In fiscal year 2022, an amendment to the Comprehensive Support Law for Persons with Disabilities was enacted on December 10, 2022, and will be implemented starting April 1, 2024.
The Comprehensive Support Law for Persons with Disabilities is reviewed every three years, but how has it changed with this amendment?
In this article, we will explain the basic knowledge of the Comprehensive Support Law for Persons with Disabilities and the six main points of the recent amendment.
The amendment also includes changes related to businesses providing welfare services and those involved in employing persons with disabilities, so it is important for related companies as well as individuals with disabilities to fully understand these changes.
1. What is the Comprehensive Support Law for Persons with Disabilities?
The Comprehensive Support Law for Persons with Disabilities is a social welfare law designed to provide comprehensive support for the daily and social lives of persons with disabilities.
Officially, it is called "The Law for Comprehensive Support for the Daily and Social Lives of Persons with Disabilities," but it is abbreviated as the Comprehensive Support Law for Persons with Disabilities for simplicity.
From its enactment in fiscal year 2006 until the amendment on April 1, 2012, it was known as the "Law for Supporting the Independence of Persons with Disabilities."
However, the initial law lacked basic principles and had vague criteria for determining the necessity of welfare services, leading to issues such as individuals having to pay more than their income.
Particularly, those receiving disability pensions, who previously had no out-of-pocket expenses, began to bear 10% of the cost under the law, leading to reduced use of welfare services.
In 2010, these issues were addressed by amending the law to align out-of-pocket expenses with income.
In 2013, the law was further amended to emphasize the removal of social barriers and respect for the human rights of persons with disabilities, including those with intractable diseases, leading to the establishment of the current "Comprehensive Support Law for Persons with Disabilities."
2. The Purpose of the Amendment is to Strengthen and Expand Support for Community Living and Employment for Persons with Disabilities
The amendment to the Comprehensive Support Law for Persons with Disabilities was submitted as the "Amendment Bill for the Comprehensive Support Law for Persons with Disabilities" at the 210th National Diet session held on October 26, 2022.
The main objectives of this amendment are structured around the following three pillars:
- Realization of the community society desired by persons with disabilities
- Support systems tailored to the needs of persons with disabilities
- Review of sustainable and high-quality disability welfare services
Specific content includes strengthening the system to support community society for persons with disabilities and improving the quality of employment and work according to diverse needs by disability.
In terms of healthcare, it also includes strengthening support for welfare services that enable appropriate therapeutic living for children with disabilities and patients with intractable diseases, as well as organizing information databases related to disabilities.
More detailed content is explained in the following sections, but this amendment can be seen as addressing previously problematic employment and support systems.
The amendment is set to be implemented from April 1, 2024, with some exceptions, as decided by the Cabinet.
3. Six Key Points of the Comprehensive Support Law for Persons with Disabilities Established in 2022
Building on the three pillars explained in the previous section, the Comprehensive Support Law for Persons with Disabilities includes several specific amendment points.
The key points of the newly established "Comprehensive Support Law for Persons with Disabilities" can be broadly divided into the following six areas:
- Strengthening the support system for persons with disabilities to live safely in the community
- Improving the quality of employment for persons with disabilities and providing support tailored to their needs
- Support systems tailored to the hopes and needs of persons with mental disabilities
- Providing appropriate medical care and strengthening support for therapeutic living for patients with intractable diseases and specific diseases
- Organizing databases for disability welfare services and diseases
- Introducing disability welfare services based on regional needs
We will explain each point in an easy-to-understand manner.
3-1. Strengthening the Support System for Persons with Disabilities to Live Safely in the Community
The specific content here includes the following two points:
- Promoting the continuation and realization of community living desired by group home users
- Organizing support systems for those with mental disabilities
Group homes are facilities where elderly or disabled individuals who need care live together while receiving support.
According to a survey by the Ministry of Health, Labour and Welfare, the number of group home facilities has been increasing annually, from 675 in 2000 to 13,114 in 2016.
