300,000 residents was to be considered as one service or catchment area for a support program such as regional care and treatment for children with disabilities.
In the Ministry of Health and Welfare, the determination of the size of each catchment or service area is made by referring to the "secondary medical area" that is defined by each prefecture in its medical treatment plan, or to "the Health and Welfare areas for the elderly", which are regulated by the health and social service programs for the elderly, or by thinking of the district of jurisdiction of the administrative organizations in each prefecture, such as an area covered by a welfare office, public health center, or children's guidance office, and so on.
When a prefecture and a local authority prepare their plan for people with disabilities, the professional function that welfare institutions have as a key position for community-based services should be utilized in order to fulfill social services for people with disabilities.
3. The institutions' role and function
About 110,000 people reside in institutions for people with intellectual disabilities in Japan, including both children and adults.
In the residential institutions for children, the beds are not completely filled, so any move by the residents from the children's institutions to institutions for adults must be made based on the community service plan and a request from the individuals and/or organizations concerned.
To date, rehabilitation institutions have supported those with rather mild disabilities. Today, however,the demand is being made that these facilities accept persons with much more severe disabilities who need intensive care, including those with multiple disabilities.
Because of that, institutions also must change their functions in order to become social and human resources for community services, such as fulfilling their function of providing proper support in training for social life, as well as an opportunity for independence.
There already are "key-institution"-based programs and community-based service programs for children and adults with intellectual disabilities and physical disabilities that use welfare institutions. Also,for the promotion of the transition of people from residential life to community-based life, day activityb centers, group homes, training programs in skills for daily living, programs for respite services, and home-help service programs have been arranged.
Since 1996, when the continuation of community life became difficult for those who had been deinstitutionalized and moved to the community, the period during which they might once again live in the institution has been extended for three years.
Another change is that organizations such as permanent associations that have a support system are allowed to set up and manage group homes; also, in day service work, it is now possible to establish small-size facilities, that is, those that have a limit of five on the number of users.
People with disabilities should be able to get services easily in the community through making good use of key institutions' functions and specialties. There should be full progress of institutions for people with disabilities.
F. Employment
Recently, governmental and administrative activities relating to the employment of people with disabilities have accelerated.
In December, 1995, a Plan for People with Disabilities was issued by the Headquarters for the Promotion of Measures for People with Disabilities. In this plan, it was proposed in the chapter on "promoting social independence", among others, that the following should be developed:
-employment of people with intellectual disabilities: consideration of the application of an employment quota system, job development, development of vocational competence, and establishment of supporting systems;
-employment of people with severe disabilities: establishment of companies in the third sector (that is, those companies being run by government as well as by the private sector) that will hire people
