である場合にあっては、その役員。次において同じ。)若しくはその職員(前介護支援専門員その他厚生労働省令で定める者を含む。次において同じ。)若しくは介護支援専門員又はこれらの職にあった者は、正当な理由なしに、当該委託業務に関して知り得た個人秘密を漏らしてはならない
(7) A Designated In-Home Long-Term Care Support Provider, etc., entrusted pursuant to the provisions of paragraph (5) (in cases when said person is a juridical person, its Officers; the same shall apply in the following paragraph), its personnel (including a Long-Term Care Support Specialist as prescribed in the preceding paragraph or other person as determined by an Ordinance of the Ministry of Health, Labour, and Welfare; the same shall apply in the following paragraph), a Long-Term Care Support Specialist or other person that was in said position shall not divulge any personal confidential information learned from said entrusted operations without a justifiable reason.
8 第五規定により委託を受けた指定居宅介護支援事業者若しくはその職員又は介護支援専門員で、当該委託業務に従事するものは、刑法その他の罰則適用については、法令により公務に従事する職員とみなす
(8) A Designated In-Home Long-Term Care Support Provider, etc., entrusted pursuant to the provisions of paragraph (5), its personnel, or a Long-Term Care Support Specialist that engages in said entrusted operations shall be deemed as personnel who engage in public service pursuant to the provisions of laws and regulations with regard to the application of the Penal Code and other penal provisions.
9 第三申請に係る介護更新認定は、当該申請に係る介護認定の有効期間の満了日の翌日にさかのぼってその効力を生ずる。
(9) A Renewal of Certification of Needed Long-Term Care pertaining to an application as set forth in paragraph (3) shall be effective retroactively on the date following the date of expiry of the Effective Period of Certification of Needed Long-Term Care pertaining to said renewal application.
10 第一規定は、要介護更新認定について準用する。この場合において、同中「厚生労働省令で定める期間」とあるのは、「有効期間の満了日の翌日から厚生労働省令で定める期間」と読み替えるものとする
(10) The provisions of paragraph (1) shall apply mutatis mutandis to a Renewal of Certification of Needed Long-Term Care. In this case, the phrase "period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare" in the same paragraph shall be deemed to be replaced with "period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare from the date following the expiry of the Effective Period."
(要介護状態区分の変更の認定)
(Certification of Change of Category of Condition of Need for Long-Term Care)
第二十九条 介護認定を受けた被保険者は、その介護の必要の程度が現に受けている要介護認定に係る介護状態区分以外の要介護状態区分に該当すると認めるときは、厚生労働省令で定めるところにより、市町村に対し、要介護状態区分の変更の認定の申請することができる
Article 29 An Insured Person that was issued a Certification of Needed Long-Term Care, when it is determined that the degree of necessity of care qualifies for a Category of Condition of Need for Long-Term Care other than the Category of Condition of Need for Long-Term Care pertaining to the Certification of Needed Long-Term Care which is currently issued, may apply to a Municipality for a Certification of Change of Category of Condition of Need for Long-Term Care, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare.
2 第二十七及び第五から第八までの規定は、前申請及び当該申請に係る介護状態区分の変更の認定について準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
(2) The provisions of Article 27 and the preceding Article, paragraphs (5) to (8) shall apply mutatis mutandis to an application as prescribed in the preceding paragraph and to a Certification of Change of Category of Condition of Need for Long-Term Care pertaining to said application. In this case, the necessary technical replacement of the terms of these provisions shall be provided by a Cabinet Order.
