지역공생 포괄돌봄 거버넌스 구축에 관한 공법적 소고 - 2024년 3월 「돌봄통합지원법」의 제정을 계기로 -

Abstract

In 2025, South Korea is set to become a super-aged society, and recently, family caregiving-related anxieties for the elderly have manifested in tragic events such as caregiving-related homicides, turning “care” into a pressing social issue. In the past, South Korea maintained a family-centered welfare system, but as the ideal concept of the family has begun to disintegrate in recent years, the country is exploring a transition toward a community-integrated care welfare system. In response, the government launched a pilot Community Care project in 2019, led by local governments, to bring about significant improvements in housing, healthcare, long-term care, and caregiving services. Furthermore, on March 27, 2024, the government enacted the Integrated Care Support Act, which is set to take effect on March 27, 2026. However, the law faces challenges such as: ① providing comprehensive and multidimensional support for all community residents, ② the absence of a regional control tower and unclear guidelines for forming public-private councils, and ③ linking with strategies to revitalize local communities. In Japan, the Long-Term Care Insurance Act has facilitated the establishment of a community-based integrated care system through regional comprehensive care centers and care conferences. However, the regional comprehensive care system faces several limitations, including: ① potential regional disparities in social welfare services, ② an inability to comprehensively address issues such as double care (simultaneous care responsibilities for multiple dependents), and ③ a lack of specialists due to regional constraints. In response, Japan amended the Social Welfare Act in May 2017 to transition toward a regionally inclusive and comprehensive welfare support system. The revised law introduced and updated measures aimed at: ① realizing inclusive communities, ② linking welfare with policies on healthcare, labor, education, housing, and regional revitalization, ③ providing guidance and support from national and prefectural governments, and ➃ establishing a multi-layered support system in collaboration with private organizations. This expanded the focus of social welfare services from being primarily elderly-centered to encompassing all community residents, aiming to achieve an integrated and comprehensive one-stop administrative service for inclusive communities. In particular, municipalities, through the development of a multi-layered support system, implemented a new framework that integrates three key supports: ① non-rejecting consultation and support, ② participation support, and ③ assistance for community-building. This approach aims to facilitate the realization of community inclusion and cooperation. Japan's administrative governance transition in the social welfare system and the revision of related laws offer key insights for South Korea. These include: ① addressing complex and multilayered welfare service challenges, such as double care issues, ② encouraging the participation of various stakeholders, including related institutions and residents, and ③ expanding care support to include the restoration of community connections and ultimately contributing to regional revitalization through integrated care support. Future revisions to the Integrated Care Support Act should consider the following directions: ① welfare-related administrative legislation needs to be organically linked with the principles of a regionally inclusive and comprehensive welfare support system, ② specific provisions should be made to detail collaboration methods with local residents and related organizations. and ③ a multi-layered support system should be concretely established through local ordinances, taking into account the characteristics and resources of each region.