Advancing Plan for Health Service Development in Sichuan Province

Notice of the General Office of the Sichuan Provincial People’s Government on printing and distributing the Advancing Plan for the Development of Five Emerging and Leading Services in Sichuan Province

Issued by the General Office of the Sichuan Provincial People’s Government〔2014〕90 Resolution

All the Municipal (State) people's Governments, Provincial departments, Institutions Directly under Provincial Government, and relevant parties:

Authorized by the Provincial Government, the provisions on cause of the following actions, including Advancing Plan for E-Commerce Development in Sichuan Province, Advancing Plan for Modern Logistics Development in Sichuan Province, Advancing Plan for Modern Financial Industry Development in Sichuan Province, Advancing Plan for Scientific Service Development in Sichuan Province, and Advancing Plan for Elderly Support and Health Service Development in Sichuan Province are hereby printed and distributed to you. Please carry out the faithful implementation based on practice.  

General Office of the Sichuan Provincial People’s Government
10th October 2015

Attachment: 1. Advancing Plan for Elderly Support and Health Service Development in Sichuan Province

2. Advancing Plan for Health Service Development in Sichuan Province

The elderly care service industry is a generic term for various kinds of services for the elderly provided by the government, market, social organizations and individuals, also it is a service industry aims to provide living care and nursing and meet the special living and spiritual needs for elderly people. The industry, including services like elderly daily care, elderly products and supplies, elderly healthy service, elderly physical fitness, elderly cultural entertainment, elderly financial service, elderly tourism, etc., is an important force for expanding domestic demand, increasing job opportunities and promoting economic transformation and upgrading. In order to develop elder care service industry into emerging and leading service industry, this promote plan is formulated.

1. The Significance and Development Trend

1) The Significance

Firstly, it is an urgent need in dealing with the aging problem to accelerate the development of elderly care service industry. The aging index in our province is 4% higher than that of nation, and the characteristics of elderly group are big population base, fast growing rate, old age and large empty nest population, therefore it is an urgent to provide diversified and multi-level elderly services. Secondly, accelerating the development of elderly care service industry is an important measure for protecting and improving people’s livelihood. Furthermore, covering wide ranges of industries and multi-investment, and having positive impact on bringing related industry, the elder service industry is an crucial economic measure as well as an emerging service sector for adjusting economic structure and transforming the way of economic development.

2) The Development Trend

Based on the studies of development on international and domestic elder service industry, there are 3 development trends in our province’s development. Firstly, the elder service industry will be gradually socialized and mercerized. With the increase of elderly income, the elderly people’s need is individualized and diversified; witch requires the various social sectors to provide convenient and reasonable-priced services and products utilizing multi-resources. Secondly, the elderly service industry will be large-scale and industrialized. It should play its size effect as it is featured as large initial investment, long return cycle, low profit and high risk. Thirdly, the elderly service industry will be professionalized and standardized. It will be developed from simple elder daily care to combination of general service and personalized service, which requires it to promote profession of its service team and advance service standard.

2．Development Status and Foundation

1) The elderly care system is in embryo.

By the end of 2013, the coverage rate of elderly care in urban and rural has reached 55.4% and 21.3% respectively. Community elderly care facilities are improving. Following the demonstration of state-run elderly care institutions, our province is engaging the social sector to the industry step by step. Nowadays, there are 3336 elderly care institutions with 363,000 elderly care beds (including beds in community care and Rural Happiness Courtyard) ranking the third in the nation, which means there are 23.82 beds among per thousand elderly people. The governmental basic elder care guarantee policy plays a vital role. The concentrated care rate for over-50000 “Three-no” urban elderly people is 54.5%, while that for 506,000 “Five-guarantee” rural people is 52.1%. The number of beds in rural “Five-guarantee” care service institutions has reached 299,000, ranking the top in the nation. Old age subsidy policy has benefited 740,000 elderly people. The government is studying to establish elderly care service subsidy system and disabled elderly nursing subsidy system for elders who are facing economic difficulties, so as to support home-based care service. At the same time, attaching important to and developing rural elderly care service; the Rural Old-age Home should open to the society on the premise of fulfilling the need in “Five-guarantee” people’s concentrated care, and gradually become regional elderly care service center. The number of Rural Happiness Courtyard is 2454. The employees in elderly care service has reached over 350,000.

2) Emerging service sector is forming.

The emerging service mode and structure according with the development requirement of modern service industry are applied into elderly care service sector. For example, the information service industry has engaged into elderly care service to develop new service mode such as intelligent one and personalized one. The trend of combination elderly care service and relevant industry is growing. For example, the combination of medical care and elderly care, insurance and capital investment in elderly service sector, the operation of elderly care and tourism, and the elderly real estate like new elderly care community is promoting the transformation of traditional real estate industry.

