Professional services to ensure the elderly
According to the seventh national census, the population of our country is 264 million people aged 60 and above.
The establishment of a basic elderly care service system for all elderly people, so that every elderly person can be provided for the elderly, is an institutional arrangement to meet the needs of basic elderly care services for the vast number of elderly people, and it is an inevitable arrangement to enhance the well-being of the elderly and realize the common prosperity of all people. Require.
Since the beginning of this year alone, General Secretary Xi Jinping has conducted 4 field visits and researches on elderly care services, and made important instructions and instructions 11 times.
To provide for the elderly, General Secretary Xi Jinping is here to devote all his efforts.
This roundtable shared the thoughts and practices of the civil administration system to promote the construction of the elderly care service system in my country.
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Xu Xiangmei, Director and Researcher of the Economic Research Department of Economic Daily
Constructing an elderly care service system with Chinese characteristics
Moderator: What is the current progress of my country's basic elderly care service system and what are the key development directions in the future?
Yu Jianliang (Director of the Department of Elderly Services of the Ministry of Civil Affairs): Since the 18th National Congress of the Communist Party of China, the fairness and accessibility of basic elderly services in my country has continued to improve. Hundreds of millions of elderly people have joined the people of the whole country to enter a well-off society in an all-round way.
Initially establish a standardized comprehensive evaluation system for the abilities of the elderly.
On the basis of summing up many years of practical experience, in 2013, the Ministry of Civil Affairs issued the "Guiding Opinions on Promoting Elderly Service Evaluation Work" and "Elderly Ability Assessment" industry standards, providing a unified, standardized, and operable for comprehensive evaluation of elderly ability Comprehensive evaluation work has been carried out extensively in localities.
This year, the National Medical Insurance Bureau and the Ministry of Civil Affairs jointly issued the "Long-term Care Disability Level Evaluation Standard (Trial)" to explore the establishment of a cross-departmental mutual recognition mechanism for evaluation results.
Basically establish a welfare subsidy system for the elderly.
In 2014, the Ministry of Civil Affairs, the Ministry of Finance, and the National Office on Aging jointly issued the "Notice on Establishing and Improving the Subsidy System for the Elderly and Disabled in Economic Difficulties".
In accordance with their own actual conditions, all localities have generally established old-age allowances, pension service subsidies, and disabled elderly care subsidy systems, basically achieving full coverage at the provincial level.
The demand for elderly care services for the elderly, disabled and other needy elderly people is better guaranteed. More than 38 million elderly people across the country enjoy various welfare subsidies.
Effectively guarantee the basic life of the destitute elderly.
Through decentralized support and centralized support, it is ensured that the elderly in extreme poverty "are usually taken care of, and sick people take care of them."
As of the end of 2020, 3.876 million elderly people in extreme poverty nationwide have been supported. Among them, the basic living standard of rural elderly people in extreme poverty is 8568.8 yuan per year, and the basic living standard of urban elderly people in extreme poverty is 11,257.1 yuan per year.
Establish a visit system for the left-behind elderly in rural areas, and promote the rural left-behind elderly information management system to achieve full coverage at the county level.
Initiate the implementation of aging reforms for the elderly in special difficulties.
The Ministry of Civil Affairs, in conjunction with the Development and Reform Commission, the Ministry of Finance, the Health Commission and other departments, issued the "Guiding Opinions on Accelerating the Implementation of the Ageing Reconstruction Project for the Elderly’s Homes". The elderly, disabled, and disabled elderly in the population range will be reformed for aging at home.
Actively promote the construction of the basic old-age service system, and support all localities to try first.
Incorporate the establishment of a basic service system for the elderly in special and difficult situations and the formulation of a list of basic home and community elderly care services into the home and community elderly care service reform pilots, focusing on satisfying the disabled, lost independence, empty nest, left-behind, and senior citizens of economically disadvantaged families in urban and rural areas People’s needs for elderly care services.
Carry out home and community basic elderly care services improvement action, this year, 42 districts including Chaoyang District in Beijing have become pilot areas.
Support localities to explore basic elderly care services. Provinces such as Beijing, Shanghai, Shandong, Jiangsu, Zhejiang, Anhui, Guangdong, Guizhou, Gansu and other provinces will closely integrate basic elderly care services into local regulations and issue special documents.
