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| Opinions of the General Office of the State Council on Advancing the Development of Elderly Care Services | | 国务院办公厅关于推进养老服务发展的意见 |
| (No. 5 [2019] of the General Office of the State Council) | | （国办发〔2019〕5号） |
| People's governments of all provinces, autonomous regions, and municipalities directly under the Central Government; all ministries and commissions of the State Council; and all institutions directly under the State Council: | | 各省、自治区、直辖市人民政府，国务院各部委、各直属机构： |
| The CPC Central Committee and the State Council have attached great importance to the elderly care services, brought about policy measures for accelerating the development of the elderly care service industry and fully liberalizing the elderly care market since the 18th CPC National Congress, and made conspicuous achievements in the construction of the elderly care system. Nevertheless, generally, the elderly care service market has not been fully invigorated, problems such as imbalanced and inadequate development, insufficient effective supply, and low-quality services persist, and the public need for elderly care services has not been effectively met. According to the arrangements for elderly care service work made by the 2019 Government Work Report, for the purposes of removing “bottleneck,” eliminating “pains," clearing obstacles to development, improving the market mechanism, continuing to improve the elderly care service system based on aging in place, supported by the community, supplemented by institutions, and combining medical care with elderly care, establishing and improving a permanent care service system for seniors of advanced years and disabled, strengthening the service management system with credit as the core, with quality as guarantee, with a focus on both decentralization and regulation, vigorously promoting the continuous optimization of the supply structure of elderly care services, manifest expansion of effective social investment, continual enhancement of the quality of elderly care services, and fulfillment of the potential for the consumption of elderly care services, and ensuring that by 2022, on the basis of guaranteeing the availability of basic elderly care services to all, seniors' need for diversified and multi-faceted elderly care services will have been met, and seniors and their children's feelings of fulfillment, happiness, and security will have improved significantly, the following opinions are hereby offered with the approval of the State Council. | | 党中央、国务院高度重视养老服务，党的十八大以来，出台了加快发展养老服务业、全面放开养老服务市场等政策措施，养老服务体系建设取得显著成效。但总的看，养老服务市场活力尚未充分激发，发展不平衡不充分、有效供给不足、服务质量不高等问题依然存在，人民群众养老服务需求尚未有效满足。按照2019年政府工作报告对养老服务工作的部署，为打通“堵点”，消除“痛点”，破除发展障碍，健全市场机制，持续完善居家为基础、社区为依托、机构为补充、医养相结合的养老服务体系，建立健全高龄、失能老年人长期照护服务体系，强化信用为核心、质量为保障、放权与监管并重的服务管理体系，大力推动养老服务供给结构不断优化、社会有效投资明显扩大、养老服务质量持续改善、养老服务消费潜力充分释放，确保到2022年在保障人人享有基本养老服务的基础上，有效满足老年人多样化、多层次养老服务需求，老年人及其子女获得感、幸福感、安全感显著提高，经国务院同意，现提出以下意见。 |
| I. Deepening the reform of simplifying procedures, decentralizing powers, combining decentralization with appropriate control, and optimizing services | | 一、深化放管服改革 |
| 1. Establishing a comprehensive regulatory system for elderly care services. A liability list advocating “exemption from liability by the list for performance of duties, enforcing accountability by the list for negligence of duty” shall be developed, policy documents on tightening the comprehensive regulation of elderly care services shall be developed, an inter-departmental coordinated regulatory mechanism in which everyone has their place and is dutiful shall be established, and the interim and ex-post regulatory system shall be improved. The working mechanism of “random selection of inspectees and inspectors and public disclosure” shall be improved, efforts to investigate and punish violations shall be increased, and the most stringent standards, the strictest regulation, the toughest punishment, and the most serious accountability shall be adhered to. Market