3) The private capital investment has accelerated in the elder care industry.

The leading role of government and the main role of society are further playing. The investment of social strengths is growing. There are important and large projects of elderly care investing by private capitals under construction. The elder care service cooperates (institutions) are heading to be collectivized and chained.

4) The improving of governmental support system.

The document, Implement Opinion on Accelerating the Development of Elderly Care Industry by the People’s Government of Sichuan Province (issued by the People’s Government of Sichuan Province [2014] No.8) has confirmed 6 major tasks in developing elder care service industry and 6 policies including investment and financing, land supply, preferential tax, subsidy, personnel training and employment, and encouraging public welfare charities to support elder care service. The relevant department has formulated several matched documents to improve the elderly care policy and help solving problems concerning difficulties in financing, land using and operating.

Even thought the elderly care service in our province is growing fast, there are still problems remain to solve, for example, the coexistence of insufficient elderly care supply and consumption, the imperfect environment for society to impact policy, the lack of long-acting mechanism in building and operating elderly care facilities, and the elder care industry has not shaped into industry scale and chain.

3. Development Ideas and Goals

1) Development Ideas

On the basis of principles of “ deepen reform and opening up in system, adhere to ensuring basic security, pay attention to the overall development, and perfect marketing mechanism”, the development ideas are to fully paly the leading role of government and the main role of market, develop both the course and the industry of elderly care, bring along the development of relevant industries, and increase employment, so as to transform the elderly care service industry to emerging and leading service industry.

2) Development Goals

The accelerated development of elderly care service industry has raised the care level for governmental guaranteed people. With higher added value annual growth rate than that of GDP, the elderly care service has become an important part of service industry. By 2017, the elderly care facilities will cover over 90% urban communities, over 75% villages and towns, and over 50% rural communities. The number of elderly care beds in total will reach over 550,000, equaling to over 33 beds per thousand elderly people. There will be over 650,000 employees in the industry. By 2020, the elderly care facilities will cover all urban communities, over 90% villages and towns, and over 60% rural communities. The number of elderly care beds in total will reach over 610,000, equaling to over 35 beds per thousand elderly people. There will be over 710,000 employees in the industry.

4. Key Tasks

1) Overall enhancement of home-based elderly care service

Strengthen the force of fostering and supporting home-based elderly care service cooperates and social organizations. Build home-based elderly care service network in city (urban district), towns (streets), and communities (villages) to match elder’s need, based on viewing elder care cooperates and social organizations as main bodies, and communities as linkage. Strongly develop household management service to provide standardized and personalized services for the elderly. Guide individual businesses that have strong capacity of operation and well performance to develop towards production operation scale and organized cooperate. By 2017, various kinds of home-based cooperates (institutions) and social organizations will be over 25,000, while by 2020, the number will be 35,000. (Responsible units: Department of Civil Affair, Provincial Industry and Commerce Bureau, Provincial Development and Reform Commission, the People’s Government in each city (the state), county (city, district))

Build long-acting mechanism to support home-based elderly care service. Implement elder care service subsidy policy to disabled elders with economic difficulties, elders who live alone and elders over 80. Make sure to coverage all the people needed subsidy before 2016. (Responsible units: Department of Finance, Department of Civil Affair, the People’s Government in each city (the state), county (city, district))

2) Accelerate the development of community elderly care service

Implement special cleaning and rectification to home-based and communities’ elderly care service facilities in cities and towns, which should be done by the end of 2014. As for the old urban area and built communities without elderly care service facilities or the facilities are substandard, the rectification should be done within a year by the way of purchasing, replacement or renting. (Responsible units: Department of Civil Affair, Department of Housing and Urban-Rural, Department of Finance, Department of Land and Resources, the People’s Government in each city (the state), county (city, district))

Accelerate building of communities elderly daily care center in cities and towns to provide day time service for elders who stay alone or are disabled. Encourage and support the social strength to invest, build and operate communities elderly daily care centers in cities and towns, and the government will provide one-off construction subsidy to the qualified ones. By 2017, realize building communities elder daily care centers over 90% urban communities and 50% rural communities; while by 2020, the number will be 100% and 60%. (Responsible units: Department of Civil Affair, Department of Housing and Urban-Rural, Department of Finance, Department of Land and Resources, the People’s Government in each city (the state), county (city, district))