Guangzhou has basically established a basic old-age care service system covering all the elderly, universal benefits, clear rights and responsibilities, appropriate protection, and sustainable basic old-age care. A good proposition of the times.
The "14th Five-Year Plan" period is an important strategic opportunity period for my country to actively respond to the aging of the population.
The Ministry of Civil Affairs will conscientiously implement the Party Central Committee’s national strategy to actively respond to the aging of the population, improve the major deployment of the basic elderly care service system, and strive to achieve a more complete basic elderly care service system by 2025, basic elderly care service objects, service content, service standards, and services The methods, element guarantees, and quality supervision are more clearly regulated.
Strive to complete the establishment of a basic old-age care service system that covers all the elderly, has clear rights and responsibilities, appropriate protection, and is sustainable by 2035. The old-age care service system with Chinese characteristics is mature and finalized.
Accelerate the establishment of a basic pension service system framework.
Clarify the connotation and core essentials of the basic elderly care service system, deepen the understanding of key issues such as who to serve, what to serve, who will serve, and study the establishment of basic elderly care service guidance catalogs, effective service supply and effective supervision systems.
Accurately do a good job of linking up policies with related fields.
The construction of the basic old-age service system is a complex system project involving multiple departments and all levels. The system concept must be adhered to, and the linkage and policy coordination with long-term care insurance, welfare and assistance for the elderly must be strengthened.
At the same time, speed up the shortcomings of rural elderly care services, improve the level of rural basic elderly care service system construction, strengthen urban and rural regional coordination, and gradually advance the equalization of basic elderly care services.
Strengthen the guarantee of relevant elements and conditions.
Provide support for basic elderly care services in terms of facilities, funds, and talents.
The implementation of the three key projects of the “14th Five-Year Plan” for the development of civil affairs undertakings, the construction of public elderly care institutions, the transformation of elderly families in special difficulties, and the construction of community home care service networks, will give priority to the construction of facilities.
Make basic elderly care services the focus of future funding support, use lottery public welfare funds and investment in the central budget to support local projects, and prioritize funding.
Establish and improve the skill level evaluation system for elderly caregivers, implement employment subsidies and job subsidies for elderly caregivers, and take multiple measures to strengthen the training of elderly service personnel.
Beijing's elderly care services focus on ensuring basics
Moderator: Beijing ranks second in the country in terms of aging. The implementation of the national strategy to actively respond to the aging of the population is an arduous task. How to coordinate and promote the construction of the elderly care service system?
Li Wanjun (Secretary of the Social Work Committee of the Beijing Municipal Party Committee and Director of the Civil Affairs Bureau): Beijing is currently entering a deeply aging society at a rate of 500 new people every day.
By the end of 2020, there were 3.786 million registered elderly people aged 60 and above, accounting for 27% of the total registered population.
In recent years, the Beijing Municipal Party Committee and Municipal Government has comprehensively coordinated and promoted the work of elderly care services.
This year, Beijing has included 27 high-frequency and difficult livelihood issues such as home-care security, fees and services of elderly care institutions in the "Monthly Question" key supervision mechanism, focusing on improving the happiness and sense of acquisition of the elderly.
The first is to improve classification protection, focusing on ensuring basic elderly care services for key groups.
Include the disabled, demented and senior citizens of urban and rural extremely poor, subsistence allowances, and low-income families, as well as the disabled, demented, severely disabled, and family-planning special families of the elderly into the basic elderly care service objects, accurately find the bottom, establish a ledger, Guarantee the supply of elderly care services from multiple levels including policies, funds, resource supply, and service organization.
Through "subsidies", basic old-age service objects are guaranteed.
Establish a comprehensive evaluation system for the abilities of the elderly, improve the pension service subsidy for the elderly in need, the nursing subsidy for the disabled elderly, and the old-age allowance subsidy system. The elderly who meet the conditions can apply for the "three supplements."
Implement the "Beijing Implementation Measures for the Relief and Support of the Extremely Poor Persons", and grant support and support subsidies to the urban and rural extremely poor.
In addition, monthly subsidies will be provided to five types of service objects, including urban and rural extreme poverty and subsistence allowances, to stay in elderly care institutions.
Based on this comprehensive calculation, in Beijing, a “three-no-elder” who has no ability to work, no source of livelihood, and no supporters and supporters can receive a total of about 5,000 yuan in subsidies per month if he lives in an elderly care institution.