The occupancy rate is high at an average of 97.5%, with an average of 6.87 people waiting per facility.
Reference: 20th Social Security Council | Ministry of Health, Labour and Welfare
On the other hand, some persons with disabilities wish to live alone.
Therefore, this amendment clarifies the support content for those wishing to live alone, in addition to supporting group home residents.
For example, if residing in a group home, support such as household chores and living assistance necessary for living alone is clarified, and after leaving, regular consultation support is provided.
For persons with mental disabilities, efforts such as establishing bases in each municipality and sharing information with regional councils are mandated.
Additionally, it has been decided to add mental health consultation assistance to the duties of mental health welfare workers.
3-2. Improving the Quality of Employment for Persons with Disabilities and Providing Support Tailored to Their Needs
The specific support measures here include the following three points:
- Implementing employment support in line with the individual's wishes and abilities
- Expanding employment opportunities to allow for short working hours
- Reviewing disability employment adjustment funds
A new service (employment selection support) will be established to support choices that match the hopes, work abilities, and aptitudes of persons with disabilities.
For example, Hello Work will provide vocational guidance based on this service.
Additionally, even for persons with disabilities who work particularly short hours, if they work 10 hours or more per week, they can be counted towards the company's employment rate.
This will expand opportunities for those with mental disabilities, severe physical, and severe intellectual disabilities who can only work short hours.
Furthermore, with the review of disability employment adjustment funds, the amount of adjustment funds and rewards paid when employing a certain number of persons with disabilities has been revised, and new subsidies have been established to support employer initiatives, strengthening support for disability employment.
3-3. Support Systems Tailored to the Hopes and Needs of Persons with Mental Disabilities
The specific examples here include the following three points:
- Reviewing medical protection hospitalization
- Establishing an inpatient visit support project
- Strengthening efforts to prevent abuse in psychiatric hospitals
Among mental disabilities, there are patients who become subjects of medical protection hospitalization due to decreased judgment ability.
The current medical protection hospitalization has been reviewed, and even without family consent or expression of intent, it has been amended to allow for medical protection hospitalization with the consent of the municipal mayor while respecting the individual's will.
Additionally, support towards discharge with a set hospitalization period will be strengthened.
The second "inpatient visit support project" involves providing regular external consultation support for patients under medical protection hospitalization.
Specifically, consultants visit the psychiatric ward where the patient is hospitalized, listen carefully to the patient, and provide necessary guidance.
Additionally, efforts to prevent abuse in psychiatric hospitals include mandatory training for staff and strengthening systems to allow immediate reporting by managers if abuse is discovered.
Facilities and medical institutions that have taken measures against abuse will be publicly disclosed by the national and prefectural governments.
3-4. Providing Appropriate Medical Care and Strengthening Support for Therapeutic Living for Patients with Intractable Diseases and Specific Diseases
Children battling chronic illnesses from a young age and those with intractable diseases are also included in the recent amendment to the Comprehensive Support Law for Persons with Disabilities.
The main content includes the following three points:
- Reviewing the system to smoothly receive medical expense support during worsening conditions
- Strengthening support for therapeutic living
- Strengthening self-support for children with chronic specific diseases
Medical expenses for those with intractable diseases or specific diseases are covered by medical expense support, but there have been delays in creating medical certificates and determining grant recognition.
However, with this amendment, the time to receive medical expense support has been significantly shortened, reducing economic anxiety and allowing patients to focus on treatment.
Additionally, to widely recognize necessary medical and employment support for patients with intractable diseases, linking with My Number and registering disease information provides the advantage of smoother service application.
The creation of the "actual condition grasping project" to understand the actual conditions of specific disease children and their guardians in the region, and to analyze and address issues, has been established as an effort obligation, allowing for the implementation of projects tailored to individual needs.
3-5. Organizing Databases for Disability Welfare Services and Diseases
The implementation and organization of legal grounds for databases have progressed in fields such as medical insurance (NDB) and nursing care insurance (Care DB), but organization is also necessary in the fields of welfare disabilities and intractable diseases.