regulatory authorities shall share the basic information on enterprise registration on sharing platforms at provincial level or through data interface between provincial authorities; and civil affairs authorities shall promptly download information on residential care homes and strengthen guidance and interim and ex-post regulation. The construction of a social credit system in the field of elderly care services shall be advanced at a faster pace, and by the end of June 2019, a joint disciplinary action mechanism for the dishonest will have been established and improved, so as to take joint disciplinary action against services for elderly care service institutions (including residential care homes, home and community care service institutions, and other enterprises, public institutions, and social organizations whose scope of business and bylaws cover elderly care services) which have committed serious dishonesty. The information of an elderly service institution such as administrative licensing, administrative punishment, and results of random inspection shall be recorded under the name of the said institution and published according to the law, respectively on the National Credit Information Sharing Platform and the National Enterprise Credit Information Publicity System, based on the nature of its business. (The Ministry of Civil Affairs, the National Development and Reform Commission, the People's Bank of China, and the State Administration for Market Regulation shall be responsible according to division of functions, and local people's governments shall be responsible) | | （一）建立养老服务综合监管制度。制定“履职照单免责、失职照单问责”的责任清单，制定加强养老服务综合监管的相关政策文件，建立各司其职、各尽其责的跨部门协同监管机制，完善事中事后监管制度。健全“双随机、一公开”工作机制，加大对违规行为的查处惩戒力度，坚持最严谨的标准、最严格的监管、最严厉的处罚、最严肃的问责。市场监管部门要将企业登记基本信息共享至省级共享平台或省级部门间数据接口；民政部门要及时下载养老机构相关信息，加强指导和事中事后监管。加快推进养老服务领域社会信用体系建设，2019年6月底前，建立健全失信联合惩戒机制，对存在严重失信行为的养老服务机构（含养老机构、居家社区养老服务机构，以及经营范围和组织章程中包含养老服务内容的其他企业、事业单位和社会组织）及人员实施联合惩戒。养老服务机构行政许可、行政处罚、抽查检查结果等信息按经营性质分别通过全国信用信息共享平台、国家企业信用信息公示系统记于其名下并依法公示。（民政部、发展改革委、人民银行、市场监管总局按职责分工负责，地方各级人民政府负责） |
| 2. Continuing to deepening the reform of public residential care homes. The role of public residential care homes and publicly constructed and privately-run residential care homes in providing elderly care security shall be maximized, and under the premise of meeting the current and future demand for the support of the destitute, the focus shall be on providing financially distressed and disabled (either physically or mentally, here and below) seniors and those from special families under family planning with free or low-cost residential care services. The public welfare attributes of public residential care homes shall be adhered to, the scope of security shall be determined, the rest of the beds shall be allowed to made available to the public, the development of guiding fee rates shall be researched, and the proceeds shall be used to support the elderly care services for elderly care beneficiaries. The conversion of public residential care homes with good conditions into state-owned elderly care service enterprises shall be explored. Measures for the administration of publicly constructed and privately-run residential care homes shall be developed, evaluation standards and selection rules shall be elaborated, and the regulation of contract performance shall be strengthened. The operators of publicly constructed and privately-run residential care homes shall regularly report the asset condition and operations of the institutions to the principal authorities and report major emergencies in a timely manner. (The Ministry of Civil Affairs, the National Development and Reform Commission, the Ministry of Finance, the State Commission Office for Public Sector Reform, the State-owned Assets Supervision and Administration Commission of the State Council, and the National Health Commission shall be responsible according to division of functions, and local people's governments shall be responsible) | | （二）继续深化公办养老机构改革。充分发挥公办养老机构及公建民营养老机构兜底保障作用，在满足当前和今后一个时期特困人员集中供养需求的前提下，重点为经济困难失能（含失智，下同）老年人、计划生育特殊家庭老年人提供无偿或低收费托养服务。坚持公办养老机构公益属性，确定保障范围，其余床位允许向社会开放，研究制定收费指导标准，收益用于支持兜底保障对象的养老服务。探索具备条件的公办养老机构改制为国有养老服务企业。制定公建民营养老机构管理办法，细化评审标准和遴选规则，加强合同执行情况监管。公建民营养老机构运营方应定期向委托部门报告机构资产情况、运营情况，及时报告突发重大情况。（民政部、发展改革委、财政部、中央编办、国资委、卫生健康委按职责分工负责，地方各级人民政府负责） |
