Social security subsidies for persons with disabilities in rural areas

At present, 75% of China's 83 million persons with disabilities live in rural areas (about 62.25 million), and in recent years, through the development of the cause of persons with disabilities and the development of poverty alleviation for persons with disabilities in rural areas, social security for persons with disabilities in rural areas has made considerable achievements. During the Eleventh Five-Year Plan period, in particular, the basic livelihood of some poor rural persons with disabilities has been safeguarded through a combination of universal and preferential safeguards, and a combination of general and specialized institutional arrangements, as well as through the promotion of the prioritization of their inclusion in, and the classification of their assistance. Social security for persons with disabilities in rural areas has taken welcome steps forward.

I. Achievements in social security for the disabled in rural areas

(1) Preliminary formation of a social security system framework for the disabled in rural areas, with "four guarantees and one rescue"

The minimum subsistence guarantee system for rural areas, based on the "categorization of guarantees", has been widely implemented. The social security system has been widely implemented. On the basis of ensuring that all persons with disabilities in rural areas are covered, and taking into account such special expenditure factors as medical rehabilitation for rural persons with disabilities, many localities have raised the standard for subsidies for persons with disabilities under the minimum subsistence guarantee through the "categorization of guarantees," gradually incorporating the marginalized households under the minimum subsistence guarantee into the minimum subsistence guarantee, and providing full subsidies for persons with disabilities with severe disabilities who are members of a family under the minimum guarantee, and for persons with disabilities who are members of a family under the minimum guarantee who have more than one disability. In 2009, persons with disabilities receiving the minimum subsistence guarantee in rural areas accounted for 23.6 per cent of the total number of persons with disabilities in rural areas, another substantial increase over the 19.6 per cent in 2008. Nationwide, 5.16 million persons with disabilities in rural areas enjoy the minimum subsistence guarantee.

Rural persons with disabilities are generally given preferential assistance in participating in the new rural cooperative medical care system. The participation of severely disabled persons and poor disabled persons in the new rural cooperative medical care system is generally subsidized or paid for by governments at all levels; the special medical needs of disabled persons have been included in the scope of reimbursement in some places. The proportion of persons with disabilities in rural areas participating in the new rural cooperative medical care has continued to rise, from 84.4 percent in 2007 to 93.5 percent in 2008 to 94.4 percent in 2009, with the vast majority of persons with disabilities in rural areas nationwide participating in the new rural cooperative medical care.

A system of subsidizing government contributions on behalf of persons with disabilities in rural areas to participate in the new rural social pension insurance pilot program has basically been established. By the end of 2009, 1.92 million rural persons with disabilities in the pilot areas had applied for second-generation disability cards and met the conditions for participation in the insurance scheme, with 1.589 million persons actually participating in the scheme, a participation rate of 82.8 per cent, much higher than the national participation level of around 60 per cent for the same period. Among the insured persons with disabilities, 396,000 persons with severe disabilities and 273,000 persons with non-severe disabilities received care from the Government in the form of contributions. As of the Spring Festival of 2010, 364,000 rural disabled people over the age of 60 had received basic pensions nationwide***.

Projects for the reconstruction of dilapidated housing for the rural disabled have been implemented year by year, with outstanding results. Since the implementation of the Dangerous Housing Reconstruction Program for Rural Poor Persons with Disabilities, a National Lottery Public Welfare Fund project, in 2003, the housing conditions of 420,000 rural poor families with disabilities had been improved by the end of 2009, accumulating rich experience in exploring the establishment of a guaranteed housing system for the rural poor.

Relief and assistance for rural persons with disabilities is being continuously strengthened. Localities are actively incorporating eligible rural persons with disabilities into the "five guarantees of sustenance" program, and the proportion of poor persons with disabilities receiving temporary relief assistance continues to rise.

(2) The production and living conditions of rural persons with disabilities are constantly improving

Ten million poor rural persons with disabilities have had their food and clothing provided for them. The number of persons with disabilities living in absolute poverty has fallen from more than 20 million in 1992 to around 10 million by the end of 2009.

The beneficiary area of rural rehabilitation services has been expanding. Community-based rehabilitation has been carried out in 70.2 percent of counties nationwide, and the cumulative number of persons with disabilities who have received community-based rehabilitation services in urban and rural areas has exceeded 13 million.

The proportion of rural children with disabilities receiving compulsory education has gradually risen; in 2009, the proportion of rural children with disabilities receiving compulsory education at school was 68.5 percent, up 5.7 percentage points from 2008, and a marked improvement from the end of the Tenth Five-Year Plan.

