Article 19(1)A public health center's director must carry out medical examinations or provide consultation for children with physical disabilities, and must guide medical treatment and education necessary for them.

(2)A public health center's director may carry out medical examinations or provide consultation for children in need of long-term medical treatment due to illness, and may provide guidance for medical treatment and education necessary for them.

(3)When a public health center's director finds that a child to whom a physically disabled certificate is issued pursuant to the provisions of Article 15, paragraph (4) of the Act on Welfare of Persons with Physical Disabilities (Act No. 283 of 1949) (or the custodian of a child to whom a physically disabled certificate is issued as aforementioned, if the person is a child with physical disabilities under 15 years of age; the same applies hereinafter) falls under any of the reasons listed in Article 16, paragraph (2), item (i) or (ii) the same Act, the public health center's director must notify the prefectural governor to that effect.

Article 20(1)The prefectural government may hospitalize a child suffering from bone and joint tuberculosis or other tuberculosis and provide medical treatment and education benefits to them, in order to afford learning assistance together with medical treatment.

(2)Medical treatment and education benefits means the provision of medical care and goods necessary for learning and for life with medical treatment.

(3)The medical care set forth in the preceding paragraph means the performance listed in the following items:

(4)Medical treatment and education benefits pertaining to the medical care set forth in paragraph (2) are entrusted to, and provided by, a hospital designated by the Minister of Health, Labor and Welfare or the prefectural governor pursuant to the provisions of the following paragraph (hereinafter referred to as a "designated treatment and education institution").

(5)The prefectural governor is to designate the medical providers in charge of the medical care set forth in paragraph (2) with the content of organizers of hospitals.

(6)The designation set forth in the preceding paragraph is made toward hospitals conforming to the standards specified by a Cabinet Order.

(7)A designated treatment and education institution may decline the designation by giving not less than 30 days of advanced notice.

(8)When a designated treatment and education institution ceases to conform to the standards specified by a Cabinet Order pursuant to paragraph (6), violates the provisions of the following Article, or is found to be extremely inappropriate as a designated treatment and education institution in charge of the medical care set forth in paragraph (2) due to any other reason, the prefectural governor may rescind its designation.

Article 21A designated treatment and education institution must take charge of the medical care set forth in paragraph (2) of the preceding Article pursuant to the provisions specified by the Minister of Health, Labor and Welfare

Article 21-2Provisions of Article 19-12 and Article 19-20 apply mutatis mutandis to a designated treatment and education institution.In this case, necessary terminological replacements is prescribed by Cabinet Order.

Article 21-3(1)The prefectural governor, if it is found to be necessary to investigate whether medical fees are correctly claimed by a designated treatment and education institution, may request the manager of the designated treatment and education institution to make a necessary report, or may make relevant official carry out on-site inspection on medical records, books and documents, and other objects of the designated treatment and education institution with the consent of its manager.

(2)If the manager of a designated treatment and education institution, without justifiable ground, fails to respond to the request for reporting set forth in the preceding paragraph or makes a false report, or refuses the consent set forth in the same paragraph, the prefectural governor may instruct temporary halt of, or halt of, the payments of medical fees by the prefectural government to the relevant designated treatment and education institution.

(3)The Minister of Health, Labor and Welfare, if it is found to be an urgent necessity to protect interests of a child with regard to the affairs placed under the authority of a prefectural governor prescribed in the preceding paragraph, may instruct the prefectural governor to conduct the affairs set forth in the same paragraph.

Article 21-4(1)The national government is to promote surveys and research contributing to the treatment method of specified chronic pediatric diseases and the sound upbringing of children, etc. who require long-term treatment due to other specified chronic pediatric diseases or other diseases (referring to as "children, etc. with diseases" in paragraph (3) and the following Article).

(2)When the national government promotes surveys and research provided in the preceding paragraph, the national government is to pay attention to appropriate coordination on surveys and research on the mechanism of the occurrence, diagnosis and the treatment method of intractable diseases which serve as foundation for securing high-quality and appropriate medical care for patients with intractable diseases (which refers to the intractable diseases provided in Article 1 of Act on Medical Care for Patients with Intractable Diseases; the same applies hereinafter in this paragraph).

(3)The Minister of Health, Labour and Welfare is to actively provide results of the surveys and research provided in paragraph (1) to persons who conduct surveys and research contributing to the treatment method of specified chronic pediatric diseases and the sound upbringing of children, etc. with diseases, physicians, children, etc. with diseases, their families, and other relevant persons by appropriate means.

(4)When the Minister of Health, Labour and Welfare offers the results of the surveys and research provided in paragraph (1) pursuant to the provisions of the preceding paragraph, the Minister of Health, Labour and Welfare must pay attention to protecting personal information.

Article 21-5Ministry of Health, Labour and Welfare is to formulate the basic policy to promote measures pertaining to implementing high-quality and appropriate medical support for specified chronic pediatric diseases and sound upbringing of other children, etc. with diseases.

Article 21-5-2The payment of outpatient benefits for children with disabilities and exceptional case outpatient benefits for children with disabilities are the benefits provided pursuant to the following Article and Article 21-5-4 concerning outpatient support for children with disabilities listed as follows.

Article 21-5-3(1)A municipality, if a recognized outpatient beneficiary custodian receives outpatient support for children with disabilities (hereinafter referred to as "designated outpatient support") from a person who provides outpatient support services for children with disabilities designated by a prefecture (hereinafter referred to as "designated operator of outpatient support services for children with disabilities") or designated developmental support medical institution (hereinafter referred to as "designated operator of outpatient support services, etc. for children with disabilities" collectively) within the effective period of grant decision on outpatient benefits payment set forth in Article 5-7, paragraph (8), is to pay outpatient benefits for children with disabilities with regard to the expenses required for the relevant designated outpatient support (excluding the expenses specified by Order of the Ministry of Health, Labour and Welfare from the expenses required for provision of meals and other expenses for daily life (hereinafter referred to as "outpatient specified expenses)) to the relevant recognized outpatient beneficiary custodian.

(2)The amount of payment of outpatient benefits for children with disabilities is the amount obtained by deducting the amount listed in item (i) from the one listed in item (ii).

Article 21-5-4(1)A municipality may pay exceptional case outpatient benefits for children with disabilities for the expenses required for the expenses (excluding outpatient specified expenses) the relevant designated outpatient support or appropriate outpatient support prescribed in item (ii) (limited within amount of grant specified in Article 21-5-7, paragraph (7)) pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare in the following cases if acknowledged to be necessary.

(2)The provisions of item (ii) of the preceding paragraph is specified in accordance with the standards specified by Order of Ministry of Health, Labour and Welfare concerning the particulars listed in items (i) through (iii); the particulars of item (iv) is specified by setting based on the standard provided in Order of the Ministry of Health, Labour and Welfare and other particulars are specified by taking into consideration the standard provided in Order of the Ministry of Health, Labour and Welfare.

(3)A municipality is to determine the amount of exceptional case outpatient benefits for specified children with disabilities based on the amount obtained by per month by deducting the amount provided by Cabinet order by taking into account the financial capacity of the household of the relevant recognized outpatient beneficiary custodian respectively (when ten-hundredths (10/100) of the relevant amount provided by the relevant Cabinet Order exceeds the amount provided by a Cabinet Order, the relevant amount equivalent thereto) from the total sum of the amount provided by the following items according to the category of outpatient support for children with disabilities listed in the relevant items in the same month.

Article 21-5-5(1)A custodian of a child with disabilities who intend to receive payment of outpatient benefits for children with disabilities or exceptional case outpatient benefits for children with disabilities (referring to as "outpatient benefits, etc. for children with disabilities" hereinafter in this subsection) must receive decision for payment of municipal outpatient benefits, etc. for children with disabilities (hereinafter referred to as "grant decision on outpatient benefits ").

(2)Grant decision on outpatient benefits is made by the municipality where the custodian of a child with disabilities has their residences; provided, however, that the custodian of the child with disabilities do not have their residence or whose residence is not obvious, another municipality where such custodian of the child with disabilities has their current residences are to make such grant decision.

Article 21-5-6(1)When the custodian of a child with disabilities intends to receive grant decision on outpatient benefits, the custodian is to make an application to the municipality pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.

(2)If the application of the preceding paragraph has been filed, a municipality, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, is to make the relevant official interview with the child with disabilities or the custodian of the child with disabilities pertaining to relevant application and inspect their physical and mental status, circumstances where they are placed, and other particulars prescribed in Order of the Ministry of Health, Labour and Welfare.In this case the municipality may entrust the relevant investigation to designated operators of general consultation support business prescribed in Article 51-14, paragraph (1) of Act on the Comprehensive Support for the Daily and Life in Society of Persons with Disabilities and other persons specified by Order of the Ministry of Health, Labour and Welfare (hereinafter referred to as "designated operators, etc. of consultation support services for children with disabilities" in this Article).

(3)The designated operators, etc. of consultation support services for children with disabilities who are entrusted pursuant to the provisions of the second sentence of the preceding paragraph are to make the persons specified by Order of the Ministry of Health, Labour and Welfare as having specified knowledge and skills relating to health or welfare for children with disabilities conduct the investigation pertaining to the relevant entrustment.

(4)The officers of the designated operators, etc. of consultation support services entrusted pursuant to the provisions of the second sentence of paragraph (2) (meaning employees, directors, or executive officers who execute business, or the equivalent thereof, including those recognized as having the same or greater influence over corporations as employees who execute business, directors, corporate officers, or the equivalent thereof, regardless of what titles they may have, such as counselor, consultant, etc., which includes the cases of applying mutatis mutandis in the following paragraph and Article 21-5-15, paragraph (3), item (vi) including the case of applying mutatis mutandis in Article 24-9, paragraph (3) (including the case of applying mutatis mutandis in Article 24-10, paragraph (4)) and Article 24-28, paragraph (2) (including the case of applying mutatis mutandis in Article 24-29, paragraph (4))), or the persons prescribed in Order of the Ministry of Health, Labour and Welfare set forth in the preceding paragraph or the persons who used to be in such positions must not disclose personal secrets obtained concerning the relevant entrusted services without a valid reason.

(5)With regard to application of the Penal Code and other penal provisions, an officer or employee of a designated operators, etc. of consultation support services for children with disabilities who are entrusted pursuant to the provisions of the second sentence of paragraph (2) is deemed to be an official engaged in the public services pursuant to laws and regulations.

Article 21-5-7(1)If the application of paragraph (1) of the preceding Article is filed, a municipality is to decide the necessity of grant of payment of outpatient benefits, etc. for children with disabilities (hereinafter referred to as "decision on grant necessity" in this Article) by taking into consideration the mental and physical condition of the child with disabilities pertaining to the relevant application, the condition of the person who takes care of the relevant child with disabilities, the intention relating to use of outpatient support for children with disabilities of the relevant child with disabilities and their custodian and other particulars prescribed in Order of the Ministry of Health, Labour and Welfare.

