보건의료법체계를 고려한 장애아동 지원 정책 -장애아동 「발달재활서비스」사업을 중심으로-

김소연 ( So Yeun Kim ),배현아 ( Hyun A Bae ) 한국법정책학회 2013 법과 정책연구 Vol.13 No.4

장애아동은 아동임과 동시에 장애인이라는 이중적인 사회적 약자의 위치에 놓여 있기 때문에 장애아동은 아동 또는 성인장애인과는 다른 장애아동의 특성을 반영한 그들만의 복지적 욕구와 권리가 법적으로 보호될 필요가 있다. 이를 위하여 2012년 「장애아동복지지원법」이 시행되었고, 보건복지부에서는 특히 경제적으로 어려운 장애아동의 재활치료를 지원하기 위하여 2008년부터 “장애아동재활치료사업”을 시작하였으며, 현재 「장애아동복지지원법」 제 21조에 근거를 두고 “발달재활서비스사업“으로 개칭하여 계속하여 사업을 진행 중이다. 본 제도를 도입함으로써 필수적인 재활치료에 대한 장애아동과 그 가족의 경제적 부담을 완화하기 위하여 대상자에게 바우처를 발행하고 지정된 서비스 제공기관에서 바우처를 사용하여 재활치료를 받을 수 있도록 하여 지원시장논리를 이용하여 서비스 제공기관이 서로 경쟁적으로 서비스를 제공함으로써 장애아동들은 금전적 지원과 동시에 치료기회의 확대라는 지원도 동시에 받을 수 있게 되었다. 재활치료 제공기관의 수가 늘어나면서 장애아동들은 좀 더 수월하게 재활치료를 접할 수 있게 되었지만 본 사업에는 아직 보완해야 할 부분들이 많다. 먼저 장애아동에게 제공되는 발달재활서비스 중 우리나라 보건의료법체계를 고려할 때 그 제공 주체 여러 가지 재활치료들 중에서 물리치료와 작업치료는 의사의 지도가 필요한 의료행위로 분류되기 때문에 이 둘을 제외한 심리치료, 미술치료, 행동치료 등 비 의료적 성격의 재활치료만을 본 사업에서 지원하고 있다는 제한점이 있다. 이 연구에서는 발달재활서비스 제공 주체들을 중심으로 이 사업이 문제점 내지는 우선적으로 적용되어야 하는 정책 목표와 대상을 검토하였으며 다른 사회복지 영역에서와 마찬가지로 서비스 제공 주체가 국가에서 민간의 영역으로 변화하고 있는 현상과 그 의의를 살펴 궁극적으로 장애아동에게는 안정적인 재활치료와 양질의 재활치료가 제공될 수 있기 위한 정책목표 달성을 위한 제안들을 모색하였다. 따라서 사회복지 서비스의 사적화는 시장 논리에 기대어 재활치료서비스 제공을 확대한다는 긍정적인 의의가 있지만 그러한 재활치료시장에 대한 관리 및 감독은 여전히 국가의 몫임을 강조하고자 하였다. Children with disabilities should be considered the first priority in public welfare policy, as they are not only young but also disabled. In enacting public welfare policy, they should be considered separately from the other children or the rest of the disabled population, and their needs and their right to welfare must be protected legally. To address this issue, Public Welfare Act for Children with Disabilities was executed in 2012; The Ministry of Health and Welfare started Rehabilitation for Children with Disabilities in 2008 and has continued this project under the name of Developmental Rehabilitation Program for Children with Disabilities (Public Welfare Act for Children with Disabilities Title 21). Children with disabilities need more attention in their development than those without disabilities. They also require rehabilitation treatments under the supervision of therapists, which cost a lot of money. To relieve the financial burden imposed on the children and their families, this project supports the children and their families by issuing the vouchers and having them use the voucher to receive rehabilitation treatments in the selected centers. This project uses the logic of market and let the selected centers compete each other, from which the children not only benefit financially but also enjoy increased opportunity to treatments. Even though the number of rehabilitation centers increased and the treatments more accessible through this project, it still has a lot to make up for. Since physical therapy and work therapy are classified as medical practice that require medical supervision, they are currently out of the scope of this project; only the non-medical treatments such as psychological therapy, art therapy, and behavioral therapy are supported. Even though this is understandable in that covering the medical therapies will accompany conflicts in administration, what the children-especially those with financial difficulties-need the most should be considered first. Thus, the details of the project should be revised and expanded according to the exact needs of the children. How the project is managed should be improved as well. Using the logic of market to expand the rehabilitation services seems optimistic. However, the government has the responsibility to manage and supervise the market, as lack of proper management and supervision by the government can lead to lack of proper support to the children. Thus, the government should make an effort to improve the project and to manage the efficient administration of the budget.

