During the panel discussions and responding to questions raised
by the audiences at the symposium, President Igata and other delegates
have expressed their respective comments, views, opinions and exchange
of views among the delegates which will be dealt in the next summary
of this symposium at our website.
As CEO of providers of long-term care services for the elderly
with invaluable experience as well as scholars specializing in the
issues of aging, Dr.Mokuno introduced his remarks focusing on some
specific issues relating to the current system and made his views
and recommendations in the process of reviewing the current system
which are now being undertaken for the completion of the review
and revision by the end of March 2005.
He has provided the materials concerning comparative notes between
Japan and the United States in the system of long-term care services.
Although the structure of the system is different due to law(s),
regulations and codes between the two countries, he touched on some
of important points which will be implemented in the operation of
institutional facilities providing long-term care services under
the current system but also recommended items to be reviewed and
revised in order to create more realistic and sound system.
has listed a number of issues which are regarded to be reviewed
for improvement in the system through the process of review and
revision of the on-going task of completing the review process by
the end of March 2005. Firstly. He sated that the auditing system
into institutional facilities for care services for the elderly
under the current system should be improved. He pointed out that
the auditors being assigned from the regional government in charge
of the long-term care service insurance system, is not appropriate
nor productive by large in terms of how the operation of providers
of care services be audited in terms of its methods and contents
of the auditing. His observations based on his involvement at the
time of auditing demonstrate that those assigned to conduct the
task of auditing of the providers of care services at institutional
settings are less interested in how the operation of facilities
are being conducted in accordance with the regulations and guidance
applied under the current system but they are primary concerned
about the financial figures of how it is properly documented to
meet the requirements.
The auditors assigned are, in the most cases, neither knowledgeable
nor professionalized in terms of how the long-term care services
being provided. Since the auditors are assigned from respective
regional government in which the institutional facilities are located,
the auditors tended to think of their task not only in terms of
how the providers of care are maintaining financial records but
also they tended to think that the providers of care services for
the elderly be directed by these bureaucratic staff. These auditing
methods prevent providers of care services for the elderly from
properly evaluated, particularly how the detailed task of care services
are being provided for the elderly, which will provide the opportunity
for the users of the facilities in their choice.
Dr.Mokuno recommended that institutional facilities for care services
for the elderly be audited by more independent entities rather than
regional government, which will provide full disclosure of quality
of care services provided for the choice by potential beneficiaries
of the current system.
Another issue he focused on is a question of the issue of licensing
and certificates for professional persons who are engaged in care
services. Although Japanese Ministry of Health, Labor and Welfare
has implemented some of licensing and certificate programs but it
is not enough to enhance the ability and quality of those professional
persons to meet the requirement of changing care services and medical
services to provide them with the elderly. In this regard, he urged
that some of the measures implemented in the United States be helpful
to advance these issues.