(2)If a municipality acknowledges it is necessary to make decision on grant necessity, it may hear the opinions of child guidance center and other organizations specified by Order of the Ministry of Health, Labour and Welfare (referring to as "child guidance center, etc." in the following paragraph, Article 21-5-10 and Article 21-5-13, paragraph (3)).

(3)If a child guidance center, etc. acknowledges it is necessary to express the opinions of the preceding paragraph, it may hear the opinions of a child with disabilities, their custodian and family, physician and other relevant persons pertaining to the relevant decision on grant necessity for outpatient benefits.

(4)A municipality, if Order of the Ministry of Health, Labour and Welfare specifies it as necessary to make decision on grant necessity, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, is to request the custodian of the child with disabilities pertaining to the application of paragraph (1) of the preceding Article to submit a proposed plan for utilization of support for children with disabilities which designated operators of consultation support services for children with disabilities prepare prescribed in Article 24-26, paragraph (1), item (i).

(5)The custodian of the child with disabilities who is requested to submit proposed support use plan for children with disabilities may submit the proposed support use plan for children with disabilities specified in Order of the Ministry of Health, Labour and Welfare in lieu of the one in the same paragraph, in the case where Order of the Ministry of Health, Labour and Welfare specifies.

(6)If the proposed plan for utilization of support for children with disabilities Children with disabilities in the preceding two paragraphs is submitted, a municipality is to make a decision on grant necessity for outpatient benefits by taking into consideration the particulars specified by Order of the Ministry of Health, Labour and Welfare of paragraph (1) and the relevant proposed plan for utilization of support for children with disabilities.

(7)If the grant decision on outpatient benefits payment is made, a municipality must determine the amount of grant of outpatient support for children with disabilities (hereinafter referred to as "amount of grant") to pay outpatient benefits, etc. for children with disabilities in the period specified by Order of the Ministry of Health, Labour and Welfare for each type of outpatient support for children with disabilities by the month.

(8)Grant decision on outpatient benefits payment is effective limited to the period specified by Order of Ministry of Health, Labour and Welfare (hereinafter referred to as "effective period for grant decision on outpatient benefits payment")

(9)If grant decision on outpatient benefits payment is made, a municipality must issue outpatient beneficiary certificate which describes amount of grant, effective period for grant decision on outpatient benefits payment and other particulars specified by Order of the Ministry of Health, Labour and Welfare (hereinafter referred to as "outpatient beneficiary certificate") to the relevant recognized outpatient beneficiary custodian pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.

(10)A recognized outpatient beneficiary custodian who intends to receive designated outpatient support is to receive relevant designated outpatient support by presenting their outpatient beneficiary certificate to the designated operators, etc. of outpatient support services for children with disabilities pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare; provided, however, that this does not apply in the case of an emergency or any other unavoidable reason.

(11)If a recognized outpatient beneficiary custodian has received designated outpatient support from designated operators, etc. of outpatient support services for children with disabilities (limited to the cases where relevant recognized outpatient beneficiary custodian has presented their outpatient beneficiary certificate to relevant designated operators, etc. of outpatient support services for children with disabilities), a municipality may, in lieu of relevant recognized outpatient beneficiary custodian, pay the expenses (excluding outpatient specified expenses) incurred for relevant designated operators, etc. of outpatient support services for children with disabilities payable by relevant recognized outpatient beneficiary custodian to relevant designated operators, etc. of outpatient support services for children with disabilities within the extent of the amount payable to the relevant recognized outpatient beneficiary custodian as outpatient benefits for children with disabilities.

(12)When a payment is made pursuant to the provisions of the preceding paragraph, outpatient benefits for children with disabilities is deemed to have been paid to the relevant recognized outpatient beneficiary custodian.

(13)If outpatient benefits for children with disabilities are claimed by designated operators, etc. of outpatient support services for children with disabilities for children with disabilities, a municipality is to pay such benefits after examination in light of the standard specified by Minister of Health, Labour and Welfare of Article 21-5-3, paragraph (2), item (i) and the standards relating to the equipment and operation of the services for designated outpatient support of Article 21-5-19, paragraph (2) (limited to the part relating to handling of designated outpatient support).

(14)The municipality may entrust the duties pertaining to the examination and payment under the preceding paragraph to a federation.

Article 21-5-8(1)A recognized outpatient beneficiary custodian, when requiring for alternation for the amount of grant actually received and other particulars prescribed by Order of the Ministry of Health, Labour and Welfare pertaining to grant decision on outpatient support for children with disabilities, may make an application for alternation for the relevant grant decision on outpatient support for children with disabilities.

(2)A municipality, if it is found to be necessary, may make a decision on alternation of a grant decision on outpatient benefits for a recognized outpatient beneficiary custodian upon receiving an application referred to in the preceding paragraph or authority by taking into consideration the particulars prescribed by Order of the Ministry of Health, Labour and Welfare.In this case, the municipality is to request the relevant recognized outpatient beneficiary custodian to submit their outpatient beneficiary certificate.

(3)The provisions of Article 21-5-5, paragraph (2), Article 21-5-6 (excluding paragraph (1)) and the preceding Article (excluding paragraph (1)) apply mutatis mutandis to the alternation of grant decision on outpatient benefits payment in the preceding paragraph.In this case, necessary terminological replacements are prescribed by Cabinet Order.

(4)If a decision is made on alternation of a grant decision on outpatient benefits payment of paragraph (2), a municipality is to state the particulars pertaining to the relevant decision on outpatient beneficiary certificate and return it.

Article 21-5-9(1)A municipality which has made a grant decision on outpatient benefits may rescind the relevant grant decision on outpatient benefits payment in any of the cases listed in the following items:

(2)A municipality that has rescinded a grant decision on outpatient benefits payment pursuant to the provisions of the preceding paragraph is to ask the recognized outpatient beneficiary custodian pertaining to the rescission to return the outpatient beneficiary certificate pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.

Article 21-5-10A prefecture is to provide cooperation on technical particulars conducted by child guidance centers prescribed in Order of the Ministry of Health, Labour and Welfare and other necessary assistance for municipalities in response to requests from the municipality concerning the service conducted by municipalities pursuant to provisions of Article 21-5-5 through the preceding Article.

Article 21-5-11(1)If a municipality applies the provisions of Article 21-5, paragraph (2) to payment of outpatient benefits for children with disabilities received by a recognized outpatient beneficiary custodian since it finds difficult for them to bear expenses spent for outpatient support for children with disabilities due to a disaster or other special circumstances specified by an Order of the Ministry of Health, Labour and Welfare, the term "amount" referred to in item (ii) of the same paragraph is replaced with "the amount specified by the municipality within the range of the amount ".

(2)If the provisions of Article 21-5-4, paragraph (3) are applied to payment of exceptional case outpatient benefits for children with disabilities received by a recognized outpatient beneficiary custodian specified in the preceding paragraph, the term "a municipality is to determine based on the amount obtained by deducting" is replaced with "the amount obtained by deducting the amount determined by a municipality within the extent".

Article 21-5-12(1)If the amount of the expenses spent for outpatient support for children with disabilities received by a recognized outpatient beneficiary custodian obtained (in the case the amount actually required exceeds the amount calculated from the standard specified by Minister of Health, Labour and Welfare, the relevant amount actually required) by deducting the total amount of outpatient benefits for children with disabilities and exceptional case outpatient benefits for children with disabilities paid in relation to the relevant expenses is extremely costly, a municipality must pay high-cost outpatient benefits for children with disabilities to the relevant mount of the expenses spent for outpatient support received by a recognized outpatient beneficiary custodian.

(2)Beyond what is provided for in the preceding paragraph, necessary particulars for requirements for payment of high-cost outpatient benefits for children with disabilities, grant amount, other particulars concerning payment of high-cost outpatient benefits for children with disabilities is prescribed in Cabinet Order by considering impact of the burden of expenses spent for designated outpatient support on household finances.

Article 21-5-13(1)With regard to a child with disabilities who receives after school day services (referring to as "attendee" in this paragraph), if it is found that the welfare of the relevant attendee is likely to be impaired unless their receipt of such services is continued, a municipality may, notwithstanding the provisions of Article 21-5-3, paragraph (1), Article 21-5, paragraph (1) or paragraph (1) of the preceding Article, continue the payment of outpatient benefits for children with disabilities, exceptional case outpatient benefits for children with disabilities or high-cost outpatient benefits for children with disabilities (referring to as "outpatient benefits, etc. of after school day services for children with disabilities" in the following paragraph) pertaining to after school day services, based on the relevant attendee's application, pursuant to the provisions of Order of Ministry of Health, Labour and Welfare even after the child attains the age of 18 until they become 20 years of age.; provided, however, that this does not apply to the case where the relevant attendee can receive the public assistance provided in Article 5, paragraph (7) of the Act on the Comprehensive Support for the Daily and Life in Society of Persons with Disabilities or other support.

(2)With regard to a person who is eligible for receiving payment of benefits, etc. of after school day services for children with disabilities pursuant to the provisions of the preceding paragraph, they are deemed to be children with disabilities or the custodian of a child with disabilities and the provisions of Articles 21-5-3 through the preceding Article apply mutatis mutandis.In this case, necessary terminological replacements are prescribed by a Cabinet Order.

(3)In the event that a municipality acknowledges it is necessary to make a decision, if it is found to be necessary in the case of paragraph (1), a municipality may hear the opinions from child guidance centers.

Article 21-5-14Beyond what is provided for in this subsection, necessary particulars for payment of outpatient benefits for children with disabilities, exceptional case outpatient benefits for children with disabilities or high-cost outpatient benefits for children with disabilities and claim for outpatient benefits for designated operator, etc. of outpatient support services for children with disabilities is specified by Order of Ministry of Health, Labour and Welfare.

Article 21-5-15(1)Designation set forth in Article 21-5-3, paragraph (1) is conducted for each type of outpatient support and each office that provides outpatient support services for children with disabilities (hereinafter referred to as "outpatient support office for children with disabilities") pursuant to the provisions of Order of Ministry of Health, Labour and Welfare, based on application by the persons who provide outpatient support services for children with disabilities.

(2)The designation of Article 21-5-3, paragraph (1) pertaining to after school day services and other outpatient support prescribed in Order of the Ministry of Health, Labour and Welfare (referring to as "outpatient support for specified children with disabilities" in this paragraph and paragraph (5) and Article 21-5-20, paragraph (1)) is to determine the amount of the relevant outpatient support for specified children with disabilities.

(3)A prefectural governor must not make a designation of designated operator of outpatient support services for children with disabilities if an application referred to in paragraph (1) is filed and the filed application falls under any of the following items (excluding item (vii) in case of the application of medical services child developmental support):

(4)A prefecture is to specify the Prefectural Ordinances of item (i) of the preceding paragraph pursuant to the standard of Order of Ministry of Health, Labour and Welfare.

