b) Restructuring of the Administration of Health and Welfare Services for the Elderly
In the year 1990 we witnessed another significant development： a fundamental restructuring of the public health and welfare services for the elderly implemented through the revision of the Law for the Welfare of the Elderly, the Law for the Health and Medical Services for the Elderly and several related laws and orders. The crux of the restructuring can be summarized in the following two points.
* Decentralization
First, by the revision of the Law for the Welfare of the Elderly, the authority to decide the admission of an older person into a home for the aged or a nursing home was transferred from the Prefectural Government to the Local Government. With this change, the Local Governments have come to assume all the responsibilities for public health and welfare services for the elderly, from long-term institutional care to preventive, promotive and recreational services. As a result, there has been better coordination among the various care services in regard to both the maximum quality of life and efficiency.
*Long-term Planning
As a result of the revision of the two basic laws, all local governments were required to make a long-term plan for the development of health and welfare services for the elderly, including institutional care services, community care services, preventive, promotive, and recreational services. Before the end of fiscal year 1993, all the local governments completed these long-term plans.
c) Revision of the Ten-year Gold Plan
The most conspicuous trend after 1990 with regard to social security and health and social services is the growing concern of people of the need for so-called "kaigo hosho" (care security) in the coming highly aging society. "Care security" means a social service system by which all the needs for the care of older persons, including both institutional care and home care, are met publicly regardless of income. In March, 1994, "the Advisory Group on the Welfare Vision in the Coming Highly Aging Society" presented its report to the Minister of Health and Welfare. This report proposed, among other things, the construction of a comprehensive public care service system. It also pointed out that the goals set by the 1990 Gold Plan mentioned above were not satisfactory in light of the predicted future growth of the care needs of older persons.