| 3. Solving the issues on fire protection inspection of residential care homes. In accordance with the Code for Fire Protection Design of Buildings, the fire protection approval services for residential care homes shall be effectively provided, and approval efficiency shall be raised. For residential care homes that apply for fire protection design review, fire protection inspection, and fire protection filings according to the law, fire protection technical consulting services shall be voluntarily provided, and their applications shall be processed as soon as possible. All regions shall implement the standardized fire safety management in the elderly care service industry according to the actual circumstances, pay attention to guidance by classification, specify the fire resistance levels of residential care homes, floor setting and layout, fire resisting shield measures, safety evacuation and shelter design, construction fire protection facilities, fire protection management institutions and personnel, the construction of micro-sized fire stations, and other requirements, promote residential care homes in implementing their main responsibility for fire safety, conduct self-inspection and self-correction of hidden risks, and improve self-management level. If rural homes for seniors, or residential care homes established by using school buildings, factory buildings, or commercial properties in compliance with fire safety requirements, fail in fire protection inspection because of failure to complete realty registration, land planning, or other procedures, provincial civil affairs authorities shall, before the end of December 2019, request provincial people's governments to arrange for relevant authorities to research on solutions in a concentrated manner. If technical conditions for fire safety are met, the relevant competent authorities shall issue opinions and allow the application of corresponding support policies. (The Ministry of Emergency Management, the Ministry of Housing and Urban-Rural Development, the Ministry of Natural Resources, the Ministry of Civil Affairs, and the State Administration for Market Regulation shall be responsible according to division of functions, and local people's governments shall be responsible) | | （三）解决养老机构消防审验问题。依照《建筑设计防火规范》，做好养老机构消防审批服务，提高审批效能。对依法申报消防设计审核、消防验收和消防备案的养老机构，主动提供消防技术咨询服务，依法尽快办理。各地要结合实际推行养老服务行业消防安全标准化管理，注重分类引导，明确养老机构建筑耐火等级、楼层设置和平面布置、防火分隔措施、安全疏散和避难设计、建筑消防设施、消防管理机构和人员、微型消防站建设等配置要求，推动养老机构落实消防安全主体责任，开展隐患自查自改，提升自我管理水平。农村敬老院及利用学校、厂房、商业场所等举办的符合消防安全要求的养老机构，因未办理不动产登记、土地规划等手续问题未能通过消防审验的，2019年12月底前，由省级民政部门提请省级人民政府组织有关部门集中研究处置。具备消防安全技术条件的，由相关主管部门出具意见，享受相应扶持政策。（应急部、住房城乡建设部、自然资源部、民政部、市场监管总局按职责分工负责，地方各级人民政府负责） |
| 4. Reducing the tax and fee burden on elderly care services. The reduction of taxes and fees shall be brought into focus, and elderly care service institutions that meet the conditions provided by the policy in force may enjoy preferential fiscal and tax policies for micro and small-sized enterprises and the like. An enterprise income tax support policy for non-profit elderly care service institutions shall be researched. Elderly care service institutions that provide day care, convalescent care, assisted eating and walking, and other community-based services shall be entitled to tax and fee reduction support policies. Various administrative charges reduction and waiver policies shall be implemented, the policy that elderly care service institutions use electricity, water, gas, and heat at the same prices as private individuals shall be implemented, and the implementation of the relevant price policy may not be denied on the grounds of the nature of land, housing, and the like. (The Ministry of Finance, the State Taxation Administration, the National Development and Reform Commission, and the State Administration for Market Regulation shall be responsible according to division of functions, and local people's governments shall be responsible) | | （四）减轻养老服务税费负担。聚焦减税降费，养老服务机构符合现行政策规定条件的，可享受小微企业等财税优惠政策。研究非营利性养老服务机构企业所得税支持政策。对在社区提供日间照料、康复护理、助餐助行等服务的养老服务机构给予税费减免扶持政策。落实各项行政事业性收费减免政策，落实养老服务机构用电、用水、用气、用热享受居民价格政策，不得以土地、房屋性质等为理由拒绝执行相关价格政策。（财政部、税务总局、发展改革委、市场监管总局按职责分工负责，地方各级人民政府负责） |
