Yuki Hamao
Access Nemuro
(Nemuro Area Comprehensive Consultation Support Center
for Persons with Disabilities)

1. Area Overview

The Nemuro Area is located at the easternmost part of Hokkaido and consists of one city and four towns: Nemuro City, Betsukai Town, Nakashibetsu Town, Shibetsu Town, and Rausu Town under the jurisdiction of the Nemuro Subprefectural Bureau.  The land area is about 8,500 km2 (including the four northern islands), accounting for 10.2% of Hokkaido. (The area excluding the four northern islands is about 3,497 km2.)  The population is about 72,000.

Our office is located in Nakashibetsu Town, which is close to the center of the area, about 77 km to the center of Nemuro City, and about 64 km to Rausu Town.  The projects we are implementing for persons with disabilities are the Wide-area Consultation Support System Development Project, the Basic Consultation Support Center (with an assigned coordinator), the Consultation on Planning, and the Community Consultation, which are commissioned by Hokkaido Prefecture.  Other than the Community Consultation, we implement the projects in one city and four towns as target areas.

There are three consultation support offices in the Nemuro Area: Nemuro City (with one consultation support specialist), Betsukai Town (with two consultation support specialists), and Nakashibetsu Town (with four consultation support specialists), which means specialists are not assigned in all municipalities.

2. History of the Establishment of the Center

In the Nemuro Area, one counselor was assigned to our Center in the town of Nakashibetsu in 2009 as part of the commissioned wide-area consultation support project for persons with disabilities in one city and four towns.  At that time, there was only one consultation support office in the area, and only two counselors were assigned to cover the entire area.  The Service Use Program was introduced, and the number of consultation and support specialists has since increased.  Meanwhile, we were often faced with issues in the communities that could not be resolved.

To establish the Community Life Support Center for Persons with Disabilities, the municipal welfare officers in the area, together with the officers of Hokkaido Prefectural Government (Nemuro Subprefectural Bureau) and our Center (commissioned by the municipalities), have met on a regular basis to assess the current situation, discuss the policies, establish a base in each municipality, review the issues, and determine the needs that have to be addressed.

Based on the cases we have dealt with so far, we have identified the things that we have done and the challenges we face in the functions of the Community Life Support Center, exchanged opinions and held repeated discussions.  Instead of aiming to create a perfect center all at once, we have focused on what we can do and how we can improve the inadequate functions.

Matters concerning the whole area were also reviewed and discussed in the Independent Living Support Council of each municipality. Then the Community Life Support Centers began in April 2018.

3.  Major Developments

(1) Consultation

The commissioned consultation function has been transferred to the key consultation center.  One center coordinator has been assigned.  Two counselors have been assigned for the city and four towns, thereby being able to continuously provide a 24-hour, 365-days-a-year wide-ranging consultation system, including emergency cases.

(2) Opportunities and Places to Experience Living Independently

To provide a place where a person with a disability can experience and practice living independently without fear or hesitation, we have secured a budget for the rental of an apartment house by a commissioned corporation.

To support persons with disabilities transitioning towards living independently, group home users may also try the apartment to experience living alone.  It is also assumed that those living at home with their parents will try to use it to experience living independently without their parents.

(3) Coping with Emergencies

Basically, admissions in institutions are only for a short term.  However, since there are only two institutions within the area and vacancies are few, we have a system to search for institutions outside the area or temporarily use the apartment stated above as an option.

In the past, there were cases of persons with disabilities who temporarily lost a living space due to trouble with their families or with landlords.  So, we are ready to respond to such unexpected cases with some flexibility.

(4) Securing and Training Specialists

We hold trainings to provide basic knowledge of our programs and improve their skills, create a network between consultation support offices and support schools, and disseminate information on training conducted by various organizations.

(5) Building a Community System

We maintain a network with welfare departments and consultation support offices of the municipalities in the area to understand their needs and clarify issues.  To secure living spaces, we collect information on boarding houses, rental rooms, and apartments that do not require a guarantor.  We also actively collaborate with people in fields other than welfare for persons with disabilities (such as poverty, children, elderly, medical care, and judicial fields) so we can make effective use of those resources.

4. Status since the Establishment (2018-2021)

(1) Consultation

The number of persons with disabilities who do not use welfare services and rather use our consultation services is around 200 every year.  Consultation done on Saturdays and Sundays and during the time outside the hours of 9:00-17:00 accounts for more than 10% of the total.  Consultation related to children (childcare, school, employment), infringement of the law, delinquency, debts, personal bankruptcy, etc. is on the rise, and cases that cannot be resolved only by welfare services are increasing.

(2) Opportunities and Places to Experience Living Independently

So far, nine persons, including group home users, have tried using the apartment.  As a result, two persons have started living independently.  There are persons who first tried the apartment to prepare for living independently from their families, and then actually began living alone elsewhere; while others decided to move into a group home, realizing the difficulties of living alone after experiencing the stay at the apartment.  I believe that it is effective to experience and evaluate the experience before making a decision.

(3) Coping with Emergencies

There were 6 cases of persons with disabilities who resorted to staying in the apartment due to an emergency.  One of them was kicked out of the home after a divorce.  Another person ran away from home due to parent-child quarrels and was taken into custody by the police.  Another one was suspected of being abused.  The others also used the apartment for various emergency reasons.

Before the establishment of the Community Life Support Center, we were burdened with looking for livable places, and there were times when our counselor had no choice but to stay with the client in the consultation center.  Now, with the established system, the counselors’ emotional burden has been reduced.

In some cases, we had to cope with the emergencies together with the clients who sent us SOSs as they were not able to depend on their families.  One such case was when the spouse of a person with a physical disability was transported to the hospital at night, but she could not get into the ambulance because of her disability.  So, our staff member took her to the hospital and stayed with them until he died.  Another example is when we received an SOS from a person who was not able to depend on his family, saying “My wife collapsed from a seizure and I called an ambulance, but I don’t know what to do.”

(4) Securing and Training Specialists

Due to COVID-19, our training is mainly done online.  The advantage is that even if one cannot participate in the training on the day itself, many can participate later at their convenience.

(5) Building a Community System

We are increasingly involved in collaboration with people in other fields, and added to the collaboration with groups involved in issues about children (education), the elderly, and medical care, there is an increase in collaboration with poverty-related organizations and lawyers.  Every system has its own gaps in it, and I am sure that it is important for concerned organizations to put their heads together to make up for those gaps.

5. Challenges

Recently, there are more cases in which it is difficult for a person to cope with the situation alone – such as when a person with a disability has to support his/her parents (emergency hospitalization, medical care, nursing care, etc.) or when a parent dies.  Taking care of aging parents is one of those challenges.

There are many other challenges.  There are only a few medical care services and services able to handle persons with severe behavioral disorders.  There are people who cannot go to an institution because they live in a remote place and have no public transportation available (sometimes, our accompanying staff member travels 400 km in a day).  Some people have no choice but to leave their hometowns as they do not have a group home in their community.  Such are the many challenges we have to cope with.

Given the shortage of workers, I fully realize how difficult it is to create a system that supports a secure life 24 hours a day, 365 days a year, taking into account the working conditions.

I realize that the establishment of the Community Life Support Center is not the goal but a preparation for a beginning.  We will continue to tackle the challenges to create as much peace of mind in community life according to the changing needs of persons with disabilities in each community over time, systems, and circumstances.