Your Key to Disability Services in Japan: The Day Services Recipient Certificate

Tsuusho Jukyuusha Shou / 通所受給者証

The day services recipient certificate (tsuusho jukyuusha shou / 通所受給者証) is the document that gives your child access to publicly funded day-use disability services in Japan, the therapy, after-school programs, and developmental support most families rely on. Issued by your city or ward, it is separate from a disability handbook (techou / 手帳, also called a disability certificate), and here is the part that surprises many parents: you do not need a handbook to get one. A doctor’s written opinion that your child needs developmental support is enough to apply.

A disability handbook proves your child’s disability. The tsuusho jukyuusha shou does something different: it states which services your child is approved to use, how many days per month, and what your family’s out-of-pocket cost will be. They are separate documents, and you can have one without the other. Because a doctor’s opinion letter is enough to apply, families whose children are still being assessed, or whose children do not meet handbook criteria, can still reach services.

What It Is

The tsuusho jukyuusha shou / 通所受給者証 is a recipient certificate issued by your city or ward office that approves your child to use specific services under the Child Welfare Act (jidou fukushi hou / 児童福祉法). It records exactly which services your child can use, the number of days per month, your family’s cost tier and monthly out-of-pocket cap, and the valid period. Every facility will ask to see it before your child can start attending.

It is not a disability handbook and not proof of disability. It is the practical key that lets your child walk through the door and use day services.

Who Is Eligible?

Children under 18 who fall into any of these categories can apply:

• Children with a physical disability (shintai shougai / 身体障害)
• Children with an intellectual disability (chiteki shougai / 知的障害)
• Children with a mental health condition or developmental disability (seishin shougai / 精神障害, including hattatsu shougai / 発達障害)
• Children with a designated intractable disease (nanbyou / 難病) on the government’s designated disease list

And this is the important part: even if your child does not fall neatly into one of these categories, you can still apply if a doctor or other professional states in writing that your child needs therapy or developmental support. You do not need a disability handbook to apply.

To apply without a disability handbook, you will typically need one of the following:

• A doctor’s opinion letter or referral (ikensho / 意見書 or shoukaijou / 紹介状)
• A letter from the child guidance center (jidou soudanjo / 児童相談所)
• A recommendation from a developmental assessment center or a health center (hoken sentaa / 保健センター)

What Services Does It Unlock?

The tsuusho jukyuusha shou covers services under the Child Welfare Act’s day support system for children with disabilities (shougaiji tsuusho shien / 障害児通所支援). Which services your child uses depends mostly on their age.

Early Years (Birth to School Age, Approximately 0 to 6)

Child development support (jidou hattatsu shien / 児童発達支援):

The main service for preschool-age children. It provides therapy, developmental support, and group activities for children not yet in elementary school, and may include speech, physical, and occupational therapy, social skills training, sensory activities, and structured play. Facilities are sometimes called jihatsu (児発) for short. Some children attend full-time as their main daytime activity, while others attend part-time alongside preschool or kindergarten.

Home-visit child development support (kyotaku houmon gata jidou hattatsu shien / 居宅訪問型児童発達支援):

For children who cannot attend a facility due to severe disability. A therapist visits the child at home.

School Years (Age 6 to 18)

After-school day services (houkago tou dei saabisu / 放課後等デイサービス):

The main service for school-age children, providing after-school and school-holiday support for children enrolled in elementary, junior high, or high school. Activities typically include social skills training, homework support, physical activities, arts and crafts, outings, and life skills practice. Facilities are commonly called houday (放デイ) for short. They run on school days after school, on Saturdays, and during spring, summer, and winter breaks. Many families use houday as a combination of after-school care and therapy.

Available Across Both Stages

School and nursery visit support (hoikusho tou houmon shien / 保育所等訪問支援):

A specialist visits your child’s school, nursery, or kindergarten to provide support within their regular setting, including observing your child, advising teachers, and helping create accommodations. This is available during both the early years and the school years, and many families do not know it exists.