Since the implementation of the policy, it has aroused good social response throughout the country and has been highly recognized by the Ministry of Civil Affairs.
Through "giving services", basic old-age service objects can live in.
The policy clearly stipulates that the main function of all public and private pension institutions in the city is to support the government's basic pension service targets.
All public-run private nutrition and elderly institutions provide at least 20% of the beds to meet the needs of the elderly in urban and rural areas with extreme poverty, subsistence allowances, low-income and financially difficult groups.
Promote the establishment of at least one district-level public elderly care institution in each of the 16 districts of Beijing, and each institution shall be equipped with no less than 60% of nursing beds.
Through "replenishment institutions", basic elderly service objects can live well.
Implement the civil price policy for water, electricity, gas, and heat for elderly care service institutions, and improve the one-time construction fund support policy for non-profit elderly care institutions established by social forces.
Implement differentiated subsidies for elderly care institutions and guide them to better meet the needs of basic elderly care services.
The second is to adhere to the nearest precision, and build a multi-level long-term care system that coordinates the home and community institutions and combines medical care and health care.
Build up the "three beds" for care services.
Accelerate the construction of centralized care beds in elderly care institutions, short-term care beds in post stations, and home care beds.
At present, the total number of “three beds” in the city has reached 128,000, of which 112,000 are centralized elderly care beds in institutions, 12,500 temporary nursing beds in post stations, and 3,500 home care beds for the elderly.
Do a good job of integrating medical care and nursing care.
Relying on post stations to carry out health services, including medical assistance services into the basic service functions of post stations; including post and nursing station related service items into the policy support category; adding medical services to the family care bed function, so that the elderly can enjoy professional elderly care services at home Provide door-to-door service.
Build a "food aid".
Support the social forces to provide meal assistance services by giving basic pension service objects meal subsidies and granting pension assistance meal operation subsidies, etc., and focus on solving the problems of disability, dementia, and inconvenience in eating for the elderly.
The third is to optimize the business environment and accelerate the establishment of an industrial system for elderly care services.
Issued the "Implementation Opinions on Fully Liberalizing the Elderly Service Market to Further Promote the Development of the Elderly Service Industry" and the "Implementation Plan on Accelerating the Development of Elderly Service" to strengthen the top-level design of industrial development.
Strengthen financial support.
Deepen the reform of the management system of public elderly care institutions, vigorously promote the public and private enterprises, support chain brand institutions to undertake the operation of public elderly care institutions, and improve service efficiency.
The "Administrative Measures for the Operational Subsidies of Elderly Care Institutions in Beijing" was issued, and subsidies included public and private institutions and social institutions based on multiple dimensions such as the physical condition of the recipients of the elderly care institutions, star ratings of service quality, credit status, and medical service capabilities.
At present, there are 576 old-age care institutions in Beijing, including 51 public office institutions, 78 public and private institutions, and 447 social old-age institutions.
Promote the construction of facilities.
Promulgated measures for the handover of old-age service facilities in newly-built communities, including old-age facilities in the positive list, the city's unused facilities that have been evacuated will be given priority for the construction of old-age facilities, and the coverage of “side”, “bedside” and “peripheral” of old-age facilities will be improved.
Take the lead in exploring a centralized home care service model, transforming heavy assets into light assets through the construction of residential and commercial houses with shared property rights for the elderly, and attracting social assets to participate.
Standardize service standards and strengthen the supervision system.
Carry out a star rating of service quality for elderly care institutions, and consolidate the achievements of standardized construction of elderly care institutions.
Formulate comprehensive supervision policies for elderly care services, establish a cross-departmental coordinated supervision mechanism, establish a reporting system for major and emergencies, and build a solid monitoring bottom line for the safety and quality of elderly care services.
The fourth is to persist in mechanism innovation and build a talent system for the elderly service team.
Improve remuneration and pay attention to training.
Give job rewards to graduates who enter senior care service institutions to engage in full-time senior care services; take the lead in setting up an award and subsidy system for senior care positions in the country.
In the first 10 months of this year, a total of 9.89 million yuan of job rewards and allowances were issued, involving more than 5,800 elderly care workers.
Improve the hierarchical and hierarchical training system of municipal, district, and elderly care service organizations, organize and carry out professional skill competitions for elderly care workers, and increase social recognition.
