General Education Support Section, Kyoto City Board of Education

The Act on Support for Children in Need of Medical Care and Their Families was enacted in September 2021. Its purpose is to assist children who require daily medical care, such as suctioning sputum and tube feeding, and to support their families from society as a whole. This Act emphasizes that local governments establishing schools must offer adequate support and create an environment that enables children to enjoy their school days safely and securely without needing their family members to accompany them.

Before this Act was passed, Kyoto City had already been actively enhancing its systems by assigning nurses to schools for students in need of medical care and developing guidelines for medical care. However, some issues still need attention. The challenge arises from the burden placed on families when transporting these children to and from school. Many children in Kyoto who require medical care are enrolled in the city’s four region-based comprehensive support schools, commonly known as ‘special needs schools’ nationwide. Due to the extensive service areas of these schools, most children commute by school bus. However, for those unable to use the school bus because of their medical needs during transit, family members must pick up and drop off, which puts a strain on the family.

In response to this situation, a new service initiative was launched in 2022 to support school commuting. This initiative offers two flexible options. The first involves signing a contract with a service provider, such as a home-visiting nursing service, that can send nurses or aides to deliver medical care. The provider is not standardized but selected individually, allowing each child to choose a provider they feel comfortable with, whether it’s one they regularly use or one located near their home. We make such adjustments and decisions on an individual basis according to the families’ preferences. The second method entails hiring a welfare taxi or another vehicle, which requires a customized contract tailored to specific circumstances. By combining these two options, we have created a system that enables families who previously needed to use their cars for pick-ups and drop-offs to arrange for a welfare taxi accompanied by a nurse or another staff member, allowing the child to commute to school without their family members present. The costs associated with pick-up and drop-off, including nurse dispatch and taxi fares, are typically covered by public funds, so families do not incur any expenses.

Those who wish to use the school commuting support service should apply through the school where the child needing daily medical care is enrolled. After selecting a service provider, a meeting will be held with the provider, school representatives, and the family to ensure everyone understands the procedures related to the school commuting service and the protocols for handling emergencies. We conduct preliminary test runs to verify the pick-up and drop-off routes and identify stop locations for medical care in advance, ensuring the service is safe and secure before it begins. In the system’s inaugural year, 2022, budget constraints required a weekly limit on service usage. However, we have lifted that limit this year and are working to enhance the service to accommodate as much usage as needed.

As of June 2023, 11 students are using this system. We have received feedback, including positive comments such as, ‘I am so happy that I can see my child off at the front door like any other family.’ We will continue to collaborate with relevant businesses to ease the burden on families by addressing their individual needs. Additionally, we will strive to create an environment where children can attend school safely and feel comfortable.

Edited and Published by the Japanese Society for Rehabilitation of Persons with Disabilities.

Published on July 25th, 2023