Ryoji Mori
Manager and Consultation Support Specialist
Wakatake Consultation Support Office, Social Welfare Corporation Wakatake-kai

1. Outline of the Area and Community Independence Support Council

The Chusan East area is located in the center of Kagawa Prefecture and consists of one city and two towns: Sakaide City, Utazu Town, and Ayagawa Town. The land area is about 210㎢ (11.2% of the entire prefecture), and the population is about 91,243 (as of the end of March 2022). The number of people with disabilities living in the area: 3,779 with a Physical Disability Certificate, 751 with a Medical Rehabilitation Certificate, and 676 with a Mental Disability Certificate. As for welfare services to persons with disabilities, almost 100% of the welfare service plan has been created by consultation support specialists.

The Chusan East Area Community Independence Support Council is centered on the welfare administration for persons with disabilities of one city and two towns in the area, four outsourced consultation support offices, and six specific, child, and general consultation support offices. We regularly hold general meetings, management subcommittees, secretariat meetings, and specialized subcommittees to discuss welfare issues for people with disabilities in the community.

2. Outline of the Development Process of Community Life Support Centers

Since 2015, discussions have been done mainly by the management subcommittee of the Chusan East Area Community Independence Support Council. In December 2016, a project group was established within the Council, consisting of local governments and consultation support offices in the area. In the meetings held about once a month, it has been discussed and agreed that the local governments, which are the implementing bodies, and welfare offices for persons with disabilities in the area, will share the functions and cooperate with each other to provide various kinds of support to persons with disabilities so that they can live peaceably in familiar surroundings.

In June 2017, we held a briefing session for the welfare offices serving persons with disabilities in the area and requested their cooperation regarding the admission of persons with disabilities in case of an emergency. After that, we conducted a questionnaire on their willingness to give us cooperation, and signed a contract with the offices that offered their cooperation. Currently, 38 offices have signed a contract with us.

On October 1, 2017, the services began full scale, and by a joint commission from the city and the two towns, the Wakatake Consultation Support Office has a coordinating function (actual number of staff: 2, who have other jobs concurrently), such as coordination in cases of emergency, as we make efforts to contribute to the development and promotion of this service.

3.Details of Necessary Functions and Status of Initiatives

① Consultation

The staff members of Wakatake Consultation Support Office serve as coordinators, providing consultation services 24 hours a day, 365 days a year, including at night, and accepting emergency admission through the local governments and consultation support offices in the area as the main contact points.

② Opportunities and places to experience community life

As part of our support for transition to community life, we provide opportunities and places to experience staying out, conducting trial admissions to a facility, short-term admissions, etc.

③ Admission to welfare facilities in case of an emergency

Welfare offices for persons with disabilities in the area (38 locations, as of the end of FY2021) accept admission in emergency cases.

Since the start of the service in October 2017 to the end of March 2021, we have accepted a total of 11 persons with disabilities from Sakaide City, Utazu Town, and Ayagawa Town in emergency situations. The reasons are: abuse (5), hospitalization or death of family members (3), domestic violence (DV) (1), disaster (1), and influenza infection (1). By admission type, there are 10 cases at short-term admission institutions and small-scale multifunctional institutions, and one case of home support by a helper. After that, in six cases, they returned to their homes after coordinating with relatives and service providers and continued community life, and in five cases, they either moved to institutions or started living alone.

④ Securing and training professional human resources

The specialized subcommittee of the Independence Support Council discusses and studies the improvement of community systems that can meet the diverse needs of the community and the development of human resources.

As for the establishment of a community-based comprehensive care system that also supports people with mental disabilities, the community-based comprehensive care subcommittee participates in community meetings aimed at understanding and raising awareness of people with mental disabilities in the community, and together with peer supporters we conduct seminars for welfare commissioners and local residents.

In the development of a system for children requiring constant medical care, the Medical Care Subcommittee assesses the current situation and issues within the area and considers how to build a network.

⑤ Building a community system

The staff members of the Wakatake Consultation Support Office act as coordinators for the community life support centers and serve as the secretariat for the Chusan East Area Community Independence Support Council, as well as cooperate to improve the community system.

4. Current Issues and Future Prospects

Five years have passed since the start of the community life support services, and as part of the verification and evaluation of the services, which are described in the Welfare Plan for Persons with Disabilities, we are looking into the current status of the offices for their preparedness to admit persons with disabilities in case of an emergency. At the beginning of the services, briefing sessions were held on welfare services for persons with disabilities in the area, and there was a series of activities to promote the services from the Ministry of Health, Labour and Welfare and the Kagawa Prefectural Community Independence Support Council. Therefore, the objectives and contents of the services were well understood by the offices of the welfare for persons with disabilities in the area. However, five years have passed since the start of the services, and due to the transfer of managers within the relevant offices and the situation of new offices that have been established in the area during the last five years, I think that the objectives and contents of the services are not fully understood by the service providers in the area.

For this reason, we are planning to conduct a survey of the welfare service offices that have already contracted with each municipality for the admission of persons with disabilities and let them recognize the objectives and contents of the services once again, as well as ask them if they can continue to admit persons with disabilities in an emergency. In addition, we will explain the objectives and contents of the services to the welfare service offices for persons with disabilities that are newly established after the start of the community life support centers and ask them if they can admit persons with disabilities in case of an emergency.

To this day, the following is the situation of persons with disabilities who have been admitted and dealt with in emergencies: ① those who use welfare services for persons with disabilities but have not yet been categorized in any disability support classification, ② those who are under long-term care insurance and hold a physical disability certificate, but do not use welfare services as persons with disabilities, ③ those who used to avail of welfare services, but are currently employed or living alone in the community. In many cases, the Employment and Life Support Center or Municipal Health Center and the Social Welfare Council are involved. 100% of the inquiries are not from the person or family, but from such related organizations. Before the services started, we expected that there would be many inquiries from persons with disabilities who had no connection with any place, but in reality, the persons with disabilities we mainly communicate with are those who have always had some kind of relationship with welfare services. From this, it is safe to assume that persons with disabilities in the area are receiving some kind of welfare services and the support is sufficient, or that persons with disabilities who need support are not receiving information on the availability of community life support services. Identifying persons with disabilities who do not use welfare services through outreach has been discussed in the review committees for the establishment of core consultation support centers in the area, but has not yet been realized.

Furthermore, preparation and discussion relative to a multi-layered support system development program in the area comprising the city and the two towns, and this program includes continuous support program through outreach and other means. We shall continue discussing how we should position the community life support center in the medium- to long-term range in the welfare system for people with disabilities, and together with cross-sectional support for children, people with disabilities, the elderly, and indigent people, we shall cooperate and collaborate with related organizations in order to provide sufficient support to persons with disabilities who might not have yet received any support.