Since fiscal year 2006, Japan has mandated that municipalities establish comprehensive community support centers (CCSCs). With an aging population, the trend toward establishing further CCSCs, especially in small- and medium-sized municipalities, has become conspicuous in recent years. This study examines the cases of Suzuka City and Kameyama City, Mie Prefecture, for an examination and detailed elucidation of how the areas served by CCSCs were demarcated, how each CCSC’s location was decided, the processes through which area reorganization has subsequently been implemented in response to an aging population, based on documents and interviews with various actors, such as local governments and social welfare corporations.

Initial budgetary restrictions were implemented in fiscal 2006, and few corporations were willing to manage centers. Therefore, “four areas in Suzuka City and one area in Kameyama City” were designated for implementing the system. Subsequent changes consisted entirely of the partial segmentation of these areas through the establishment of sub-centers and the creation of multilayered functions. However, changes in demand as the population aged and in supply as new corporations were established and existing ones expanded their business, thus resulting in enhanced functions when the areas were reorganized in fiscal 2021 (with “eight areas in Suzuka City and two areas in Kameyama City”). Nonetheless, area reorganization and the establishment of new CCSCs do not guarantee the creation of an effective community-based integrated care system, given the remaining challenges, including outsourcing the management of core CCSCs to social welfare councils and not utilizing the capabilities of cities as key players.