Deepen the reform of elderly care services

Deepening the reform and development of elderly care services is an urgent requirement for implementing the national strategy of proactively responding to population aging, an important task for ensuring and improving people's livelihood, and is related to the well-being of hundreds of millions of people and social harmony and stability. To accelerate the construction of an elderly care service system that suits China's national conditions, better ensure that the elderly are well cared for, and enable all the elderly to enjoy a happy and peaceful old age, the following opinions are hereby put forward.
I. General Requirements
Strengthen basic elderly care services with a focus on the care of disabled elderly people, improve an elderly care service system that is classified and graded, inclusive and accessible, covers both urban and rural areas, and is sustainable, enhance the promotion of elderly health, expand and improve elderly care services, further stimulate the vitality of the elderly care cause and industry, and better meet the multi-level and diversified elderly care service needs of the elderly.
The main goals are: by 2029, the elderly care service network will be basically established, the service capacity and level will be significantly enhanced, obvious progress will be made in expansion, quality improvement and efficiency enhancement, and the supply of basic elderly care services will be continuously optimized; By 2035, the elderly care service network will be more complete, the supply and demand of services will be more coordinated and matched, all the elderly will enjoy basic elderly care services, and an elderly care service system suitable for China's national conditions will be mature and well-defined.
Second, accelerate the improvement of a three-level elderly care service network covering both urban and rural areas
(1) Build a county-level comprehensive elderly care service management platform. Relying on the county-level support service institutions for the extremely poor and the elderly care service information system, a comprehensive elderly care service management platform will be built. On the basis of undertaking the function of providing a safety line, it will expand and strengthen the comprehensive functions such as service demonstration, industry guidance, emergency assistance and resource coordination, and promote the efficient utilization of elderly care service resources in the county in a coordinated manner. Provincial and municipal elderly care institutions should promote the downward flow of high-quality resources, enhance their technical support, exemplary leadership and talent cultivation roles for county-level comprehensive elderly care service management platforms, and promote regional linkage.
(2) Strengthen the construction of regional elderly care service capabilities in towns (sub-districts). Relying on the elderly care homes in towns (sub-districts), high-quality private elderly care institutions, etc., they will be renovated and expanded into regional elderly care service centers, playing the roles of professional care, service referral, resource connection, etc., to promote the interaction between upper and lower levels and facilitate the connection between supply and demand. Support localities with the necessary conditions in promoting the direct management of elderly care homes in towns (sub-districts) by the county-level civil affairs department, and explore the promotion of entrusted operation to enhance the quality and efficiency of service management.
(3) Improve the elderly care service facilities and stations in villages (communities). Give full play to the leading role of regional elderly care service centers in towns (sub-districts), adopt methods such as "center + station", vigorously develop embedded community elderly care service facilities and mutual assistance elderly care service stations, improve elderly care service facilities in old residential areas, strengthen the comprehensive utilization with public service facilities such as education, health care and culture, and build service complexes for the elderly and children. Give full play to the role of facility stations in connecting families with social services, and collect and refer service demands in a timely manner.
Iii. Integrate and coordinate the three types of elderly care services: home-based, community-based and institutional
(4) Consolidate the fundamental role of home-based elderly care. Improve the policies and measures for elderly care services that are tangible and accessible at the bedside and around the elderly. Improve the support policies for family-based elderly care, explore the construction of family-based elderly care beds with continuous, stable and professional service functions for the disabled elderly living at home, and carry out training on the care skills of family members of the elderly. Actively cultivate professional service institutions, and encourage communities and domestic service, Internet platform enterprises, etc. to provide diversified services such as meal assistance, bathing assistance, cleaning assistance, mobility assistance, medical assistance, and emergency assistance for the elderly at their doorsteps, so as to better meet the needs of home care services. Accelerate the construction of elderly-friendly housing, promote the adaptation of families for the elderly, support the installation of elevators in old residential areas, and enhance the construction of barrier-free environments.