장애영아 조기개입 서비스를 위한 통합적 전달체계 모형

조상미(Cho, Sang Mi),남성희(Nam, Sung Hee) 한국사회복지행정학회 2012 한국사회복지행정학 Vol.14 No.1

현대 교육복지정책의 동향과 법제의 방향

노기호 ( Ki Ho Noh ) 한국법정책학회 2008 법과 정책연구 Vol.8 No.2

「장애아동복지지원법」시행에 따른 원장의 역할 및 장애아전문어린이집 운영변화와 개선방향

김미나 ( Mina Kim ),조윤경 ( Younkyung Cho ) 한국특수아동학회 2015 특수아동교육연구 Vol.17 No.2

The purpose of this study was to investigate the meaning of legal change for the field which was caused by designation of specialized child care and education centers according to「Welfare Support Act for Children with Disabilities」(Ministry of Health and Welfare, 2011), the difficulties of role and management from the perspective of directors, what positive changes they expected despite the difficulty from the legal change, what the plans for the improvement, what the directors request to ease the difficulty from legal change and practical solution for the survival at this time when the upcoming consolidation of kindergarten and child care and education centers is approaching after the legal change. The subjects of this study were 12 directors and semi-structured interviews were conducted on them, after which qualitative analysis was conducted with duplicated contents. The results of the study are as follows. First, directors felt that the some legal changes were simply changes in terms and thus meaningless while they expected positive effect and new roles like early intervention in others such as fortification of the professionalism. Second, directors responded that they felt difficulty in the management of teaching personnel due to the legal change. Third, directors confessed the burdens due to shortage of children and difficulty to recruit normal children and complained that laws were enacted to fit the convenience of the city and provincial government in ignorance of the field. Fourth, directors expressed expectation that social recognition on specialized child care and education centers would change into special kindergartens and amelioration on the restriction on minimum number of children with disabilities for alleviating their loads. In addition, they had positive expectation that deployment of special teachers with professional expertise would enhance the overall level of teachers. Fifth, to relieve the difficulty of their roles, directors suggestedimprovement plans such as support of professional team cooperation etc. Sixth, for the improvement of operation, directors came up with practical solutions such as raising the wage of the teachers etc. Seventh, directors requested supports such as strengthening following actions and support system, consideration of the special traits, designation of administrative personnel in charge, support for general and integrated child care and education centers and increase of regional support. Eighth, for the survival of centers in the future, directors emphasized the exercise of professionalism by cooperation of experts, integrated approach such as full-in therapist system, and development of professional programs unique to each centers. For the upcoming consolidation of kindergartens and child care and education centers, directors also suggested treatment improvement and support as the special kindergartens supported by Ministry of Education.

장애아동복지지원법 제정의 의의와 후속과제

김치훈 ( Kim Chi Hoon ) 한국장애인개발원 2011 장애인복지연구 Vol.2 No.3

Enactment of the “Welfare and Child Support Laws for Disabled Children” in August 4th, 2011, have provided an important opportunity to improve welfare environment for disabled children that used to be left in the blind spot. These laws, much like the “Special Education Laws for Disabled and Others,” are yet another legal accomplishment by parent forces for their disabled children and the newly enacted laws are seen as ‘a big step forward’ to establish an enhanced support system for its contribution to establish a chain of public system that both encompasses individual support plans and case management. However, in terms of improving the quality of welfare services such as expanding number of welfare beneficiaries and provided services, establishing qualification standard for persons serving developmental rehabilitation services, etc., the “Welfare and Child Support Laws for Disabled Children” faces certain limitations that need to be overcome. Until the enforcement orders and regulations are correctly enacted, the Law Enactment Movement shall continue, and efforts to expedite enforcement of related matters also need to be put in place, as well.