A Compilation of Aid Policies for Persons with Intellectual Disabilities in Shanghai City

Abstract

The classifying criteria for intellectual disability in practice vary from organization to organization, or specialization to specialization.

Mei Liao is the compiler of this chapter.

Definition and Classification of Intellectual Disability (ID)

The classifying criteria for intellectual disability in practice vary from organization to organization, or specialization to specialization.

Intellectual disabilities comprise intellectual developmental disorder and dementia. In accordance with the China Classification and Diagnosis Criteria for Mental Disorders 3rd Edition (CCMD-3), intellectual developmental disorder refers to some syndromes of mental deficiency or retardation. Persons with the disorder tend to behave at a low grade of average intelligence and with a certain level of difficulty in social adaptation. The disability develops before the age of maturity at 18, and its syndromes either occur singularly or with complications such as intellectual disorders or physical diseases. Their intelligence grades, by the standardized approach to intelligence testing and assessment, are found to be lower than normal.

In reference to standardized IQ values, intellectual disability can be scaled as shown in Table 1.

Table 1 Descriptions of intellectual disability and related IQ ranges

Moreover, in accordance with the National Standard of Disability Classification and Scales for Disabled Persons (GB/T26341-2010), disabled children aged 0–6 years are classified into several scales of intellectual disability in reference to their developmental quotients (DQ) and adaptive behaviors. Developmental quotients are referred to for children in the DQ range of less than 72, whereas for those in the DQ range of 72–75, their adaptive behavior is referred to. For children aged 7 years or older, their disabilities are scaled by their IQ values and their adaptive behavior. If the two are not scored at the same grade, the later reference is preferred. Their ID can be scaled as shown in the Table 2.¹

Table 2 Scales of intellectual disability

Dementia refers to a case of intelligence deficiency due to causal factors such as physical, chemical, or virus-induced injury to the originally normal brain.

Persons with intellectual disabilities interviewed for this book mainly refer to those with intellectual developmental disorder from the fetal or infant period.

Educational Policies

Children with Profound and Severe ID

Children with profound intellectual disability are unable to walk outdoors, and thus they may complete their compulsory education via access to direct approaches such as teaching at home.

Children with Profound, Moderate, and Mild ID

Children with ID are admitted to special public kindergartens and special preschool classes. For mild cases, a special or general class of a public or private kindergarten where children with disabilities are funded by the government in the city applies. After completion of their preschool education, these children may go on to a special 9-year compulsory school. For mild cases, they are assigned to a general school special class, or a full-time general class of such a school together with their normally developing peers.

After their completion of their 9-year compulsory special education, students with ID may, at their own will and capacity through tests, be enrolled to study at elementary vocational and technical schools.

Persons with ID who are able and eligible for further study may attend general secondary specialized schools as well as institutions of higher learning.

Successively from 2004 onwards and across the country, free education has been provided to students with disabilities during their compulsory education. In Shanghai, students with disabilities enjoy free preschool education, compulsory primary up to junior high school education, and even senior high school education. For student with disabilities at senior high schools, apart from tuition waivers, free textbooks, and workbooks, they are also granted an annually sum of 4,000 yuan as a national stipend. For those at specialized secondary schools, they are offered tuition waivers, free textbooks, and workbooks, plus a sum of 2,000 yuan as a national stipend.²

Students with disabilities and children living with individuals with disabilities, who study at full-time institutions of higher learning with Shanghai registered permanent residences in financially disadvantaged families, are also eligible for a certain sum of grant-in-aid to cover part of their tuition: a grant of up to 6,500 yuan per academic year for higher vocational education, junior college up to undergraduate levels; 8,000 yuan for postgraduates per academic year; and 10,000 yuan per academic year for PhD candidates. The aforesaid sums are for the recipient’s actual tuition settlements within the amount limits for each academic year.

Children living with disabled family and disabled students, who study at adult education institutions with Shanghai registered permanent residences in financially disadvantaged families, bear 10% of their adult education tuition. The rest (90%) is subsidized to students with disabilities receiving a secondary education with the disabled persons’ employment security fund at sums of up to 3,600 yuan; those receiving their junior college education may be given a total of up to 9,000 yuan; those receiving their undergraduate education may receive 13,500 yuan.³

This policy may vary from region to region. In some districts or counties of Shanghai municipality, students with disabilities, who receive their secondary education, higher education, adult education, or vocational education, may have their full tuition amounts subsidized by the local government.