There are about 12,000 elderly care workers in the city. In view of the shortage of personnel, a three-year training target for elderly care service personnel has been set. From 2020 to 2022, 10,000 elderly care workers, 500 agency leaders, and 500 elderly social workers will be trained annually from 2020 to 2022. By.
Innovative work ideas.
Establish a “time bank” for voluntary services for the elderly, and improve the time recording, management, exchange and incentive mechanisms for elderly care services in accordance with the idea of “saving time today and changing services tomorrow”.
In 2020, the Beijing Senior Volunteers Association is entrusted to carry out a pilot project for the construction of a voluntary service time savings system for the elderly in Dashilan, Xicheng, Liuduhe Village, Bohai Town, Huairou, etc., from inspection visits, health management, psychological comfort, elderly dining tables, family services, etc. , To organize enthusiastic public welfare undertakings and healthy residents of this city to provide voluntary services for the elderly at home.
This year, in cooperation with the People's Bank of China, we formulated the "Beijing Pension Service Time Bank Implementation Plan" (for trial implementation). It is planned to gradually establish a pension service time banking system throughout the city and expand the senior care service team.
Zhejiang makes common prosperity even better
Moderator: The main indicators for the development of the elderly care service system in Zhejiang Province rank among the top in the country.
What experience can you share in ensuring the supply of elderly care services to help common prosperity?
Wang Jianhou (Director of the Department of Civil Affairs of Zhejiang Province): Zhejiang Province has listed elderly care services as a fact of the people's livelihood of the provincial government for 13 consecutive years.
Years of construction have achieved remarkable results. The elderly care service system has solved the problem of "from nothing to something" and is working hard to develop from "from good to good" and "from good to excellent".
There are 2,485 elderly care institutions in the whole province, with a total of 450,000 beds. There are 40.2 beds in institutions per 1,000 elderly people, of which two-thirds are privately run.
23,000 home care service centers for the aged in urban and rural communities have been built, basically achieving full coverage; more than 1,400 home care service centers in towns (streets) have been built, covering all towns (streets) by the end of the year.
The age-appropriate reforms benefit families of the elderly in difficulties in the province. The welfare of the elderly is gradually improved, and the management of elderly service institutions is gradually standardized.
In order to better adapt to the new trend of population aging and solve the difficult problems of elderly care services, Zhejiang Province is problem-oriented, timely adjusts development strategies, strengthens the pertinence and effectiveness of policies, and promotes the innovative development of elderly care services.
Aiming at the shortage of senior care professionals, the indicator of "certified senior care workers per 10,000 seniors" is designed.
Zhejiang Province has set "the number of certified elderly care workers per 10,000 elderly people" as a key indicator of the "14th Five-Year Plan" for the development of elderly care services, and has been included in the "Zhejiang Province’s Fourteenth Five-Year Plan for National Economic and Social Development and the Second Five-Year Plan". One of the 35 most important indicators in the "Outline of the 035-Year Vision Goals" is also included in the comprehensive evaluation indicators for the implementation of the "88 Strategy" and the indicators for the construction of a demonstration zone for common prosperity, to promote the work in an all-round way.
At present, there are 18.26 certified elderly caregivers per 10,000 elderly people, and we will strive to reach 25 by 2025.
In response to the imbalance of regional elderly care services, strengthen regional cooperation to resolve the problem of island elderly care.
The landforms of Zhejiang are complex, and the diversity of geography brings about the complexity of old-age care. The old-age care services in mountainous areas and islands are relatively backward.
Zhoushan has the highest degree of aging in the province, but its population and economy are not large, and foreign aid is urgently needed.
Especially the remote islands in Zhoushan, some floating islands are full of elderly people, public facilities are poor, transportation is inconvenient, and nursing staff is extremely scarce.
In May of this year, the “Island Supporting the Elderly and Keeping Good Together” was officially launched to organize three-year counterpart support in Hangzhou, Ningbo, Huzhou, Jiaxing, and Shaoxing, which have relatively high professional levels of elderly care services. The four aspects of culture allow the islands to share the fruits of the development of elderly care services.
Up to now, a total of 30 elderly care workers have been stationed on 15 remote islands to provide elderly care services on a regular basis.
After more than half a year of hard work, the level of care for the elderly on the island has improved significantly.
In response to the difficulties in the combination of health and nutrition, the establishment of a health and health complex was initiated.
