To accelerate the high-quality development of elderly care services across the city, this Action Plan has been formulated in accordance with the requirements of the “Joint Supervision Plan on Actively Addressing Population Aging and Accelerating the Development of Elderly Care Services” issued by the Standing Committee of the Henan Provincial People’s Congress and the “Three-Year Supervision Plan (2024–2026) on Promoting the Accelerated Development of Elderly Care Services” issued by the Standing Committee of the Zhoukou Municipal People’s Congress, and in light of the actual conditions of our city.
I. Guiding Principles
Guided by Xi Jinping Thought on Socialism with Chinese Characteristics for a New Era, we will fully implement the spirit of the 20th National Congress of the Communist Party of China,we adhere to a people-centered development philosophy. Taking the satisfaction of the multi-level and diverse elderly care service needs of the elderly as our starting point and ultimate goal, we will focus on promoting the development of home-based and community-based elderly care services, advancing the integrated development of medical care and elderly care, and enhancing the quality, efficiency, and standardization of elderly care services. We aim to comprehensively improve the level of elderly care services in our city, effectively meet the high-quality and differentiated elderly care service needs of the elderly, and ensure that the elderly are provided for, receive medical care, have access to learning opportunities, and enjoy a fulfilling life.
II. Basic Principles
(1) Prioritize Basic Needs and Coordinate Development.Comprehensively safeguard the basic elderly care service needs of vulnerable groups, including those in extreme poverty, the elderly, those living alone, and those with full or partial loss of self-care ability, ensuring that everyone enjoys basic elderly care services. Coordinate home-based, community-based, institutional, and mutual-aid elderly care to form a reasonable hierarchy; integrate elderly care services with medical services and other specialized services to achieve a reasonable division of labor and organic integration; coordinate various elderly care service policies and measures to create a synergistic policy effect; and coordinate urban and rural elderly care resources to promote the equalization of basic elderly care services across urban and rural areas.
(2) Adhere to a systemic approach and pursue balanced development. Optimize the allocation of system resources to promote the standardization of elderly care facilities, the standardization of service content, the informatization of service delivery methods, and the professionalization of personnel across all counties (cities, districts). Simultaneously enhance the hardware and software infrastructure of the elderly care service sector to foster an open, transparent, competitive, and dynamic environment for elderly care services.
(3) Addressing Weaknesses to Improve Quality and Efficiency. Advance supply-side structural reforms, focusing on addressing shortcomings in the elderly care service system—particularly in universal elderly care, rural elderly care, and the integration of medical, elderly care, and rehabilitation services. Shift the focus from quantity and scale to quality and efficiency; from increasing general beds to increasing nursing beds; from hardware construction to improving software infrastructure; and from general services to specialized, targeted, emergency, and seamless care services.
III. Development Goals
Phase One: Tackling Difficult Challenges. In 2024, the focus will be on resolving key challenges in facility construction, funding guarantees, and the implementation of policy support.We will thoroughly carry out a special campaign to ensure the construction and completion of elderly care facilities in urban residential areas, ensuring that issues involving facilities planned but not built, or built but not handed over, are resolved, and addressing issues where facilities should have been planned but were not through categorized management. We will identify challenges in securing subsidy funds for the elderly care sector, as well as in implementing supportive policies such as tax incentives, preferential treatment for supporting facilities, subsidies for staff, and the allocation of public welfare positions. We will formulate specific implementation measures to ensure that the funding guarantees and supportive policies stipulated by national, provincial, and municipal regulations are fully implemented in our city.Actively develop meal assistance services for the elderly, achieving coverage of 40% of urban communities and 10% of administrative villages across the city, with each township (subdistrict) having at least one senior canteen capable of providing meal delivery services.