Enhance building rural elderly care service facilities. Relying on administrative villages and large natural villages, utilizing rural courtyards, build mutual aid elder care service facilities like daily care center, old-age home and elderly activities station. Strongly promote the building of Rural Happiness Courtyard to solve the problems concerning mutual aid elder care and activities places. Encourage urban capital, property and resources to invest rural elderly care service. Build related support and operation mechanism between urban state-run elder care institutions and rural “Five-guarantee” care institutions. By 2017, there will be 12,500 Rural Happiness Courtyard covering 30% villages (not include rural communities); while by 2020, the number will be 20,000 and 50%. (Responsible units: Department of Civil Affair, Department of Housing and Urban-Rural, Department of Finance, Department of Land and Resources, the People’s Government in each city (the state), county (city, district))

Strongly promote the building of elder care institutions. Organize and encourage social strength to develop elderly care service, focusing on building private elder care institutions and increasing the number of beds in the institutions. Apart from ethnic minority areas, remote areas and poor areas, the rest places with sound economic status and convenient transportation will no longer build new state-run elderly care institutions, and the governmental guaranteed people can buy service form private institutions so as to realize concentrated care. Lower the threshold for social strength to develop elder care institutions. Encourage and support individuals to build family-type and small elderly care institutions, while cooperates and social organizations are encouraged to develop towards large scale and chained institutions. Encourage and support private capitals to utilize and transform the available social resources like factory or business facilities for elderly care used. Encourage and support state-run cooperates to invest elderly care service industry. Encourage and support foreign direct investment in elderly care industry. Actively absorb the foreign advanced elderly care management experience. Provide the same treatment to the foreign investors as to the domestic ones concerning land using, taxing and financing subsidy. (Responsible units: Department of Civil Affair, Provincial Development and Reform Commission, Department of Housing and Urban-Rural, Department of Commerce, Department of Finance, Department of Land and Resources, the People’s Government in each city (the state), county (city, district))

Set up pilot nursing institutions for the elderly people. Improve their capacity by extended service coverage and quality services, increase the quantity and proportion of beds in those nursing institutions. Implement private operation for those public nursing institutions by offering extra subsidies, service outsourcing etc, and boost their development by the private operations. Explore a new way for public and social cooperation, and franchise long-term operation rights and usufruct for the private sectors. By such ways, guide and promote the investments for facilities supply for these nursing homes. Rebuild news facilities for those public nursing homes, adding 30,000 beds per year. (Responsible body includes the civil affairs department, financial department, provincial development and reform committee, the provincial SASAC and all levels of governments.)

4) Establish a new pension service information network for the elderly people. Build up a new pension network, attracts social support and investment for this network, and find new home and community nursing models. Build a new call service and emergency system for the elderly people, forming an information platform of comprehensive information network for home, community and institutional nursing. By 2017, the network system needs to cover all the county level areas in Sichuan province, and the new provincial network system is set up. By 2017, the network system needs to cover all the town level areas in Sichuan province. (Responsible bodies include provincial economic and information committee, civil affair department, all levels of different governments).

5) Improve the nursing service. Integrate medical and nursing service developments, introduce more medical resources into nursing institutions, communities and families. Support qualified nursing institutions by setting up medical institutions for them, and some qualified institutions could be set as pilot institutions for medical insurance coverage and new integration of rural and urban insurance. Build a new cooperation system for medical and nursing institutions, and establish new service agreements between the community and individuals. Medical institutions should help to develop the nursing service, and several second layer hospitals should have the geriatric department, and increase their beds in that department, offer good service in the geriatric diseases preventions and care. Encourage medical institutions to add geriatric departments or convert into elderly care centers. Support social bodies to establish nursing homes, convalescent home and hospice care institutions. Support the state-owned companies to cooperate with medical institutions, and establish nursing institutions with medical departments. Encourage insurance company offering tailor-made insurance program for the elderly people, including commercial insurance and accidental injury insurance, disease insurance, health care insurance, long-term care insurance and disability income insurance and other kinds of insurance products. By 2017, cover all the elderly people in, and hospitals with geriatric departments should accounts to 30% of the total hospitals. By 2020, the percentage need go up to 40%. (Responsible bodies include Provincial health and family planning committee, the department of human resources and social security, the civil affairs department, the provincial development and reform commission, municipalities (state), county (city, area) people's government.)

