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In Sweden, responsibility for the public care of the frail elderly rests with three authorities acting at different levels. At national level, the Riksdag and the Government realize policy goals through legislation and financial control measures. At regional level, 18 county councils and two regions are responsible for the provision of health and medical care. At local level, Sweden's 290 municipalities have a statutory duty to meet the social service and housing needs of the elderly. Sweden's municipalities and county council have a high level of autonomy by international standards. Activities in caring services are ultimately controlled by politicians appointed to policy-making assemblies in municipalities and county councils through general elections. The decentralization of responsibility for elderly care makes it possible for local and regional conditions to be taken into account when policies for the elderly are formulated. The national authorities – the National Board of Health and Welfare and the 20 county/region administrative boards – are responsible for supervision, follow-up, and evaluation of municipal and county council caring services.