Policies on Social Relief and Aid

Minors with Disabilities

Subsidies for Rehabilitation Training to children with disabilities at specialized rehabilitation institutions designated by the Shanghai Disabled Persons’ Federation are granted by the government in the sum of 15,000 yuan per year for each child with cerebral palsy and 3,000 yuan per year for each child with intellectual disability.⁴

Institutional Care Subsidies are available for persons with disabilities, financially disadvantaged children aged 8–16 years with a Disability Certificate of the People’s Republic of China, who are unable to receive a compulsory education because of severe disability and live in a disabled persons caring institution designated by the Shanghai Disabled Persons’ Federation. They are granted from the government a monthly sum of 1,000 yuan if eligible for the institutional care service through verification. The institutions that provide care to severely minors with disabilities are granted an additional subsidy of 500 yuan per bed each year. Individuals with disabilities, who receive such supportive policies, are no longer entitled, meanwhile, to the subsidies for rehabilitation training for the disabled aged 8–16 years.⁵

Adults with Disabilities

Living and Nursing Subsidies are available for unemployed disabled persons aged over 16 at the primary (disability Grade I), secondary (disability Grade II), or tertiary (disability Grade III) disability rating scales.

In 2017, for the unemployed and persons with severe disabilities in Shanghai, a sum of 1,270 yuan was granted as a living subsidy.

The living subsidies for financially disadvantaged persons with disabilities are divided into three categories: a monthly sum of 330 yuan to each unemployed person with a severe disability for his or her minimum living provision; 300 yuan for persons with disabilities living with a household receiving basic living allowances; and 200 yuan for persons with disabilities living in a low-income household. Meanwhile, any persons with a disability, who is eligible for any of these three categories, may apply for a higher category with a greater subsidy sum.

The Nursing Subsidies for Persons with Severe Disabilities are divided into two categories: a monthly sum of 300 yuan for each person with a disability rated at disability Grade I, and a monthly sum of 150 yuan for each person with ID rated at disability Grades II and III. Persons with disabilities who already enjoy nursing subsidies are also eligible to apply for access to institutional, household, and relevant nursing services.

The eligible persons with disabilities may also apply for Living Subsidies for Financially Disadvantaged Disabled Persons, as well as Nursing Subsidies for Severely Disabled Persons.⁶

Medical Insurance is raised by the government in full for urban and rural residents with severe disabilities, for which two-thirds of the premium is covered with the disabled persons’ employment security fund at the regional or national level in Shanghai, and the remaining third is covered by the social welfare lottery public welfare fund.⁷

Medical Subsidies are granted to persons with severe disabilities insured against their outpatient emergency or household sickbed fees at a starting sum of 300 yuan. Any excess is covered with the medical insurance fund, of which a 70% payment of the fees from the fund applies to Grade I medical institution outpatient emergencies; a 60% payment at Grade II; and 50% at Grade III.

For their hospitalization or emergency room observation fees, the starting sum of payment varies: 50 yuan at Grade I medical institutions; 100 yuan at Grade II medical institutions; and 300 yuan at Grade III medical institutions. The excess is covered with the medical insurance fund, of which a 90% payment of the fees from the fund applies to the Grade I medical institution hospitalization; 80% at Grade II; and 70% at Grade III.

The entire fee for which a patient with severe disabilities must pay at their own expense for medical treatment, inclusive of outpatient expenses, is covered by the government via relief and subsidy.⁸

Institutional Nursing Subsidies are available for the eligible unemployed and persons with severe disabilities, who may apply to the government for access to institutional nursing services with these subsidies. From July 2011 onwards, each eligible person with a disability is subsidized a sum of 700 yuan directly transferred to the account of the nursing institution with any inadequate amount to be complemented by the applicant.

Each district and county in Shanghai, as the case may be, increases nursing subsidies of its own accord. For instance, in Jiading District, institutional care services have reached out to all persons with disabilities in need within the entire district, subsidizing up to a monthly sum of 400 yuan each to the non-severe, unemployed, institutionalized persons with disabilities with minimal assurance families; and up to a monthly sum of 200 yuan to each applicant with disabilities certified and eligible for nursing conditions through examination.⁹

In-Household Care applies to persons with severe disabilities, unemployed in the 16–59 years bracket, who have not yet received institutional nursing or daytime care subsidies. They are eligible to apply for government-funded in-household care services, for whom service workers go to the household of a person with a disability offering 1 h of nursing on a daily basis, such as housework and living care.¹⁰

Transport Subsides apply to the certified person with disabilities at ages below 65 years (exclusive of 65) with a Shanghai registered permanent residence, at the monthly sum of 45 yuan each.¹¹