(V) Strengthen the supporting role of community-based elderly care. Expand the effective supply of community-based elderly care services and provide strong support for home-based elderly care relying on communities. Develop embedded community elderly care services, vigorously cultivate professional, chain and brand-operated community elderly care service institutions, integrate surrounding venues and facilities and other resources, promote "community + property + elderly care services", and enhance the capabilities of professional care, day care, rehabilitation nursing and home visits. Incorporate community elderly care services into the key contents of the construction of the 15-minute convenient living circle in cities. Explore effective ways to supply elderly care services in old residential areas and promote the construction of complete communities. Explore the implementation of "elderly care advisor" services, providing professional consultation, agency services and other elderly assistance projects. The village (community) "two committees" should take serving the elderly as an important responsibility, understand the situation and service demands of the elderly within their jurisdiction, and assist in carrying out elderly care services. Make up for the shortcomings of activity venues for the elderly in the community and carry out cultural and sports entertainment, social interaction and other activities. Strengthen the visiting and care services for the elderly living alone.
(6) Optimize the professional support role of institutional elderly care. According to the service targets and facility conditions, promote the classified reform of elderly care institutions in a way that suits local conditions, and adjust and improve the supply structure. The bottom-line security type of elderly care institutions mainly take in extremely poor elderly people and economically disadvantaged and disabled elderly people, etc. Inclusive and supportive elderly care institutions are open to all the elderly. The municipal government at the prefecture level shall formulate support measures and strengthen the guidance and management of charges. Fully market-oriented elderly care institutions implement full competition and offer high quality at high prices to meet the diverse needs of the elderly. Improve the operation mechanism of public elderly care institutions. On the basis of ensuring a safety net, open up spare beds to the public, expand inclusive elderly care services, and establish and improve income management and performance incentive systems. Encourage social forces to build or expand elderly care service facilities, and support the expansion of high-quality institutional elderly care service supply through public construction and private operation and other means. Give full play to the role of elderly care institutions in technological innovation demonstration, service skills training, and equipment promotion and application, and promote the extension of professional services to home and community care. Strengthen the care services for the disabled and disabled elderly, focus on increasing the supply of nursing beds, guide elderly care institutions to actively admit the disabled elderly, and develop long-term care and care services for the elderly with cognitive impairments. Explore the joint residence of "elderly parents + disabled children" in elderly care institutions or other care institutions, and support capable elderly care institutions to admit severely disabled people.
(7) Promote the integration of medical care and elderly care. Strengthen the organic integration of medical and health services and elderly care services in terms of policy systems, service systems, business processes, etc., and enhance disease prevention and control. Strengthen the coordination between elderly care service institutions and medical and health service institutions, enhance integrated care, improve a stable and smooth two-way transfer green channel, and simplify the referral and medical treatment procedures. In accordance with the needs of medical institutions set up within elderly care institutions, corresponding prescription rights shall be granted in accordance with laws and regulations. Encourage elderly care institutions with corresponding medical conditions to carry out palliative care services in accordance with laws and regulations. Strengthen the early identification and prevention of disability among high-risk groups, and carry out health guidance and comprehensive intervention.
(8) Accelerate the improvement of the shortcomings in rural elderly care services. Expand the supply of rural elderly care services in accordance with local conditions. The development of rural elderly care services should be regarded as an important part of implementing the rural revitalization strategy, and rural elderly care service facilities should be included in the township-level territorial space planning or village planning. We will vigorously promote mutual assistance elderly care services and improve the visiting, caring and emergency rescue service mechanisms for rural left-behind, elderly, disabled and other elderly people. Encourage rural collective economic organizations to develop elderly care services and guide social forces to actively participate. Where conditions permit, rural elderly assistance positions may be developed and set up in accordance with regulations. Guide urban elderly care service institutions to operate rural elderly care service facilities and promote balanced development of elderly care services in urban and rural areas.
(IX) Strengthen and improve the comprehensive supervision of elderly care services. Improve the standards and evaluation system for elderly care services. Improve the registration and filing management of elderly care institutions and strengthen the supervision of advance charges. Establish and improve the management system for home and community-based elderly care services, and perfect the supervision mechanisms such as elderly care communities. We will improve the emergency management system for elderly care services, fully implement the responsibility system for work safety, and hold elderly care institutions, relevant administrative departments, and local Party committees and governments accountable. Strengthen the quality supervision of elderly products.
