Kotaro Yamaguchi
Disability Welfare Division, Health and Welfare Department, Odawara City

1. City Overview

Odawara City is the central city in western Kanagawa Prefecture, where the natural environment of forests, countryside, rivers, and sea is in harmony with urban functions. The city is conveniently located and served by six railroad lines, including the Tokaido Shinkansen bullet train, which many people use to commute to Tokyo for work. The city has a harmonious blend of history and culture, as it was the castle town centered around Odawara Castle which prospered as one of the best post towns on the main Tokaido Road.

The population of the city is 186,808 (as of April 1, 2023). People holding a Physical Disability Certificate number at 5,946. Those with a Medical Rehabilitation Certificate number at 1,967,and those with a Mental Disability Certificate number at 1,702. The number of people holding such certificates and using welfare services for persons with disabilities is increasing every year.

The western area of the prefecture, in which Odawara City is located, is made up of two cities and eight towns, including Odawara City. This city has more than half of the population of this area, and welfare service facilities for persons with disabilities are concentrated in this city. The commissioned consultation support facilities have been established in a wide area by the city and the towns of Hakone, Manazuru, and Yugawara in Ashigarashimo-gun. There are four facilities and each of them has its special field — namely, physical, intellectual, mental, and children with disabilities. The four different facilities provide consultation support in an integrated manner in the same place. They operate under the name of the “Clover – Odawara Comprehensive Consultation Support Center for Persons with Disabilities” (commonly known as “Clover”), which compares the system to a four-leaf clover. It also houses the “Odawara City Core Consultation Support Center” for the purpose of building and strengthening the consultation support system in the community, and is implementing individual consultation support and community building in an integrated manner.

2. Progress in the Development of Community Life Support Centers

When the 4th Odawara City Disability Welfare Plan (FY2015-FY2017) was formulated, the development of community life support centers was deliberated, and the goal set was to make an area-wide development centered on Eikou-en, a support facility for persons with disabilities operated by Eikou-kai, a social welfare corporation.

However, Eikou-en, which mainly targets persons with intellectual disabilities, alone cannot meet the needs of people with various types of disabilities. Therefore, it became necessary to consider its reorganization. In addition, four of the six support facilities in the western area of the prefecture were located in Odawara City, and due to the uneven distribution of social resources, there were requests for the wide-area development of community life support centers. Therefore, a committee was formed to study the ideal way of developing community life support centers in the entire western area of the prefecture.

The committee decided to place the highest priority on the development of consultation and emergency reception/response functions, with the commissioned consultation support facilities serving as coordinators of these functions. It was decided that the area would be divided into two based on the two commissioned consultation support facilities within the area, and the city would promote the development of the community life support centers in a wide area together with the three towns in Ashigarashimo-gun.

3. Status of Development of Community Life Support Centers in Odawara City

Odawara City started the Odawara City Community Life Support Center Project in 2022. Under this project, the city appointed some facilities to take on the functions of community life support centers.
In addition, the “Emergency Support Project” was launched to identify persons with disabilities who are at high risk of having difficulties while living at home due to the sudden illness of their primary caregiver, and to provide risk management support in case of emergencies. Based on the analysis of the past cases, we have identified “elderly guardians,” “no use of welfare services for persons with disabilities,” and “persons with severe disabilities” as cases that require emergency measures, for which we are developing consultation support through outreach.

(1) Consultation

In the Emergency Support Project, Clover serves as a coordinator that provides emergency consultation support, while the Odawara City Core Consultation Support Center provides operational management for the entire project. In addition, the 24-hour/365-day consultation support system is supplemented by the administrative agencies providing nighttime and holiday support through the scheme of the Center for the Prevention of Abuse of Persons with Disabilities. In addition, by having designated specific consultation support facilities take on some of the consultation functions, we are building a consultation support system for the entire community.

(2) Admission into facilities in case of an emergency

Eikou-en has been appointed as a community life support center by the city since the beginning. Eikou-en, the core facility, and other facilities for persons with disabilities accept admission of persons with disabilities for short-term stays in case of emergencies. Through the Emergency Support Project, coordinators and facility staff visit the homes of persons with disabilities identified as having a high risk of emergency cases. They also share information in preparation for emergency admissions (Photo 1).

(3) Provision of opportunities to experience places

There are persons with disabilities who have never used welfare services. To prepare them for an emergency, we provide them with opportunities to practice spending time outside of their homes using support facilities for persons with disabilities. They begin with spending time in rooms or shared spaces in the facilities by using temporary daytime support.

(4) Securing and training professional personnel

Kanagawa Prefecture has unique projects. One is the project to assign community centers for welfare services for persons with disabilities which subsidizes facilities that accept persons requiring constant medical care and those with behavioral disorders. Another is the community life support project for persons with disabilities. Both projects are utilized to provide specialized support for them. In addition, long-term care insurance service facilities that operate short-term residential care on a co-existence basis assume the functions of community life support centers to meet the complex needs of aging persons with disabilities.

(5) Building a community system

The Odawara City Core Consultation Support Center serves as the secretariat of the Community Independence Support Council for Persons with Disabilities, and is working to build a consultation support system in the community. The center holds meetings to exchange opinions among facility members that perform the functions of community life support centers, shares examples of responses in the emergency support projects, and discusses how the service provision system should be, thereby working to create a system that will support the lives of people with disabilities throughout the community.

4. Current Issues and Future Prospects

When a person with a disability, who has never been connected to our support system, uses a short-term residential care service in case of an emergency, we think that it is difficult to deal with this kind of situation because there is little information on the characteristics of the person’s disability and physical/mental condition. A decade ago, there was a time when administrative staff sent to a facility an indigent person with a disability at night. At that time, the facility admitted the person since the administrative staff and the facility staff knew each other. Today, however, support is provided based on the evidence from assessments, and it has become difficult to admit a person with a disability because there is a lack of information about the person. Coordinators feel that it is important to collect information in advance and conduct simulations in order to provide the necessary information to the admitting facility. This will also lead to a sense of security and reduce the burden on the part of persons with disabilities who use the service for the first time.

In developing the community life support centers, in some cases, we started with the pilot operation of the Emergency Support Project, and we were actually able to accept people with disabilities for a short-term stay in case of an emergency. By seeing the coordinators, who exerted efforts to coordinate the admission of persons with disabilities with limited information, and by seeing the facilities and the staff members on the admitting side, I re-realized that what is important in the development of community life support centers is a common awareness that the entire community should support the community life of persons with disabilities, and that there are many facilities with such enthusiasm in the city. We will continue to hold interactions with local residents, and consider what the entire community can do, and strive to fulfill the functions of community life support centers which are not enough.

Photo 1: Eikouen, a support facility for persons with disabilities that served as the starting point for the development of community life support centers

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

Published on July 25th, 2023.