Koka Coordinating Council of Services for Persons and Children with Disabilities (Koka Independence Support Council for Persons with Disabilities)

１. Outline of the Koka Area and the Koka Coordinating Council of Services for Persons and Children with Disabilities (Koka Independence Support Council for Persons with Disabilities)

The Koka area is located in the southeastern part of Shiga Prefecture and consists of Koka City and Konan City, with a population of approximately 144,000 (as of the end of January 2023). It is a vast land area of 552.02㎢, occupying 13.7% of the prefecture’s land. As of the end of March 31, 2022, among the people with disabilities in the area, 5,549 people have a Physical Disability Certificate, 1,936 people with an Intellectual Disability Certificate, and 1,442 people with a Mental Disability Certificate. In 1995, the Koka-gun Coordinating Council for Services was established as a forum for sharing issues related to the welfare of persons with disabilities in the Koka area. For almost 30 years since then, the Koka Coordinating Council of Services for Persons and Children with Disabilities (hereinafter referred to as “Coordinating Council”) has pioneered the establishment of a system to support the community life of people with disabilities through public-private partnership. Currently, the Koka City and Konan City Core Consultation Support Center for Persons with Disabilities, as well as the service offices in the two cities, participates in the management of the Coordinating Council, which holds regular management and specialized subcommittee meetings to discuss the welfare of persons with disabilities in the communities.

２. Progress in the development of the center and in related projects

In July 2017, the government announced in the basic guidelines of the Fifth Welfare Plan for Persons with Disabilities that the “promotion of the improvement of community life support centers” should be a priority measure, and that one such center should be established in each municipality and area, and that Koka City and Konan City (Koka welfare area) would also consider this as a joint project with the Coordinating Council. Looking at the current situation in the Koka area, a significant number of people are expected to have difficulty living at home as their families age, and the transition from home to the community has become an urgent issue. Therefore, it has been confirmed that securing a place to live alone or in a group home, and guaranteeing opportunities to try the transition from home to the next stage of life are priorities. Recognizing that the Community Life Support Center Project is indispensable for future community development, a project meeting was held in October 2018 by the Coordinating Council. In order to ensure that people can continue to live in their familiar neighborhoods, the project was discussed under the theme of “Unique to Koka,” including city-owned projects, so that the project can effectively utilize the strengths of the Koka area; and the project has been in operation since April 2020.

３. Details of the “Unique to Koka” initiative

(1) Center manager (*1)

In the Koka area, one center manager is assigned to each of the four outsourced consultation support offices in the area, and these managers play a central role in coordinating with the government, planned consultation support offices, and service providers regarding emergency admission and the use of opportunities for independent living in this project (Fig. 1*). In the Koka area, each center office (center manager) basically handles cases according to the types of disabilities (physical, severe motor and intellectual disabilities, intellectual, mental, or developmental disabilities) in consideration of the manager’s expertise. In some cases, however, the center manager may be assigned to a person with a disability regardless of the type of disability. In addition, monthly meetings of the Community Life Support Center Project Steering Committee are held to exchange information and promote cooperation among the center managers.
* only Japanese version

(2) Admission into welfare facilities in case of an emergency

The first step to admission is for the neares consultation centers (government, consultation support offices, facilities for persons with disabilities, etc.) to obtain information on any emergencies (sudden illness, accident, etc.) of users and caregivers. The center manager, in cooperation with the nearest consultation office, provides logistical support for immediate action, such as getting a good grasp of the situation, selecting a place to admit the user (any short-term care facility or night care facility in the area, etc.), as well as coordination in the use of the facilities. The Koka area is characterized by its independent municipal services as it has the function to dispatch support personnel in an emergency (Table 1). If the admitting institution and the user are unfamiliar with each other, this could generate a combined apprehension in both parties. Thus, there is this system that evaluates the support given by such familiar support organizations dispatching personnel to the admitting facility or becoming the admitting facility to ensure the safety and security of the user. We strive to create a system that does not concentrate the burden on a single support organization.

Table 1: Unique municipal services in the Koka area

Functions related to “Admission into welfare facilities in case of an emergency”: – Emergency community support staff dispatch service: 2,000 yen/hour (Weekdays from 5:00 p.m. to 8:00 a.m. of the following morning, and all day on Saturdays, Sundays, holidays and rest days of the offices) * Need to be discussed at a meeting of the Community Life Support Center Project Steering Committee.	The amount is paid when the primary caregiver is unable to perform daily activities due to an accident or illness. * An additional 2,000 yen per hour is added when a nurse or other staff provides medical care.
Functions related to “Opportunities for independent living”: – Opportunities provision support service: 5,700 yen/day * Need to be discussed at a meeting of the Community Life Support Center Project Steering Committee.	Provided when relevant personnel are dispatched to conduct assessments during the experience of transitioning from welfare facilities or hospitals to community living or to become independent from their parents by using a group home, etc.

(3) Opportunities for independent living

Support begins when a familiar consultation center (government, consultation support office, facilities for persons with disabilities, etc.) gets to know the hopes of the users, like “I want to experience living outside of my home” or “I want to leave the facility (hospital) and live in the community.” The center manager, in cooperation with the familiar consultation office, provides logistical support since before the opportunities for independent living were provided until after that. The support includes attending interviews with the users, selecting a place to experience independent living (apartment house, group home, etc.), and the necessary coordination relative to that. Another feature of the Koka area is the addition of an assessment function (Table 1) in independent municipal services. This is a system for evaluating the implementation of the assessment of daily living skills, etc. by a support organization that knows the user well and visits the place where the user is actually experiencing the independent living program. The goal is not merely to complete the experience, but to understand the strengths of the user through the experience, and to link these to the appropriate support that will enable the user to maximize his or her strengths.

(4) Securing and training professional human resources

The project aims to establish a community comprehensive care system that also addresses mental disabilities, ensure a system and develop human resources capable of providing specialized care for people who need constant medical care, people with behavioral disorders, and people whose disabilities become more severe with age. In the Koka area, a human resource development project was launched in FY2022. The project is considering:
・ the creation of opportunities for less experienced workers to learn, making the Koka area an option for employment, and
・the training of the next generation who will be responsible for the future operation of the Coordinating Council.

(5) Building a community system

We hold daily discussions led by the Coordinating Council to resolve various community issues. In addition, a monthly meeting of the Community Life Support Center Project Steering Committee is held to discuss the promotion of the project and to review current issues as needed.

４. Future Issues and Outlook

In this way, the Community Life Support Center Project in the Koka area has been promoted with the aim of realizing an area-wide “Unique to Koka” development by connecting existing projects, services, and supporters. In the past, when something happened to a user, we had no choice but to cope with the situation alone, but now a temporary support team led by the center manager can think together, divide responsibilities, and work together,” which has reduced the uneven burden on supporters and made it possible to deliver higher quality support.

On the other hand, in the Koka area as well, the service providers that implement welfare for persons with disabilities are becoming increasingly diverse. Organizations with different philosophies and objectives do not necessarily have the same answer to the question of whether they can work together to support the lives of people with disabilities, whether at night or on holidays. Although many offices registered immediately after the start of the project, the number of newly registered offices is decreasing each year. We will continue to make efforts to build a community where persons with disabilities can continue to live in, while adhering to the philosophy of “Unique to Koka” by knowing that there is a life “after the loss of parents,” and by putting our ideas together to prepare for the future.

* 1 : For the nationally used term “center coordinator,” in the Koka area, we use the term “center manager.”

Edited and published by the Japanese Society for Rehabilitation of Persons with Disabilities.

Published on April 25th, 2023.