The overall quality of poor rural disabled persons is changing. "Since the Eleventh Five-Year Plan, more than 9 million rural disabled persons have received various types of technical training, and many rural disabled persons have mastered one or two practical agricultural techniques.

Income-generating channels for poor rural disabled persons are gradually being broadened. In 2009, more than 4,000 poverty-alleviation bases for the rural disabled were set up nationwide, supporting and driving 300,000 poor persons with disabilities.

II. Difficulties in Social Security for Rural Persons with Disabilities

Because of the large size of the population and the wide disparities between them, rural persons with disabilities are still experiencing a number of difficulties in their basic lives. The level of social assistance is low, the coverage is narrow, rehabilitation and other special protection needs are difficult to effectively meet, the low rate of disabled people's insurance, insurance renewal difficulties are still very prominent, for the rural disabled people's social welfare and special charitable projects there are still many gaps in rural social security for people with disabilities are still facing a lot of challenges. Compared with urban areas, the lagging problem of rural disabled persons is more prominent, the most need to speed up; rural disabled persons' poverty is more prominent, the most need to support; rural disabled persons' income is the lowest, the most need to improve.

(1) The rural disabled have a large poverty area, and it is difficult to participate in insurance contributions

The rural poor disabled population accounts for a considerable proportion of China's rural poor population, according to the new national per capita net income of 1,196 yuan of the new standard for poverty alleviation, with reference to the new poverty alleviation goal of "basically eliminating absolute poverty" by 2020, there are still at least 17,000 poor disabled people in the country, and there are also at least 17,000 disabled people in the rural areas. At present, there are at least 17 million poor persons with disabilities in rural areas throughout the country, of whom 10.63 million have an annual per capita income of less than RMB 1,196 yuan, and 6.61 million have low incomes (according to the 2009 Annual Report on China's Disabled Persons' Affairs). Affected by various factors such as natural disasters and the price of agricultural products, it is difficult for rural disabled people to increase their incomes, and even more difficult for them to pay fees to participate in various types of protection.

(2) Rural persons with disabilities are y impoverished, and their ability to lift themselves out of poverty is weak

The National Monitoring Report on the Well-being of Persons with Disabilities shows that in 2009, the per capita disposable income of households with persons with disabilities was 5,672 yuan, accounting for 57.9% of the national average per capita disposable income, and that of rural households with persons with disabilities was 4,066 yuan, accounting for 85.0% of the national average per capita disposable income of rural households. In 2009, the per capita health-care expenditure of rural households of persons with disabilities was 551.1 yuan, or 2.24 times the national per capita health-care expenditure of rural households. Most of the income of rural families of persons with disabilities is transfer income, with very little property or wage income, and they still rely mainly on temporary assistance and family and neighbor support for their livelihood.

Low income on the one hand, and high medical and rehabilitation expenditures on the other hand, in addition to the loss of labor capacity due to severe disabilities, extremely poor living conditions, and poorer overall ability, the intertwining of poverty-causing factors such as disasters, illnesses, and children's schooling, as well as the lack of implementation of preferential and supportive policies, have resulted in the quality of life of the disabled in the countryside being significantly lower than that of other peasants, and their living conditions are very difficult. Therefore, the task of raising the income and living standards of the rural disabled, and narrowing the gap with the average level is still very arduous and urgent.

(3) Limited means of poverty alleviation and development for rural persons with disabilities

In the past, it was difficult to implement targeted and effective poverty alleviation for persons with disabilities in the government's major poverty alleviation efforts, and it was difficult for the poverty alleviation projects and funds for poverty alleviation led by the major poverty alleviation efforts to make it possible for persons with disabilities in poverty to directly participate in and benefit from the programs, and the special measures for poverty alleviation for persons with disabilities were limited, with obviously insufficient financial input and training. The limited poverty-alleviation policies for persons with disabilities in rural areas lack rigid requirements, and the vast majority of persons with disabilities with the ability to work who are below poverty-alleviation standards are in urgent need of poverty-alleviation and development. At present, the State's special poverty-alleviation measures for persons with disabilities rely mainly on rehabilitation and poverty-alleviation loans, projects for the reconstruction of dilapidated buildings, and very limited funding for training, and there are very few "preferential" policies for poverty-alleviation and development for persons with disabilities, so that while persons with disabilities in poverty aspire to develop their production, raise their incomes, and achieve self-development, there are clearly insufficient measures and means to help them realize those aspirations. Few programs, insufficient funds, and a lack of services are the outstanding difficulties facing poverty alleviation for the disabled in rural areas at present.