The combination of health and care is a new thing, and there are many difficulties encountered in the process of integration. For example, the staff of primary health centers and public elderly care institutions in cities and counties are not very motivated to come to provide health care services.
In December 2020, the General Office of the Provincial Party Committee and Provincial Government issued the "Opinions on Accelerating the Construction of the Health Care System and Promoting the Development of Elderly Care Services", making a comprehensive plan for the construction of the health care system.
For example, for the elderly care institutions, health care, medical insurance and other departments that apply for setting up medical offices (nursing stations), they provide full support to optimize the evaluation and approval process.
In the future, we will also focus on promoting the elderly care institutions and township (street) home care service centers that are included in the pilot health care complex. Each of them will establish a close cooperative relationship with at least one hospital and township health center (community health service center). There is substantial cooperation in on-site care, opening of referral channels, and facilitating medical treatment and prescribing medications.
Aiming at the problem of insufficient layout planning, we took the lead in implementing the "institutions follow the elderly" action.
Organize localities to prepare special plans for the layout of elderly care service institutions and facilities to ensure that the high-density residential area (>3000 people/km2) of the main urban area for the elderly is about 500 meters away, and the medium-density residential area (1000-3000 people/km2) is about 1000 meters away. 1 elderly care institution; a large number, small-scale, and good location to arrange elderly care service facilities to ensure that there are about 300 beds for every 10,000 elderly people.
In response to the lagging development of elderly care services in towns and villages, strengthen the construction of home care service centers in towns (streets).
Promote the construction of township (street) home care service centers, require the township (street) level to provide professional services, and community level to provide general services, and build a dislocation development and mutually complementary community home care service network.
By the end of this year, a total of 1,445 home care service centers in towns (streets) will be built, covering all towns (streets). The service centers will all be operated by third-party professional organizations to realize life services, rehabilitation nursing services, nursing services, and family support. Six professional service functions: services, social work and psychological counseling services, and rehabilitation assistive device rental services.
In view of the weak current situation of home furnishings, implement aging-appropriate reforms for the needy elderly families.
Focusing on the five major functions of toilet and bathing safety, indoor walking convenience, home environment improvement, intelligent monitoring and follow-up, and auxiliary appliance adaptation, the ground, wall, kitchen, bathroom, etc. are transformed.
This year's target is 20,000 households, and 27,000 households have been completed.
The provincial subsidy standard is 6000 yuan/household, and certain supporting facilities will be provided by various regions to allow the elderly to truly feel cared about, while training teams for aging-appropriate transformation and driving the development of aging-appropriate industries.
Common prosperity is a good social form of high-quality sharing of public services throughout the life cycle of people. The sense of happiness and security of the elderly directly reflects the quality of the construction of the common prosperity demonstration zone.
In the future, Zhejiang Province will continue to take the mission of building a high-level “Benchmarking Zone for Happy and Elderly Care” to ensure that basic elderly care services are within reach and effective supply of high-quality elderly care services to help common prosperity.
Make basic elderly care services within reach as the main direction of attack.
Study and establish a list of high-level basic elderly care services.
In-depth study of the comprehensive security system for long-term care, and increase policy support for the disabled and demented elderly and their families.
It is a higher requirement to improve the effective supply of high-quality elderly care services.
Build a digital platform to provide convenient elderly government services, public services, and public welfare services for all types of users at all levels, link market services, and strive to achieve a platform to provide elderly care services, a set of data to control elderly care service resources, and one mobile phone to handle elderly care services. Service business, a map shows the situation of elderly care services, and a set of algorithms assists in intelligent decision-making for elderly care.
Give full play to the advantages of big data, Internet of Things, blockchain and other advantages to strengthen technological support, promote more convenient elderly care services, and promote more accurate financial subsidies.
Do a good job in building a team of certified elderly care workers to ensure that the core indicators play a key role and ensure the effective supply of high-quality elderly care services.
Give full play to the health and wellness complex's advantages in mechanism integration and resource integration to provide high-quality health care services for the elderly.
In addition, take reform and innovation as a way to overcome difficulties.
Use reform and innovative thinking to find solutions to restrict the development of elderly care services, promote the reform of the financial subsidy system, explore the reform of public elderly care institutions, innovate family support policies for the elderly, and solve the problems of elderly care services in remote areas.