(5)If the application under paragraph (1) has been filed, the prefectural governor may determine not to grant an designation under Article 21-5-3, paragraph (1), in cases where it is found that the amount of designated outpatient support for children with disabilities for each type pertaining to the relevant application in the area including the location of the outpatient support office for children with disabilities pertaining to the relevant prefecture or the relevant application (referring to the area specified by the prefecture pursuant to the provisions of Article 33-22, paragraph (2), item (ii)) has already reached to the amount necessary for the relevant prefecture or the relevant area specified in the prefectural welfare plan for children with disabilities determined by the relevant prefecture pursuant to the provisions of paragraph (1) of the same Article or the relevant amount may be exceeded by designation of the service office pertaining to the relevant application and that it is likely to cause problems with accomplishment of the prefectural welfare plan for children with disabilities.

Article 21-5-16(1)Unless the designation of Article 21-5-3, paragraph (1) is renewed every six years, the designation ceases to be effective upon the expiration of such period.

(2)In the case where a renewal set forth in the preceding paragraph is applied, when no disposition is implemented for the application by the expiration date of the period set forth in the same paragraph (referred to as a "effective period for designation" hereinafter in this Article), the designation before the renewal remains in force until the disposition is implemented, even after the expiration of the effective period for designation.

(3)When the designation is renewed in the case referred to in the preceding paragraph, the effective period for designation as renewed starts from the day following the expiration date of the effective period for designation before the renewal.

(4)The provisions of the preceding Article apply mutatis mutandis to renewal of designation set forth in paragraph (1).In this case, necessary terminological replacements are prescribed by a Cabinet Order.

Article 21-5-17(1)With regard to child developmental support and other outpatient support office for children with disabilities pertaining to other outpatient support services for children with disabilities specified by Order of Ministry of Health, Labour and Welfare, in the case where application of Article 21-5-15, paragraph (1) (which includes applying mutatis mutandis in paragraph (4) of the preceding Article) pertaining to the relevant outpatient support office for children with disabilities is filed from the person who was granted the designation in the text of Article 41, paragraph (1) of Long-term Care Insurance Act (Act No. 123 of 1997) (limited to the one pertaining in-home services specified by Article 8, paragraph (1) of the same Act of the categories specified by Order of Ministry of Health, Labour and Welfare, in accordance with the categories of outpatient support for children with disabilities practiced by the relevant outpatient support office for children with disabilities), the designation in the text of Article 42-2, paragraph (1) of the same Act (limited to the one pertaining community-based services specified by Article 8, paragraph (14) of the same Act of the categories specified by Order of Ministry of Health, Labour and Welfare, in accordance with the categories of outpatient support for children with disabilities practiced by the relevant outpatient support office for children with disabilities), the designation in the text of Article 53, paragraph (1) of the same Act (limited to the one pertaining preventive long-term care services specified by Article 8-2, paragraph (1) of the same Act of the categories specified by Order of Ministry of Health, Labour and Welfare, in accordance with the categories of outpatient support for children with disabilities practiced by the relevant outpatient support office for children with disabilities), or the designation in the text of Article 54-2, paragraph (1) of the same Act or the designation of the designated operator of welfare service for persons with disabilities of Article 29, paragraph (1) of Act on the Comprehensive Support for the Daily and Life in Society of Persons with Disabilities (limited to the one pertaining to welfare services for persons with disabilities specified by Article 5, paragraph (1) of the same Act of the categories specified by Order of Ministry of Health, Labour and Welfare, in accordance with the categories of outpatient support services for children with disabilities practiced by the relevant outpatient support services office for children with disabilities) regarding application of the provisions of Article 21-5-15, paragraph (3) which includes applying mutatis mutandis in paragraph (4) of the preceding Article; hereinafter the same applies in this paragraph) in the case where such application falls under all the following items, "of Article 21-5-19, paragraph (1)" is replace with "pertaining to the employees engaged in designated outpatient support of Article 21-5-17, paragraph (1), item (i), and "Article 21-5-19, paragraph (2)" of item (iii) of the same paragraph with "Article 21-5-17, paragraph (1), item (ii)" respectively; provided, however, that these provisions do not apply when the applicant makes a special notification pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.

(2)The provisions of all the items of the preceding paragraph are specified in accordance with the standards specified by Order of Ministry of Health, Labour and Welfare concerning the particulars listed in through items (i) through (iii); the particulars of item (iv) is specified by setting based on the standard provided in Order of the Ministry of Health, Labour and Welfare and other particulars are specified by taking into consideration the standard provided in Order of the Ministry of Health, Labour and Welfare.

(3)In the paragraph (1), in the case where a person prescribed in the same paragraph receive designation of Article 21-5-3, paragraph (1) pertaining to the application of the same paragraph, for such person, the provisions of Article 21-5-19, paragraph (3) are not applicable; with regard to application of the provisions listed in the left column of the following table, the letters listed in the middle column are to correspond to the letters of the right column of the same table.

(4)If the notification is made for any of the following items by the person specified in paragraph (1) who was granted designation of Article 21-5-3, paragraph (1) pertaining to the application of the same paragraph, it is deemed as notification of abolishment or suspension pursuant to the provisions of Article 21-5-20, paragraph (4) with regard to the designated outpatient support services pertaining to the relevant designation.

(5)If the person specified in paragraph (1) who was granted designation of Article 21-5-3, paragraph (1), intends to abolish or suspend the services of the designated community-based service specified in Article 42-2, paragraph (1) of the Long-Term Care Insurance Act (limited to the services provided in outpatient support office for children with disabilities pertaining to the relevant designation) or the services of the designated community-based preventative long-term care service specified in Article 54-2, paragraph (1) of the same Act (limited to the services provided in outpatient support office for children with disabilities pertaining to the relevant designation), pursuant to the provisions of Order of Ministry of Health, Labour and Welfare, by one month prior to the date of abolishment or suspension, the person must notify to that effect to the prefectural governor who has made the relevant designation.In this case, if the relevant notification is made, the relevant person is deemed to notify abolishment or suspension of the services pursuant to the provisions of Article 21-5-20, paragraph (4).

Article 21-5-18(1)In order to enable a child with disabilities to lead self-reliant daily life or social life, the establisher of a designated operator of outpatient support services for children with disabilities and designated developmental support medical institution (hereinafter referred to as "designated services operator, etc. for children with disabilities") must endeavor to effectively implement outpatient support for children with disabilities according to the intention, aptitudes, characteristics of dysfunctions and other circumstances of relevant child with disabilities, while facilitating close coordination with administrative organs, educational institutions and other relevant bodies, as well as respecting the willing of a child with disabilities or their custodian as much as possible constantly from the standpoint of children with disabilities and their custodians.

(2)The designated services operator, etc. for children with disabilities must endeavor to improve the quality of outpatient support for children with disabilities by evaluating the quality of outpatient support for children with disabilities provided by such operator and taking other measures.

(3)The designated services operator, etc. for children with disabilities must respect the personality of children with disabilities, comply with this Act and the orders based on this Act, and implement their duties faithfully for children with disabilities and their custodians.

Article 21-5-19(1)The designated services operator, etc. for children with disabilities must have employees engaged in the relevant designated outpatient support, per outpatient support office for children with disabilities or per designated developmental support medical provider institution pertaining to the relevant designation in accordance with the standard specified in the Prefectural Ordinance.

(2)The designated services operator, etc. for children with disabilities must provide the designated outpatient support in accordance with the standard relating to equipment and operation of the services of the designated outpatient support specified in the Prefectural Ordinance.

(3)The provisions of the preceding two items are specified in accordance with the standards specified by Order of Ministry of Health, Labour and Welfare concerning the particulars listed through items (i) through (iii); the particulars of item (iv) are specified by setting based on the standards provided in Order of the Ministry of Health, Labour and Welfare and other particulars are be specified by taking into consideration the standards provided in Order of the Ministry of Health, Labour and Welfare.

(4)If the designated operator of outpatient support services for children with disabilities notifies abolishment or suspension of the services pursuant to the provisions of paragraph (4) of the following Article, for the person who receives the relevant designated outpatient support within one month prior to the date of the relevant notification and the person who seeks to continue provision of support corresponding to the relevant designated outpatient support even after the date of abolishment or suspension of the relevant services, such operator must carry out liaison and coordination with other designated outpatient services operators, etc. for children with disabilities and other relevant persons and provide other benefits in order to continuously provide necessary outpatient support for children with disabilities.

Article 21-5-20(1)If the designated operator of outpatient support services for children with disabilities intends to increase the amount of outpatient support for specified children with disabilities pertaining to the designation of Article 21-5-3, paragraph (1), the operator may apply alternation of designation of the same paragraph pursuant to the Order of Ministry of Health, Labour and Welfare.

(2)The provisions of Article 21-5-15, paragraph (3) through (5) apply mutatis mutandis to the case where application for alternation of the designation in the preceding paragraph is made.In this case, necessary terminological replacements are prescribed by Cabinet Order.

(3)If the designated operator of outpatient support services for children with disabilities changes the name and location of outpatient support office for children with disabilities pertaining to the relevant designation and other particulars set forth in Order of the Ministry of Health, Labour and Welfare is made, or the services of the relevant designated outpatient support whose operation had been suspended resumed, the operator must notify that effect to the prefectural governor within ten days.

(4)If the designated operator of outpatient support services for children with disabilities intends to abolish or suspend the services of the relevant designated outpatient support for children with disabilities, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, the operator must notify the prefectural governor by one month prior to the date of abolishment or suspension.

Article 21-5-21(1)If a prefectural governor or municipal mayor is found to be necessary to smoothly provide the benefits specified in Article 21-5-21, the governor and mayor may carry out mutual liaison and coordination with the relevant designated operator of outpatient support services for children with disabilities and other relevant persons or provide advice and other assistance for the relevant designated operator of outpatient support services for children with disabilities and other relevant persons,

(2)Minister of Health, Labor and Welfare, in the case of liaison and coordination or assistance pursuant to the preceding paragraph by two or more prefectural governors regarding the identical designated operator of outpatient support services for children with disabilities, if it is found necessary for smooth provision of benefits specified in Article 21-5-19, paragraph (4), may provide mutual liaison and coordination between the relevant prefectures, advice and other assistance from a cross-regional viewpoint beyond the areas of the prefectures for the relevant designated operator of outpatient support services for children with disabilities.

Article 21-5-22(1)When a prefectural governor or municipal mayor finds it to be necessary, they may make the relevant officials or relevant persons, for a person who used to be a designated operator of outpatient support services for children with disabilities, or its employee, (hereinafter referred to as "a person who used to be a designated operator, etc. of outpatient support services for children with disabilities") pertaining to the relevant designation, report or submit or present books and documents and other objects, request the appearance of a person who was used to be a designated operator of outpatient support services for children with disabilities, or may make relevant prefecture's official ask relevant persons questions or enter any office of the outpatient support office pertaining the relevant designated operator of outpatient support services for children with disabilities, any office or other location of the services of the relevant designated outpatient support and inspect its equipment, books and documents and other objects.

(2)The provisions of the preceding paragraph apply mutatis mutandis to the establisher of the designated developmental support medical institution.In this case, necessary technical replacement of the terms in this case are provided by Cabinet Order.