(4) Limited social security coverage for rural persons with disabilities

The inadequacy of social security for rural persons with disabilities in China is a relatively prominent phenomenon. The 2009 National Monitoring Report on the Situation of Persons with Disabilities and the Progress Toward Well-being shows that the Engel coefficient for rural households with persons with disabilities is 47.1%, 3.5 percentage points higher than the national Engel coefficient for rural households, and that the quality of life of rural households with persons with disabilities lags significantly behind that of the country as a whole. The proportions of people with disabilities' needs for medical assistance, living assistance, rehabilitation assistance, and educational assistance are all very high; in 2009, the proportion of rural people with disabilities' needs for living assistance was as high as 65%, for educational assistance was 13.9%, for medical assistance was as high as 66.2%, and for rehabilitation assistance was 32%.

There is insufficient education and training for rural persons with disabilities; in 2007-2009, more than 75 percent of persons with disabilities aged 18 and older had never attended school or had only attended elementary school. As a result of the lack of education and training, rural persons with disabilities generally have a low level of literacy and a lack of skills, making it difficult for them to adapt to the opportunities and challenges presented by modern agriculture and the rural job market. in 2009, the proportion of rural school-age children in school who were receiving compulsory education was only 68.5 per cent, and more than 30 per cent of rural school-age children with disabilities still do not have the opportunity or conditions to receive compulsory education.

The degree of accessibility and availability of medical and rehabilitation services for persons with disabilities in rural areas is not high. Many rural persons with disabilities do not yet have access to urgent rehabilitation training and basic assistive devices, and the degree of disability of some persons with disabilities is still worsening, greatly restricting their social participation; in 2009, only 19.3 percent of all rural persons with disabilities in that year had received rehabilitation services in that year.

The problem of housing difficulties for poor rural disabled persons is still quite prominent. The phenomenon of poor or extremely poor living conditions is not isolated among poor rural persons with disabilities and their families; persons with disabilities and their families are unable to resolve their housing difficulties on their own, and at present there are still nearly 600,000 rural households of persons with disabilities in urgent need of a solution or improvement to their housing problems.

Three, the social security of the rural disabled countermeasures

(a) the implementation of the Party Central Committee and State Council on the social security of the rural disabled a series of major deployments

the party's seventeenth session of the third plenum decision pointed out that "strengthen the prevention of disability and rehabilitation of persons with disabilities in rural areas, and to promote the cause of the development of rural disabled persons. ". The Opinions of the Central Government and the State Council on Promoting the Cause of Persons with Disabilities puts forward the idea of "improving the social security system for persons with disabilities" and "effectively implementing the State's policy measures on rural poverty alleviation and development and its policies on supporting and benefiting the agricultural sector into the homes of poor rural persons with disabilities, and formulating and improving poverty alleviation policies and measures that are specific to the characteristics of persons with disabilities". Document No. 1 of the Central Government of China in 2010 put forward the idea of "increasing production support and livelihood assistance for persons with disabilities in rural areas, and prioritizing the coverage of persons with disabilities in all social security policies in rural areas". The General Office of the State Council has forwarded to the China Disabled Persons' Federation and other departments and units the Circular on Guidelines for Accelerating the Construction of a Social Security System and a Service System for Persons with Disabilities, which proposes that "the relevant government departments should support impoverished persons with disabilities in the rural areas as a key target of poverty alleviation and development". To accelerate the establishment of a comprehensive social security system for the rural disabled, it is necessary to comprehensively implement the policies and measures of the CPC Central Committee and State Council relating to the social security of the rural disabled, so as to truly enable the rural disabled to benefit from the general.

(2) Accelerating the soundness and perfection of the "four guarantees and one rescue" social security system for rural persons with disabilities

Accelerating the promotion of the "minimum subsistence guarantee system for rural areas" based on the rural minimum subsistence guarantee system, the new type of rural cooperative medical care, the new type of rural social old-age pension insurance, and the guaranteed housing system, and supplemented by the "four guarantees and one rescue" social assistance system for rural persons with disabilities (c) To accelerate the promotion of the soundness and perfection of the "four guarantees and one rescue" social security system for persons with disabilities in rural areas at the present stage, with the new rural cooperative medical care system, the new rural social pension insurance system and the guaranteed housing system as the basis, and with medical assistance, education assistance, housing assistance and other social assistance as the complement, so as to ensure universal coverage. Among other things, we must continue to promote the establishment of a social security system for persons with disabilities, with social assistance as the bottom line, social insurance as the foundation, supplemented by special benefits, and improve the coverage and basic level of social security for persons with disabilities in rural areas.