How to Apply

Step 1: Find the services you want to use. Before applying, visit the facilities you are interested in. Most day facilities welcome tours, so call ahead and schedule one. Ask about their programs, schedule, staff qualifications, and whether they have openings, then choose the facility or facilities you want. You will need to name them on your application.

Step 2: Go to your city or ward office welfare desk. Visit the disability welfare desk (shougai fukushi tantou madoguchi / 障害福祉担当窓口). For children, this may sit in the children’s section (kodomo katei ka / こども家庭課) rather than the general disability desk, depending on your municipality. Tell them you want to apply for a tsuusho jukyuusha shou, and they will give you the application form and explain the required documents. Some offices schedule an interview (kikitori chousa / 聞き取り調査) of about an hour to ask about your child’s situation, daily life, and support needs.

Step 3: Prepare a service use plan. Before approval, you need a service use plan (shougaiji shien riyou keikaku / 障害児支援利用計画). There are two routes:

• Option A: A consultation support provider (shougaiji soudan shien jigyousho / 障害児相談支援事業所) creates the plan for you at no cost to the family. The welfare desk can provide a list of providers.
• Option B: A self-plan (serufu puran / セルフプラン), which you write yourself on a form from the welfare desk. It is simpler and faster but without professional guidance. Many families start here.

Step 4: Submit your application. Bring the completed application form, the service use plan, evidence of your child’s disability or need for support (handbook, doctor’s opinion letter, or assessment report), your My Number card or notification card, your household’s health insurance card, and any income documents requested. The exact list varies by municipality, so confirm with your welfare desk.

Step 5: Receive your recipient certificate. Once processed, the welfare desk issues the tsuusho jukyuusha shou. In many cities it can be ready within about one to two weeks, sometimes the same day if all documents are in order, though some municipalities take longer. The certificate lists your child’s and guardian’s names, the approved service types, the number of days per month approved (shikyuuryou / 支給量), your cost tier and monthly cap (futan jougen getsugaku / 負担上限月額), and the valid period.

Step 6: Sign a contract with the provider. Take the certificate to your chosen facility and sign a service use contract (riyou keiyaku / 利用契約). They verify the approved services and days, and your child can begin.

How the Cost System Works

Disability services in Japan use a shared-cost system: the government covers most of the cost, and the family pays a portion that is capped at a monthly maximum based on household income. The cap is set nationally according to your household’s municipal tax status. Categories range from households receiving public assistance (seikatsu hogo / 生活保護) and tax-exempt households, who pay nothing, up to higher-income households, with most families falling into the lower-cost tiers. For the current categories and cap amounts, see the Children and Families Agency page in Useful Resources below.

One important benefit: child development support is free for the three years before school entry under the preschool disability services fee waiver (mushouka / 無償化), so families of children in that age range generally pay nothing for 児童発達支援.

On top of the service fee, some facilities charge small separate amounts for things like snacks, craft materials, or outings. These are not covered by the certificate and are paid directly.

Renewal and Changes

The tsuusho jukyuusha shou has a fixed validity period, typically one year. Before it expires you must apply for renewal at the welfare desk, a process similar to the original application and requiring an updated service use plan. Start one to two months early rather than waiting until the last day.

If your child’s needs change something, for example more or fewer days per month, or adding a second facility, you can request a change to the certificate at any time, not only at renewal.

Understanding Shikyuuryou (支給量): Days Per Month

One of the most important numbers on the certificate is the shikyuuryou (支給量), the number of days per month your child is approved to use each service type. The welfare desk sets it based on your child’s needs and the service use plan. If the approved number feels too low, discuss it with the welfare desk; you may be able to increase it with a doctor’s opinion letter or an updated plan.

Important: the shikyuuryou is a maximum of days you can use. It is not a requirement. You do not have to use every approved day, and you only pay for the days your child actually attends.

Around Age 18: What Comes Next

The day services covered by this certificate run under the Child Welfare Act, which is built around children. Around the time your child reaches 18, those children’s day services end.