Phase Two: Consolidation and Standardization. By 2025, fully achieve the development goals set forth in the national, provincial, and municipal 14th Five-Year Plans. Ensure a 100% compliance rate for the construction of elderly care facilities in new urban areas and newly developed residential (small) communities; increase the total number of elderly care beds to 67,000; complete aging-friendly renovations for 25,400 households of elderly individuals with special difficulties; establish 67 elderly care skills training stations (training labs);and one training base for elderly care professionals will be established; the network of meal assistance services for the elderly in urban and rural communities will be further improved, with a significant increase in the convenience and satisfaction of elderly diners; the monthly visitation rate for elderly individuals with special difficulties will reach 100%; all county-level institutions providing support services for persons in extreme poverty will offer integrated medical and elderly care services; 60% of township-level support facilities for persons in extreme poverty (nursing homes) will be transformed into regional elderly care service centers; and 102 standardized village-level elderly care service stations will be established;At least one health and elderly care project will be established in each county (city, district); the proportion of general hospitals at or above the secondary level establishing geriatric medicine departments will reach 60%; the rate of standardized health management services for urban and rural community residents aged 65 and older will reach 65%; and the rate of traditional Chinese medicine health management for those aged 65 and older will reach 75%;Enrollment in elderly care-related programs at undergraduate universities and vocational colleges has seen significant growth; there is at least one social worker for every 1,000 elderly people; and every county (city, district) has established at least one senior citizens’ university.
Phase Three: Breakthrough and Enhancement.By 2026, the supply of elderly care services will be of higher quality. Elderly care facilities at the subdistrict and community levels will provide strong support for home-based care, while the scope of home-based and community-based care services will continue to expand. Rural elderly care facilities linking the county, township, and village levels will become more comprehensive, and urban and rural elderly care services will develop in a balanced manner. All elderly care institutions will be able to provide basic medical and health services to residents in various forms. The professional nursing workforce will grow steadily, comprehensive care capabilities will be significantly enhanced, and the quality of elderly care services will continue to improve.The government, the market, families, and social forces will fully leverage their respective roles. The government’s functions in public elderly care services will be further expanded; market entities will gradually mature; various social forces will participate collectively; the foundational role of family-based care will be increasingly consolidated; and the elderly care service mechanism—guided by the government, involving society, and operated by the market—will be continuously improved.The market for senior products will see improved quality and expanded scale; health and wellness services will integrate deeply with sectors such as ecology, tourism, and real estate; and new technologies, business models, and industries will continue to emerge. A range of health and wellness venues—including wellness towns, wellness parks, and rural complexes—will be established. This will foster the development of influential, competitive, and branded health and wellness service enterprises with multi-sector integration, as well as industrial clusters characterized by long supply chains, broad coverage, and significant economic and social benefits.
IV. Division of Responsibilities
(1) Implement the Action Plan to Expand and Enhance Home-Based and Community-Based Services.
1. Actively develop meal assistance services for the elderly. In accordance with the goal of “establishing demonstration projects within one year and achieving tangible results within three years,” formulate specific plans for the development of meal assistance services for the elderly. Fully leverage market mechanisms and adopt various approaches—such as utilizing existing facilities, expanding the reach of meal distribution centers, and implementing chain-style operations by enterprises—to increase the supply of meal assistance services through multiple channels. This will help build a meal assistance service system for the elderly that covers both urban and rural areas, is convenient and accessible, and is sustainable.(Lead Agency: Municipal Bureau of Civil Affairs; Responsible Agencies: Municipal Development and Reform Commission, Municipal Human Resources and Social Security Bureau, Municipal Bureau of Natural Resources and Planning, Municipal Bureau of Agriculture and Rural Affairs, Municipal Finance Bureau, Municipal Bureau of Housing and Urban-Rural Development, Municipal Bureau of Commerce)
2. Strengthen service guarantees for elderly individuals with special difficulties. Implement a home adaptation project for elderly individuals with special difficulties, providing renovation subsidies to eligible households. Improve visitation and care services for elderly individuals with special difficulties and refine the mechanisms for such services.Implement centralized care services for economically disadvantaged elderly individuals. Leverage the incentive and guiding role of fiscal funds to provide assistance to economically disadvantaged elderly individuals with disabilities who reside in elderly care institutions. Additionally, provide appropriate subsidies to elderly care institutions that admit such individuals based on performance evaluation results, thereby gradually enhancing the capacity for centralized care services for economically disadvantaged elderly individuals with disabilities. Initially meet the demand for centralized care services among economically disadvantaged elderly individuals with disabilities who wish to reside in elderly care institutions, and significantly alleviate the burden of family care.(Lead Agency: Municipal Bureau of Civil Affairs; Responsible Agencies: Municipal Finance Bureau, Municipal Bureau of Housing and Urban-Rural Development, Municipal Health Commission, Municipal Federation of Disabled Persons)