This amendment also reviewed the database.
The key points include the following three aspects:
- Establishing legal grounds for databases on persons with disabilities, children with disabilities, intractable diseases, and chronic specific diseases
- Establishing new rules for safety management measures and third-party provision, enabling linked analysis with other public databases
- Allowing registration of patients with mild designated intractable diseases
The first point involves the national government collecting data from a legal perspective to determine whether a particular disability or disease qualifies for assistance or benefits.
Additionally, new rules have been established to link with other public databases, allowing for safer data handling.
Furthermore, by allowing patients with mild designated intractable diseases who were not previously eligible for medical expense support to register, the scope of registrants is expanded.
3-6. Introducing Disability Welfare Services Based on Regional Needs
This amendment reviewed the following two points:
- Municipalities can express opinions on the designation of service providers for day care, home visits, and child services by prefectures
- Adding nursing care insurance facilities to the residence special case targets
Previously, the designation of service providers was solely determined by the prefecture, but the lack of organization to meet regional needs was an issue.
By newly allowing municipalities to attach opinions or conditions to the designation of service providers, welfare services that meet regional needs can now be provided.
If conditions are violated, the prefecture can issue recommendations or revoke the designation of the business.
Additionally, rules have been included to add nursing care insurance facilities to the residence special case targets.
The residence special case system is a system where, when persons with disabilities enter a facility, the municipality where they lived before entering the facility handles the decision to provide disability welfare services to reduce the financial burden on the region.
Under the current Comprehensive Support Law for Persons with Disabilities, the special case does not apply to nursing care insurance facilities, increasing the burden on the municipality where the facility is located, but with this amendment, financial burden can be distributed.
4. Welfare Services Related to the Comprehensive Support Law for Persons with Disabilities
So far, we have explained the welfare services related to the Comprehensive Support Law for Persons with Disabilities, which can be broadly divided into two categories: "Self-Support Benefits," which partially cover the costs of support services used by persons with disabilities, and "Community Life Support Projects," which are led by each region to support persons with disabilities.
Here, we will explain the specific content of these services.
4-1. Self-Support Benefits
Self-support benefits are a system that provides necessary disability welfare services to enable persons with disabilities to lead independent daily or social lives.
Self-support benefits are classified into the following five disability welfare services.
| Name of Benefit | Example of Service |
| Care Benefits | Severe Home-Visit Care, Accompanied Support, Short-Term Stay (Short Stay), Life Care |
| Training Benefits | Self-Reliance Training, Employment Transition Support, Employment Continuation Support Type A & B, Employment Retention Support |
| Service Use Plan Creation Cost Grant | *Support plan services tailored to persons with disabilities |
| Self-Support Medical Expense Grant | Rehabilitation Medical Care, Developmental Medical Care, Outpatient Psychiatric Medical Care |
| Assistive Device Cost Grant | *Funding for purchasing assistive devices such as wheelchairs, prosthetic limbs, and artificial eyes |
Care benefits are support services centered on the daily lives of persons with disabilities and the elderly.
Training benefits are provided to support rehabilitation and employment-related services aimed at the independence of persons with disabilities.
The service use plan creation cost is the cost necessary to plan support tailored to the needs of persons with disabilities.
The self-support medical expense grant is a system to cover medical expenses for regular outpatient visits by persons with disabilities.
For detailed information on the self-support medical system, please refer to
The assistive device cost grant provides funding for purchasing assistive devices necessary for the daily lives of persons with disabilities, such as wheelchairs and prosthetic limbs.
4-2. Community Life Support Projects
Community life support projects are services implemented at the discretion of prefectures or municipalities based on the Comprehensive Support Law for Persons with Disabilities.
These projects are flexible, tailored to the characteristics of the region and the individual circumstances of users.
Services include mandatory projects defined by law and optional projects.
