Yuma Taki
Disability Welfare Section, Welfare Division, Atsugi City
Masaru Kurihara
Atsugi City “Yui Heart” All-round Consultation Room for Disabled People

1. Overview of the city (as of 1 September 2022)

Atsugi City, with a population of 244,095 and an area of 93.84 km2, is located more or less in the centre of Kanagawa Prefecture. The city is a transportation hub: in addition to access Shinjuku Station by direct train from Hon-Atsugi Station on the Odakyu Odawara Line in around an hour and Yokohama Station in around 40 minutes, the Tomei Expressway, Shin-Tomei Expressway, and Metropolitan Inter-City Expressway run through the city and there are multiple exits.

The city is also blessed with tourism resources, such as an abundance of nature including Oyama, one of the most famous tourist spots in Kanagawa Prefecture, and hot spring areas. According to the “2021 Tokyo Metropolitan Area LIFULL HOME’S Ranking of Areas where People Want to Live”, calculated based on the number of searches on and enquiries to the LIFULL HOME’S property and housing information website in 2020, the area around Hon-Atsugi Station was number 1 for “Areas where people want to rent homes” and number 3 for “Areas where people want to buy homes”.

9,824 people in the city hold a disability certificate of one kind or another, and 2,513 people use disability welfare services; these numbers are growing each year. There are several social welfare corporations and others running support facilities for disabled people in the city, and they play an important role in rolling out various services and supporting the local community.

2. The process of setting up community life support hubs

Atsugi City’s community life support hubs (hereinafter, “hubs”) covering the city’s entire area were set up in FY 2016.

In FY 2015, “Atsugi City “Yui Heart” All-round Consultation Room for Disabled People”, the core consultation and support centre for disabled people (hereinafter, “the core”) was established, and in FY 2016, consultation and support centres for disabled people (hereinafter, “centres”) were rolled out in four locations within the city (eight locations in FY 2022). They handle requests for advice on a wide range of topics related to disability, and the core has a 24-hour phone helpdesk for emergencies, so it can be said that consultation facilities were plentiful even before the hubs were set up.

We are also working to secure expert personnel and to build local community structures. Expert personnel including employment consultants, peer counsellors and, from FY 2021, developmental disability consultants are assigned to the hub. They hold workshops for consultation and support providers in the city and work in partnership with community comprehensive support centres and community coordinators.

In FY 2016, the city and the hub took the lead in launching the “Project to establish a system for emergency admissions”, made up of designated short-stay providers within the city, and the “Project to establish opportunities and venues for various experiences”, made up of communal living assistance providers also within the city. The aims were to organize the city’s resources and to position existing providers as hub facilities while, at the same time, to put in place the ability to admit and respond to people in emergency situations, and opportunities and venues for various experiences, both of which were lacking.

As a result, the “Plan for reassuring life support” was put in place to admit and respond to people in emergency situations. By stating the fact that people were eligible for this plan in their service usage plans, together with the contact details of the consultation and support specialist in charge, their need for support in an emergency could be shared with the relevant providers beforehand at the service managers’ meeting. A system to coordinate emergency admissions by contacting the consultation and support specialist responsible for the person during provider opening hours, or the 24-hour phone helpdesk at the core outside those hours, was set up, and it was decided that the hubs would be in place from March 2017.

3. Initiatives after the hubs were set up

As described above, a “Plan for reassuring life support” was put in place, but since this plan was limited to users of planned consultation and support, it was not possible to respond to other people even if they were in situations where their lives or daily lives were in danger.

For this reason, in order to provide additional emergency responses, the “Subsidy to enhance the functions of Atsugi City community life support hubs for disabled people” was established in FY 2021.

This subsidy is paid when the carer for a disabled person living in the city is suddenly absent due to an emergency and providers registered as hubs take any of the eligible actions listed in Table 1.

Table 1  Menu of assistance under the subsidy to enhance the functions of Atsugi City community life support hubs for disabled people

The subsidy amount for (1) “Admission” can be paid not just to short-stay or communal living assistance providers but also to any providers registered as hubs which have rooms and can provide the necessary support, whether or not they are designated disability welfare service providers. In the same way, it is possible not just for visiting care service providers but also for staff of day service providers who are familiar with supporting the disabled person receiving (2) “Nursing care support”, for instance because the person regularly attends their facility, to visit their home and provide emergency care.

Through the services provided under this subsidy, and the fact that the ability to respond is not limited to designated disability welfare service providers, we have been able to make effective use of limited local resources and to strengthen emergency admissions and response functions.

Moreover, meetings to explain and publicise the subsidy to all the providers within the city, aiming to encourage their registration as hubs, were held on multiple dates. As a result, the number of registered providers rose from 15 before the meetings to 37 at the end of March 2022 and, of these, 11 providers have made it possible for disabled people who do not normally use their facilities to be admitted in an emergency.

In addition, the emergency contact system was formerly an issue because there was no clear contact point that people could call in an emergency; but the emergency response process was established together with the subsidy. It was decided that the Disability Welfare Section of the City Hall should be contacted during opening hours or the City Hall’s duty officer outside opening hours, establishing a process from contact by the person discovering the situation, such as a neighbour or care assistant, through to the smooth admission of the disabled person who had been left alone.

4. Issues for the future and conclusion

We have introduced the hubs in our city, and anyone who has read this far probably thinks that opportunities and venues for various experiences have not been set up. As a matter of fact, the hubs in our city do not have concrete facilities for opportunities and venues for various experiences.

For this reason, the issue that needs to be addressed next is facilities for opportunities and venues for various experiences, and we are currently considering promoting trial usage of short-stay facilities, the establishment of venues for people in residential facilities to experience transition into the local community, and so on.

In order to prepare for emergency responses to disabled people who do not use short-stay facilities, such as those with behavioural disorders, and who need assistance with daily life, or to disabled people whose carers are elderly, it is important to build their connections with short-stay providers.

In addition, the current preparations for emergency admissions envisage the admission of disabled people who have not formerly needed support by providers registered as hubs. Supporting them without information about the characteristics of their disability, the management of any medication they are taking, and so on entails major risks for the disabled people themselves. In order to resolve these issues, we are planning ways to ensure a system for the sharing of necessary information, and intend to build an admissions structure which gives disabled people peace of mind.

Next, the transition of people living in residential facilities into the local community is also a major issue in national and Kanagawa Prefectural policies. We believe that aiming to enable even those with severe disabilities to spend their days in the areas in which they themselves wish to live and providing venues in which people can experience transition into the local community are important. It is our hope that these experiences, in which the changes in the environment bring new realisations about the disabled person, will give us hints about how to support their decision-making and further improve support for them after they return to the facility, and so we intend to consider this as one of the functions of such venues.

To conclude, in our city we have made effective use of our resources; positioned existing providers as hubs for consultation facilities, the securing of expert personnel, etc.; focused on emergency admissions and response functions related to dangers to people’s lives or daily lives; and moved ahead with the establishment of hubs.

However, local community needs and issues are constantly evolving, and from our day-to-day work, we feel that disability welfare administration confronts one new challenge after another. For this reason, the establishment of hubs is not the end. Rather, we intend to review the current situation of these hubs as appropriate and, taking into account the actual situations in local communities, to go on working so that people can feel reassured about continuing to live in these communities.