Deepening the reform and development of elderly care services is an urgent requirement for implementing the national strategy of actively responding to population aging, an important task for ensuring and improving people's livelihoods, and is related to the well-being of hundreds of millions of people as well as social harmony and stability. In order to accelerate the construction of an elderly care service system that suits China's national conditions and better ensure that the elderly are taken care of, enabling all elderly people to enjoy a happy old age, the following opinions are hereby put forward.

I. General Requirements
Adhere to the guidance of Xi Jinping Thought on Socialism with Chinese Characteristics for a New Era, thoroughly implement the spirit of the 20th National Congress of the Communist Party of China and the second and third plenary sessions of the 20th CPC Central Committee. Adhere to doing what is within our capacity while striving for the best, enhance scientific prediction, make forward-looking arrangements, accelerate the improvement of the elderly care service network, optimize the supply pattern of elderly care services that takes home-based care as the foundation, community-based care as the support, institutional care as the professional support, and combines medical care with elderly care, strengthen the basic elderly care services that focus on the care of disabled elderly people, improve the elderly care service system that is classified by levels, inclusive and accessible, covers both urban and rural areas, and develops continuously, strengthen the promotion of elderly health, promote the expansion and quality improvement of elderly care services, further stimulate the vitality of the development of the elderly care cause and industry, and better meet the multi-level and diversified elderly care service needs of the elderly.

The main goals are as follows: By 2029, the elderly care service network will be basically completed, the service capacity and level will be significantly enhanced, remarkable progress will be made in expanding capacity, improving quality and increasing efficiency, and the supply of basic elderly care services will be continuously optimized; by 2035, the elderly care service network will be more complete, the supply of services will be more coordinated and adapted to the demand, all elderly people will enjoy basic elderly care services, and the elderly care service system that suits China's national conditions will be mature and finalized.

II. Accelerate the Improvement of the Three-Level Elderly Care Service Network Covering Both Urban and Rural Areas
(1) Build a county-level comprehensive elderly care service management platform. Relying on county-level institutions providing support for extremely poor people and the elderly care service information system, build a comprehensive elderly care service management platform. On the basis of assuming the function of providing a basic guarantee, expand and strengthen comprehensive functions such as service demonstration, industry guidance, emergency rescue, and resource coordination, and make overall arrangements to promote the efficient utilization of elderly care service resources in the county. Provincial and municipal elderly care institutions should promote the sinking of high-quality resources, strengthen their roles in providing technical support, demonstration and guidance, and talent cultivation for the county-level comprehensive elderly care service management platform, and promote regional linkage.

(2) Strengthen the construction of the regional elderly care service capacity in townships (sub-districts). Relying on nursing homes in townships (sub-districts), high-quality private elderly care institutions, etc., expand and renovate them into regional elderly care service centers, give play to their roles in professional care, service referral, and resource connection, promote upward and downward linkage, and facilitate the connection between supply and demand. Support localities with conditions to promote the direct management of township (sub-district) nursing homes by county-level civil affairs departments, explore and promote entrusted operation, and improve the quality and efficiency of service management.

(3) Improve the elderly care service facilities and sites in villages (communities). Give play to the leading role of regional elderly care service centers in townships (sub-districts), adopt the mode of "center + site" and other methods, vigorously develop embedded community elderly care service facilities and mutual assistance elderly care service sites, improve the elderly care service facilities in old residential areas, strengthen the comprehensive utilization with public service facilities such as education, health, and culture, and build "elderly and children" service complexes. Give play to the role of facilities and sites in connecting families and social services, and timely collect and refer service needs.

III. Integrate and Coordinate the Three Types of Elderly Care Service Forms of Home-based, Community-based and Institutional Care
(4) Consolidate the fundamental role of home-based elderly care. Improve the elderly care service policies and measures that are accessible and perceptible beside the beds and around the elderly. Improve the family elderly care support policies, explore the construction of family elderly care beds with continuous, stable and professional service functions for home-based disabled elderly people, and carry out training on the care skills of family members of the elderly. Actively cultivate professional service institutions, encourage communities, domestic service and Internet platform enterprises to provide diversified services such as meal assistance, bathing assistance, cleaning assistance, walking assistance, medical assistance, and emergency assistance for the elderly at home, so as to better meet the needs of home-based care services. Accelerate the construction of elderly-friendly residences, promote the aging-friendly transformation of households, support the installation of elevators in old residential areas, and strengthen the construction of barrier-free environments.

