Because of the increasing number of people with severe disabilities in sheltered workshops and small-scale workshops, the Ministry of Health and Welfare's Committee for Considering the Sheltered Workshop Program recommended in 1992 that day centers should be classified into three types: (a) welfare factories, (b) sheltered workshops, and (c) day centers that have day care functions for creation and light work, emphasizing social participation and worthwhile living, and that all these facilities should be improved. To establish the third type of facility, the Liaison Council of Organizations for Children and People with Mental and Physical Disabilities has had day care centers for people with severe disabilities as the theme of its yearly study conference on community living support systems for people with mental and physical disabilities for the past three years (since 1994).
At the same time, in April, 1995, the National Social Welfare Council established a Research Committee on Community Living Support for People with Disabilities (Chairman, Tsurukichi Takamatsu).
In May, 1996, this group presented a report to the Ministry of Health and Welfare on day activity centers for people with disabilities: "for the community life of people with severe multiple and profound disabilities".Here is an outline of that report:
Community living support basically should cover all adults with severe disabilities, should be available for long-term use, and should be managed flexibly according to the local situation. The contents of the activities should emphasize social participation and worthwhile living, such as creation or light work,cultural activities, and recreation. It should guarantee activities five days a week. The size of the program should be about twenty persons, devising the small size and separate types. The standard should be three consumers to one direct care staff; social workers and nurses should be provided.
Lunch and transportation services should be available. Local governments should support the shift from the current variety of facilities to this new program. There should be one such program for every 50,000 in the population.
In the plan for people with disabilities that was published in December, 1995, an increase in day services is indicated, but there is no mention about real day care facilities for people with severe disabilities. However, it does specity the reconsideration of the facility system and related plans. This means that a good environment for synthetically systematizing community living support for people with severe disabilities should be prepared through the integration of the departments concerned with disability within the Ministry of Health and Welfare. In this attempt, we succeeded in promoting mutual understanding between those concerned about the various kinds of disabilities. Additional efforts of persons and agencies concerned toward the realization of this conception are hoped for, while, at the same time, further research should be promoted.
F. Occupation
1. Synthetic Model Program for the Employment of People with Disabilities in the Community
Since fiscal year 1993, in order to promote the occupational independence of people with severe disabilities, local Departments of Employment and Welfare have coordinated their efforts in order to provide a well thought-out vocational rehabilitation program and arrange the proper environment for vocational living. The Synthetic Model Program for Employment of People with Disabilities in the Community has been administered in three prefectures -- Saitama, Okayama, and Kumamoto, and is being prepared for administration in Iwate, Fukui, and Hyogo prefectures.
In this model program, we are now preparing to construct a vocational rehabilitation network for sharing information between the Departments of Employment and Welfare, by making databases from the information available in each department.
Additionally, we are providing well thought-out vocational rehabilitation. For example, we have set up Vocational Support Centers for people with disabilities at the community level which, as a personal support system, can treat various problems consistently. In these Centers, workshops were set up to provide work training for people with disabilities.