Further improving the preferential support measures for urban and rural persons with disabilities to participate in social pension, medical care and other insurance, and ensuring that persons with severe disabilities, the elderly and disabled as a whole, and persons with multiple disabilities in a single household, as well as persons with disabilities in rural areas, are provided with basic protection. Timely coordination has been undertaken to resolve difficulties and problems in the implementation of preferential policies and in the participation and renewal of insurance for rural persons with disabilities, and to actively promote the formulation and implementation of special support policies, such as financial subsidies for the participation and payment of premiums by poor rural persons with disabilities, and collective subsidies. Poor rural persons with disabilities are generally provided with special grants and hardship subsidies on the basis of the full coverage of the insurance scheme; persons with disabilities who are suffering from temporary difficulties, such as illness or disaster, are provided with timely relief and assistance; the social assistance system for persons with disabilities is being improved; and the level of centralized support and social assistance for rural persons with disabilities who are covered by the Five Guarantees is being raised. Continuing to accelerate the implementation of projects for the reconstruction of dilapidated housing for poor rural families with disabilities, six ministries and commissions, including the Ministry of Housing and Construction, have recently issued the Circular on Prioritizing the Resolution of Housing Difficulties of Urban and Rural Low-Income Families with Disabilities, which will further promote the construction of secure housing for persons with disabilities in rural areas, and prioritize the reconstruction of the housing of families with disabilities in rural areas with the greatest difficulties.

(3) Continuously Improving Rehabilitation and Disability Prevention for Rural Persons with Disabilities

Improving measures to safeguard rehabilitation services for rural persons with disabilities. The Government is strengthening medical rehabilitation and disability prevention for rural persons with disabilities, improving the network of socialized rehabilitation services, strengthening the construction of professional rehabilitation institutions at the provincial, municipal and county levels, promoting the standardization of the construction of rehabilitation institutions, improving the relevance and effectiveness of rehabilitation services, and constantly raising the level of "rehabilitation services for all" for rural persons with disabilities. Rural persons with disabilities are guaranteed access to basic medical and health-care services, and relevant policies and measures are being implemented and improved to resolve such outstanding problems as the difficulty of access to medical care and rehabilitation for poor persons with disabilities in rural and remote areas. A sound system of rehabilitation services and disability prevention in rural areas is being established, and a reporting system for birth defects and disabilities is being implemented, so as to form a mechanism for disability prevention that is accurate in its information, scientific in its methodology, sound in its management, and effective in its monitoring.

(4) Guaranteeing the right of rural persons with disabilities to receive an education

We must give more prominence to the education of rural children and adolescents with disabilities and their children, as well as the skills training and cultural knowledge of adults with disabilities in rural areas, so as to continually enhance the ability of persons with disabilities in rural areas to achieve self-development. We will implement policies to support education for the disabled, improve the quality and level of education for the disabled, continuously raise the compulsory education enrollment rate for school-age disabled children and adolescents, improve policies for assisting disabled students, and ensure that rural disabled students and children from disabled families receive free compulsory education. Through the organization of high schools for the disabled, the expansion of the scale of higher education for the disabled, and the development of adult education and distance education for the disabled, more rural disabled persons are able to receive education beyond the high school level; vocational training, skills acquisition and quality education for the disabled are being strengthened, and rural disabled persons are being given free access to secondary vocational education; the scale of vocational training for the disabled is being further expanded, and special education schools (institutes) of all levels and types, vocational schools and other educational and training institutions are being encouraged to develop multi-purpose programmes. Schools and other educational and training institutions at all levels are being encouraged to carry out multi-level vocational education and training for rural disabled persons, to train more rural disabled persons with a skill that demonstrates a special comparative skill advantage, and to continually improve the employment competitiveness of rural disabled persons.