3. Ensure planning and land use guarantees. Strengthen the coordinating role of territorial spatial planning, standardize the formulation of land supply plans for elderly care facilities, rationally plan the spatial layout of such facilities, and enhance supervision over their planning and land use to effectively guarantee land allocation for elderly care facilities. (Lead Agency: Municipal Bureau of Natural Resources and Planning; Responsible Agencies: Municipal Bureau of Civil Affairs)
4. Address Shortfalls in Elderly Care Facilities in Residential Communities. New residential communities shall include elderly care facilities in accordance with the principles of simultaneous planning, construction, inspection, and delivery. For existing residential communities without elderly care facilities, or in older urban areas where current facilities fail to meet planning and construction standards, ensure the supply of elderly care facilities through new construction, renovation, expansion, purchase, exchange, or leasing, and address shortfalls in elderly care facilities in existing urban residential areas based on local conditions.(Lead Agency: Municipal Bureau of Housing and Urban-Rural Development; Responsible Agencies: Municipal Bureau of Natural Resources and Planning, Municipal Bureau of Civil Affairs)
5. Enhance the functionality of community elderly care facilities. Each sub-district comprehensive elderly care service center shall have a floor area of no less than 2,000 square meters and provide no fewer than 50 beds, possessing a strong capacity for social elderly care services, and shall operate community day care centers through a “large-to-small” model.All community elderly care service facilities across the city shall meet the standard of no less than 200 square meters in area, with a focus on providing daytime care for the elderly, and extending to offer the “Six Assistance, One Patrol, and One Care” services—including meal assistance, bathing assistance, cleaning assistance, medical assistance, emergency assistance, mobility assistance, patrols, and nursing care—to elderly residents living at home. (Lead Agency: Municipal Bureau of Civil Affairs; Responsible Agencies: Municipal Bureau of Natural Resources and Planning, Municipal Bureau of Housing and Urban-Rural Development)
(2) Implement the Rural Elderly Care Upgrading and Standardization Initiative.
6. Enhance the service capacity of county-level institutions for the support of persons in extreme poverty. Continuously improve the physical facilities of county-level institutions for the support of persons in extreme poverty, increase the supply of nursing beds, and enhance the safety net and service quality of these institutions to provide standardized centralized care services for elderly persons in extreme poverty who are either fully or partially incapacitated. (Lead Agency: Municipal Bureau of Civil Affairs; Responsible Agencies: Municipal Development and Reform Commission, Municipal Health Commission)
7. Promote the transformation and upgrading of township nursing homes. Facilitate the transformation of 103 township nursing homes into regional elderly care service centers, each with an area of at least 2,000 square meters and a capacity of at least 60 beds. While meeting the centralized care needs of the destitute in the township, these centers will provide care services to elderly individuals in the community who are incapacitated, partially incapacitated, disabled, or without caregivers, and will gradually extend services such as meal assistance, bathing assistance, and assistive device rentals to surrounding rural areas and households.(Lead Agency: Municipal Civil Affairs Bureau; Responsible Agency: Municipal Health Commission)
8. Accelerate the construction of village-level elderly care facilities. Establish 102 standardized village-level elderly care service centers, with one independent facility set up in each central village or densely populated village. These centers will primarily provide mutual aid for the elderly, day care, residential care, and meal preparation and delivery services. (Lead Agency: Municipal Bureau of Civil Affairs; Responsible Agencies: Municipal Health Commission, Municipal Bureau of Rural Revitalization, Municipal Bureau of Agriculture and Rural Affairs, Municipal Bureau of Commerce)
9. Guide the aggregation and development of multi-source resources. Vigorously develop rural mutual-aid elderly care and establish sound mechanisms for volunteer service savings, rewards, incentives, and evaluation. Support public welfare and charitable organizations in conducting targeted fundraising, charitable trusts, and other public welfare activities centered on the elderly care needs of rural seniors, and in establishing care service projects.Villages with the necessary conditions may allocate a certain proportion of collective economic revenues—such as those from land transfers and the leasing or transfer of collective operational construction land—through internal democratic procedures of the village collective organization to support the elderly care service needs of the village’s residents. (Lead Agency: Municipal Bureau of Civil Affairs; Responsible Agencies: Municipal Bureau of Natural Resources and Planning, Municipal Bureau of Agriculture and Rural Affairs)
(3) Implement the Action Plan to Enhance the Quality and Capabilities of Integrated Medical, Elderly Care, and Wellness Services.
