Chapter 4 Welfare Services
Welfare for Persons with Disabilities in Japan 2007
1. Independent Living Support Benefits System in Relation to Welfare Services
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Welfare services used to be provided according to the type of disability i.e. physical, intellectual or mental disability. It had been pointed out that the system of facilities and programs was complicated to understand and it was difficult to use these services. In order to enable persons with disabilities to use the necessary services regardless of the type of their disabilities i.e. physical, intellectual or mental, the service system was unified and the facilities and programs were accordingly rearranged.
This chart shows the changes of the services. The following shows the current services.
Services at home
- 1. Home help (for persons and children with physical, intellectual, or mental disability)
- 2. Day service (for persons and children with physical, intellectual, or mental disability)
- 3. Short-stay (for persons and children with physical, intellectual, or mental disability)
- 4. Group homes (for persons with intellectual or mental disability)
Services at facilities
- 1. Facilities for children with severe physical and intellectual disabilities (for children with disabilities)
- 2. Nursing homes (for persons with physical disability)
- 3. Rehabilitation facilities (for persons with physical or intellectual disability)
- 4. Sheltered workshops (for persons with physical, intellectual or mental disability)
- 5. Welfare factories (for persons with physical, intellectual, or mental disability)
- 6. Dormitories for workers (for persons with intellectual disability)
- 7. Welfare homes (for persons with physical, intellectual, or mental disability)
- 8. Training facilities for daily living (for persons with mental disability)
The following shows the new services.
The following ten services are covered by Care Benefit.
- 1. Home help (Personal care at home). This provides support at home in bathing, toileting, eating etc.
- 2. Visiting care for persons with severe disabilities. This provides comprehensive assistance to persons with severe orthopedic disabilities who need constant support in bathing, toileting and eating at home and also in moving when they go out etc
- 3. Activity support. This provides necessary support to avoid dangers when persons with a limited ability to judge by themselves go out and engage in some activities
- 4. Comprehensive support for persons with severe disabilities etc. This provides several services comprehensively such as ‘home help (personal care at home’ to persons in great need of care
- 5. Day service for children. This gives guidance to children with disabilities regarding basic movements in daily life and provide training for adapting to group activities
- 6. Short-stay. This provides support in bathing, toileting, eating for a short period including during the night in case a carer at home is ill, etc.
- 7. Medical and nursing care. This provides persons, who need medical treatment and constant care, with functional trainings, necessary control for their recuperation, nursing, care, and support in daily living activities at medical institutions
- 8. Care in daily life. This provides support to persons, who need constant care, in bathing, toileting, eating etc during the day and also provide opportunities for creative activities and productive activities
- 9. Nighttime care etc at support facilities for persons with disabilities (support for living in a facility). This provides support to persons admitted to facilities in bathing, toileting, eating etc during the night and at weekends
- 10. Care homes. This provides support at collective homes in bathing, toileting, eating etc during the night and at weekends
The following four services are covered by the Training Benefit
- 11. Training for Independent Living. This provides necessary trainings for a certain period to improve physical functions and social skills so that independent living and social life can be lead
- 12. Assistance for employment. This provide persons who wish to work in a private company with necessary trainings for a certain period to improve their knowledge and skills necessary for employment
- 13. Assistance for continued employment (type A = in the form of employment, type B = not employed). This provides support to persons admitted to facilities in bathing, toileting, eating etc during the night and at weekends
- 14. Group homes. This provides consultation and support in daily living at collective homes during the night and at weekends
- These four services are covered by the Training Benefit
The three are covered by Community Life Support Programs
- 15. Mobility support. This provides mobility support so that persons with disabilities can go out without difficulties
- 16. Community activity support center. This provides opportunities for creative activities and productive activities as well as interaction with society
- 17. Welfare homes. This provides rooms to those who need housing for low price and also necessary support in daily life
Combination of daytime activity programs and nighttime living support programs
Services provided in institutions and facilities are divided into ‘day services (daytime activity programs)’ and ‘nighttime services (living support programs)’ and users can select and combine these services.
When using these programs, an individual support plan for each user is formulated to provide appropriate services in accordance with their purpose of use.
For example, a person in a nursing home for persons with physical disabilities who needs constant care can select ‘life care’ program from daytime activity programs and ‘support for living in a facility’ from nighttime living support programs. When persons with disabilities move to live in a community, they can continue to use the ‘life care’ program during the day.