| 5. Raising the precision level of government grants. The Ministry of Civil Affairs and local governments shall increase the lottery public welfare funds used for good social purposes, and will, by 2022, have used not less than 55% of the funds to support the development of elderly care services. Residential care homes receiving financially distressed and disabled seniors of advanced age are equally entitled to operating subsidies according to the number of such seniors, regardless of their operating nature, and such seniors are entitled to elderly care service subsidies as specified. Elderly care services shall be included in guiding catalogs for government procurement of services, various elderly care service projects currently arranged by fiscal expenditure shall be comprehensively reorganized, standards for government procurement of elderly care services shall be developed by provinces, and the focus shall be on the procurement of assisted living, convalescent care, institutional operation, social work, personnel training, and other services. (The Ministry of Finance, the Ministry of Civil Affairs, and the National Health Commission shall be responsible according to division of functions, and local people's governments shall be responsible) | | （五）提升政府投入精准化水平。民政部本级和地方各级政府用于社会福利事业的彩票公益金，要加大倾斜力度，到2022年要将不低于55%的资金用于支持发展养老服务。接收经济困难的高龄失能老年人的养老机构，不区分经营性质按上述老年人数量同等享受运营补贴，入住的上述老年人按规定享受养老服务补贴。将养老服务纳入政府购买服务指导性目录，全面梳理现行由财政支出安排的各类养老服务项目，以省为单位制定政府购买养老服务标准，重点购买生活照料、康复护理、机构运营、社会工作和人员培养等服务。（财政部、民政部、卫生健康委按职责分工负责，地方各级人民政府负责） |
| 6. Supporting the scale and chain-based development of residential care homes. The building of a group of influential and competitive elderly care service trademarks and brands in the field of elderly care services shall be supported, and the protection of elderly care service trademarks and brands shall be strengthened according to the law. An enterprise shall not be required to establish a subsidiary when conducting operating activities in a place, if it has obtained a business license in another place. An action plan for cities and enterprises to collaboratively advance the development of elderly care services shall be implemented. A non-profit residential care home may establish more than one service establishment not qualified as a legal person in the jurisdiction of its registration administration authorities. (The State Administration for Market Regulation, the National Intellectual Property Administration, the Ministry of Civil Affairs, and the National Development and Reform Commission shall be responsible according to division of functions, and local people's governments shall be responsible) | | （六）支持养老机构规模化、连锁化发展。支持在养老服务领域着力打造一批具有影响力和竞争力的养老服务商标品牌，对养老服务商标品牌依法加强保护。对已经在其他地方取得营业执照的企业，不得要求其在本地开展经营活动时必须设立子公司。开展城企协同推进养老服务发展行动计划。非营利性养老机构可在其登记管理机关管辖区域内设立多个不具备法人资格的服务网点。（市场监管总局、知识产权局、民政部、发展改革委按职责分工负责，地方各级人民政府负责） |
| 7. Effectively making information disclosure and policy guidance in the field of elderly care services. A monitoring, analysis, and development assessment mechanism for elderly care services shall be established, the statistical classification standards for elderly care services shall be improved, and statistical monitoring shall be strengthened. By the end of June 2019, each provincial people's government will have released a list of elderly care service support policy measures in force in its administrative region and information on the supply and demand of elderly care services or investment guides. Standards of practice