Grain and Cooking Oil Poverty-Relief Subsidies apply to persons with severe disabilities and unemployed persons living with a Shanghai urban or rural household receiving the minimal subsistence allowances, or their spouses and children. They are granted monthly grain and cooking oil cards and vouchers. The poverty-relief subsidy cards include 10 kg rice, 900 ml cooking oil, and 0.5 kg table sugar, convertible to a sum of 72 yuan; and 4 kg rice, convertible to 22 yuan.¹²

Training and Employment

Sunshine Home, one of the Shanghai Municipal Government’s projects in operation in 2005, is a community aid-to-the-disabled training institution for persons with intellectual disabilities in the age bracket of 16–35 years. The home develops activities such as educational training, rehabilitation exercises, Special Olympic sports, and simple labor, helping persons with ID improve their capacity for self-care and social skills while promoting their chances to include themselves into society. The trainees at the home include mostly persons with moderate to severe ID.

The full-time training activity subsidy amounts to 250 yuan per person per month, in addition to the monthly meal subsidy of 150 yuan. The two subsidy categories are funded to the Sunshine Home for its purchase of activity-purposed supplies and consumables as well as for its provision of lunch, drinks, etc., for the trainees.¹³

At present, Shanghai has 241 such homes altogether in all its downtown street neighborhoods and towns. Institutions similar to Sunshine Homes are established across the country, although they may differ slightly in their institutional names.

The Sunshine Vocational Rehabilitation Aids Base, or Sunshine Base, Sunshine workshop, is one of the Shanghai Municipal Government’s practical projects of 2010. Taking its communities as its units, it is an informal employment institution designed to organize relatively centralized vocational rehabilitation activities such as production and vocational training for persons with disabilities with employment difficulties. The subjects for aid are persons with mild to moderate disabilities of working age. Through labor and employment training, persons with disabilities gain a basic living provision and their inclusion into society is fostered.

The trainees’ pension contributions as well as their medical and unemployment insurance are paid on their behalf; 40% of the Shanghai urban workers’ minimal wages are granted to the trainees as employment subsidies; to those intending to purchase commercial insurance, such as group life accident insurance and additional group health insurance against accidental injury, at an annual subsidy of up to 80 yuan; to the eligible for their lunches, etc.; and to the Sunshine bases’ purchase of tutorial materials and consumables, at a monthly training subsidy of 250 yuan, and a monthly meal subsidy of 150 yuan.¹⁴

So far, Shanghai City boasts 170 Sunshine bases, some of which have collaborated and merged with the Sunshine Home. Each trainee is entitled to choose one of these institutions.

The Off-Duty Register is a local practice by which workers with disabilities sign employment contracts with an employer although they do not actually work in the nominated job posts. However, the worker still receives full insurance, as the state stipulates, against the pension fund, medical treatment, unemployment, occupational injury, and child delivery, have their housing funds contributed, and receive a certain wage no less than the city’s minimum.

According to the stipulations of the Shanghai Municipal Government, governmental organizations, enterprises, and public institutions shall employ persons with disabilities with the city’s registered permanent residence in the proportion of 1.5% to the total number of on-the-job workers in the workplace in the previous year.¹⁵Any workplace that fails to employ workers with disabilities on a pro-rata basis as stipulated shall pay into persons with disabilities employment security fund. After a worker with disabilities registers as off duty, the workplace is entitled to a waiver of the proportionate disabled persons’ employment security fund. There are also some local enterprises that rent disability certificates just for exemption from contribution to the fund.

Taking Shanghai as a case in December 2017,¹⁶ the city provided that an employer must pay registered workers with disabilities (or those really employed) the minimum wage and contribute a minimum to the social insurance premium; thus, the employer shall pay each person with disabilities, actually, 3,927 yuan as a minimal monthly wage plus a contribution to the five types of social insurance premiums;¹⁷if the employer also contributes to the housing fund for workers with disabilities, each shall be paid at least an additional 306 yuan—thus the actual expenditure of the employer shall be 4,233 yuan.¹⁸ In the case that the employer does not employ any person with disabilities, but rather chooses to contribute to the employment security fund for persons with disabilities for the inadequate number of workers with disabilities less than 1.5% as required in proportion to the total number of workers, contributions shall be made through monthly payments of the disabled persons’ employment security fund, at the sum of 3,902 yuan each.¹⁹In other words, the expenditure on off-duty registration (or actual employment of workers with disabilities) is greater than that of the contribution of a business to the employment security fund for persons with disabilities.

In the beginning, local disabled persons federations and other relevant institutions assisted with persons with disabilities to find off-duty register workplaces. In recent years, in order to facilitate persons with disabilities on-the-job employment and inclusion, disabled persons’ federations now do not advocate the off-duty register.

Translated by Chongshun Bai