(5) Strengthen the supporting role of community-based elderly care. Expand the effective supply of community-based elderly care services and rely on communities to provide strong support for home-based elderly care. Develop embedded community elderly care services, vigorously cultivate professional, chain and branded community elderly care service institutions, integrate surrounding site facilities and other resources, implement the model of "community + property + elderly care service", and enhance the abilities of professional care, day care, rehabilitation nursing, and home-based services. Incorporate community-based elderly care services into the key contents of the construction of urban 15-minute convenient life circles. Explore effective ways to supply elderly care services in old residential areas and promote the construction of complete communities. Explore the implementation of "elderly care consultants" services, and provide professional consultation, entrusted agency and other services for the elderly. The Party committees and neighborhood committees (village committees) in villages (communities) should regard serving the elderly as an important responsibility, master the situation and service needs of the elderly in their jurisdictions, and assist in carrying out elderly care services. Make up for the shortcomings of activity places for the elderly in the community, and carry out cultural, sports and entertainment, social interaction and other activities. Strengthen the visit and care services for lonely and widowed elderly people.

(6) Optimize the professional supporting role of institutional elderly care. According to the service objects and facility conditions, promote the classified reform of elderly care institutions in line with local conditions, and adjust and improve the supply structure. Institutions providing basic guarantee mainly accommodate extremely poor elderly people and disabled elderly people with financial difficulties, etc.; inclusive support-type elderly care institutions are open to all elderly people, and the municipal governments in the districts where they are located shall formulate support measures to strengthen the guidance and management of charges; fully market-oriented elderly care institutions implement full competition, with high quality commanding high prices, to meet the diversified needs of the elderly. Improve the operation mechanism of public elderly care institutions. On the basis of providing a basic guarantee, open up vacant beds to the society, expand inclusive elderly care services, and establish and improve the income management and performance incentive systems. Encourage social forces to newly build or expand and renovate elderly care service facilities, and support the expansion of the supply of high-quality institutional elderly care services through methods such as public construction and private operation. Give full play to the roles of elderly care institutions in technological innovation demonstration, service skill training, and equipment promotion and application, and promote the extension of professional services to home-based and community-based care. Strengthen the care services for disabled and disabled elderly people, focus on increasing the supply of nursing beds, guide elderly care institutions to actively accommodate disabled elderly people, and develop long-term care and care services for elderly people with cognitive impairments. Explore the joint accommodation of "elderly parents + disabled children" families in elderly care institutions or other care institutions, and support elderly care institutions with the ability to accommodate severely disabled people.

(7) Promote the combination of medical care and elderly care. Strengthen the organic combination of medical and health services and elderly care services in aspects such as policy systems, service systems, and business processes, and strengthen disease prevention and control. Strengthen the coordination between elderly care service institutions and medical and health service institutions, strengthen integrated care, improve the stable and smooth two-way transfer green channel, and simplify the referral and medical treatment procedures. According to the needs of medical institutions established within elderly care institutions, grant corresponding prescription rights in accordance with laws and regulations. Encourage elderly care institutions with corresponding medical conditions to carry out hospice care services in accordance with laws and regulations. Strengthen the early identification of high-risk groups of disability and disability prevention among the elderly, and carry out health guidance and comprehensive intervention.

(8) Accelerate the filling of the gaps in rural elderly care services. Expand the supply of rural elderly care services in line with local conditions. Take the development of rural elderly care services as an important part of implementing the rural revitalization strategy, and incorporate rural elderly care service facilities into the township-level territorial space planning or village planning. Vigorously promote mutual assistance elderly care services, and improve the visit and care and emergency rescue service mechanisms for rural left-behind, elderly, disabled, and disabled elderly people. Encourage rural collective economic organizations to develop elderly care services and guide social forces to actively participate. Localities with conditions may develop and set up rural elderly assistance positions in accordance with regulations. Guide urban elderly care service institutions to operate rural elderly care service facilities to promote the balanced development of urban and rural elderly care services.