第三十条 市町村は、要介護認定を受けた被保険者について、その介護の必要の程度が低下したことにより当該介護認定に係る介護状態区分以外の要介護状態区分に該当するに至ったと認めるときは、要介護状態区分の変更の認定をすることができる。この場合において、市町村は、厚生労働省令で定めるところにより、当該変更の認定に係る被保険者に対しその被保険者証の提出を求め、これに当該変更の認定に係る介護状態区分及びにおいて準用する第二十七第五後段規定による認定審査会意見(同第二に掲げる事項に係るものに限る。)を記載し、これを返付するものとする
Article 30 A Municipality, when it is determined that an Insured Person that was issued a Certification of Needed Long-Term Care, qualifies for a Category of Condition of Need for Long-Term Care other than the Category of Condition of Need for Long-Term Care pertaining to said Certification of Needed Long-Term Care due to a lowering of the degree of necessity of long-term care, may certify a change of Category of Condition of Need for Long-Term Care. In this case, the Municipality shall request the Insured Person pertaining to said change of certification to submit said Certificate of Insured Person, shall enter the Category of Condition of Need for Long-Term Care pertaining to said change of certification and the opinion of the Certification Committee pursuant to the provisions of the second sentence of Article 27, paragraph (5) as applied mutatis mutandis pursuant to the following paragraph (limited to those changes pertaining to matters listed in item (ii) of the same paragraph), and then return said Certificate of Insured Person to the Insured Person.
2 第二十七第二から第六まで及び第七前段並びに第二十八第五から第八までの規定は、前の要介護状態区分の変更の認定について準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
(2) The provisions of Article 27, paragraphs (2) to (6), the first sentence of paragraph (7), and Article 28, paragraphs (5) to (8) shall apply mutatis mutandis to a Certification of Change of Category of Condition of Need for Long-Term Care as prescribed in the preceding paragraph. In this case, the necessary technical replacement of the terms of these provisions shall be provided by a Cabinet Order.
(要介護認定の取消し)
(Rescission of Certification of Needed Long-Term Care)
第三十一条 市町村は、要介護認定を受けた被保険者が次の各のいずれかに該当するときは、当該介護認定を取り消すことができる。この場合において、市町村は、厚生労働省令で定めるところにより、当該取消しに係る被保険者に対しその被保険者証の提出を求め、第二十七第七に掲げる事項の記載を消除し、これを返付するものとする
Article 31 When an Insured Person that was issued a Certification of Needed Long-Term Care is subject to any of the following items, a Municipality may rescind said Certification of Needed Long-Term Care. In this case, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, the Municipality shall request the Insured Person pertaining to said rescission to submit said Certificate of Insured Person, delete the entry of matters listed in each item of Article 27, paragraph (7), and return the Certificate of Insured Person to the Insured Person:
一 介護者に該当しなくなったと認めるとき。
(i) when the Municipality determines that the Insured Person fails to or no longer qualifies as a Person Requiring Long-Term Care;
二 正当な理由なしに、前第二若しくはにおいて準用する第二十七第二規定による調査(第二十四の二第一第二又は第二若しくはにおいて準用する第二十八第五規定により委託された場合にあっては、当該委託に係る調査を含む。)に応じないとき、又は第二若しくはにおいて準用する第二十七第三ただし書規定による診断命令に従わないとき。
(ii) when the Insured Person fails to comply with an investigation pursuant to the provisions of Article 27, paragraph (2) as applied mutatis mutandis pursuant to the preceding Article, paragraph (2) and the following paragraph (in a case when said investigation is entrusted pursuant to the provisions of Article 28, paragraph (5) as applied mutatis mutandis pursuant to Article 24-2, paragraph (1), item (ii), the preceding Article, paragraph (2), or the following paragraph, including an investigation pertaining to said entrustment) without a justifiable reason, or when the Insured Person fails to act in compliance with an order for diagnosis pursuant to the provisions of the proviso of Article 27, paragraph (3) as applied mutatis mutandis pursuant to the preceding Article, paragraph (2), and the following paragraph.
2 第二十七第二から第四まで、第五前段、第六及び第七前段並びに第二十八第五から第八までの規定は、前第一規定による要介護認定の取消しについて準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
(2) The provisions of Article 27, paragraphs (2) to (4), the first sentence of paragraph (5), paragraph (6), the first sentence of paragraph (7), and Article 28, paragraphs (5) to (8) shall apply mutatis mutandis to a rescission of a Certification of Needed Long-Term Care pursuant to the provisions of the preceding paragraph, item (i). In this case, the necessary technical replacement of the terms of these provisions shall be provided by a Cabinet Order.