(3)The provisions of Article 19-16, paragraph (2) apply mutatis mutandis to the questions and inspection pursuant to the provisions of paragraph (1), and the provisions of paragraph (3) of the same Article apply mutatis mutandis to the authority pursuant to the provisions of paragraph (1) (including application mutatis mutandis to the preceding paragraph).

Article 21-5-23(1)If the prefectural governor finds that the designated operator, etc. for children with disabilities falls under the cases listed in all the following items (excluding item (iii) for the establisher of the designated developmental support medical institution; the same applies to this paragraph and paragraph (5).), the prefectural governor may recommend the measures to be taken specified in the relevant items, for the relevant designated operator, etc. for children with disabilities by a set deadline.

(2)the prefectural governor, in the case where recommendation is made pursuant to the provisions of the preceding paragraph and the designated operator, etc. for children with disabilities does not comply with such recommendation within the period of the same paragraph, may issue a public announcement to that effect.

(3)the prefectural governor, in the case the designated operator, etc. for children with disabilities who has received recommendation pursuant to the provisions of paragraph (1) does not take measures pertaining to such recommendation without justifiable grounds, may order the relevant designated operator, etc. for children with disabilities to take measures pertaining to such recommendation by a set deadline.

(4)The prefectural governor must notify the public to that effect, in the event of issuing an order pursuant to the preceding paragraph.

(5)If a municipality finds that the designated operator, etc. for children with disabilities who provided the designated outpatient support pertaining to payment of outpatient benefits for children with disabilities falls under any of the cases listed in the items of paragraph (1), the municipality must notify the prefectural governor of the location of outpatient support office for children with disabilities or the designated developmental support medical institution pertaining to the relevant designation to that effect.

Article 21-5-24(1)The prefectural governor, in the case of falling under any of the following items, may rescind the designation set forth in Article 21-5-3, paragraph (1) pertaining to the relevant designated operator of outpatient support services for children with disabilities or suspend the validity of the designation, in whole or in part, for a period of time to be specified:

(2)A municipality must, if it is found that the designated operator of outpatient support services for children with disabilities who has provided outpatient support for children with disabilities pertaining to payment of outpatient benefits, etc. for children with disabilities or outpatient medical treatment for orthopedically impaired children specified by Article 21-5-29, paragraph (1) pertaining to payment of outpatient medical expenses for orthopedically impaired children falls under any of the items of the preceding paragraph, notify the prefectural governor of the location of outpatient support office for children with disabilities pertaining to the relevant designation to that effect.

Article 21-5-25A prefectural governor must give public notice in any of the cases listed in the following items to that effect:

Article 21-5-26(1)The designated operator, etc. for children with disabilities must establish a management system in accordance with the requirements specified by Order of the Ministry of Health, Labour and Welfare to ensure that the duties prescribed in Article 21-5-18, paragraph (3) are carried out.

(2)The designated operator, etc. for children with disabilities, according to their category set forth in the relevant following items, must give notification of particulars pertaining to the establishment of a management system to the relevant person specified in that item, in accordance with Order of the Ministry of Health, Labour and Welfare:

(3)If any changes have been made to the particulars in the notification which the designated operator, etc. for children with disabilities made pursuant to the preceding paragraph, that designated operator, etc. must give notification to the effect without delay to the Minister of Health, Labour and Welfare, the prefectural governor, or the mayor of the designated city or core city (hereinafter referred to as the "Minister of Health, Labour and Welfare, etc." in this subsection) to whom they gave the notification in question, in accordance with Order of the Ministry of Health, Labour and Welfare.

(4)If the designated operator of outpatient support services for children with disabilities business that gave the Minister of Health, Labour and Welfare, etc. the notification under paragraph (2) gives notification to another Minister, etc. other than that Minister, etc. pursuant to the same paragraph due to a change in their category set forth in the items of the same paragraph, they must also give notification to the effect to that Minister, etc. in accordance with Order of the Ministry of Health, Labour and Welfare.

(5)The Ministers of Health, Labour and Welfare, etc. must endeavor to coordinate closely with each other to ensure that the notification under the preceding three paragraphs are made appropriately.

Article 21-5-27(1)If the Minister of Health, Labour and Welfare, etc. who has receive a notification under paragraph (2) of the preceding Article finds it necessary for the establishment of the a management system under paragraph (1) of the same Article for the designated operator, etc. for children with disabilities (excluding the designated operator of outpatient support services for children with disabilities that has filed a notification under paragraph (4) the same Article, in cases of the Minister of Health, Labour and Welfare, etc. who has received the notification), they may order that designated operator to make a report; order them to submit or show books, documents or other materials; request that operator or their employees to appear; require the relevant personnel to question the persons concerned; or require them to reenter the places of outpatient support office for children with disabilities or offices relevant to their designation, or enter other places related to the provision of the designated outpatient support services for children with disabilities, in order to inspect the equipment, books, documents or other materials.

(2)If the Minister of Health, Labour and Welfare or the mayor of a designated city or core city exercises the authority prescribed in the preceding paragraph, they are to do so in close cooperation with the prefectural governor who conferred the designation upon the designated operator of outpatient support services for children with disabilities (referred to as the "relevant prefectural governor" in paragraph (5) of the following Article).

(3)When the prefectural governor finds it necessary for the establishment of a management system under paragraph (1) of the preceding article for the designated operator of outpatient support services for children with disabilities relevant to the designation which that prefectural governor conferred or intends to confer, the prefectural governor may request the Minister of Health, Labour and Welfare or the mayor of a designated city or core city to exercise the authority set forth in paragraph (1).

(4)If the Minister of Health, Labour and Welfare or the mayor of the designated city or core city exercises the authority prescribed in paragraph (1) in response to a request made by the prefectural governor pursuant to the preceding paragraph, they must make the notification of the results to that prefectural governor who made that request, in accordance with Order of the Ministry of Health, Labour and Welfare.

(5)The provisions of Article 19-16, paragraph (2) apply mutatis mutandis to the questioning and inspection under paragraph (1) of this Article; the provisions of paragraph (3) of Article 19-16 apply mutatis mutandis to the authority under paragraph (1) of this Article.

Article 21-5-28(1)If the Minister of Health, Labour and Welfare, etc. who has received the notification under Article 21-5-26, paragraph (2) finds that the designated operator, etc. for children with disabilities that has filed the notification (in the case of the Minister of Health, Labour and Welfare, etc. who has received a notification pursuant to paragraph (4) of the same Article, this does not include the designated operator of outpatient support services for children with disabilities who made the notification pursuant to the same paragraph) does not establish an appropriate management system, the Minister, etc. may recommend that designated operator, etc. for children with disabilities to establish an appropriate management system, in accordance with the requirements specified by Order of the Ministry of Health, Labour and Welfare, by the specified date.

(2)If the Minister of Health, Labour and Welfare, etc. has issued the recommendation under the preceding paragraph, and the designated operator, etc. for children with disabilities that has received the recommendation fails to comply with the recommendation within the period specified in the same paragraph, the Minister, etc. may make a public announcement to that effect.

(3)If the designated operator, etc. for children with disabilities that has received the recommendation under paragraph (1) fails to implement measures pertaining to these recommendations without just cause, the Minister of Health, Labour and Welfare, etc. may order that designated operator, etc. for children with disabilities to implement those measures within a specified period.

(4)The Minister of Health, Labour and Welfare, etc. who has issued an order under the preceding paragraph must make a public notice of the fact.

(5)If a designated operator of outpatient support services for children with disabilities violates an order under paragraph (3), the Minister of Health, Labour and Welfare or the mayor of a designated city or core city must send notice of the violation to the relevant prefectural governor in accordance with Order of the Ministry of Health, Labour and Welfare.

Article 21-5-29(1)A municipality, in the case where a child with disabilities pertaining to grant decision on outpatient benefits payments, within effective period of grant decision on outpatient benefits payments, is to receive medical services child developmental support pertaining to medical treatment, (hereinafter referred to "outpatient medical treatment for orthopedically impaired children" in this Article), from designated operators, etc. of outpatient support service for children with disabilities (limited to hospital or other facility specified in Order of Ministry of Health, Labour and Welfare; the same applies in this subsection), for recognized outpatient beneficiary custodian pertaining to the relevant children with disabilities, pay outpatient medical expenses for orthopedically impaired children.

(2)The amount of outpatient medical expenses for outpatient medical treatment for orthopedically impaired children is the amount obtained by deducting the amount specified by Cabinet Order (when ten-hundredths (10/100) of the relevant amount provided by the relevant Cabinet Order exceeds the amount provided by a Cabinet Order, the relevant amount equivalent thereto) from the amount calculated according to the example of calculation method of the amount of the expenses required for medical treatment of health insurance for outpatient medical treatment for orthopedically impaired children (excluding dietary treatment) per month by taking into account the financial capacity of the household of the relevant recognized outpatient beneficiary custodian.

(3)When a child with disabilities pertaining to a decision on outpatient benefits receives outpatient medical treatment for orthopedically impaired children from a designated operator, etc. of outpatient support services for children with disabilities, the municipality may pay the expenses required for relevant outpatient medical treatment for orthopedically impaired children payable by the recognized beneficiary custodian pertaining to the relevant child with disabilities to the relevant designated operator, etc. of outpatient support services for children with disabilities in lieu of the relevant recognized outpatient beneficiary custodian, to the relevant designated operator, etc. of outpatient support services, within the limit of the amount payable to the relevant recognized beneficiary custodian as the outpatient medical expenses for orthopedically impaired children.

(4)When a payment is made pursuant to the provisions of the preceding paragraph, the outpatient medical expenses for orthopedically impaired children for relevant recognized outpatient beneficiary custodian is deemed to have been paid.

Article 21-5-30The provisions of Article 19-12 and Article 19-20 apply mutatis mutandis to payment of the outpatient medical expenses for orthopedically impaired children to the designated operator, etc. of outpatient support services, and the provisions of Article 20 to the designated operator, etc. of outpatient support services, respectively.In this case, necessary terminological replacements are prescribed by Cabinet Order.

Article 21-5-31Payment of the outpatient medical expenses for orthopedically impaired children is not to be made for medical care of orthopedically impaired children to the extent provided by Cabinet Order if the child is eligible for benefits equivalent to payment of the outpatient medical expenses for orthopedically impaired children among benefits provided by Cabinet Order which are benefits for dependents' medical expenses under the Health Insurance Act or any other benefits based on Laws and Regulations in light of the condition of the relevant disabilities or to the extent covered by the benefits granted if benefits have been provided which are other than the benefits provided by the relevant Cabinet Order and which are equivalent to payment of the outpatient medical expenses for orthopedically impaired children at the expense of the national or local governments.

Article 21-5-32Beyond what is specified in this subsection, necessary particulars concerning payment of the outpatient medical expenses for orthopedically impaired children and claim for payment of the outpatient medical expenses for orthopedically impaired children of the designated operator, etc. of outpatient support services is specified by Ministry of Health, Labour and Welfare.