This picture shows the example of the combination of daytime and nighttime programs. The left box shows the place for the daytime activities. One or more programs should be selected from the below; Medical care (this is provided to hospitalized patients in medical institutions), Life care, Training for independent living (function/daily living), Assistance for employment, Assistance for continued employment (type A = in the form of employment, type B = not employed) and Community activity support center (Community life support programs). The right box shows the living place at nighttime and the support for living in a facility for persons with disabilities or living support (functions of care home, group home, and welfare home) is provided.
2. Independence Support Medical Cost Benefit
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Costs of medical treatments such as operation of children/persons with physical disabilities to reduce or recover from disabilities as well as medical costs of outpatients with psychiatric disabilities are subsidized.
3. Assistive Devices Cost Benefit
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Costs to purchase adaptive equipment to compensate or substitute the lost body parts or damaged body functions of children/persons with physical disabilities are subsidized. (prosthesis, orthosis, wheelchair, glasses, white cane for the blind, hearing aid, etc)
Note: Care Benefit, Training Benefit, Independent Living Support Medical Care Allowance, and Adaptive Equipment Allowance are ‘Independent Living Support Benefits’ provided to individual users.
4. Community Life Support Program
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(1) Programs at Municipal Level
| Programs | Contents |
|---|---|
|
Consultation support program |
Consultation for persons with disabilities, their guardians and carers, provision of necessary information and support to protect rights of persons with disabilities, and establishment of Independent Living Support Council to build a consultation support system and network in a community |
|
Communication support program |
Dispatch of sign language interpreters, note takers, Braille translators, etc. in order to intermediate the communication with persons who have difficulty in communicating due to hearing, speech, voice, visual impairments |
|
Program to supply equipment for daily living |
Provision or rental of devices necessary in a daily life to support independent living of persons with severe disabilities |
| Mobility support program |
Provision of support to persons who have difficulty in mobility when they go out |
|
Community activity support center |
Provision of opportunities for creative activities and productive activities to persons with disabilities in the community and promotion of their interaction with society |
| Other programs |
Programs necessary for independent daily living or social life, according to the judgment of municipal government Examples: welfare home program, visiting bathing service program, day time temporal support service, social participation promotion program, etc. |
(2) Programs at Prefectural Level
| Programs | Contents |
|---|---|
|
Highly professional consultation support program |
Consultation and provision of necessary information regarding disabilities which requires highly professional knowledge such as developmental disorders, higher brain dysfunction, etc. |
| Wide-area support program | Programs which require supports beyond the scope of municipalities, e.g. program to promote and support persons with mental disabilities in leaving hospital |
|
Other programs (including training program) |
Programs necessary for independent daily living or social life, according to the judgment of prefectural government Examples: welfare home program, information support program, comprehensive promotion program of IT for persons with disability, social participation promotion program, etc. Training programs etc targeted for service providers and instructors |
5. Institutions not targeted for Independent Support Benefits
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(1) Institutions for children with disabilities
Institutions for children with intellectual disabilities, institutions for children with visual impairments, institutions for children with hearing impairments, institutions for children with physical disorders, etc
(2) Community institutions for persons with physical disabilities
Welfare centers for persons with physical disabilities, Braille libraries, facilities to provide information to persons with hearing impairments, guide dog training centers, etc
6. Welfare Services and User Expense
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Welfare service users who receive Independent Living Support Benefit etc have to principally bear all the costs for food, electricity and water, and 10% of other costs. In case of persons with low income, the cost shall be reduced or exempted.
7. Support of Using Welfare Services
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○ Statement of Dissatisfaction
If not satisfied with designated classification of the degree of disabilities or decisions on the benefits, they can appeal to prefectural government (Examination Board of Statements of Dissatisfaction regarding Care Benefits of Persons with Disabilities etc).
○ Complaints Resolution Program
Complaints Resolution Program can be utilized for complaints on welfare service for persons with disabilities in general. The users can state complaints at a service counter designated for receiving complaints, which is established at each service provider, or directly file complaints at Management Adjustment Committee set up in the Prefectural Council of Social Welfare.
○ Community Welfare Rights Protection Program
This is a service to support persons with a limited ability to judge with utilizing welfare services, managing their money or keeping documents in daily life. Consultation can be made at a nearby Social Welfare Council.
○ Adult Guardian Program
This system protects rights of persons with a limited ability to judge who are not sure about their own intentions and decisions at the time of taking legal actions such as making a contract etc. The program compensates their limited ability to judge and prevents them from receiving damage. Consultations can be made at a nearby local government offices, or a consultation desk of disability welfare, Social Welfare Council, offices of judicial scriveners, law firms etc in a local community.
