Breaking Barriers in the 'Every Child Can Attend Nursery' Initiative: Florence Receives Commission from Shinagawa Ward for Support Program for Children Requiring Medical Care

Photo: Trial service in progress

Certified NPO Florence (Chiyoda City, Tokyo; Representative Director: Midori Akasaka) has been commissioned by Shinagawa Ward to implement the 'Support Program for the Growth of Children Requiring Medical Care.' This marks the first time a municipal government in Tokyo has adopted this program, which will be included in Tokyo’s budget starting fiscal year 2025 (Reiwa 7). The program will begin operations within Shinagawa Ward in August 2026.

The initiative aims to support preschool-aged children who face barriers to group childcare due to medical care requirements. By offering co-childcare services at home—regardless of whether parents are employed or recognized as needing childcare—it promotes children’s development and prevents family isolation. This aligns perfectly with the goals of the 'Every Child Can Attend Nursery' initiative. It represents an advanced, nationwide model that brings childcare support to families previously overlooked by existing systems.

Background: The 'System Gap' Faced by Families of Children Requiring Medical Care and Their Urgent Needs

Children requiring daily medical care, such as ventilators or gastrostomy feeding tubes—known as 'children requiring medical care'—number approximately 20,000 nationwide, doubling over the past decade. In September 2021, the 'Act on Support for Children Requiring Medical Care' was enacted, and starting in fiscal year 2026, the 'Every Child Can Attend Nursery' initiative will be fully implemented. While this initiative allows access to childcare regardless of employment status, non-working families with children who require medical or disability-related care remain excluded due to insufficient reception infrastructure.

Situation of Parents Raising Children Requiring Medical Care

Data shows that 43% of mothers raising children requiring medical care are not employed※1. Due to unstable health conditions and constant care needs, many parents find it difficult to work.

In a survey conducted by Florence targeting families of children with disabilities and those requiring medical care※2, participants shared the following:

"Many parents, like me, had to give up returning to work early because their infants required medical care. I tried to return, but couldn’t find a facility willing to accept my child five days a week, so I eventually resigned."

(Mother of a child with physical/intellectual disabilities and medical care needs)

※1) Survey by the National Council for Support of Children Requiring Medical Care (2020)

※2) Certified NPO Florence, 'Survey on the “Every Child Can Attend Nursery” Initiative (Provisional Name) Targeting Families of Children with Disabilities and Those Requiring Medical Care' (2023)

Current Status of Children Requiring Medical Care under the 'Every Child Can Attend Nursery' Initiative

The 'Every Child Can Attend Nursery' initiative enables childcare access regardless of employment status. However, it currently assumes group childcare as the standard※3. Many children cannot attend due to lack of medical care readiness at local nurseries or concerns about illness exacerbation and infection risks—effectively excluding them from the program.

※3) At the third deliberation meeting on the 'Every Child Can Attend Nursery' initiative on October 30, Reiwa 6, it was indicated that while 'home-visit childcare services' remain outside the official scope, dispatching childcare workers from certified facilities to homes may be permitted in practice. However, whether this approach will truly meet user needs remains uncertain, warranting close attention to future developments.

Florence’s aforementioned survey※4 revealed that many families desire childcare access regardless of employment status.

Some also expressed hopes for their children’s growth through childcare:

"Due to high infection risks and potential severity, I’ve hesitated to send my child to nursery despite wanting to, fearing inadequate infection control practices. (…) Time spent with people other than parents could become valuable developmental moments for my child."

(Mother of a child with physical disabilities and medical care needs)

※4) Certified NPO Florence, 'Survey on the “Every Child Can Attend Nursery” Initiative (Provisional Name) Targeting Families of Children with Disabilities and Those Requiring Medical Care' (2023)

Tokyo Metropolitan Government established the 'Support Program for the Growth of Children Requiring Medical Care,' designed to provide childcare at home or other residences regardless of parental employment, promoting healthy child development. Shinagawa Ward has swiftly adopted this program, and Florence has now been selected as the implementing organization.

We will continue collaborating with various stakeholders to create a new 'normal' where every child—regardless of disability or medical needs—can grow within society, and families can move forward with hope.

Overview of the 'Shinagawa Ward Support Program for the Growth of Children Requiring Medical Care'

Eligibility

Preschool children aged 6 months and older residing in Shinagawa Ward who face difficulties attending group childcare due to medical care needs

Service Content

Staff who have completed specialized training in home-visit childcare will visit families’ homes to provide co-childcare together with parents

Frequency

Approximately twice a week, around three hours per session

User Cost

None

Application Process

Apply to Shinagawa Ward for eligibility certification, then coordinate usage directly with the service provider