Article 21-6A municipality, if it is found to be extremely difficult for the custodian of a child with disabilities in need of the welfare services for persons with disabilities prescribed in Article 5, paragraph (1) of Act on the Comprehensive Support for the Daily and Life in Society of Persons with Disabilities (hereinafter referred to as " welfare services for persons with disabilities") to receive nursing care benefits or exceptional nursing care benefits prescribed in the same Act (referred to as "nursing care benefits, etc." in Article 56-6, paragraph (1)) due to any unavoidable reason, in accordance with the standards specified by a Cabinet Order, may provide outpatient support for children with disabilities or welfare services for persons with disabilities to relevant child with disabilities or entrust the provision of outpatient support for children with disabilities or welfare services for persons with disabilities to a person other than relevant municipality.

Article 21-7A person engaged in the welfare services for persons with disabilities provided in Article 5, paragraph (1) of Act on the Comprehensive Support for the Daily and Life in Society of Persons with Disabilities, if requested to accept entrustment pursuant to the provisions of the preceding Article, must not refuse it without justifiable grounds.

Article 21-8In order that welfare services pertaining to the child care support services provided in the following Article and other carefully-crafted welfare services in line with the condition of each region can be positively provided and that each custodian can comprehensively receive the most adequate support for fostering their children in line with the mental and physical condition, environment and other conditions of relevant children and custodians, a municipal government must endeavor to facilitate liaison and coordination for activities of the persons providing or participating in welfare services, and develop other systems in line with the condition of each region.

Article 21-9For the purpose of contributing to the sound upbringing of children, a municipality must endeavor to implement necessary measures in order that after-school child sound upbringing services and short-term child care support services, house-call services for all households with babies, house-call services to support childrearing, local childrearing support center services, temporary custody services, childcare for sick children and family support center services and the following services as specified by an order of the competent ministry (hereinafter referred to as "child care support services") can be carried out steadily within its district:

Article 21-10For the purpose of contributing to the sound upbringing of children, a municipality must perform after-school child sound upbringing services in line with the condition of each region and endeavor to promote the utilization of after-school child sound upbringing services for the children provided in paragraph (2) of Article 6-3 by such means as carrying out coordination with persons engaged in after-school child sound upbringing services other than the relevant municipality.

Article 21-10-2(1)For the purpose of contributing to the sound upbringing of children, a municipality is to endeavor to perform house-call services for all households with babies and house-call services to support childrearing and, in the case where child, etc. requiring assistance (excluding specified expectant mothers) are found by house-call services for all households with babies or the mayor of the head of the municipality receive referral pursuant to the provisions of Article 26, paragraph (1), item (iii) or notice pursuant to the provisions of item (xiii) of the same paragraph or referral pursuant to Article 8, paragraph (2), item (ii) of Child Abuse Prevention and Treatment Act or notice pursuant to the provisions of item (iv) of the same paragraph, is to implement house-call services to support childrearing and provide other necessary support.

(2)A municipality may perform house-call services for all households with babies beyond guidance of Article 10, Article 11, paragraph (1) or (2), Article 17, paragraph (1) or Article 19, paragraph (1) of Maternal and Child Health Act) (including application mutatis mutandis to Article 19, paragraph (2) of the same Act).

(3)A municipality may entrust the whole or a part of the affairs of house-call services for all households with babies and house-call services to support childrearing.

(4)A person who is, or used to be, engaged in the affairs concerning house-call services for all households with babies and house-call services to support childrearing must not divulge any secret that may have come to their knowledge with regard to the relevant affairs.

Article 21-10-3When performing house-call services for all households with babies and house-call services to support childrearing, a municipality must endeavor to secure coordination and harmonization with the project concerning maternal and child health based on Maternal and Child Health Act.

Article 21-10-4A prefectural governor, in the case of finding the person as deemed to be a child requiring assistance upon implementing the project or affairs concerning maternal and child health based on Maternal and Child Health Act, is to notify this to the mayor or head of a municipality of the current location of the relevant person.

Article 21-10-5(1)A person engaged in organizations relevant to medical treatment, welfare or education such as a hospital, clinic, child welfare facility, school and others and the duties relevant to medical treatment of children or expectant and nursing mothers including a doctor, dentist, public health nurse, midwife, nurse, official of child welfare facility, teacher in schools and others, in the case of finding the person deemed to be a child, etc. requiring assistance, the relevant person must endeavor to provide information for the mayor or head of a municipality of the current location of the relevant person.

(2)The provisions concerning the crime of unlawful disclosure of confidential information set forth in the Penal Code and provisions in any other Act that provide for confidentiality obligations must not be construed to preclude a report .

Article 21-11(1)A municipality is to collect and provide necessary information concerning child care support services and, upon request from a custodian, provide consultation and necessary advice to enable the relevant custodian to utilize the most adequate Child Care Support Services, by taking into consideration the relevant custodian's wishes, the state of foster care of their child the content of the support necessary for the relevant child and other circumstances.

(2)Upon request from the custodian receiving advice set forth in the preceding paragraph, the municipal government, where necessary, is to make arrangements or carry out coordination for the utilization of Child Care Support Services and make a request for such utilization by relevant custodian to a person engaged in the Child Care Support Services

(3)A municipality may entrust the affairs concerning the collection and provision of information and consultation and advice set forth in paragraph (1), and the arrangement, coordination and requests set forth in the preceding paragraph to a person other than relevant municipality.

(4)A person engaged in child care support services must cooperate in the collection of information, arrangement, coordination and requests made pursuant to the provisions of the preceding three paragraphs as much as possible.

Article 21-12A person who is, or used to be, engaged in the affairs concerning the provision of information, the consultation and advice, and the arrangement, coordination and requests pursuant to the provisions of paragraph (3) of the preceding Article (referred to as "coordination and other affairs" in the following Article and Article 21-14, paragraph (1)) must not divulge any secret that may have come to their knowledge with regard to such affairs.

Article 21-13When a mayor of a municipality finds it necessary in order to ensure adequate implementation of coordination and other affairs conducted pursuant to the provisions of Article 21-11, paragraph (3), the mayor may give orders necessary for the supervision of relevant affairs to the persons accepting the entrusted affairs.

Article 21-14(1)When a mayor of municipality finds it necessary in order to ensure adequate implementation of coordination and other affairs conducted pursuant to the provisions of Article 21-11, paragraph (3), the mayor may, within the limit necessary therefor, request a person accepting the entrusted affairs to make a report, or make relevant municipality's official ask relevant persons questions or enter any office of the person accepting relevant entrusted affairs and inspect the books and documents and other objects.

(2)The provisions of Article 18-16, paragraphs (2) and (3) apply mutatis mutandis to the case referred to in the preceding paragraph.

Article 21-15A person engaged in child care support services, other than the national government, prefectural governments and municipal governments, may notify the mayor of municipality of the particulars concerning their services, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.

Article 21-16The national and local governments must endeavor to provide information and give consultation and other appropriate assistance to persons engaged in child care support services

Article 21-17The national government and prefectures must endeavor to encourage such studies as well as assist in measures for improvement of the quality of welfare services performed by persons engaged in child care support services, and other researches and studies necessary to support to take care of children by their custodians and promote welfare of children.

Article 24-2(1)When a recognized admission beneficiary custodian provided in paragraph (6) of the following Article (referred to as a "recognized admission beneficiary custodian" hereinafter in this Article) applies for admission or institutionalization (hereinafter referred to as "admission, etc.") into an admission institution for children with disabilities (hereinafter referred to as "designated admission institution for children with disabilities") or a designated developmental support medical institution (hereinafter referred to as "designated admission institution, etc. for children with disabilities" collectively.) designated by the prefectural governor during the period of time provided pursuant to the provisions of paragraph (4) of the following Article and the custodian receives admission support for children with disabilities from relevant designated admission institution, etc. for children with disabilities (hereinafter referred to as "designated admission support"), the prefecture is to pay admission benefits for children with disabilities to relevant recognized admission beneficiary custodian with regard to expenses spent for relevant designated admission support (excluding such expenses spent for meal provision, expenses spent for residency or stay and other expenses spent for daily life provided by an Order of the Ministry of Health, Labour and Welfare, and expenses spent on medical treatment (hereinafter referred to as "specified admission expenses")).

(2)The amount of payment of admission benefits for children with disabilities is to be the amount obtained by deducting the amount listed in item (i) from the one listed in item (ii).

Article 24-3(1)When the custodian of a child with disabilities intends to receive admission benefits for children with disabilities pursuant to the provisions of paragraph (1) of the preceding Article, the custodian must make an application with the prefectural government, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.

(2)When an application set forth in the preceding paragraph is made, the prefecture is to decide whether to pay admission benefits for children with disabilities, by taking into consideration the type and level of the dysfunction of the child with disabilities pertaining to relevant application, the state of a caretaker of relevant child with disabilities, the state of receipt of admission benefits for children with disabilities by the custodian of relevant child with disabilities, and other particulars specified by an Order of the Ministry of Health, Labour and Welfare.

(3)In the case where a decision is made pursuant to the provisions of the preceding paragraph, the prefectural government must hear opinions from the director of a child guidance center.

(4)In the case where a decision to pay admission benefits for children with disabilities (hereinafter referred to as "decision on admission benefits payment") is made, a period for payments of admission benefits for children with disabilities must be specified.

(5)A period set forth in the preceding paragraph may not exceed the period specified by an Order of the Ministry of Health, Labour and Welfare.

(6)When a decision on admission benefits payment is made, the prefectural government must issue a beneficiary certificate (hereinafter referred to as " admission beneficiary certificate") stating the period specified pursuant to the provisions of paragraph (4) (hereinafter referred to as "benefits payment period") to the custodian of the child with disabilities for whom relevant decision on admission benefits payments is made (hereinafter referred to as "recognized admission beneficiary custodian"), pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.

(7)A recognized admission beneficiary custodian who intends to receive designated admission support must receive relevant designated admission support by presenting their admission beneficiary certificate to the designated institution, etc. for children with disabilities, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare; provided, however, that this does not apply in the case of an emergency or any other unavoidable reason

(8)When a recognized admission beneficiary custodian has received designated institutional support from a designated admission institution, etc. for children with disabilities, (limited to the cases where the relevant recognized admission beneficiary custodian has presented the custodian admission beneficiary certificate to relevant designated admission institution, etc. for children with disabilities), the prefecture may pay expenses spent for the relevant designated admission support that are payable by the relevant recognized admission beneficiary custodian to the relevant designated institution, etc. for children with disabilities (excluding specified expenses), in lieu of relevant custodian, to relevant designated admission institution, etc. for children with disabilities, within the limit of the amount payable to the relevant recognized admission beneficiary custodian as the admission benefits for children with disabilities.

(9)When a payment is made pursuant to the provisions of the preceding paragraph, the admission benefits for children with disabilities for the referenced recognized admission beneficiary custodian is deemed to have been paid.