(v) Increasing the efforts of poverty alleviation and development for rural persons with disabilities

The effectiveness of poverty alleviation for rural persons with disabilities is an important test of the Government's ability to genuinely alleviate poverty, as well as an important support for the implementation and consolidation of the achievements of social security for rural persons with disabilities. Poverty alleviation for the disabled in rural areas is an important part of the national poverty alleviation and development strategy, and without lifting the disabled out of poverty, the country's goal of basically eliminating absolute poverty by 2020 will be difficult to realize. The General Office of the State Council has implemented the requirements of the Circular of the Office of the State Council Transmitting the Opinions of the Office of Poverty Alleviation and Other Departments on the Expanded Pilot Work of Effectively Bridging the Rural Minimum Livelihood Guarantee System and Poverty Alleviation and Development Policies, and has included impoverished persons with disabilities in the expanded pilot work of bridging the rural minimum livelihood guarantee and poverty alleviation and development policies, so as to provide focused assistance to persons with disabilities who are the recipients of the rural lowincome guarantee and poverty alleviation. Policies formulated by the State and governments at all levels to support and benefit agriculture should give priority to covering persons with disabilities, and poverty-alleviation policies and measures should be formulated to address the characteristics of persons with disabilities. Financial investment in poverty alleviation for persons with disabilities should be increased, special poverty-alleviation funds for persons with disabilities should be established, and all kinds of poverty-alleviation funds should be tilted in favour of poor rural persons with disabilities. Rural financial institutions are encouraged to provide accessible financial services to persons with disabilities, and farmers' professional cooperatives and various social service organizations in rural areas are encouraged to help persons with disabilities.

(6) Actively developing care services for the disabled in rural areas

Promoting the establishment and improvement of a system of care services for the disabled in rural areas, with professional institutions as the backbone, towns and villages as the foundation, and families and neighborhoods as the backbone. Vigorous efforts are being made to develop in-home care services for the disabled in rural areas, to organize and implement the "Sunshine Home Programme", to expand the coverage of subsidies for care services for the disabled, and to promote the establishment of a comprehensive system of special subsidies. Where conditions exist, they are accelerating the establishment of model institutions (or day-care stations) for the care of persons with disabilities in counties, streets (townships), and communities, giving priority to solving the care service needs of a number of persons with intellectual disabilities, psychiatric disabilities, and persons with severe physical disabilities; they are organizing and carrying out in-home care services, and are providing services for the care of persons with severe disabilities who are living at home in the areas of life care, rehabilitative nursing care, spiritual comfort, and life skills; and they are establishing and improving the relevant policies and measures, and are providing services for the rural employment-age group. policies and measures to provide centralized care or comprehensive vocational rehabilitation services for persons with severe disabilities of working age in rural areas, and to subsidize in-home services for families of persons with severe disabilities who are providing for them at home or entrusting them with care.

(VII) Strengthening the organizational leadership of social security for the disabled in rural areas

Governments at all levels of party committees should take the acceleration of the construction of a social security system for the disabled in rural areas as an important and urgent task for the comprehensive construction of a moderately prosperous society and the building of a socialist and harmonious society, and should incorporate it into the overall situation of economic and social development, and into the overall work situation of the party committees and governments in the "Three Rural Areas". It should be integrated into the overall situation of economic and social development, and into the "three rural areas" of the work of the Party committee and government, with increased investment and accelerated promotion. The construction of a social security system for persons with disabilities in rural areas should be incorporated into the Twelfth Five-Year Plan, relevant special plans and annual plans. All relevant departments and units should include the construction of a social security system for persons with disabilities in rural areas in their areas of responsibility and target management, and governmental working committees for persons with disabilities at all levels should strengthen coordination, supervision and inspection. In particular, the role of grass-roots party organizations at the village and township levels should be brought into full play, combined with the activity of creating excellence and striving for excellence, and the implementation of policies and measures to safeguard the rural disabled, so that the disabled can truly benefit.

(viii) Giving full play to the role of grass-roots organizations of persons with disabilities in social security for rural persons with disabilities

Governments at all levels should pay further attention to grass-roots organizations of persons with disabilities, give further attention and support to the role of grass-roots organizations of persons with disabilities and full-time rural commissioners of persons with disabilities, and enrich grass-roots Disabled Persons' Federation services and personnel so that they can better assist the government to promote the country's various social security policies and measures. to be implemented for the vast majority of rural persons with disabilities.

In the process of accelerating the establishment and improvement of a social security system for the disabled in rural areas, it is necessary to adhere to the guidelines of government-led and social participation, state support and market promotion, balanced and categorized guidance, and grass-roots orientation and orientation to the masses, to accelerate the development of the cause of the disabled in rural areas, to speed up the establishment and improvement of a social security system for the disabled in rural areas, to narrow the gap between the living conditions of the disabled in rural areas and those of urban areas and society on average, and to endeavor to promote the development of rural disabled persons in line with the urban and social average.

(The author is the vice president of the China Disabled Persons' Federation)

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