for public disclosure of information on the service quality of the elderly care service institutions shall be developed, and lists of elderly care service projects, service guides, service standards, and other information shall be publicly disclosed. Regional protectionism, exclusion of for-profit elderly care service institutions from competition, and other provisions and practices that impede the unified market and fair competition in the public construction and private running of elderly care service institutions, tendering for elderly care facilities, and government procurement of elderly care services shall be reviewed and repealed in a concentrated manner. (The National Bureau of Statistics, the National Development and Reform Commission, the Ministry of Civil Affairs, the Ministry of Finance, and the State Administration for Market Regulation shall be responsible according to division of functions, and all provincial people's governments shall be responsible) | | （七）做好养老服务领域信息公开和政策指引。建立养老服务监测分析与发展评价机制，完善养老服务统计分类标准，加强统计监测工作。2019年6月底前，各省级人民政府公布本行政区域现行养老服务扶持政策措施清单、养老服务供需信息或投资指南。制定养老服务机构服务质量信息公开规范，公开养老服务项目清单、服务指南、服务标准等信息。集中清理废除在养老服务机构公建民营、养老设施招投标、政府购买养老服务中涉及地方保护、排斥营利性养老服务机构参与竞争等妨碍统一市场和公平竞争的各种规定和做法。（统计局、发展改革委、民政部、财政部、市场监管总局按职责分工负责，各省级人民政府负责） |
| II. Broadening investment and financing channels for elderly care services | | 二、拓宽养老服务投融资渠道 |
8. Promoting the resolution of financing problems faced by elderly care service institutions. The monetary and credit policy transmission mechanism shall be rationalized, a variety of tools shall be comprehensively used, and the implementation of refinancing in support of small businesses and other policies shall be effectively ensured. Private residential care homes that meet credit conditions but temporarily encounter operating difficulties shall continue to be financially supported. Problems such as relevant financial institutions' charging service fees, assessment fees, commitment fees, and fund management fees during the financing process of elderly care service institutions shall be effectively solved, so as to reduce financing surcharges and financing costs. Commercial banks shall be encouraged to explore the giving of mortgages on assets (facilities) and accounts receivable-pledged loans to private residential care homes under clear and good ownership. Allowing for-profit residential care homes to mortgage land, facilities, and other assets acquired onerously for financing shall be explored. Qualified, market-oriented, and well-regulated elderly care service enterprises shall be vigorously supported in raising financing by flotation. Commercial insurance institutions shall be supported in establishing elderly care service institutions or participating in the construction and operation of such institutions and appropriately broadening the sources of funds to invest insurance money in constructing elderly care projects. The startup secured loan policy shall be better brought into play, loan support shall be given to qualified individuals and micro and small-sized enterprises that are engaged in the elderly care service industry, and financial institutions shall be encouraged to reasonably fix lending rates, taking into account the basic lending rate, in light of risk sharing. (The People's Bank of China, the Ministry of Finance, the China Banking and Insurance Regulatory Commission, the China Securities Regulatory Commission, and the Ministry of Natural Resources shall be responsible according to division of functions)
．．．．．． | | （八）推动解决养老服务机构融资问题。畅通货币信贷政策传导机制，综合运用多种工具，抓好支小再贷款等政策落实。对符合授信条件但暂时遇到经营困难的民办养老机构，要继续予以资金支持。切实解决养老服务机构融资过程中有关金融机构违规收取手续费、评估费、承诺费、资金管理费等问题，减少融资附加费用，降低融资成本。鼓励商业银行探索向产权明晰的民办养老机构发放资产（设施）抵押贷款和应收账款质押贷款。探索允许营利性养老机构以有偿取得的土地、设施等资产进行抵押融资。大力支持符合条件的市场化、规范化程度高的养老服务企业上市融资。支持商业保险机构举办养老服务机构或参与养老服务机构的建设和运营，适度拓宽保险资金投资建设养老项目资金来源。更好发挥创业担保贷款政策作用，对从事养老服务行业并符合条件的个人和小微企业给予贷款支持，鼓励金融机构参照贷款基础利率，结合风险分担情况，合理确定贷款利率水平。（人民银行、财政部、银保监会、证监会、自然资源部按职责分工负责）
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