From that point, your child uses the disability welfare services recipient certificate (shougai fukushi saabisu jukyuusha shou / 障害福祉サービス受給者証). That certificate is not an “adult version” of this one; it is a separate, all-ages certificate that some children might already use for services like home help or short-stay care, and that becomes the main certificate. It covers a different set of services, including day activity programs (seikatsu kaigo / 生活介護), employment transition support (shuurou ikou shien / 就労移行支援), continued employment support (shuurou keizoku shien A gata / B gata / 就労継続支援A型・B型), independent living training (jiritsu kunren / 自立訓練), group homes (kyoudou seikatsu enjo / 共同生活援助), home help (kyotaku kaigo / 居宅介護), and short-stay respite care (tanki nyuusho / 短期入所).

The application is similar but involves a more detailed needs assessment called the disability support classification (shougai shien kubun / 障害支援区分). Start visiting and planning for these services well before the transition. See our articles on the disability welfare services recipient certificate and “When Your Child Turns 18: Transition to Adulthood.”

Practical Tips

• Visit facilities first. Tour at least two or three places before deciding; quality varies widely. Ask about staff qualifications, the daily schedule, how they handle behavior, and their experience with your child’s specific needs.
• You do not need a disability handbook. A doctor’s opinion letter is enough to apply, so do not wait for a handbook if your child needs services now.
• Ask about the self-plan option. If you do not want to wait for a consultation support provider, a self-plan can speed things up.
• You can use multiple facilities. Your child can attend more than one jihatsu or houday as long as the total stays within the approved shikyuuryou.
• Renew early. Start one to two months before the certificate expires.
• Bring the certificate to every facility. They will need to see and copy it before services begin.
• Plan ahead for the transition around 18. The children’s and adult systems are separate, so start visiting adult services well before the change.
• Ask about school and nursery visit support (hoikusho tou houmon shien / 保育所等訪問支援). This sends a specialist to your child’s school or daycare to help teachers understand your child and build better accommodations. Many families never hear about it.

Key Terms

English	Japanese
Day services recipient certificate	tsuusho jukyuusha shou / 通所受給者証
Day support services for children with disabilities	shougaiji tsuusho shien / 障害児通所支援
Child development support (preschool-age)	jidou hattatsu shien / 児童発達支援
After-school day services (school-age)	houkago tou dei saabisu / 放課後等デイサービス
School and nursery visit support	hoikusho tou houmon shien / 保育所等訪問支援
Home-visit child development support	kyotaku houmon gata jidou hattatsu shien / 居宅訪問型児童発達支援
Number of approved days per month	shikyuuryou / 支給量
Monthly out-of-pocket cost cap	futan jougen getsugaku / 負担上限月額
Service use plan (required to apply)	shougaiji shien riyou keikaku / 障害児支援利用計画
Self-plan	serufu puran / セルフプラン
Consultation support provider	shougaiji soudan shien jigyousho / 障害児相談支援事業所
Disability welfare services recipient certificate (all ages)	shougai fukushi saabisu jukyuusha shou / 障害福祉サービス受給者証
Disability support classification (needs assessment)	shougai shien kubun / 障害支援区分
Child Welfare Act	jidou fukushi hou / 児童福祉法
Comprehensive Support for Persons with Disabilities Act	shougaisha sougou shien hou / 障害者総合支援法
Disability welfare desk	shougai fukushi tantou madoguchi / 障害福祉担当窓口
Child guidance center	jidou soudanjo / 児童相談所

Useful Resources

• Children and Families Agency: Disability Child Support Policies (障害児支援施策) — https://www.cfa.go.jp/policies/shougaijishien/shisaku
• Children and Families Agency: Preschool Disability Services Fee Waiver (就学前障害児の発達支援の無償化) — https://www.cfa.go.jp/policies/shougaijishien/shisaku/mushouka
• Children and Families Agency: User Fee Structure (利用者負担の仕組み) — https://www.cfa.go.jp/policies/shougaijishien/shisaku/futan
• MHLW: Disability Services for Children Overview (障害児支援施策) — https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/0000117218.html
• MHLW: Disability Services Overview (PDF) — https://www.mhlw.go.jp/file/06-Seisakujouhou-12200000-Shakaiengokyokushougaihokenfukushibu/0000059663.pdf