6) Actively form new groups of nursing industries. Encourage and guide the relevant industries on actively expanding suitable cultural entertainments for the elderly people, including sports fitness, leisure trips, health services, spiritual activities, legal services, information services and other services, pension service, in order to boost the consumer market. Develop the elderly tourism, speed up the development of leisure activities, sports games, and other characteristic products, such as perfecting the elderly tourist service facilities, promote professional senior tourism service brand. Positively produce assistive devices, ensure food and drug safety and safe clothing accessories, and guide the business institutions to establish an elderly supplies zone. Moderately develop elderly housing, senile apartments, and living facilities in order to improve the quality of the old life. Guide and standardize the commercial Banks, insurance companies, securities companies and other financial institutions to develop suitable products for the elderly people, like low risk financing, credit, insurance, and other products, make a good management of elderly investments. Accelerate the cultivation of endowment service markets, guide the development of communities for endowment services, encourage the development of nursing services for SME enterprises, support the development of leading enterprises, vigorously promote the development of enterprise scale, key support for major projects, ensure of the implementation of brand strategy, and improve the innovation ability. Form a long industrial chain, by covering broad areas, in order to make remarkable economic and social benefits for the industrial cluster.

5. Working Measures

1) Meet the requirements for different service facilities construction land demands, control for reasonable land prices, and reduce the construction cost. For nonprofit endowment service agencies, they could take the allocated lands by cost price for their nursing service facilities. Nonprofit elderly service facilities, should be used by paying rent, by leasing, in principle, a rental basis would be given priority. For land release, institutions could list the lands (the transfer price should not be lower than 70% of the original price). Once meets of all the premise of the planning, it allows to make advantage and upgrade the existing idle factories, schools, community buildings for non-profit endowment service agencies. The use of the lands cannot be changed. The rural collective construction land can be used in accordance with the law of nursing institutions establishments. In 2014, adopt new policies of land use on nursing development, and support nursing development (responsible bodies include land and resources department, civil affairs department.)

2) Encourage and support the endowment insurance fund investment in services, guide the integration of commercial insurance and pension services, proceed with the pension agency liability insurance, effectively reduce the endowment agencies operational risk, promote the healthy development of the endowment institutions. In 2014, adopt new policies on the development of the pension services of insurance, and support its development. (Responsible bodies include the Provincial Insurance Regulatory Bureau, civil affairs department.)

3) Enhance the medical service for the elderly people, and resolve their medical settlements cross different areas. Take qualification evaluations for nursing agency doctors, nurses, doctors, rehabilitation therapists, social workers and other professionals and technical staff, and perform the same policies as the medical institutions and welfare institutions. Within 2014 year, achieve different settlements across different areas for medical cost and insurance.(Responsible bodies include the department of human resources and social security, the provincial health and family planning committee and the financial department.)

4) Increase the financial investments for the pension and nursing service, make full use of the government by leading the nursing service development. SEMs set up special funds for qualified industries of offering nursing services. Adopt appropriate policies on subsidies for nursing services in the society. (Responsible bodies include financial department, provincial economic and information committee, and civil affairs department.)

5) Enhance the development of information network, prompt integration of social information and resources for a better nursing service, and build up a comprehensive network of pension and nursing information, covering the whole country. Provide new policies on information collection and network construction within the year of 2014. (Responsible bodies include provincial economic and information committee, civil affairs department.)

6) Through establishing its statistical system and standardizing its evaluating method, a sound information releasing system for elderly care should be perfected. (Accountability units: Department of Civil Affairs, Department of Statistics of Sichuan Province)

7) Boost effective credits and loans for old-age service industry by widening financing channels and making full use of small loan policies. Build credit systems for aged support agencies and make them more attractive to credit funds and private capital. (Accountability units: the Office of Finance of Sichuan Provincial Government, The Peoples Bank of China Chengdu Branch, CBRC Sichuan Office, Department of Civil Affairs)

8)  Adjust the method of decomposing the tasks and goals. Issue all at once the key objectives and tasks for the coming 3 years (2015-2017) before the end of 2014 so that local authorities can arrange and organize corresponding implementation. (Accountability units: Department of Civil Affairs, Provincial Development and Reform Commission, Provincial Department of Finance, Provincial Department of Land and Resources )

9) Accelerate the implementation of major projects of old-age service industry. Identify a series of major projects of old-age service industry in Sichuan Province within 2014. (Accountability units: Department of Civil Affairs, Provincial Development and Reform Commission, Provincial Department of Land and Resources.)

10) Promote a working mechanism for old-age service industry. Set up a working group in which provincial government leaders in charge of relevant area are appointed as group leaders; deputy secretary generals in charge of relevant area as deputy group leaders; and related departments directly under the province jointly participated. Analyze periodically the problems existed in old-age service industry, promote policies to accelerate its development and implement earnestly the tasks required in the process. (Accountability units: Department of Civil Affairs, Provincial Department of the General Administration)

 
11) Establish and perfect a supervisory mechanism for old-age service industry. Monitor not less than 2 times/year in which supervision in January and July should be on previous year and the first half of current year respectively. (Accountability units: Provincial Supervision and Inspection Office, Department of Civil Affairs)