Examples of mandatory projects include the following.
| Mandatory Municipal Projects | Example of Project Content |
| Understanding Promotion Training and Awareness Projects | Creating a barrier-free map of the municipality, holding events to deepen understanding of disabilities |
| Voluntary Activity Support Projects | Support for exchange meetings where information can be exchanged, monitoring activities for the elderly and persons with disabilities, training and activity support for volunteers for persons with disabilities, etc. |
| Consultation Support Projects | Plan Consultation Support, Child Consultation Support, Regional Transition Support, Regional Settlement Support |
| Adult Guardianship System Utilization Support Projects | Support for the use of the adult guardianship system |
| Communication Support Projects | Dispatch of sign language interpreters and summary writers, proxy writing and reading, audio translation, assistance in understanding and expressing in conversations |
| Daily Life Equipment Grant Projects | Care and Training Support Equipment, Independent Living Support Equipment, Home Care Support Equipment, Home Living Activity Assistance Equipment (Housing Renovation Costs) |
| Mobility Support Projects | Support services for going out, circulation and pick-up services with welfare buses, etc. |
In addition to the mandatory projects mentioned above, optional projects include home visit bathing services and welfare home operations.
The daily life equipment grant projects include not only living equipment but also renovation costs to make housing barrier-free.
5. How to Apply for Services under the Comprehensive Support Law for Persons with Disabilities
To receive self-support benefits such as care benefits or training under the Comprehensive Support Law for Persons with Disabilities, follow the process below to apply.
- Apply at the municipal office and receive certification for the disability support category
- Create a "Service Use Plan Proposal" with a "Designated Specific Consultation Support Provider" and submit it to the municipality
- Receive a decision on the grant
- Hold a service provider meeting
- Create an actual "Service Use Plan"
- Start using the service
- Review the use plan as needed (monitoring)
Reference: About the Use of Disability Welfare Services | Ministry of Health, Labour and Welfare
If you wish to use a service, first apply at the municipal office and receive certification for the "disability support category."
However, some disability welfare services do not require certification, so inquire at the municipal office.
Once the application is complete and the grant is decided, a meeting with the service provider is held to determine what services will be provided based on the plan proposal.
Afterward, a meeting with the service provider is held to create a "Service Use Plan", and the service is actually started.
After starting the service, a process called monitoring is conducted at regular intervals to verify the usage status of the service and review the plan, completing the cycle.
6. Future Prospects and Challenges of the Comprehensive Support Law for Persons with Disabilities After Repeated Amendments
With the implementation of the Disability Support Law from April 2024, flexible responses tailored to the characteristics of disabilities and individual needs, such as support systems for persons with disabilities to live safely in the community and a review of disability employment, are now required.
However, as of December 2023, the statutory employment rate for private companies is 2.3%, but the actual rate is 2.25%, with only 48.3% of companies achieving this rate.
According to the "Summary of the Employment Situation of Persons with Disabilities in Fiscal Year 2022" announced by the Ministry of Health, Labour and Welfare, there are 55,684 companies that have not achieved the statutory employment rate in fiscal year 2022, with many private companies not reaching the target.
Even with repeated amendments, if persons with disabilities cannot choose a way of working or living that suits their needs, the Comprehensive Support Law for Persons with Disabilities loses its meaning.
Going forward, the challenge is to ensure that the amendment content is properly implemented and that the voices of persons with disabilities are reflected in the results.
7. Conclusion
This time, we have explained six key points of the amendment to the Comprehensive Support Law for Persons with Disabilities.
As the author, I feel that the amendment has further enriched the options available, allowing individuals to decide where to work, live, and what support services to receive, respecting the basic principle of "fundamental human rights for persons with disabilities".
Additionally, it seems that support and systems are being strengthened to enable persons with disabilities and non-disabled individuals to coexist naturally in the community.
The Comprehensive Support Law for Persons with Disabilities is expected to undergo regular amendments in the future to improve the lives of persons with disabilities as needs change.
Therefore, it is important not only for persons with disabilities but also for businesses related to disability welfare to fully understand the content of this amendment.
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