(10)When a designated admission institution, etc. for children with disabilities, etc. requests admission benefits for children with disabilities, the prefecture is to pay the same after the examination in light of the standards specified by the Minister of Health, Labor and Welfare as set forth in paragraph (2), item (i) of the preceding Article and the standards on facilities and operation of the designated child with mental disabilities outpatient, etc. as set forth in Article 24-12, paragraph (2) (limited to the portions of such standards relating to handling of designated admission support).

(11)A prefectural government may entrust the federation of national health insurance to conduct the affairs concerning examination and payments pursuant to the provisions of the preceding paragraph.

Article 24-4(1)A prefectural government making a grant decision on admission benefits payment may rescind the relevant decision on outpatient benefits payment may rescind the relevant decision on admission benefits payment in any of the cases listed in the following items:

(2)A prefecture having rescinded a decision on admission benefits payment pursuant to the provisions of the preceding paragraph is to request the recognized admission beneficiary custodian pertaining to the relevant rescission to return the admission beneficiary certificate pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.

Article 24-5In the case where the prefectural government applies the provisions of paragraph (2) of Article 24-2 to payments of admission benefits for children with disabilities to a recognized admission beneficiary custodian since it finds difficult for the custodian to bear the expenses spent for admission support for children with disabilities due to disaster or other special circumstances specified by an Order of the Ministry of Health, Labour and Welfare, the term "amount" referred to in the same paragraph, item (ii) is replaced with "the amount specified by the prefectural government within the range of (the amount ".

Article 24-6(1)When the amount obtained (in the case the amount actually required exceeds the amount calculated from the standard specified by Minister of Health, Labour and Welfare, the relevant amount actually required) by deducting the total amount of admission benefits for children with disabilities paid in relation to the expenses spent for designated admission support received by a recognized admission beneficiary custodian from the total amount of such expenses is extremely costly, high-cost admission benefits for children with disabilities are paid to the relevant custodian pursuant to the provisions of Cabinet Order.

(2)Beyond what is prescribed in the preceding paragraph, the requirements for payments of high-cost admission benefits for children with disabilities, the amounts to be paid, and other necessary particulars concerning payments of high-cost admission benefits for children with disabilities are prescribed by a Cabinet Order by considering the impact of the burden of expenses spent for designated admission support on household finances.

Article 24-7(1)When a child with disabilities pertaining to such a recognized admission beneficiary custodian that is specified by an Order of the Ministry of Health, Labour and Welfare is taken into account through the custodian's state of income and other circumstances is admitted into a designated admission institution, etc. for children with disabilities, during the benefits payment period and the children with disabilities receives designated admission support from relevant designated admission institution, etc. for children with disabilities, the prefecture is to, pursuant to the provisions of a Cabinet Order, pay benefits for meal expenses, etc. for specified institutionalized children with disabilities to relevant recognized admission beneficiary custodian with regard to the expenses spent for the provision of meals and for residence in relevant designated admission institution, etc. for children with disabilities,

(2)The provisions of paragraphs (7) through (11) of Article 24-3 apply mutatis mutandis to payments of benefits for meal expenses, etc. for specified institutionalized children with disabilities.In this case, necessary terminological replacements are prescribed by a Cabinet Order.

Article 24-8Beyond what is prescribed in this Subsection, necessary particulars concerning the payments of admission benefits for children with disabilities, high-cost admission benefits for children with disabilities or benefits for meal expenses, etc. for specified institutionalized children with disabilities and requests by designated admission institutions, etc. for children with disabilities for admission benefits for children with disabilities or benefits for meal expenses, etc. for specified institutionalized children with disabilities are prescribed by an Order of the Ministry of Health, Labour and Welfare.

Article 24-9(1)The designation under Article 24-2, paragraph (1) is made specified by Order of Ministry of Health, Labour and Welfare, upon application by the establisher of admission institution for children with disabilities, by specifying admission capacity of the relevant admission institution for children with disabilities.

(2)When the application for designation under the preceding paragraph has been filed, the prefectural governor may decide not to grant an designation under Article 24-2, paragraph (1), if the total maximum capacity of designated admission institution for children with disabilities pertaining the relevant application of the relevant prefectural governments, covering for which the application was filed has already reached the total required maximum capacity for the relevant designated admission institution for children with disabilities of the relevant prefecture specified in prefectural plan for welfare of persons with disabilities pursuant to the provisions of Article 33-22, paragraph (1); where the prefectural governor finds that the establishment of designated admission institution for children with disabilities for which the application was filed would result in the authorized number of residents in excess of such maximum capacity; or in any other cases where the prefectural governor finds that the establishment thereof may prejudice the attainment of the prefectural plan for welfare of persons with disabilities.

(3)The provisions of Article 21-5-15, paragraph (3) (excluding item (vii)) apply to a designation of designated admission institution for children with disabilities of Article 24-2, paragraph (1).In this case, necessary terminological replacements are prescribed by a Cabinet Order.

Article 24-10(1)The designation set forth in paragraph (1) of Article 24-2 must cease to be effective after a lapse of the term then in force, unless the designation is renewed every six years.

(2)In the case where a renewal set forth in the preceding paragraph is applied, when no disposition is implemented for the application by the expiration date of the period set forth in the same paragraph (referred to as a "valid period for designation" hereinafter in this Article), the designation before the renewal is to remain in force until the disposition is implemented, even after the expiration of the valid period for designation.

(3)When the designation is renewed in the case referred to in the preceding paragraph, the valid period for designation as renewed is to start from the day following the expiration date of the valid period for designation before the renewal.

(4)The provisions of the preceding Article apply mutatis mutandis to renewal of designation set forth in paragraph (1).In this case, necessary terminological replacements are prescribed by a Cabinet Order.

Article 24-11(1)In order to enable a child with disabilities to lead a self-reliant daily or life in society according to their inherent abilities and aptitudes, the establisher of a designated admission institution, etc. for children with disabilities, must facilitate close coordination with administrative organs, educational institutions and other relevant bodies, and endeavor to effectively implement institutional support for children with disabilities according to the intention, aptitudes, characteristics of dysfunctions and other circumstances of relevant child with disabilities.

(2)The establisher of a designated admission institution, etc. for children with disabilities must endeavor to improve the quality of its admission support for children with disabilities, by carrying out assessment of the quality of its own institutional support for children with disabilities and by taking other measures.

(3)The establisher of a designated admission institution, etc. for children with disabilities must respect the character of each child with disabilities, comply with this Act or orders pursuant to this Act, and faithfully perform their own duties for children with disabilities and their custodians.

Article 24-12(1)The establisher of a designated admission institution, etc. for children with disabilities must have employees engaged in designated admission support in accordance with the standards specified by an Order of the Ministry of Health, Labour and Welfare.

(2)The establisher of a designated admission institution, etc. for children with disabilities must provide designated admission support in accordance with the standards on facilities and operation of designated admission institutions for children with disabilities specified by an Order of the Ministry of Health, Labour and Welfare.

(3)In specifying the provisions of the preceding item (ii), in accordance with the standards specified by Order of Ministry of Health, Labour and Welfare concerning the particulars listed as follows and is to prescribe other particulars by taking into consideration Order of the Ministry of Health, Labour and Welfare.

(4)The standards specified by the ordinances of the prefectures of paragraph (1) and (2) must ensure appropriate support in accordance with the characteristics of respective disabilities relating to mentally disabled children, blind children (including severely amblyopic children), deaf children (including severely cloth-eared children), children with severe intellectual and physical disabilities and other children with disabilities who admit into designated admission institution, etc. for children with disabilities.

(5)When the an establisher of designated admission institution for children with disabilities intends to decline the designation pursuant to the provisions of Article 24-14, for the person who received the relevant designated admission support and desires to continue to be provided with the services corresponding to the relevant designated admission support for children with disabilities even after the date of the relevant declination of the designation, in order to continuously provide necessary designated admission support for children with disabilities, the relevant establisher must carry out liaison and coordination with other designated admission institution for children with disabilities and persons concerned and provide other benefits.

Article 24-13(1)When the establisher of designated admission institution for children with disabilities intends to increase the admission capacity pertaining to the designation of Article 24-2, paragraph (1), the establisher may make an application for alternation of the designation of the same paragraph pursuant to the ordinance of Ministry of Health, Labour and Welfare.

(2)The provisions of Article 24-9, paragraphs (2) and (3) apply mutatis mutandis to the case where there is alternation of designation.In this case, necessary terminological replacements are prescribed by Cabinet Order.

(3)When there is any change in their address or any other particulars specified by an Order of the Ministry of Health, Labour and Welfare, the establisher of a designated admission institution, etc. for children with disabilities, must notify the prefectural governor to that effect within 10 days pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.

Article 24-14A designated admission institution for children with disabilities may decline its designation with not less than three months period of advance notice.

Article 24-14-2The provisions of Article 21-5-21 apply mutatis mutandis to provision of benefits by the establisher of Designated Admission Institution set forth in Articles 24-12, paragraph (5) In this case, the phrase "the prefectural governor or the mayor of municipality" is replaced with "the prefectural governor".

Article 24-15(1)When a prefectural governor finds it necessary, they may order a person who is, or used to be, the establisher or director or any other employee of a designated admission institution, etc. for children with disabilities, (hereinafter referred to as "designated institution establisher, etc.") to make a report or submit or present books and documents and other objects, request the appearance of a person who is, or used to be, a designated admission institution, etc. for children with disabilities, or may make the relevant prefecture's official ask relevant persons questions or enter any office of the relevant designated admission institution, etc. for children with disabilities, the other places related to operation of relevant designated admission institution, etc. for children with disabilities, and inspect books and documents and other objects.

(2)The provisions of Article 19-16, paragraph (2) apply mutatis mutandis to the questioning or inspection pursuant to the provisions of the preceding paragraph, and the provisions of paragraph (3) of the same Article apply mutatis mutandis to the authority pursuant to the provisions of the preceding paragraph.

Article 24-16(1)When the establisher of a designated admission institution, etc. for children with disabilities, (in the case of designated developmental support medical institution, excluding item (iii); the same applies hereinafter) is found to fall under any of the following items, the prefectural governor may order the establisher of the relevant designated admission institution, etc. for children with disabilities, to take the measure pertaining to the recommendation by a set deadline:

(2)In the case where a recommendation is made pursuant to the provisions of the preceding paragraph, when the establisher of the designated admission institution , etc. for children with disabilities, receiving such recommendation fails to comply with the same by the due date set forth in the same paragraph, the prefectural governor may make public to that effect.

(3)When the establisher of a designated admission institution, etc. for children with disabilities, receiving a recommendation pursuant to the provisions of paragraph (1) fails to take a measure pertaining to the recommendation without justifiable grounds, the prefectural governor may order the establisher of the relevant designated admission institution, etc. for children with disabilities, to take the measures pertaining to the recommendation by a due date to be specified.

(4)When an order is provided pursuant to the provisions of the preceding paragraph, the prefectural governor must give public notice to that effect.