(9) Strengthen and improve the comprehensive supervision of elderly care services. Improve the standards and evaluation systems for elderly care services. Improve the registration and filing management of elderly care institutions and strengthen the supervision of prepaid fees. Establish and improve the management system for home-based and community-based elderly care services, and improve the supervision mechanisms for elderly care communities. Improve the emergency management system for elderly care services, fully implement the responsibility system for work safety, and 压实 the responsibilities of elderly care service institutions, relevant management departments, local Party committees and governments. Strengthen the quality supervision of elderly products.

IV. Build a Tripartite Coordination Mechanism for the Development of the Elderly Care Service Cause and Industry
(10) Give play to the leading role of the government in the development of the elderly care service cause. Strengthen the government's planning guidance, policy support, organizational guarantee, and supervision and management of elderly care services, and expand the supply of inclusive, basic, and basic guarantee elderly care services. Facilities for basic guarantee elderly care services are mainly constructed and supplied by the government according to the plan. Improve the basic elderly care service list system, optimize service contents, and improve the service supply, evaluation, and dynamic adjustment mechanisms. Establish a mechanism to promote the high-quality development of inclusive elderly care services, increase support for facility construction and venue supply, and vigorously develop inclusive elderly care services that are affordable in price, guaranteed in quality, and sustainable in operation. Improve the comprehensive assessment system for the elderly's abilities, and the assessment results shall be mutually recognized across the country and used by relevant departments as needed. Establish a supply mechanism for elderly care services in the place of permanent residence, improve the mechanisms for the off-site settlement of elderly care service subsidies and the docking of service resources, and promote the integration of elderly care services in the Beijing-Tianjin-Hebei region, the Yangtze River Delta, and the Guangdong-Hong Kong-Macao Greater Bay Area.

(11) Give play to the role of the market in allocating resources in the development of the elderly care service industry. Fully stimulate market vitality, support various market entities to actively participate in elderly care services in accordance with market-oriented principles, improve the social operation mechanism and the evaluation mechanism for the implementation of support policies, and promote the large-scale, clustered, and branded development of the elderly care service industry. Promote the participation of state-owned capital in the development of elderly care services and improve the classified assessment and evaluation. Encourage state-owned enterprises and institutions to revitalize idle assets to carry out elderly care services. For those under entrusted operation, the lease term shall be determined according to the principle of stable business expectations; if the operator has a large investment, the lease term can be appropriately extended. Encourage foreign investment in China's elderly care service industry and enjoy national treatment. Vigorously develop the silver-haired economy, strengthen the research and development and promotion of elderly products, enrich the scenarios of elderly care services, and release the potential of elderly consumption. Develop the market for elderly care tourism, develop new business forms such as health care and elderly care tourism in line with local conditions, and promote the construction of elderly care tourism destinations.

(12) Give play to the role of social participation in elderly care services. Strengthen the function of social mutual assistance and mutual aid, and build a social support pattern for elderly care services led by grass-roots Party organizations, coordinated by grass-roots mass autonomous organizations, and participated by social organizations, social workers, volunteers and other forces. Through methods such as government procurement of services, vigorously cultivate social organizations for elderly care services and grass-roots organizations for the elderly, develop volunteer services for helping the elderly, and explore the establishment of a management system for the time savings of elderly care volunteer services. Encourage the support for the development of elderly care services through means such as the establishment of charitable trusts and social donations. Establish a collaborative development mechanism for elderly education, carry out online and offline elderly education in elderly care service institutions and communities relying on universities for the elderly, and improve the support measures for the development of elderly education by social forces. Actively develop the human resources of the elderly, and create diversified and personalized employment positions suitable for the elderly. Deepen and expand the "Silver Age Action", encourage the elderly to participate in the implementation of the rural revitalization strategy and civilized practice activities in accordance with regulations. Smooth the green channels for the elderly to obtain legal aid and notarization services, and explore the establishment of an implementation mechanism for the intended guardianship of the elderly.

