Hiroshi Shirae
Director, Kennan Arinomama-sha Facility

1. Overview of Watari Town

The town of Watari is located in the southern part of Miyagi prefecture and has a population of approximately 33,000(as of 2020). While the total population of the town is decreasing, the number of people with disabilities (including children) is increasing. As of 2020, there were 1,825 holders of disability certification cards (including 94 under the age of 18) and 277 recipients of medical care for designated intractable diseases (2019).

2. History of the Development of the Watari Town Community Life Support Center

The Social welfare corporation Arinomama-sha (henceforth referred to as the corporation) conceived the idea of the community life support center in the town of Watari during the process of formulating its new five-year plan. The Great Eastern Japan Earthquake and Tsunami caused a review of the formulation of the plan, and we had been focusing on the concept of community life support centers by the Japanese government in 2012.

Against this background, following the Great Eastern Japan Earthquake and Tsunami, the corporation launched consultation and support centers in Watari and Natori City. Taking into account the damage which occurred because of these disasters, the cases of people with disabilities and intractable diseases, relationship building in the support process, service resource status centered on disability welfare, geographical conditions, and the need for long-term support, a new five-year plan was formulated that clearly stated the need to deeply understand local circumstances and continue support. After conducting consultation and support for three years, we formulated the Watari Town community life support center concept as a corporation. The direction of the plan, such as the need for social resources related to disabilities and the functional consultation as multifunctional bases, matched that of the Watari Town community life support center plan, and the corporation applied for and was selected by the independent living support council after review.

As an idea that can be considered a philosophy, we have observed the mutual support activities between disaster victims in all disaster areas during the Great Eastern Japan Earthquake support activities. Rather than simply receiving support, relationships were built, and care was provided through such mutual relationships. We felt that we had the potential to create a community based on the original concept of care, which is not just one corporation’s philosophy, but self-realization through mutual relationships and support, in other words, the creation of a caring community.

3.Watari Town Community Life Support Center Functions (Current Status)

What does it mean to live safely in a community? Also, what is necessary for that to happen? Based on the discussions within the Watari Town Council for Independent Support and our corporation, we aim to achieve seven functions, which include the five functions identified by the government (opportunities and venues for experiences, acceptance and response in emergencies, consultation, establishing community frameworks, and securing and training specialized personnel, as well as disaster support and preventing abuse and protecting human rights.

The operational structure involves a multi-functional support center where 30 individuals with disabilities are housed along with the core counseling support center of Watari. We aim to provide support for 20 individuals who come for daily life care, five rooms for short-term emergency care, and medical support for individuals with disabilities at the medical clinic through visitations by nursing staff. We also plan to establish a helper support system for emergency response and home visit care support for the severely disabled (personal assistant), which is currently suspended. Three years have passed since then, but most of that time has not been realized as much as we would like due to the corona disaster. Although both the quantity and quality are insufficient, we will report, even if it’s only a little, on what has been implemented.

(1) Opportunities and Venues for Experiences includes many things such as daytime activity experiences for short-term stay users, daily life care experiences for students before graduation from support schools, daytime activity experiences for short-term stay users and outsiders, outside daytime activity experiences for residents, and support for group home experiences, etc.

(2) Regarding Emergency Acceptance and Response, we mainly provide emergency short-term stays. The utilization rate of emergency short-term stays in the past year has been approximately one room occupied and there was even a time when two rooms were used. While we require registration for this beforehand, we have also accepted those without registration depending on their condition and situation. There were cases where individuals who previously used emergency short-term stays suddenly came to us as they had nowhere else to go after a fight with their family. As our staff members are available on a 24-hour basis, we cooperate with the core counseling support center to accept them.

(3) As for Consultation, the core counseling support serves the main office of the self-support council, we communicate through the consultation committee and provide support to designated council service providers and intervene in difficult cases to build relationships.

(4) Regarding Building a Local System, the corona pandemic has made it difficult to interact with various talents and resources outside of welfare-related resources in the community, so we cannot say that it is sufficient. However, we are planning to have a conversation with local neighborhood associations and base officials in the near future.

(5) As for Acquiring and Training Professional Personnel, visiting lectures and other forms of training are being conducted by the core consultation and support center, and the training for various disability welfare and nursing care providers in the community is also being carried out. In addition, although training within the base has been limited to internal staff due to the corona pandemic, we plan to organize a community-based training program led by medical care and other various professionals such as doctors, nurses, therapists, registered dietitians, and certified care workers in the future.

(6) Regarding the Prevention of Abuse and Protection of Human Rights, the abuse prevention center is also entrusted with the core consultation. The foundation of the center aims to be a base for the dissemination of human rights protection and abuse prevention. Abuse prevention training and response to abuse cases that have already been conducted at the core consultation and support center. In addition, we are accumulating abuse prevention training and various initiatives within the base and hope to share them not only with disability welfare professionals but also with local residents in the future.

(7) Regarding Disaster Support, we have concluded an agreement with designated welfare evacuation centers after the legal revision in 2021 and have been working on individual education plans since 2022. During a Corona disaster, even individuals using artificial respirators can be accepted for evacuation, as families can be accommodated together. We have established a system for oxygen inhalation, sputum suctioning (including tube feeding), through central piping facilities (12 rooms in total) with solar power generation and storage for an emergency power supply, following the example of another disability support facility in Sendai City. There are 39 single rooms, each approximately 20 m², with all rooms being private except for 9 rooms dedicated to short-term stays or daily care and evacuation accommodations. We have also prepared supplies for 100 occupants, including residents, users, and local residents, to stay for seven days.

We have not yet established a 24-hour nursing system for the acceptance of individuals requiring medical care, so individuals using artificial respirators cannot currently be accommodated for long-term or short-term stays. However, accommodation for daily care is possible, depending on the individual’s condition. Accommodation for other medical care, excluding artificial respirators, is possible for regular residence or short-term stays, and daily care. Due to the restrictions on the person’s condition and the number of patients, this care is on a case-by-case basis.

4. Future Initiatives (Challenges and Responses)

While all functions are activated, the quality, quantity, and coordination of support are insufficient. We also believe that it is necessary to verify the efforts and responses during this period.

In Opportunities and Venues for Experiences, we think it is necessary to establish a system where people can experience various types of living arrangements, welfare services, and a wide range of daytime activities according to their wishes.

Regarding Consultation, we believe that it is the role of the center to organize the roles of specific, general, and fundamental consultations, appropriately grasp information, and work to coordinate limited resources to prevent depletion and consulting resources.

For Emergency Acceptance and Response, it is necessary to consider how to strengthen the quality and quantity, as well as enhance support capacity in non-emergency situations.

In terms of Acquiring and Training Professional Personnel, we believe that efforts to deepen the understanding of local residents are necessary in addition to training specialized professionals.

In terms of Building a Local System, we believe it is necessary to approach resources other than welfare-related ones, including human resources.

Regarding Prevention of Abuse and Protection of Human Rights, it is also necessary to link with the establishment of a local system and the securing and training of specialized personnel. We also believe that efforts to promote understanding of individuals with severe behavioral disorders are necessary.