Article 24-17In any of the cases set forth in the following items, the prefectural governor may rescind the designation set forth in Article 24-2, paragraph (1) pertaining to the relevant designated admission institution, etc. for children with disabilities, or suspend the validity of the designation, in whole or in part, for a period of time to be specified:

Article 24-18A prefectural governor must give public notice in any of the cases listed in the following items:

Article 24-19(1)A prefectural government must provide necessary information concerning designated admission institution, etc. for children with disabilities, and provide consultations and give advice with regard to the utilization thereof.

(2)Upon request from a child with disabilities or their custodian, the prefectural government is to make arrangements or coordinate for the use of a designated admission institution, etc. for children with disabilities and, where needed, make a request for the utilization by the relevant child with disabilities to the establisher of a designated admission institution, etc. for children with disabilities.

(3)The establisher of a designated admission institution, etc. for children with disabilities must cooperate in the arrangement, coordination and requests set forth in the preceding paragraph as much as possible.

Article 24-19-2The provisions of Section 2 Subsection 3 (excluding the part pertaining to the mayor of core city) apply mutatis mutandis to the establisher of a designated admission institution, etc. for children with disabilities.In this case, the necessary technical replacement is provided by Cabinet Order.

Article 24-20(1)When a child with disabilities pertaining to a decision on admission benefits payment receives the institutional support for children with disabilities pertaining to therapy (hereinafter referred to as "admission medical care for children with disabilities") from a designated admission institution, etc. for children with disabilities (limited to such hospitals and other facilities as specified by an Order of the Ministry of Health, Labour and Welfare; the same applies hereinafter in this Article, the following Article and Article 24-23) during the benefits payment period, the prefectural government, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, is to pay admission medical expenses for children with disabilities to the recognized admission beneficiary custodian pertaining to the relevant child with disabilities with regard to the expenses spent for the relevant institutional medical care for children with disabilities; and

(2)The amount of admission medical expenses for children with disabilities are the total amount of the amounts listed in the following items per month:

(3)When a child with disabilities pertaining to a decision on admission benefits payment receives admission medical care for children with disabilities from a designated admission institution, etc. for children with disabilities, the prefectural government may pay such expenses spent for relevant institutional medical care for children with disabilities payable by the recognized beneficiary custodian pertaining to the relevant child with disabilities to the relevant designated institution for children with disabilities, etc., in lieu of the relevant recognized beneficiary custodian, to the relevant designated institution for children with disabilities, etc., within the limit of the amount payable to the relevant recognized admission beneficiary custodian as the institutional medical expenses for children with disabilities.

(4)When a payment is made pursuant to the provisions of the preceding paragraph, the institutional medical expenses for children with disabilities for relevant recognized admission beneficiary custodian is deemed to have been paid.

Article 24-21The provisions of Article 19-12 and Article 19-20 are for the payment of medical expenses for children with disabilities to a designated admission institution, etc. for children with disabilities, and the provisions of Article 21 for a designated institution, etc. for children with disabilities apply mutatis mutandis; in this case, necessary terminological replacements are prescribed by a Cabinet Order.

Article 24-22A payment of admission medical expenses for children with disabilities is not be made within the limits equivalent to the amount that a recipient can receive according to the state of the referenced dysfunction as prescribed in the subsequent sentence. When the recipient can receive dependent medical treatment expenses pursuant to the Health Insurance Act or other benefits pursuant to relevant laws and regulations and such expenses or benefits are specified by Cabinet Order and fall under the payment of admission medical expenses for children with disabilities, the limit specified by a Cabinet Order applies as the limit referred to in the preceding sentence, and when any benefit other than those specified by relevant Cabinet Order that falls under the payment of admission medical expenses for children with disabilities is paid and borne by the national government or local government, the amount so paid applies as the limit referred to in the preceding sentence.

Article 24-23Beyond what is prescribed in this Subsection, necessary particulars concerning the payments of admission medical expenses for children with disabilities and the requests by designated admission institutions for children with disabilities, etc. for admission medical expenses for children with disabilities are prescribed by an Order of the Ministry of Health, Labour and Welfare.

Article 24-24(1)For the time being, with regard to a child with disabilities under admission, etc. in any of the designated admission institution, etc. for children with disabilities specified by an Order of the Ministry of Health, Labour and Welfare (hereinafter referred to as "admittee" in this paragraph), when a prefectural government finds that welfare of the admittee is likely to be impaired unless the designated admission support for the admittee is continued, the prefectural government, notwithstanding the provisions of Article 24-2, paragraph (1), Article 24-6, paragraph (1), Article 24-7, paragraph (1) or Article 24-20, paragraph (1), may continue to pay or provide admission benefits, etc. for children with disabilities (hereinafterreferred to as "admission benefits for children with disabilities") prescribed for in the provisions of Article 50, item (vi)-3 to the relevant admittee based on their application, pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare, until the relevant admittee becomes able to adapt themselves to their social surroundings, even after the admittee attains the age of 18, until the relevant admittee attains the age of 20 ; provided, however, that this does not apply to the case where relevant admittee can receive the treatment and care services provided in Article 5, paragraph (6) of Act on the Comprehensive Support for the Daily and Life in Society of Persons with Disabilities or other support.

(2)With regard to a person who is eligible for admission benefits, etc. for children with disabilities pursuant to the provisions of the preceding two paragraphs, the person is deemed to be a child with disabilities or the custodian of a child with disabilities and the provisions of Articles 24-2 through 24-7 and Articles 24-19 through 24-22 apply.In this case, necessary terminological replacements are prescribed by Cabinet Order.

(3)In the case referred to in paragraph (1), the prefectural governor must hear opinions from the director of a child guidance center.

Article 24-25The payments of consultation benefits for children with disabilities and consultation benefits for specified children with disabilities are the benefits provided pursuant to the next Article and Article 21-5-4 concerning consultation support for children with disabilities.

Article 24-26(1)A municipality is to pay consultation support benefits for children with disabilities to a person listed in the following each item (hereinafter referred to as "custodian eligible for consultation support benefits for children with disabilities"), the expenses required for consultation support for children with disabilities specified in the relevant each item, for the categories of cases set forth respectively in the relevant item.

(2)The amount of consultation support benefits for children with disabilities is the amount of expenses calculated, in accordance with the standards specified by the Minister of Health, Labor and Welfare, with regard to expenses generally spent for the designated use of support for children with disabilities or designated continuous use of support for children with disabilities (hereinafter referred to as "designated consultation support for children with disabilities) (the full amount of such expenses actually spent for the relevant designated consultation support when the amount so calculated exceeds the relevant actual amount of the expenses required for consultation support for children with disabilities).

(3)When a custodian eligible for consultation support benefits for children with disabilities has received designated consultation support from a designated operator, etc. of consultation support service for children with disabilities, the municipality may pay expenses spent for the relevant designated consultation support payable by the relevant custodian eligible for consultation support benefits for children with disabilities to the relevant designated operator of consultation support services for children with disabilities on behalf of relevant custodian, within the limit of the amount payable to the relevant custodian eligible for consultation support benefits for children with disabilities as this payment constituting as consultation support benefits for children with disabilities.

(4)When a payment is made pursuant to the provisions of the preceding paragraph, consultation support benefits for children with disabilities for the relevant custodian eligible for consultation support benefits for children with disabilities is deemed to have been paid.

(5)When a designated operator of consultation support services for children with disabilities requests consultation support benefits for children with disabilities, the municipality is to pay the same after the examination in light of the standards specified by the Minister of Health, Labor and Welfare as set forth in paragraph (2) and the standards on facilities and operation of designated consultation support services for children with disabilities as set forth in Article 24-31, paragraph (2) (limited to the portions of such standards relating to handling of designated consultation support for children with disabilities).

(6)A municipality may entrust the federation of national health insurance to conduct the affairs concerning examination and payments pursuant to the provisions of the preceding paragraph.

(7)Beyond what is prescribed in the preceding paragraphs, necessary particulars concerning the payments of consultation support benefits for children with disabilities and requests by designated operator of consultation support services for children with disabilities for consultation support benefits for children with disabilities are prescribed by an Order of the Ministry of Health, Labour and Welfare.

Article 24-27(1)When a municipality finds necessary, in the case where custodian eligible for consultation support benefits for children with disabilities receive consultation support for children with disabilities other than designated consultation support for children with disabilities (limited to the services applicable to the particulars prescribed by Ministry of Health, Labour and Welfare which are prescribed in the standards concerning operation of the services of designated consultation support for children with disabilities prescribed by Order of Ministry of Health, Labour and Welfare of Article 24-31, paragraph (1) and the ones prescribed by Order of Ministry of Health, Labour and Welfare of paragraph (2) of the same Article, which refers to as "appropriate consultation support for children with disabilities), the municipality may pay specified consultation support benefits for children with disabilities, for the expenses required for appropriate consultation support for children with disabilities.

(2)The amount of specified consultation support benefits for children with disabilities is determined by the municipality by using the amount of expenses calculated from the standards prescribed by Minister of Health, Labour and Welfare of paragraph (2) of the preceding Article (in the case such amount actually exceeds the amount required for the relevant appropriate consultation support for children with disabilities, the relevant amount actually required for the relevant appropriate consultation support for children with disabilities).

(3)Beyond what is prescribed in the preceding two paragraphs, necessary particulars concerning the payments of specified consultation support benefits for children with disabilities are prescribed by an Order of the Ministry of Health, Labour and Welfare.

Article 24-28(1)The designation of designated operator of consultation support services for children with disabilities set forth in Article 24-26, paragraph (1), item (i) is made for each institution that practice consultation support services for children with disabilities (hereinafter referred to as "consultation support services office for children with disabilities") as the one who practice consultation services specified in Article 5, paragraph (18) of Act on the Comprehensive Support for the Daily and Life in Society of Persons with Disabilities pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.

(2)The provisions of Article 21-5-15, paragraph (3) (excluding items (iv) and (xiv)) apply to designation of designated operator of consultation support services for children with disabilities of Article 24-26, paragraph (1), item (i).In this case, the term "a person specified by prefectural ordinance" in Article 21-5-15, paragraph (3), item (i) is replaced with "a corporation". Beyond this, necessary terminological replacements are prescribed by a Cabinet Order.

Article 24-29(1)The designation of Article 24-26, paragraph (1), item (i) ceases to be effective after a lapse of the term then in force, unless the designation is renewed every 6 years.

(2)In the case where a renewal set forth in the preceding paragraph is applied, when no disposition is implemented for the application by the expiration date of the period set forth in the same paragraph (referred to as a "effective period for designation" hereinafter in this Article), the designation before the renewal remains in force until the disposition is implemented, even after the expiration of the effective period for designation.

(3)When the designation is renewed in the case referred to in the preceding paragraph, the effective period for designation as renewed starts from the day following the expiration date of the effective period for designation before the renewal.

(4)The provisions of the preceding Article apply mutatis mutandis to renewal of designation set forth in paragraph (1).In this case, necessary terminological replacements are prescribed by Cabinet Order.

