Kudo Shoichi
Director, General Consultation Office, Japan Federation of the Blind

1. Introduction

When the Ministry of Health, Labor and Welfare was promoting cooperation between labor and welfare policies in supporting the employment of individuals with disabilities, an individual with severe disabilities who was receiving home visitation services was elected to the House of Councilors in July 2019. This led to the establishment of the Enhancement Project Team for the Collaboration of Disability Employment and Welfare within the Ministry of Health, Labor and Welfare, and in December of the same year, hearings were conducted with disability organizations. The Japan Federation of the Blind (hereinafter referred to as JFB) submitted a request in advance, emphasizing the need for support in the form of mobility assistance (accompanying support) even for self-employed individuals (such as a professor of traditional Japanese music and ahakishi*). It highlighted the challenges faced by visually impaired individuals due to information barriers, emphasizing the need for support that takes into account such disability characteristics in planning future assistance.

2. Expectations for the Project

The” Special Project for Employment Support for Individuals with Severe Disabilities, etc. in Cooperation with Employment Policies (hereinafter referred to as Special Project), which came into effect in October 2020, allows support for commuting and work that was previously not allowed under the individual benefit system of accompanying support. This support for commuting and work is divided into two divisions: employment and self-employment. The employment situation is a complex system that combines both subsidies based on the employment payment system for individuals with disabilities and Community Life Support Business. Regardless, thanks to this new special project, individuals with visual impairment can now receive support such as accompanying support during their commute and assistance like writing or reading on the job. For self-employed individuals, especially self-employed Ahakishi, it can be seen as a workplace support system that they have been demanding for years. As a result, it has been warmly welcomed by many visually impaired individuals and is highly anticipated.
However, the situation for visually impaired self-employed individuals in recent years has become increasingly challenging due to fierce competition with sighted individuals, the prevalence of unqualified practitioners, and the added complications of the COVID-19 pandemic, and as a result, their incomes are declining. In the guidelines for the implementation of the special project set forth by the government, it is mentioned that municipalities may recognize activities expected to improve the income of the eligible person by engaging in self-employment, etc. This underscores the hope that the special project will contribute to improving the difficult circumstances faced by individuals with visual impairments.

3. To Make It Practical

In order to make this special project accessible and usable in practice, the first crucial step is to have the local municipalities in your place of residence institutionalize the special project as part of the Community Life Support Business. However, since the special project is an optional component of the Community Life Support Business, municipalities won’t implement it without prompting. It won’t become a reality unless the parties concerned raise their voices.
This special project started in October 2020 and has been in operation for about two and a half years. Recently, during the Ministry of Health, Labor and Welfare’s National Directors’ Meeting, the implementation status was disclosed, revealing that as of January 1st, 2023, there were 56 municipalities (including planned ones) implementing the project, with a total of 108 users. Considering the total number of municipalities nationwide, this project is still in its infancy, and a significant challenge lies in expanding its reach throughout the country.Perhaps due to this background, the General Consultation Office of the JFB continues to receive questions and consultations such as, “How can I use accompanying support for commuting and work?” Especially during the COVID-19 pandemic, there have been numerous consultations from self-employed Ahakishi, some expressing their intentions to approach job interviews with this project as a premise, wanting to use this project for their return to work after a long hiatus, or seeking it as a solution to cope with reduced bus services in rural areas for their daily commutes. Many of these inquiries revolve around commuting-related issues.

4. Specific Support Cases

In the materials presented at the Ministry of Health, labor and Welfare’s National Directors’ Meeting, three specific support cases for individuals with visual impairments were highlighted.
Here is an excerpt (with slight additions) for your reference:

①Case in Utsunomiya City (Self-employed): Visually impaired practitioner of acupuncture, moxibustion, and massage (at home and patients’ homes)

Before utilizing the special project, this practitioner primarily conducted treatments at home or in a familiar place. However, as the number of clients dwindled, the practitioner decided to make use of this project. With the support of the project, they received assistance during travel for house calls, confirmation of the preparation and cleanup of treatment locations, and assistance with restroom breaks and water supply while outside. As a result, they were able to perform treatments at unfamiliar locations and engage in business activities such as distributing flyers. They now aim to regain former clients and acquire new ones.

②Case in Nishikawa Town, Yamagata Prefecture (Employed Worker): Totally blind employee at an NPO

This individual was responsible for information dissemination targeting individuals with visual impairments, involving tasks such as collecting, drafting, photographing, editing, and delivering information about the attractions and current events in Yamagata. Before utilizing this project, the workplace had outsourced support to an accompanying assistance service provider. The employee could not extend their work hours because of limited financial resources at the workplace, which hindered them from going out to cover events. Therefore, for work at the workplace, they utilized the Workplace Assistance Subsidy for users of severe home care services, etc., and for other outings, they utilized the Special Project. As a result, in addition to support with tasks, equipment preparation assistance, and confirmation of their work content during the work hours, they were able to go out and conduct interviews with the extension of work hours, thereby broadening the scope of their duties.

③ Case in Koto Ward, Tokyo (Self-employed): Retinitis pigmentosa-affected practitioner of massage and acupuncture

Previously, this practitioner commuted independently to a different treatment facility from home, relying on support from neighboring residents and station personnel. However, accidents such as falls and collisions with elderly individuals occurred. After starting to use the special project, they received travel support during their commute (from home to the treatment facility), ensuring they could safely commute, which allowed them to continue their self-employment.

5. Future Challenges

If we continue to expand the Special Projects, it will become a meaningful system that generates significant benefits for us. However, the Special Projects is an optional business within the framework of Community Life Support Business, and their implementation is left to each municipality. In this context, the JFB outlines the future challenges it envisions, and the efforts required to resolve them. Furthermore, as the JFB, we aim to gather demands from member organizations to continue lobbying the government to ensure progress in initiatives throughout the country.

① It is crucial to raise our voices to municipalities that have not yet implemented this kind of project. Rather than individuals undertaking this task on their own, it is important for regional organizations for the visually impaired to take the lead, consult, and persistently negotiate without giving up.
② The JFB is preparing to collect successful examples of individuals with visual impairments from municipalities that have already implemented these initiatives to support these efforts. We plan to organize effective implementation examples and conduct surveys to encourage future municipalities to implement these initiatives, sharing them with individuals with visual impairments nationwide to contribute to the movement.
③ Even if special projects are launched, it is essential to have caregivers or facilities willing to take on the role in the respective regions. The role of accompanying support offices in assisting individuals with visual impairments is becoming increasingly important. Therefore, it is crucial to recognize the importance of accompanying support and to provide training for employees who can offer services tailored to the needs of individuals with visual impairments. This includes ensuring that offices can operate stably and setting appropriate compensation rates to guarantee the professionalism of support personnel, allowing caregivers to work with peace of mind.
④ Although this Special Project has been positioned within the Community Life Support Promotion Business since the 2021 fiscal year, it is necessary to continue it as part of the business until it transitions from an optional to a mandatory project. This is significant considering the current slow progress and the financial burden on municipalities.

Note: “Ahakishi” is a general term for national certified practitioners of massage, acupuncture, and moxibustion in Japanese.

Edited and published by the Japanese Society for Rehabilitation of Persons with Disabilities. Published on May 25th, 2023.