Atsushi Sano
Director of Local Base Center, Fukinoto, Certified NPO Sawaoto no Mori

Our area covers two cities and three towns (Shiogama City, Tagajo City, Matsushima Town, Shichigahama Town, Rifu Town) adjacent to the east side of Sendai City, Miyagi Prefecture. In this area, those municipalities have jointly established the Miyagi Eastern Area Independence Support Council (henceforth referred to as Council) and have promoted community development while sharing issues as a single administrative area for disability welfare. The total population of the area is about 180,000.

1. The Developmental Process

In response to the notification from the Ministry of Health, Labor and Welfare regarding the "Development of projects such as local life support bases[1]” the Council organized a workshop that was held in 2015.

The Ministry of Health, Labor and Welfare has set forth five functions for all areas of Japan to organize, (1) consultation, (2) emergency response, (3) opportunities and places for experiences, (4) securing and training professional human resources, and (5) creating local support systems. Through the workshop, I was afraid that it would be an extraordinary task  to set up and prepare everything fully, but at the same time, I received the perspective of "working from what we can do by making the most of the strengths of the area." We started first with the thought that we could work on development with the idea of gradually strengthening the functions.

As for establishing such functions, a "local life support bases developmental project" (henceforth referred to as the project) was set up in the Council. The people in charge of disability welfare in each city and town that make up the administrative area, a wide variety of disability welfare service providers, the family members of the persons with disabilities as well as psychiatric medical institutions and consultation support organizations all participated in the planning of the project.

◎ Discussion in the project

Since the enforcement of the Services and Supports for Persons with Disabilities Act, many business establishments have entered the area, and the situation where necessary services can be used in the immediate area is slowly beginning to take shape. However, families who participated in the discussions complained that they had nowhere to entrust with their disabled person in the event of a family emergency. In response to this, we proceeded with discussions on the development of this project, focusing on creating an "emergency acceptance" system that utilizes local short-term admission facilities.

● Definition of emergencies and targets for acceptance

Focusing on the word "emergency" and all of its potential meanings differ greatly depending on individual feelings, we first held discussions to define the concept of "emergency situations" pertaining to this project. We agreed that these situations are where support for persons with disabilities in their daily living routines are not available due to unavoidable circumstances such as sudden caregivers' illness or urgent need. In addition, we confirmed that those who need medical treatment are not eligible for acceptance because they cannot be suitably dealt with at short-term admission facilities in the area.

● Process of emergency consultation until the completion of support

Assuming various situations, we designed the process from the start of consultation to acceptance according to the day of the week and time of day.

● About the registration system

Since detailed assessment information of the persons with disabilities is indispensable for accepting safely and securely these individuals at short-term admission facilities, it was decided to acquire assessment information at the time of registration as a general rule. However, even if one is not registered, he/she will be accepted on the condition that related organizations cooperate in providing detailed assessment information to the accepting facility.

2. Specific contents and features

◎ About the 5 functions

① Consultation

• Each city and town entrusts basic consultation to one or more consultation support offices.
• The core consultation support center (henceforth referred to as the core) will work closely with the consultation offices commissioned by each municipality.
• Entrusting 24-hour emergency consultation reception and coordination to the core.

② Emergencies response

• Entrusting 24-hour emergency acceptance support to local short-term admission facilities.

③ Opportunities and places for experiences

• Encourage registrants to use the entrusted short-term admission facilities for experiential use in case of an emergency.
• Position the opportunity to use local short-term admission facilities in the area as an opportunity to experience accommodations for the future.
• Accumulation of experiences in various life situations utilizing local social resources (daytime activity services, etc.).

④ Securing and training professional human resources

• Opportunities for workshops and exchanges that utilize the subcommittees and networks of the council.
• The core conducts training at the request of local business establishments.

⑤ Creating local support systems (using the Council)

• Discussing issues to be solved in the area so that individuals with disabilities and their families can continue to live with peace of mind in the future.
• Through efforts to support family activities face-to-face encounters are being created on a daily basis.
• A network is being built so that supporters can cooperate with each other.

3. Current situation and issues

As mentioned above, our efforts are not complete. There are still many issues that need to be resolved in order to realize an area where people can live with peace of mind. For instance, there is no medical type of short-term admission in this administrative area, so it is not yet possible to accommodate people who need medical care in short-term emergency admission facilities. As for the number of people, secured frames available for emergency acceptances are minimal, and there have already been cases that we have been unable to accept. So, we are discussing our efforts to expand options by gaining agreements with multiple short-term admission facilities.

In addition, each of the five functions (introduced above) is currently under development. It is also necessary to enhance each function.

Anyone may have an accident and suddenly fall into an emergency situation. Ideally, various emergency situations are assumed for everyone, and measures are taken to avoid panic at those times. As a person involved in this project, it is strongly felt that in order to achieve this, all risks in an emergency should be discussed with the families of persons with disabilities and make preparations in daily life. For this reason, it is the enhancement of consultation support that is the key to this process.

4. Future development

◎ Efforts to expand reception for emergency short-term admission

At the end of 2020, there was an urgent request for emergency care from two individuals at the same time, but due to the availability of short-term admission facilities only one of them was accepted. The other one was accompanied by a staff member of an administrative agency and was dealt with. Based on this experience, we have concluded agreements in advance regarding reception when short-term facilities are filled and have begun discussions to secure a business establishment that can respond to consultations of emergency use.

◎ A perspective that will lead to the realization of an inclusive society

When considering the path to the realization of this type of society set forth by the Ministry of Health, Labor and Welfare, it can be said that the development of local life support bases is an important factor and a necessary step in the process. When focusing on such a big goal, we must continue to promote efforts for functional enhancement.