Fourth, establish a tripartite collaborative mechanism for the development of the elderly care service industry
(10) Give full play to the leading role of the government in the development of elderly care services. Strengthen the government's planning guidance, policy support, organizational guarantee and supervision and management of elderly care services, and expand the supply of inclusive, basic and bottom-line elderly care services. The bottom-line elderly care service facilities are mainly constructed and provided by the government in accordance with the planning. Improve the list system of basic elderly care services, optimize the service contents, and perfect the mechanisms for service supply, evaluation and dynamic adjustment. Establish a mechanism to promote the high-quality development of inclusive elderly care services, increase support for facility construction and venue supply, and vigorously develop inclusive elderly care services that are affordable in price, guaranteed in quality and sustainable in operation. Improve the comprehensive assessment system for the capabilities of the elderly. The assessment results are mutually recognized nationwide and used by relevant departments as needed. Establish a supply mechanism for elderly care services in the place of residence, improve mechanisms such as cross-regional settlement of elderly care service subsidies and connection of service resources, and promote the integration of elderly care services in the Beijing-Tianjin-Hebei region, the Yangtze River Delta, and the Guangdong-Hong Kong-Macao Greater Bay Area.
(11) Give full play to the role of the market in allocating resources for the development of the elderly care service industry. Fully stimulate market vitality, support all types of market entities to actively participate in elderly care services in accordance with market principles, improve the socialized operation mechanism and the evaluation mechanism for the implementation of supportive policies, and promote the large-scale, clustered and brand-oriented development of the elderly care service industry. Promote the participation of state-owned capital in the development of elderly care services and improve the classified assessment and evaluation. Encourage state-owned enterprises and public institutions to activate idle assets to carry out elderly care services. For those entrusted for operation, the lease term shall be determined in accordance with the principle of stabilizing business expectations. If the operator has made a significant investment, the lease term may be appropriately extended. Encourage foreign investment in the domestic elderly care service industry and enjoy national treatment. Vigorously develop the silver economy, strengthen the research and development and promotion of products for the elderly, enrich the scenarios of elderly care services, and release the potential of elderly care consumption. Develop the travel and residence elderly care market, develop new business forms such as health and wellness travel and residence in accordance with local conditions, and promote the construction of travel and residence elderly care destinations.
(12) Give full play to the social participation role in elderly care services. Strengthen the function of social mutual assistance and support, and build a social support pattern for elderly care services featuring the leadership of grassroots Party organizations, the overall coordination of grassroots mass self-governing organizations, and the participation of social organizations, social workers, volunteers and other forces. Through means such as government purchase of services, we should vigorously cultivate social organizations for elderly care services and grassroots elderly organizations, develop volunteer services for the elderly, and explore the establishment of a time savings management system for elderly care volunteer services. Encourage support for the development of elderly care services through the establishment of charitable trusts, social donations and other means. Establish a coordinated development mechanism for elderly education, carry out online and offline combined elderly education in elderly care service institutions and communities through elderly universities and other means, and improve support measures for the development of elderly education by social forces. Actively develop human resources for the elderly and create diverse and personalized job positions suitable for the elderly. Deepen and expand the "Silver Age Initiative", and encourage the elderly to participate in the implementation of the rural revitalization strategy and civilized practice activities in accordance with regulations. Smooth the green channel for the elderly to obtain legal aid and notary services, and explore the establishment of an implementation mechanism for the elderly's voluntary guardianship.
V. Strengthen the guarantee of powerful and effective elements for elderly care services
(13) Scientifically plan the layout of elderly care service facilities. According to the degree of population aging and changes in the demand for elderly care services, the proportion of land used for elderly care service facilities should be gradually increased or the spatial arrangement for elderly care service facilities should be expanded. Implement the requirements of simultaneous planning, construction, acceptance and delivery of new residential communities and their supporting elderly care service facilities. Incorporate elderly care service facilities into project supporting facilities, strictly manage planning approval, and ensure that new residential communities are built in accordance with standards and handed over in a timely manner as agreed. Promote the construction of county-level elderly activity centers and expand their functions of serving the elderly. Provincial governments should support the transformation of idle public service resources into elderly care facilities. They should guide cities and counties to solve issues such as planning adjustments, changes in the nature of land and property use, fire protection renovations, and the handling of fire protection inspection procedures in accordance with laws and regulations. Scientifically determine the standards for fire protection and earthquake prevention of elderly care service facilities buildings.
