Kyoichi Kosuda
Manager, Division of Promotion of Measures for Persons with Disabilities
Department of Welfare for Persons with Disabilities
Health and Welfare Bureau, Sakai City

1. Overview of Sakai City

Sakai City is located in the central and southern part of Osaka Prefecture in the central part of the Kinki region.  As of April 1, 2022, the city had an area of 149.83 km2 and a population of 817,441.  It is an ordinance-designated city with the second largest population and area in Osaka Prefecture.

As of the end of March 2022, among the people with disabilities living in the city, 35,760 people have a Physical Disability Certificate, 8,833 people are the holders of an Intellectual Disability Certificate, and 10,890 people are Mental Disability Certificate holders.  19,362 people are outpatients of mental hospitals.   The completion rates of the plan prepared by consultation support specialists are 65.8% for persons with disabilities and 47.3% for children with disabilities.

2. Upgrading Community Life Support Centers

In fiscal 2012, we, together with persons with disabilities and experts, held a study group on how persons with disabilities should live, and discussed that 24-hour support and emergency support be added to the short-term admission program.  In fiscal 2014, we implemented the “Safety Call Center” as a three-year verification project, during which we coordinated with caregivers on the telephone about short-term admissions for emergencies, such as at night and on holidays.  In fiscal 2015, in the latter half of the “Implementation Plan for Sakai City Master Plan” and the “Fourth Sakai City Welfare Plan for Persons with Disabilities,” we discussed the functions of community life support centers and decided to upgrade them.  In April 2017, as a new emergency support service, we started a night/holiday emergency consultation call center and launched the “Emergency Support Program for Persons with Disabilities” that dispatches support staff to provide transfer services in case of an emergency.  The specific components of the services were deliberated upon by the Council for the Promotion of Measures for Persons with Disabilities.  As a result, the five functions presented by the national government were shared and coordinated systematically to support the lives of persons with disabilities throughout the community.  The five functions are linked mainly by the General Consultation Information Center and the Ward Basic Consultation Support Center for Persons with Disabilities.

3. Five Functions of the Current Community Life Support Centers in Sakai City

(1) Consultation

For persons with disabilities to live with peace of mind in the community, when they or their families need to have a consultation, they can go to any of the following offices as they collaborate with one another so that the most needed support may be provided no matter which office the persons go to: whether it be the Planning and Consultation Support Office, the Community Consultation Support Office, the Ward Basic Consultation Support Center for Persons with Disabilities and the relevant sections of the Ward Office.  As of the end of March 2022, 65.8% of the recipients of welfare services for persons with disabilities use the Planning and Consultation Support; thus, it is necessary to further increase the number of offices and consultation support specialists.

Each ward office has a Basic Consultation Support Center for Persons with Disabilities, which provides one-stop support for three kinds of disabilities.  In addition to responding to consultations about living in the community, we provide advice to the Planning and Consultation Support Offices relative to the support of people who do not use welfare services or support for difficult cases, etc.  The General Consultation Information Center provides technical support to the Ward Basic Consultation Support Center for Persons with Disabilities with wide-area coordination, creating an effective and systematic collaboration system.  Additionally, in cooperation with specialized organizations in the Sakai Municipal Health and Welfare Plaza, the Support Center functions as an information center, collecting and disseminating information for the welfare of persons with disabilities.

Moreover, a coordinator in charge of transition to the community is assigned to Basic Consultation Support Center for Persons with Disabilities in each ward, thereby carrying out the transition-to-community project.  In cooperation with psychiatric hospitals, a coordinator in charge of transition to the community conducts staff training and holds tea parties with peer supporters so that in-patients may become interested in community life.  Additionally, we are holding seminars for the staff members of institutions to raise awareness about transition to the community.

(2) Admission in case of emergency

Until the Emergency Support Services for Persons with Disabilities began in April 2017, the users often contacted the familiar offices during the daytime in the event of an emergency, and the office staff would sometimes have to rush to the person’s home even beyond working hours.  Currently, when a person with a disability cannot receive nursing care in the event of a caregiver’s emergency, a short-term admission can be provided by registering in advance with a short-term admission institution.  At night and on holidays by contacting the call center of the short-term admission institution, support can be provided by the institution and even support staff can be dispatched to the site, as necessary.  Eligible persons for the Emergency Support Services are: (1) those who have an address within the city, live with a caregiver, and are 18 years of age or older; (2) persons who have concluded a contract relative to the use of services with the short-term admission institution in case of an emergency, and (3) persons whose disability support category is 3 or higher.  The support staff to be dispatched to the site shall be the staff of a daytime service institution, while the short-term admission institution shall handle the communication.

Furthermore, in case a caregiver cannot temporarily take care of a person (or child) with a disability for emergency reasons such as the caregiver’s hospitalization, the city secures an emergency bed at a designated short-term admission institution.

(3) Opportunities and places to experience

Thinking ahead of the impact of the death of parents, the Independent Living Training Program for Persons (or Children) with Disabilities provides an opportunity to experience nights away from the family—from the early stage of consultation—with an experienced supporter staying in the next room. Through the stay-out experience, we can create opportunities that will lead to future independent living and transition to community life while gradually accumulating successful experiences.   For a stay-out experience, we use a vacant room at an institution.

The living-alone experience program provides opportunities for persons with disabilities to experience living alone in a place like a weekly rental apartment and to assess the support and environment they will need in their daily lives.

(4) Development of professional human resources

The General Consultation Information Center dispatches experts such as lawyers, judicial scriveners, and social insurance labor consultants to provide expert consultation, thereby strengthening the consultation functions of the Ward Basic Consultation Support Center for Persons with Disabilities and consultation support offices.

A series of seminars are held every month for newly appointed consultation support specialists with work experience of two years or less, while advice is given by a chief specialist through mini-lectures and group work to discuss key points and challenges in providing services under Planning and Consultation Support.  There are many workplaces where a support specialist has to work alone; yet it is expected that the horizontal link between specialists will be established along with the enhancement of the quality of support specialists.  The Sakai Municipal Health and Welfare Plaza houses specialized agencies and government agencies through which we have secured a system of working together that allows for specialized support.

○ Health and Welfare Center

Citizens Exchange Center (Citizens Exchange Center, Vocational Activity Support Center), Sports Center, Visually and Hearing-Impaired Center, Life Rehabilitation Center, General Consultation Information Center, Employment and Life Support Center for Persons with Disabilities, Support Center for Persons with Developmental Disabilities, Support for Intractable Disease Patients Center

○ “Verde Sakai” – Support Center for Persons/Children with Severe Mental and Physical Disabilities

○ Government agencies

Child Consultation Center, Rehabilitation Consultation Center for Persons with Disabilities, Mental Health Center (Mental Health Welfare Center)

(5) Community system building

Each Ward Independence Support Council operated by the Ward Basic Consultation Support Center for Persons with Disabilities builds a network with related organizations and people in the community, and exchanges opinions and collaborates on the issues and needs of the community.

４. Future Issues and Policies on the Development and Operation of Community Life Support Centers

In view of the increasing severity of disabilities and the aging of the population, we believe that it is necessary to tackle the issues that have emerged from collecting individual cases so that the five functions can effectively work together.

Photo:  Sakai Municipal Health and Welfare Plaza