[MHLW] “Basic direction for the revision of remunerations for disability welfare services in 2021” announced

On December 11th, 2020, the Remuneration Revision Review Team announced the "Basic direction for the revision of remunerations for disability welfare services in FY 2021". The team held 17 meetings from February 2nd, 2020 to hear opinions from 46 related organizations regarding remunerations for disability welfare services. The main focus and revised items are as follows.

1. Remuneration system for caretakers in order to cope with the aging of persons with disabilities and the increasing severity of their conditions, and to provide high-quality consultation and community life support.

Remuneration for the following care/support will be reviewed.

- Adaptation to the aging of people with disabilities who are living in group homes and the increasing severity of their conditions

- Care for persons with severe behavioral disabilities

- Nighttime support

- Support for independent living

- Support to enhance the functions of community life support bases

- Support for persons with severe physical and mental disabilities

- Support to provide high-quality consultation

2. Effective employment support and attentive care for persons/children with disabilities

(1) Regarding remuneration for employment support, the following items/support will be reviewed.

- Evaluation methods for employment transition support

- Basic conditions for remuneration for employment retention support (“face-to-face meeting with users once a month or more,” etc.)

- Calculation methods for work performance in Employment Continuation Support Type A

- Basic remuneration system for Employment Continuation Support Type B

- Setting up a further evaluation system for cases successfully transferring from employment continuation support to employment

(2) In order to provide more attentive care to persons/children with disabilities, remuneration for the following care/support will be reviewed.

- Support to continue living at home

- Support for the strengthening of short-stay services according to the needs of persons with disabilities and their families

- Oral hygiene management and assistance with eating and swallowing for people living in residential care homes

- Emergency care for visiting care users while traveling by car

At the same time, the eligibility for Comprehensive Support Services for persons with severe disabilities will also be reviewed.

3. Promoting support for children with disabilities who need medical care

The following points will be reviewed.

- Criteria for examination and judgement about providing medical support for children with disabilities

- Remuneration system for day care support of children with disabilities who need medical care

- Basic remuneration system for after-school day care services and support for children with disabilities with high care needs

- Professional support in the after-school day care services

- Basic remuneration system for Child Development Support Centers

- Remuneration system and personnel standards in facilities for children with disabilities

- Remuneration to support children with disabilities over 18 living in facilities in starting community life

4. Promoting a comprehensive community care system for persons with mental disorders

In order to support people with mental disorders in starting community life, the following points will be reviewed and promoted.

- Transition support from facilities to starting community life

- Cooperation in the field of medical care and social welfare

- Expertise in peer support

5. Strengthening of the ability to respond to infectious diseases and disasters, etc.

(1) Preparation for pandemics/disasters on a regular basis, making the amendments to operational standards necessary to continue providing welfare services even in extraordinary situations

(2) Easing restrictions on and requirements for operational standards and remuneration systems

6. Reviewing the remuneration system to ensure the sustainability of disability welfare services and provide appropriate services

(1) Reviewing the remuneration system to provide appropriate services while ensuring their sustainability

(2) Securing human resources and improving work efficiency in disability welfare services

The specific content of the revision will be decided in the future budgeting process, taking into consideration the experience of the revision of nursing care remuneration. For further information, please visit the following website (Japanese Only): https://www.mhlw.go.jp/content/12200000/000704861.pdf

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