Care management for people with disabilities : Institutional ideals and issues

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As disability welfare services shift toward contract operation, equal standing between welfare service business operators and their beneficiaries is increasingly essential. Among other things, such equality protects the users’ right to appropriate care management. This paper first presents some representative definitions for “care management,” as proposed by the Ministry of Health, Labor and Welfare and by Takeuchi and Moxley. I prefer the definition “organizing the network of activities” because it emphasizes “cooperation among supporters.” I will then report the results of my questionnaire on the degree of cooperation between care plan preparers, that is, guidance officers and service management officers. I will also explore several responses concerning the elements other than “cooperation of supporters” that constitute “good care management.” The questionnaire results suggest that, at present, guidance officers and service management officers “cooperate almost not at all” and typically have low awareness of the importance of such cooperation. I draw the following conclusion: as care management in disability welfare services is currently widely implemented, quantitative gains have been achieved; however, qualitative improvement, especially with regard to personal support of users, is still needed.

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