Article 24-30(1)In order to enable a child with disabilities to lead a self-reliant daily or social life according to their inherent abilities and aptitudes, designated operator of consultation support services for children with disabilities must facilitate close coordination with administrative organs, educational institutions and other relevant bodies, and endeavor to effectively implement institutional support for children with disabilities according to the intention, aptitudes, characteristics of dysfunctions and other circumstances of the relevant child with disabilities constantly from the standpoint of children with disabilities and their custodians.

(2)The designated operator of consultation support services for children with disabilities must endeavor to improve the quality of its consultation support for children with disabilities by carrying out assessment of the quality of its own institutional support for children with disabilities and by taking other measures.

(3)The designated operator of consultation support services for children with disabilities must respect the character of each child with disabilities, comply with this Act or orders pursuant to this Act, and faithfully perform their own duties for children with disabilities and their custodians.

Article 24-31(1)The designated operator of consultation support service for children with disabilities must have employees engaged in the relevant designated consultation support for children with disabilities in accordance with the standards specified by an Order of the Ministry of Health, Labour and Welfare for each designated operator of consultation support service office for children with disabilities pertaining to the relevant designation.

(2)The designated operator of consultation support service for children with disabilities must provide designated consultation support for children with disabilities in accordance with the standards on facilities and operation of designated consultation support services for children with disabilities specified by an Order of the Ministry of Health, Labour and Welfare.

(3)When a designated operator of consultation support services for children with disabilities makes a notification of abolition or suspension of operation pursuant to the provisions of paragraph (2) of the following Article, the designated operator of consultation support services for children with disabilities must conduct liaison and coordination with other designated operator of consultation support services for children with disabilities and relevant persons, and provide other benefits to ensure that the a person, who has received the designated consultation support for children with disabilities within one month before the date of the notification and wishes to continue receive the provision of support equivalent to the designated consultation support for children with disabilities even after the date of abolition or the suspension of the operation, continues to receive the necessary designated consultation support for children with disabilities.

Article 24-32(1)When the name and location of the consultation support services office for children with disabilities pertaining to the designation and other particulars specified by Order of the Ministry of Health, Labour and Welfare are changed, or when the suspended operation of designated consultation support for children with disabilities is resumed, the designated operator of consultation support services for children with disabilities must notify the mayor of municipality to that effect within ten days, in accordance with the provisions of Order of the Ministry of Health, Labour and Welfare.

(2)When a designated operator of consultation support services for children with disabilities intends to abolish or suspend the operation of designated consultation support for children with disabilities, the designated operator of consultation support services for children with disabilities must notify the mayor of municipality to that effect one month before the date of its abolition or suspension, in accordance with Order of the Ministry of Health, Labour and Welfare.

Article 24-33When a mayor of municipality finds it necessary to smoothly carry out the provision of the benefits prescribed in Article 24-31, paragraph (3) by a designated operator of consultation support services for children with disabilities, the mayor of municipality may conduct liaison and coordination between the designated operator of consultation support services for children with disabilities and other relevant persons, or provide advice and other assistance to the designated operator of consultation support services for children with disabilities and other relevant persons.

Article 24-34(1)When it is found necessary, a mayor of municipality may order a person who is, or used to be, the designated operator of consultation support services for children with disabilities or the employee of the consultation services support office for children with disabilities pertaining to the designation (hereinafter referred to as the "person, etc. who used to be the designated operator of consultation support services for children with disabilities" in this paragraph) to make a report or submit or present books and documents and other objects, request the appearance of the designated operator of consultation support services for children with disabilities or the employee of the designated operator of consultation support services for children with disabilities or the person, etc. who was the employee of the designated consultation support services office for children with disabilities, or may make the official ask relevant persons questions or enter any consulting support services office for children with disabilities pertaining to the designation of the designated operator of consultation support services for children with disabilities and other places related to the operation of consultation support for children with disabilities and inspect equipment, books and documents and other objects.

(2)The provisions of Article 19-16, paragraph (2) apply mutatis mutandis to the question or the inspection under the provisions of the preceding paragraph, and the provisions of paragraph (3) of the same Article apply mutatis mutandis to the authority under the provisions of the preceding paragraph.

Article 24-35(1)When a mayor of a municipality finds that a designated operator of consultation support services for children with disabilities falls under any of the following items, the mayor of a municipality may recommend the designated operator of consultation support services for children with disabilities to take measures prescribed in each item, by a due date to be specified.

(2)In the case where a recommendation is made pursuant to the provisions of the preceding paragraph, when the designated operator of consultation support services for children with disabilities receiving the recommendation fails to comply with the same by a set deadline, in the same paragraph, the mayor of a municipality may make public to that effect.

(3)When the designated operator of consultation support services for children with disabilities receiving a recommendation pursuant to the provisions of paragraph (1) fails to take a measure pertaining to the recommendation without justifiable ground, the mayor of a municipality may order the designated operator of consultation support services for children with disabilities to take the measure pertaining to the recommendation by a set deadline.

(4)When an order is provided pursuant to the provisions of the preceding paragraph, the mayor of a municipality must give a public notice to that effect.

Article 24-36In any of the cases set forth in the following items, a mayor of municipality may rescind the designation set forth in Article 24-26, paragraph (1), item (i) pertaining to the relevant designated operator of consultation support services for children with disabilities or suspend the validity of the designation, in whole or in part, for a period of time to be specified:

Article 24-37A mayor of municipality must give public notice in any of the cases listed in the following items:

Article 24-38(1)The designated operator of consultation support services for children with disabilities must establish a management system in accordance with Order of the Ministry of Health, Labour and Welfare to ensure that the duties prescribed in Article 24-30, paragraph (3) are carried out.

(2)The designated operator of consultation support services for children with disabilities, according to their category set forth in the relevant following items, must give notification of particulars pertaining to the establishment of a management system to the relevant person specified in that item, in accordance with the Order of the Ministry of Health, Labour and Welfare.

(3)A designated operator of consultation support services for children with disabilities who has made the notification pursuant to the provisions of the preceding paragraph, if there is a change in the notified particulars, must notify the Minister of Health, Labour and Welfare, the prefectural governor or the mayor of municipality (hereinafter referred to as the "Minister of Health, Labour and Welfare, etc." in this Subsection) to that effect without delay, in accordance with Order of the Ministry of Health, Labour and Welfare.

(4)When a designated operator of consultation support services for children with disabilities who has made a notification pursuant to the provisions of paragraph (2) makes a notification to the Minister of Health, Labour and Welfare, etc. other than the Minister of Health, Labor and Welfare, etc. pursuant to the provisions of the same paragraph due to changes in the categories listed in each item of the same paragraph, the designated operator of consultation support services for children with disabilities must also notify the Minister of Health, Labour and Welfare, etc. for whom the notification was made to that effect, in accordance with Order of the Ministry of Health, Labour and Welfare.

(5)The Minister of Health, Labor and Welfare, etc. is to work closely with each other so that the notification pursuant to the provisions of the preceding three paragraphs will be made properly

Article 24-39(1)When a Minister of Health, Labour and Welfare, etc. who received the notification pursuant to the provisions of paragraph (2) of the preceding Article finds it necessary for the development of management system pursuant to the provisions of paragraph (1) of the same Article in the designated operator of consultation support services for children with disabilities who made the notification (with regard to the Minister of Health, Labor and Welfare, etc. who received the notification pursuant to the provisions of paragraph (4) of the same Article, the designated operator of consultation support services for children with disabilities who made the notification pursuant to the same paragraph is excluded), the Minister of Health, Labour and Welfare, etc. may order the designated operator of consultation support services for children with disabilities to make a report or submit or present books and documents and other objects, request the appearance of the designated operator of consultation support services for children with disabilities or the employee of the designated operator of consultation support services for children with disabilities, or may make the official ask relevant persons questions or enter any establishment or consultation support services office for children with disabilities pertaining to the designation of the designated operator of consultation support services for children with disabilities and other places related to the provision of consultation support for children with disabilities and inspect equipment, books and documents and other objects.

(2)When the Minister of Health, Labour and Welfare exercise the authority set forth in the preceding paragraph, it is conducted in close cooperation with the mayor of municipality who has made the designation pertaining to the designated operator of consultation support services for children with disabilities (hereinafter referred to as the "relevant municipal mayor" in this paragraph and paragraph (5) of the following Article), and when the prefectural governor exercises the authority set forth in the preceding paragraph, it is conducted in close cooperation with the relevant municipal mayor.

(3)When a mayor of municipality finds it necessary for the development of a management system pursuant to the provisions of paragraph (1) of the preceding Article in the designated operator of consultation support services for children with disabilities pertaining to the designation made or will be made by the mayor of municipality, the mayor of municipality may request the Minister of Health, Labour and Welfare or the prefectural governor to exercise the authority set forth in paragraph (1).

(4)When a Minister of Health, Labour and Welfare or a prefectural governor exercised the authority set forth in paragraph (1) in response to a request from a mayor of municipality pursuant to the provisions of the preceding paragraph, the Minister of Health, Labour and Welfare or the prefectural governor must notify the mayor of municipality who requested the exercise of the authority about the result, in accordance with Order of Ministry of Health, Labour and Welfare

(5)The provisions of Article 19-16, paragraph (2) apply mutatis mutandis to the question or the inspection under the provisions of paragraph (1), and the provisions of paragraph (3) of the same Article apply mutatis mutandis to the exercise of the authority under the provisions of paragraph (1).

Article 24-40(1)When a Minister of Health, Labour and Welfare, etc. who received the notification pursuant to the provisions of Article 24-38, paragraph (2) finds that a designated operator of consultation support services for children with disabilities who made the notification (for the Minister of Health, Labor and Welfare, etc. who received the notification pursuant to the provisions of paragraph (4) of the same Article, the designated operator of consultation support services for children with disabilities who made the notification pursuant to the same paragraph is excluded) has not developed an appropriate operational control system in accordance with the standards specified by Order of the Ministry of Health, Labour and Welfare set forth in paragraph (1) of the same Article, the Minister of Health, Labour and Welfare, etc. may recommend the designated operator of consultation support services for children with disabilities to develop an appropriate operation control system by a set deadline, in accordance with Order of the Ministry of Health, Labour and Welfare.

(2)Minister of Health, Labour and Welfare, etc. in a case of providing recommendation pursuant to the provisions of the preceding paragraph, may provide public notice of the fact that the relevant designated operator of consultation support services for children with disabilities receiving such recommendation fails to comply with the same by the due date set forth in the same paragraph.

(3)When a designated operator of consultation support services for children with disabilities receiving a recommendation pursuant to the provisions of paragraph (1) fails to take a measure pertaining to the recommendation without justifiable ground, the Minister of Health, Labour and Welfare, etc. may order the designated operator of consultation support services for children with disabilities to take the measure pertaining to the recommendation by a due date to be specified.

(4)The Minister of Health, Labour and Welfare, etc. who has issued an order under the preceding paragraph must make a public notice of the fact.

(5)If a designated operator of consultation support services for children with disabilities violates an order under paragraph (3), the Minister of Health, Labour and Welfare or the prefectural governor must send notice of the violation to the relevant municipal mayor in accordance with Order of the Ministry of Health, Labour and Welfare.