(要支援認定)
(Certification of Needed Support)
第三十二条 支援認定を受けようとする被保険者は、厚生労働省令で定めるところにより、申請書被保険者証を添付して市町村申請しなければならない。この場合において、当該被保険者は、厚生労働省令で定めるところにより、第四十六第一規定する指定居宅介護支援事業者地域密着型介護福祉施設若しくは介護保険施設であって厚生労働省令で定めるもの又は第百十五の三十九第一規定する地域包括支援センターに、当該申請に関する手続を代わって行わせることができる。
Article 32 An Insured Person that intends to receive a Certification of Needed Support shall submit to a Municipality an application with a Certificate of Insured Person pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare. In this case, said Insured Person may, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare, have a Designated In-Home Long-Term Care Support Provider, etc., as prescribed in Article 46, paragraph (1), a Community-Based Facility for the Elderly Covered by Public Aid Requiring Long-Term Care or a Facility Covered by Long-Term Care Insurance as determined by an Ordinance of the Ministry of Health, Labour, and Welfare, or a community general support center as prescribed in Article 115-39, paragraph (1), perform the procedures of said application on behalf of the Insured Person.
2 第二十七第二及び第三規定は、前申請に係る調査並びに申請に係る被保険者の主治の医師の意見及び当該被保険者に対する診断命令について準用する
(2) The provisions of Article 27, paragraphs (2) and (3) shall apply mutatis mutandis to an investigation pertaining to an application as prescribed in the preceding paragraph, opinions of an attending physician of the Insured Person pertaining to an application as set forth in the same paragraph, and an order for diagnosis to said Insured Person.
3 市町村は、前において準用する第二十七第二の調査(第二十四の二第一第二規定により委託された場合にあっては、当該委託に係る調査を含む。)の結果、前において準用する第二十七第三の主治の医師の意見又は指定する医師若しくは当該職員で医師であるものの診断の結果その他厚生労働省令で定める事を認定審査会通知し、第一申請に係る被保険者について、次の各に掲げる被保険者の区分に応じ、当該に定める事に関し審査及び判定を求めるものとする
(3) A Municipality shall notify the Certification Committee of the result of an investigation as set forth in Article 27, paragraph (2) as applied mutatis mutandis pursuant to the preceding paragraph (in a case when the investigation is entrusted pursuant to the provisions of Article 24-2, paragraph (1), item (ii), including an investigation pertaining to said entrustment), the opinion of an attending physician as set forth in Article 27, paragraph (2) as applied mutatis mutandis pursuant to the preceding paragraph, the result of a diagnosis of a designated physician or its personnel who is a physician, or other matters specified by an Ordinance of the Ministry of Health, Labour, and Welfare, and request an examination and judgment pertaining to matters as prescribed in each said item according to the category of Insured Person listed in the following items with regard to the Insured Person pertaining to an application as set forth in paragraph (1):
一 第一被保険者 要支援状態に該当すること及びその該当する要支援状態区分
(i) Primary Insured Person: those who qualify for a Needed Support Condition and Category of Needed Support Condition for which said condition qualifies;
二 第二被保険者 要支援状態に該当すること、その該当する要支援状態区分及びその支援状態原因である身体又は精神上の障害が特定疾病によって生じたものであること。
(ii) Secondary Insured Person: those who qualify for a Needed Support Condition, a Category of Needed Support Condition for which said condition qualifies, and the physical or mental problem(s) that is the cause of said Needed Support Condition as caused by a Specified Disease.
4 認定審査会は、前項の規定により審査及び判定を求められたときは、厚生労働大臣が定める基準に従い、当該審査及び判定に係る被保険者について、同規定するに関し審査及び判定を行い、その結果を市町村通知するものとする。この場合において、認定審査会は、必要があると認めるときは、次に掲げる事項について、市町村意見を述べることができる。
(4) A Certification Committee, when being requested to perform an examination and judgment pursuant to the provisions of the preceding paragraph, shall act in compliance with standards as determined by the Minister of Health, Labour, and Welfare, examine and judge matters as prescribed in each item of the same paragraph of an Insured Person pertaining to said examination and judgment, and notify the Municipality of said result. In this case, a Certification Committee, when it determines necessary, may state opinions to the Municipality regarding the following matters:
一 当該被保険者の要支援状態の軽減又は悪化の防止のために必要な療養及び家事に係る援助に関する事
(i) matters of necessary medical care for or support pertaining to domestic home duties for the reduction or prevention of deterioration of a Needed Support Condition of said Insured Person;
二 第五十三第一規定する指定介護予防サービス又は第五十四の二第一規定する指定地域密着型介護予防サービスの適切かつ有効利用等に関し当該被保険者が留意すべき事
(ii) matters that said Insured Person shall heed to appropriately and effectively use Designated Preventive Long-Term Care Service as prescribed in Article 53, paragraph (1) or a Designated Community-Based Preventive Service of Long-Term Care as prescribed in Article 54-2, paragraph (1).