10. Promote the integration of medical and elderly care services in institutions. Each county (city, district) shall have at least one county-level special-needs care facility (nursing home) that primarily provides professional care for disabled and partially disabled individuals in extreme poverty and possesses integrated medical and elderly care functions.Promote the coordinated planning and adjacent construction of township health centers and nursing homes, as well as village clinics and rural care centers, to achieve localized medical and elderly care integration. In accordance with established procedures, incorporate medical and health institutions within eligible elderly care facilities into the designated medical insurance provider system, and include eligible medical service items within the scope of medical insurance coverage to reduce the medical burden on the elderly. (Lead Agency: Municipal Health Commission; Responsible Agencies: Municipal Civil Affairs Bureau, Municipal Medical Insurance Bureau)
11. Strengthen health management for the elderly. Establish unified and standardized electronic health records for the elderly, include them in the priority groups for family doctor contract services, and ensure standardized management and health services for the elderly. (Lead Agency: Municipal Health Commission; Responsible Agency: Municipal Medical Insurance Bureau)
12. Promote Traditional Chinese Medicine (TCM) technologies, products, and services. Promote the integration of TCM into households, communities, and care facilities to better meet the health and wellness needs of the elderly. (Lead Agency: Municipal Health Commission; Responsible Agency: Municipal Medical Insurance Bureau)
(IV) Implement the Elderly Care Talent Development and Training Initiative.
13. Strengthen talent development. Develop training plans based on the standard of one social worker per 1,000 elderly residents, and train no fewer than 5,000 care workers annually.Achieve a 100% training-to-employment rate for skilled and managerial personnel, and ensure comprehensive training coverage for facility directors. Through government-purchased services and other means, conduct skill training activities for elderly care personnel in communities and households, providing free caregiving training to family members of the elderly, with the goal that at least one member of each elderly person’s household receives elderly care training and is familiar with basic services. (Lead Agency: Municipal Civil Affairs Bureau; Responsible Agencies: Municipal Human Resources and Social Security Bureau, Municipal Health Commission)
14. Improve the talent education and training system. Guide vocational schools and technical schools to offer majors in elderly care services and management, nursing, geriatric nutrition, and the manufacturing of rehabilitation aids and assistive devices, and include these in the scope of vocational education support programs. Additionally, select elderly care talent training bases from universities, vocational schools, and technical schools. (Lead Agency: Municipal Bureau of Civil Affairs; Responsible Agencies: Municipal Bureau of Education and Sports, Municipal Bureau of Human Resources and Social Security)
(V) Implement the Action Plan for Accelerating the Development of the Elderly Care Industry.
15. Promote integrated development. Support the mutual penetration and convergence of the elderly care service industry with other sectors, and promote the integrated development of the health and elderly care industry with manufacturing, software and information technology, cultural tourism, education and training, and sports and health industries, to improve the efficiency of resource allocation and maximize the overall effectiveness of resources.(Lead Agency: Municipal Development and Reform Commission; Responsible Agencies: Municipal Bureau of Industry and Information Technology, Municipal Science and Technology Bureau, Municipal Bureau of Culture, Radio, Television, and Tourism, Municipal Bureau of Education and Sports, Municipal Bureau of Human Resources and Social Security)
16. Develop the Silver Economy. Promote the standardized development of industries closely related to the lives of the elderly. Vigorously develop the rehabilitation and assistive devices industry, strengthen innovation in products for the elderly, and support enterprises in researching and developing products and services for the elderly. Cultivate leading enterprises in the silver economy sector. Improve service facilities such as hotels and homestays that cater to both the young and the elderly and are family-friendly, and encourage the development of family-oriented tourism products. Strengthen market supervision of products for the elderly, optimize market competition order and the consumer environment, and continuously meet the diverse and multi-level consumption needs of the elderly.(Lead Agency: Municipal Bureau of Industry and Information Technology; Responsible Agencies: Municipal Development and Reform Commission, Municipal Science and Technology Bureau, Municipal Market Regulation Bureau)
17. Strengthen brand cultivation. Encourage and guide elderly care service enterprises and institutions to prioritize meeting the basic service needs of the elderly, expand various elderly care services and consumer products tailored to the characteristics of the elderly, cultivate innovative and exemplary brands in elderly care services, and form a group of industrial clusters with long industrial chains, broad coverage, and significant economic and social benefits. (Lead Agency: Municipal Bureau of Civil Affairs; Responsible Agencies: Municipal Bureau of Commerce, Municipal Market Regulation Bureau)
(VI) Implement the Comprehensive Supervision Enhancement Initiative.
