Kazumi Tokutake
Consultation Support Specialist
Hokushin Area Comprehensive Consultation Support Center for Persons with Disabilities
(Secretariat of Hokushin Area Independent Living Support Council for the Welfare of Persons with Disabilities)

Overview of the Area

The Hokushin area is located at the northernmost tip of Nagano prefecture, and is composed of six (6) municipalities: Nakano City, Iiyama City, Yamanouchi Town, Kijimadaira Village, Nozawa Onsen Village, and Sakae Village.  It is a small area with a population of 82,000 – about 5,500 of them have a Handbook for Persons with Disabilities and about 850 are users of consultation and planning services, including children.

In 2006, the Hokushin Area Independent Living Support Council for the Welfare of Persons with Disabilities (hereinafter referred to as the “Independent Living Support Council”) was established jointly by six (6) municipalities in the Hokushin area.  Since then, through the activities of the Independent Living Support Council, close working relationships have been formed among the concerned organizations, and now we have a system in place to share information and collaborate with one another on a daily basis.

Background of Studies and Development concerning Community Life Support System

In the Hokushin area, there are two residential care facilities operated by the Kosui Welfare Association (a social welfare corporation).  In 2010, within the association, study meetings on residential care were held to discuss how residential care facilities should be and how the users’ transition to living in the community should be done.  In 2011, it was decided that support be provided to home-based persons with disabilities on a trial basis – particularly a service provided 24 hours a day, 365 days a year by having staff members respond to an SOS by rushing to them and taking turns to stand by in a designated place.

In order to implement this initiative in the entire area, the 3rd Areal Welfare Plan for Persons with Disabilities (2012-2014) included plans to improve the services and the consultation system necessary to support those living alone in the community and provide seamless support to them, to establish a support system in case of emergencies, especially those that occur at nighttime and to help them transition into a new life in the community.

Furthermore, in response to the government’s guidelines, the 4th Areal Welfare Plan for Persons with Disabilities (2015-2017) stipulated that “a community life support system (group home + short-term admissions to a facility) shall be established in one place as a core and from there spread support to the entire area to help people start and continue living life in the community and to provide support in case of emergencies, including those that occur at night.”  In addition, in July 2015, we set up the “Community Life Support System Core Conference” in the Independent Living Support Council, and began to carry out specific studies for the development of the project.  In 2016, a trial operation was implemented by “General Relief Center Harukaze” (hereinafter referred to as “Harukaze” operated by Kosui Welfare Association), as a community life support system (group home + short-term admissions) to provide support in an emergency, particularly at night.  As we observed the project implementation, we continued to assess our endeavors.  Consequently, in April 2017, the six municipalities jointly planned a budget, secured 2 vacant beds in Harukaze for emergencies, and assigned two “relief coordinators” in the core consultation support center to strengthen consultation services.

In this way, in the Hokushin area, while designating Harukaze as the core of the community life support system, the relief coordinators strengthened the consultation services in the community and sought collaboration with existing facilities in the area – hence, the official beginning of collaborative development.

Moreover, in 2017, the “Community Life Support System Core Conference” was re-established as the “Community Life Support System Project Study Meeting” in which the heads of the section in charge of all six municipalities participate, and is still held every month.  We study and discuss ways to improve our functions, and if the need arises, we ask for cooperation from each specialized subcommittee of the Independent Living Support Council.  I believe that it was by utilizing the Independent Living Support Council – a setting for discussion – that the development of the community life support system has been promoted.

Current Status and Features

The project started at full scale in April 2017.  Here, I would like to introduce the current status of our project by describing our five functions:

(1) Consultation

The relief coordinators play a central role in providing consultation services to prevent any emergencies.  We have created “Guidelines for Persons with Probable Needs for Support” that are unique to the area and to identify those who need preventive support, and together with the municipalities, we are discussing timely intervention methods for people who are likely to need support.  With those whom we have identified, we simulate an emergency situation and together plan on how to respond to an emergency and come up with a relief plan.

Even for those who have already been linked with us, we continue to develop consultation support from the perspective of prevention in cooperation with local consultation support specialists.  Furthermore, as an effort to facilitate transition to living in the community, we are conducting collaborative meetings with psychiatric hospitals and surveys of the actual conditions of admission facilities.

(2) Admission and Course of Action in an Emergency

In April 2017, two vacant beds were placed in Harukaze.  However, since Harukaze is located at the southern end of the area, we have been considering the possibility of placing a bed on the north side of the area for the convenience of the people in the entire area.  As a result, in July 2021, one bed was moved to a facility named “Tokoiwa-no-sato Nagamine” on the north side of the area; thus there is now one bed in the north and another in the south of the area.

We have set a rule that in principle the use of the vacant beds shall not be more than 48 hours.  Those who are expected to use vacant beds are required to fill up a registration form in advance and state why it is necessary to use the bed and under what condition the stay may no longer be needed.  In the event of an emergency, concerned parties shall gather together to discuss the course of action and work on building a support system to prevent a recurrence.

The use of the vacant beds is decreasing year by year and I believe it is because of the result of emphasizing prevention.

(3) Opportunity to Experience Living Alone

In 2020, we made particular efforts to secure a place where people can experience living alone.  Since April 2021, six municipalities jointly budgeted for this and started a “living alone experience” support project.  We have rented a room in an apartment for this project, and each applicant who wants to avail of this project is required to make a usage plan, stay there alone, and reflect on the experience.

(4) Specialty

We conduct specialized training for people who can handle a variety of disability characteristics, such as those that require constant medical care, behavioral disabilities, etc.  In addition, the Service Improvement Subcommittee of the Independent Living Support Council holds seminars every year for the purpose of enhancing capabilities, and we are working together to develop human resources while coordinating and collaborating with concerned persons and organizations.

(5) Creating a System in the Community

We are working on increasing the number of facilities that can function as community life support systems in the community.  In 2021, we again formally requested for cooperation from all the facilities in the area, and as a result, many facilities have been certified as those that can exercise such functions.  In order to further strengthen the cooperation and collaboration in the area, we held a liaison meeting for certified facilities and held a study session on role confirmation and additional subsidies.  We plan to continue such meetings as occasions to discuss future issues.

Other than that, in order to strengthen cooperation with people in other fields such as commissioned child welfare volunteers and those who are supporting the elderly, we also reach out to them to introduce our activities.

Future Plans

While focusing on prevention, we also recognize the need to create individual evacuation and coordination plans in case of a disaster.  From the perspective of disaster prevention and mitigation, there are many things that cannot be resolved in the field of welfare for persons with disabilities alone, while various resources and collaboration are required – no matter how informal.  Using this as an indicator, I would like to proceed with the development of the community in the area.

The philosophy of the Hokushin area is “to create a community where people can live where they want to, with whom they want to, according to their will, in a manner that is fulfilling and secure.”  Using the Independent Living Support Council as a foothold, I would like to constantly conduct regional studies, share issues with all concerned organizations, discuss and cooperate with one another, and continue to work towards the realization of the philosophy throughout the region.