5 第二十七第六規定は、前前段審査及び判定について準用する
(5) The provisions of Article 27, paragraph (6) shall apply mutatis mutandis to an examination and judgment as prescribed in the first sentence of the preceding paragraph.
6 市町村は、第四前段規定により通知された認定審査会審査及び判定の結果に基づき、要支援認定をしたときは、その結果を当該支援認定に係る被保険者通知しなければならない。この場合において、市町村は、次に掲げる事項当該被保険者被保険者証に記載し、これを返付するものとする
(6) A Municipality, when providing Certification of Needed Support based on the results of an examination and judgment of a Certification Committee that is notified pursuant to the provisions of the first sentence of paragraph (4), shall notify the Insured Person pertaining to said Certification of Needed Support of said result. In this case, a Municipality shall enter the following items on the Certificate of Insured Person of said Insured Person and return the Certificate of Insured Person to the Insured Person:
一 該当する要支援状態区分
(i) said Category of Needed Support Condition;
二 第四第二に掲げる事項に係る認定審査会意見
(ii) opinions of the Certification Committee pertaining to matters listed in paragraph (4), item (ii).
7 支援認定は、その申請のあった日にさかのぼってその効力を生ずる。
(7) A Certification of Needed Support shall become effective retroactively on the date that said application was submitted.
8 市町村は、第四前段規定により通知された認定審査会審査及び判定の結果に基づき、要支援者に該当しないと認めたときは、理由を付して、その旨を第一申請に係る被保険者通知するとともに、当該被保険者被保険者証を返付するものとする
(8) A Municipality, when it is determined that the Insured Person predating the application as set forth in paragraph (1) fails to qualify the Person Requiring Support based on the results of an examination and judgment of a Certification Committee that is notified pursuant to the provisions of the first sentence of paragraph (4), shall notify said Insured Person pertaining of the results, indicating the reasons, and return the Certificate of Insured Person to said Insured Person.
9 第二十七第十から第十二までの規定は、第一申請及び当該申請に対する処分について準用する
(9) The provisions of Article 27, paragraph (10) to (12) shall apply mutatis mutandis to an application as set forth in paragraph (1) and the action for said application.
(要支援認定の更新)
(Renewal of Certification of Needed Support)
第三十三条 支援認定は、要支援状態区分に応じて厚生労働省令で定める期間(以下このにおいて「有効期間」という。)内に限り、その効力を有する。
Article 33 A Certification of Needed Support shall be effective according to the Category of Needed Support Condition during the period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare (herein referred to as "Effective Period" in this Article).
2 支援認定を受けた被保険者は、有効期間の満了後においても要支援状態に該当すると見込まれるときは、厚生労働省令で定めるところにより、市町村に対し、当該支援認定の更新(以下「要支援更新認定」という。)の申請することができる
(2) An Insured Person that has been issued a Certification of Needed Support, when he or she is expected to be in a Needed Support Condition after the expiry of the Effective Period, may apply to the Municipality for application of renewal of said Certification of Needed Support (herein referred to as "Renewal of Certification of Needed Support") pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare.
3 申請することができる被保険者が、災害そのやむを得ない理由により当該申請に係る支援認定の有効期間の満了前に当該申請をすることができなかったときは、当該被保険者は、その理由のやんだ日から一月以内に限り、要支援更新認定の申請することができる
(3) In a case when an Insured Person that may apply for the application as set forth in the preceding paragraph was not able to apply for said application prior to expiry of the Effective Period of Certification of Needed Support pertaining to said application due to a disaster or other compelling reason, said Insured Person may apply for a Renewal of Certification of Needed Support within one month from the date on which said reasons are no longer valid.