(14) Improve relevant policies on fiscal support. All regions should increase support for elderly care services in accordance with their economic development levels and the degree of population aging. In accordance with the relevant principles on the division of financial powers and expenditure responsibilities between the central and local governments, efforts should be made to strengthen the financial guarantee for basic elderly care services. Central budgetary investment actively supports the construction of the elderly care service system. Accelerate the establishment of a long-term care insurance system, reasonably determine the coverage and subsidy standards of care subsidies for economically disadvantaged and disabled elderly people, and ensure the connection between long-term care insurance and policies such as care subsidies for economically disadvantaged elderly people who are advanced in age or disabled. Carry out innovative pilot projects for the county-level elderly care service system and support the pilot areas in optimizing resource allocation. For eligible elderly care service institutions, policies such as tax and fee preferences and the implementation of residential living prices for water, electricity, gas and heat shall be implemented in accordance with the current relevant regulations. Where separate metering conditions for water, electricity, gas and heat are not available for the time being, charging methods such as fixed quantity and fixed ratio can be adopted. Encourage the provision of support such as rent reduction or exemption for community elderly care service institutions.
(15) Strengthen the construction of the talent team for elderly care services. Research and establish an evaluation system for professional and technical talents in elderly care services, standardize the occupational Settings in the field of elderly care services, and enhance the attractiveness of elderly care nursing occupations. Establish and improve the career transition channels for skilled talents and professional and technical talents, and build a skill position evaluation and appointment system that is linked to skill levels. Where conditions permit, pilot programs for free training of elderly care service-related majors can be explored in vocational colleges, and graduates can be employed in a market-oriented and socialized manner. Allocate social workers reasonably based on the number of the elderly population. Guide elderly care service institutions to improve their salary distribution methods and tilt towards front-line staff. Intensify vocational skills training and pre-job training for elderly care workers, elderly capacity assessors, etc., strengthen and standardize the management of grade recognition and evaluation, intensify the construction of professional ethics, and improve the system of prohibiting employment in accordance with the law.
(16) Vigorously develop pension finance. Through local government special bonds and other funding channels, support the construction of qualified elderly care service infrastructure and actively meet the credit financing needs of elderly care service institutions. Strengthen the support of government-backed financing guarantee and re-guarantee institutions for loan guarantees of small and micro enterprises in elderly care services. Support eligible elderly care projects in issuing real estate investment trusts in the infrastructure sector. Expand the trust business of elderly care services and promote commercial health insurance products that include long-term care responsibilities and health management.
(17) Accelerate the development and application of elderly care science and technology and informatization. Research and establish major national science and technology projects related to elderly care services, with a focus on promoting the research and application of technologies and products such as humanoid robots, brain-computer interfaces, and artificial intelligence. Deepen the national application demonstration of smart health and elderly care, promote intelligent home and smart health products, and explore the implementation of safety risk early warning and prevention services for home-based elderly care. Improve the national unified information platform for elderly care services and promote the connection between supply and demand of elderly care services. We should coordinate and carry out the national population census, sample surveys and other work, form a unified database of the elderly and elderly care services, and strengthen the connection with the national population basic information database and others.
Six. Strengthen organization and implementation
Local Party committees and governments at all levels should strengthen organizational leadership, attach great importance to elderly care services, and incorporate the construction of the elderly care service system into economic and social development plans and important agendas. The Party (working) committees of townships (sub-districts) and the Party organizations of villages (communities) should take elderly care services as an important part of connecting with the masses and guide all kinds of organizations to jointly do a good job in elderly care services. The civil affairs department should enhance overall coordination, work with relevant departments to improve policies related to the reform and development of elderly care services, and perfect the supervision and evaluation system. All regions and relevant departments should, in light of their actual conditions, earnestly implement this opinion, steadily and prudently advance the reform, respect the will of the elderly population, and avoid a one-size-fits-all approach. Major matters shall be promptly reported to the Central Committee of the Communist Party of China and The State Council in accordance with the prescribed procedures.