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장애인정책에 있어서 사람중심지원에 기반한 자기주도 개인예산제에 대한 연구 ― 미국 미네소타 주의 경험을 중심으로 ―

Exploring Self-directed Individual Budgets Based on Person-centered Support for People with Disabilities ― Learning from Minnesota in US ―

김경미
한국장애인복지학회 (Korea Academy of Disability and Welfare)|2020.06|한국장애인복지학 (Journal of Disability and Welfare)|제48권 제48호|pp. 93-120|DOI 10.22779/kadw.2020.48.48.93

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참고문헌

키워드

자기주도self-directionintellectual and developmental disability개인예산제지적발달장애사람중심individualized budgetingperson-centered

초록

‘자기주도 지원(Self-directed supports)’은 점차 장애인서비스 전달체계에서 보편적인 모델이 되고 있다. 자기주도 지원은 장애인과 그 가족의 의사결정 권한과 예산의 자율성을 극대화하는 데 초점을 둔다. 이 연구는 미국 미네소타 주의 ‘자기주도 개인예산제(Self-directed Individual Budgets program)’ 의 장점과 당면 과제를 연구하였다. 이 정책의 실행과 관련된 이해당사자 28 명과 일대일 면접을 진행하였고, 수집된 자료는 질적으로 분석되었다. 연구결과, 자기주도 개인예산제 운영에 있어서는 개인예산제 운영의 유연성과 일관성 사이에 균형을 잡는 것, 사람중심 실천을 토대로 삼는 것, 정책을 실행하는 데 있어 관련자들의 명확한 역할을 명시하는 것, 서비스와 지지에 있어선택을 보장하는 것 등이 중요함이 확인되었다. 이 연구는 개인예산제의 성공적인 정착과 발전을 위해서 정책의 유연성과 일관성 간의 균형 유지, 정책 내다양한 서비스 옵션의 선택지 제공, 모든 이해 관계자들에 대한 적절한 교육과 훈련, 그들을 위한 정부와 카운티 차원의 적절하고 필요한 지원 등을 제안한다.

Abstract

Self-directed supports have become a popular model of disability service delivery. Self-directed supports are a model of disability service delivery that focuses on supporting increased decision-making authority and budget autonomy for individuals with disabilities and their families. The purpose of the current research study is to identify challenges within a self-directed, individualized budgeting programs in Minnesota, US. Data were collected through 28 face-to-face interviews with stakeholders in a state self-directed service program and data was qualitatively analyzed. Findings suggest the best practices for successful implementation of self-directed, individualized budgeting programs are: balancing flexibility and consistency, engaging in person-centered practices, defining clear stakeholder roles, and ensuring choice in services and supports. This research suggests a set of recommendations for the development of individualized budgeting programs including: consistency balanced with flexibility, having choice in service options, adequate training for all stakeholder, and providing competent support.

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