4 (第七を除く。)及び第二十八第五から第八までの規定は、前二申請及び当該申請に係る支援更新認定について準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
(4) The provisions of the preceding Article (except for paragraph (7)) and Article 28, paragraphs (5) to (8) shall apply mutatis mutandis to an application as prescribed in the preceding two paragraphs and a Renewal of Certification of Needed Support pertaining to said application. In this case, the necessary technical replacement of the terms of these provisions shall be provided by a Cabinet Order.
5 第三申請に係る支援更新認定は、当該申請に係る支援認定の有効期間の満了日の翌日にさかのぼってその効力を生ずる。
(5) A Renewal of Certification of Needed Support pertaining to an application as set forth in paragraph (3) shall be effective retroactively on the date following the date of expiry of the Effective Period of Certification of Needed Support pertaining to said application.
6 第一規定は、要支援更新認定について準用する。この場合において、同中「厚生労働省令で定める期間」とあるのは、「有効期間の満了日の翌日から厚生労働省令で定める期間」と読み替えるものとする
(6) The provisions of paragraph (1) shall apply mutatis mutandis to a Renewal of Certification of Needed Support. In this case, the phrase "period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare" in the same paragraph shall be deemed to be replaced with "period as determined by an Ordinance of the Ministry of Health, Labour, and Welfare from the date following the expiry of the Effective Period."
(要支援状態区分の変更の認定)
(Certification of Change of Category of Needed Support Condition)
第三十三条の二 支援認定を受けた被保険者は、その支援の必要の程度が現に受けている要支援認定に係る支援状態区分以外の要支援状態区分に該当すると認めるときは、厚生労働省令で定めるところにより、市町村に対し、要支援状態区分の変更の認定の申請することができる
Article 33-2 An Insured Person that has been issued a Certification of Needed Support, when it is determined that the degree of Needed Support Condition qualifies for a Category of Needed Support Condition other than the Category of Needed Support Condition pertaining to said Certification of Needed Support that is issued currently, may apply to the Municipality for a certification of change of Category of Needed Support Condition, pursuant to the provisions of an Ordinance of the Ministry of Health, Labour, and Welfare.
2 第二十八第五から第八まで及び第三十二規定は、前申請及び当該申請に係る支援状態区分の変更について準用する。この場合において、これらの規定に関し必要な技術的読替えは、政令で定める。
(2) The provisions of Article 28, paragraph (5) to paragraph (8), and Article 33 shall apply mutatis mutandis to an application as prescribed in the preceding paragraph and change of Category of Needed Support Condition pertaining to said application. In this case, the necessary technical replacement of terms for these provisions shall be provided by a Cabinet Order.
第三十三条の三 市町村は、要支援認定を受けた被保険者について、その支援の必要の程度が低下したことにより当該支援認定に係る支援状態区分以外の要支援状態区分に該当するに至ったと認めるときは、要支援状態区分の変更の認定をすることができる。この場合において、市町村は、厚生労働省令で定めるところにより、当該変更の認定に係る被保険者に対しその被保険者証の提出を求め、これに当該変更の認定に係る支援状態区分及びにおいて準用する第三十二第四後段規定による認定審査会意見(同第二に掲げる事項に係るものに限る。)を記載し、これを返付するものとする
Article 33-3 A Municipality, when it is determined that an Insured Person that has been issued a Certification of Needed Support qualifies for a Category of Needed Support Condition other than the Category of Needed Support Condition pertaining to said Certification of Needed Support due to a lowering of the degree of Needed Support Condition, may certify a change of Category of Needed Support Condition. In this case, the Municipality shall request the Insured Person pertaining to said change of certification to submit said Certificate of Insured Person, shall enter the Category of Needed Support Condition pertaining to said change of certification and the opinion of the Certification Committee pursuant to the provisions of the second sentence of Article 32, paragraph (4) as applied mutatis mutandis pursuant to the following paragraph (limited to those pertaining to matters listed in item (ii) of the same paragraph), and then return the Certificate of Insured Person to the Insured Person.
2 第二十八第五から第八まで並びに第三十二第二から第五まで及び第六前段規定は、前の要支援状態区分の変更の認定について