V. Strengthen the Powerful and Effective Factor Guarantee for Elderly Care Services
(13) Make scientific plans for the layout of elderly care service facilities. According to the degree of population aging and changes in the demand for elderly care services, gradually increase the proportion of land used for elderly care service facilities or increase the spatial arrangements for elderly care service facilities. Implement the requirements for the simultaneous planning, construction, acceptance, and delivery of new residential communities and supporting elderly care service facilities, incorporate elderly care service facilities into the project support, strictly manage the planning and approval, and ensure that new residential communities are equipped with elderly care service facilities according to the standards and transferred in a timely manner according to the agreements. Promote the construction of county-level activity centers for the elderly and expand the functions of serving the elderly. Support the conversion of idle public service resources into elderly care service facilities. Provincial governments should guide cities and counties to solve problems such as planning adjustments, changes in the use nature of land and real estate, fire protection renovation, and the handling of fire protection inspection and acceptance procedures in accordance with laws and regulations. Scientifically determine the standards for fire protection, earthquake resistance and other aspects of elderly care service facilities.

(14) Improve relevant policies on financial support. All localities should increase their support for elderly care services according to their economic development levels and the degree of population aging. In accordance with the relevant principles for dividing the financial powers and expenditure responsibilities between the central and local governments, strengthen the guarantee of funds for basic elderly care services. The central budgetary investment actively supports the construction of the elderly care service system. Accelerate the establishment of a long-term care insurance system, reasonably determine the coverage and subsidy standards of nursing subsidies for disabled elderly people with financial difficulties, and do a good job in the connection between the long-term care insurance and policies such as nursing subsidies for elderly people with high ages and disabilities and financial difficulties. Conduct innovation pilot projects for the county-level elderly care service system, and support pilot areas to optimize resource allocation. For elderly care service institutions that meet the conditions, implement policies such as tax incentives and the implementation of residential living prices for water, electricity, gas and heat in accordance with the current relevant regulations. If water, electricity, gas and heat do not have the conditions for separate metering for the time being, billing methods such as fixed quantity and fixed proportion can be adopted. Encourage providing support such as rent reduction and exemption for community-based elderly care service institutions.

(15) Strengthen the construction of the elderly care service talent team. Research and establish an evaluation system for professional and technical talents in elderly care services, standardize the occupation settings in the field of elderly care services, and improve the attractiveness of the elderly care nursing occupation. Establish and improve the career conversion channels between skilled talents and professional and technical talents, and build a skill post evaluation and appointment system that is connected with skill levels. Localities with conditions can explore the pilot projects of publicly funded training for majors related to elderly care services in vocational schools, and after graduation, they will be employed in a market-oriented and socialized manner. Allocate social workers reasonably according to the number of the elderly population. Guide elderly care service institutions to improve the salary distribution methods and give preference to front-line staff. Increase the intensity of vocational skill training and pre-job training for elderly care nurses, elderly ability assessors and other occupations, strengthen and standardize the level recognition and evaluation management, strengthen the construction of professional ethics, and improve the system of employment prohibition in accordance with the law.

(16) Vigorously develop elderly care finance. Through channels such as local government special bonds, support the construction of elderly care service infrastructure that meets the conditions, and actively meet the credit financing needs of elderly care service institutions. Increase the support of government financing guarantee and re-guarantee institutions for loans to small and micro enterprises in the elderly care service industry. Support eligible elderly care projects to issue real estate investment trust funds in the infrastructure field. Expand the trust business of elderly care services, and promote commercial health insurance products that include long-term care responsibilities and health management.

(17) Accelerate the development and application of elderly care technology and information. Research and set up major national science and technology projects related to elderly care services, focus on promoting the research, development and application of technological products such as humanoid robots, brain-computer interfaces, and artificial intelligence. Deepen the national demonstration of smart health and elderly care applications, promote intelligent home furnishings and smart health products, and explore the implementation of early warning and prevention services for home-based elderly care safety risks. Improve the national unified elderly care service information platform to promote the docking of elderly care service supply and demand. Make overall arrangements for the national population census, sample surveys and other work, form a unified database of the elderly and elderly care services, and strengthen the connection with the national basic population information database.

VI. Strengthen Organizational Implementation
Local Party committees and governments at all levels should strengthen organizational leadership, attach great importance to the work of elderly care services, and incorporate the construction of the elderly care service system into the economic and social development plans and important agendas. Party committees of townships (sub-districts) and Party organizations of villages (communities) should regard elderly care services as an important part of connecting with the masses, and guide various organizations to jointly do a good job in elderly care services. Civil affairs departments should strengthen overall coordination, work with relevant departments to improve relevant policies for the reform and development of elderly care services, and improve the supervision and evaluation systems.（Outlook New Era）