18. Strengthen management of prepaid funds. Implement elderly care service fees in accordance with relevant national and local price management regulations, and establish dedicated accounts to hold prepaid funds and deposits collected by elderly care institutions. The civil affairs department shall conduct annual supervisory inspections of prepaid funds and deposits collected by elderly care institutions to prevent and mitigate the risks of illegal fundraising in the elderly care sector, ensure the safe management and use of funds, and protect the legitimate rights and interests of the elderly.(Lead Agency: Municipal Development and Reform Commission; Responsible Agencies: Zhoukou Regulatory Branch of the China Banking and Insurance Regulatory Commission, Zhoukou Branch of the People’s Bank of China, Municipal Bureau of Civil Affairs)
19. Strengthen supervision of operational order. Guide elderly care service providers to establish and improve systems for internal management, dispute mediation, and service quality assessment; strictly investigate and punish illegal acts involving the fraudulent sale of various products and services to the elderly; widely carry out public education campaigns to help the elderly recognize and prevent fraud; and strictly investigate and punish, in accordance with laws and regulations, acts by elderly care service providers that infringe upon the legitimate rights and interests of the elderly, such as fraud and abuse.(Lead Agency: Municipal Bureau of Civil Affairs; Responsible Agencies: Municipal Public Security Bureau, Municipal Market Regulation Bureau, Municipal People’s Court, Municipal People’s Procuratorate)
20. Strengthen supervision of safety and service standards. Enhance quality and safety oversight by establishing a comprehensive system of daily monitoring indicators and a dynamic evaluation mechanism for elderly care service quality; intensify the identification of safety risks and hazards, guiding elderly care service providers to fulfill their safety responsibilities and proactively prevent and eliminate such risks and hazards; guide elderly care service providers in developing emergency response plans for natural disasters, accidents, public health incidents, and other emergencies, thereby enhancing their risk prevention awareness and response capabilities.(Lead Agency: Municipal Civil Affairs Bureau; Responsible Agencies: Municipal Housing and Urban-Rural Development Bureau, Municipal Market Regulation Bureau, Municipal Health Commission, Municipal Emergency Management Bureau, Municipal Fire and Rescue Detachment)
V. Support Measures
(1) Strengthen Organizational Leadership. Relevant departments at all levels shall incorporate the high-quality development of elderly care services into their performance evaluation systems. They shall actively establish a working mechanism featuring Party committee leadership, government responsibility, interdepartmental coordination, and social participation, regularly addressing major issues arising during implementation to ensure effective implementation.
(2) Strengthen Policy Support. Municipal and county-level governments shall establish special funds for elderly care services. Lottery public welfare funds allocated for social welfare at all levels shall be prioritized, with no less than 55% of such funds directed toward supporting the development of elderly care services. Optimize subsidy policies for municipal and county-level special funds for elderly care services, focusing on projects such as the operation of elderly care institutions and community care facilities, meal assistance for the elderly, care services for elderly individuals with disabilities facing financial hardship, the cultivation of chain-based elderly care service brands, and the development of the elderly care service workforce.
(3) Strengthen Dynamic Evaluation. Establish a monitoring, analysis, and implementation evaluation mechanism for the Three-Year Action Plan for High-Quality Development of Elderly Care Services, and conduct statistical monitoring and evaluation. The Municipal Bureau of Civil Affairs, in conjunction with relevant departments, will strengthen guidance for counties (cities, districts), promptly identify issues, and urge their rectification. Counties (cities, districts) shall, in accordance with the requirements of this Action Plan and based on local conditions, refine relevant indicators and advance the implementation of tasks.
