[Welfare Advanced Nation 2030]⑤ Overseas Provides Comprehensive Support from Housing to Family... Domestic Policy 'Reduces' Overlaps

California, USA Provides Parental Education Starting from Residential Facilities... Free for Low-Income Families
Domestic Basic Livelihood Security Recipients Receive 220,000 KRW Support... Insufficient to Cover Actual Costs

[Asia Economy Reporters Juyoun Oh and Hyunju Lee] As social interest in people with developmental disabilities increases and the "Act on the Rights Guarantee and Support for Persons with Developmental Disabilities (Developmental Disabilities Act)" was enacted in November 2015, the caregiving burden that was previously placed solely on individuals and families has gradually shifted to a public system. However, compared to advanced foreign countries where support measures for socially vulnerable groups are more systematized, domestic support measures for people with developmental disabilities are still considered to have a long way to go. In Korea, there are policy blind spots such as reducing support when it overlaps with general disability support, whereas overseas, support is more meticulously organized, including housing for people with developmental disabilities and psychological counseling for their families living together.

▲A person with severe developmental disabilities is participating in daytime activities at a welfare center. (Photo by Seoul City)

◆Started Part-Time Jobs for Treatment Costs... Differential Support Based on Income and Overlapping Benefits Undermine 'Care Burden Relief'

According to the National Assembly Legislative Research Office's "Support Policies for People with Developmental Disabilities and Improvement Directions" on the 30th, the representative support policy for registered disabled children under 18, the developmental rehabilitation service, is provided differentially based on income. Even then, the group receiving the most benefits, basic livelihood security recipients, receive 220,000 KRW per month, the near-poor receive 200,000 KRW, and those below 65% of the median income receive 180,000 KRW monthly. Those below 180% of the median income receive only 140,000 KRW per month. Developmental rehabilitation services, which include language, art, music, sensory development, and motor development, are popular.

However, this support amount is far from sufficient to cover actual costs. According to a survey conducted by the National Human Rights Commission, during the COVID-19 situation, 20.5% of parents quit their jobs to care for their children with developmental disabilities. Given that individuals already bear the burden of various examination and treatment costs, there are calls to expand the target group for developmental rehabilitation services. A parent of a child with developmental disabilities met during reporting lamented, "Monthly examination and treatment costs exceed 1 million KRW, but since we do not meet the income criteria, we are not receiving any support."

Another issue is that various support services rely solely on the individual's 'application.' Yoon Jin-cheol, Secretary-General of the National Parents' Association for the Disabled, said, "All services are based on an application system. Individuals must apply at community centers to receive services they are eligible for, but since the total amount of services is insufficient and support depends on how much one knows, it is difficult for individuals or guardians who are not well-informed to receive services."

In the case of the domestic developmental disability support policy called the daytime activity service, it is difficult to use it concurrently with the disability activity support service. The daytime activity service for adults with developmental disabilities aged 18 to under 65 has been provided since March 2019, with options of basic type (125 hours/month), reduced type (85 hours), and extended type (165 hours).

However, if the basic or extended types are chosen, 22 hours or 56 hours, respectively, are deducted from the disability activity support service hours. This contradicts the legal basis and purpose of the 'daytime activity service' and the 'disability activity support service.' Since these services have different legal bases and purposes, overlapping benefits are not applied even if used simultaneously. Therefore, deducting support hours is criticized as inconsistent with the intent to improve the quality of life for people with developmental disabilities and reduce family caregiving burdens. Rather, it is explained that allowing simultaneous use of both systems is necessary to further alleviate family caregiving burdens.

◆Overseas, Developmental Disability Service Costs Supported by the State... Families Also Need 'Rest,' Focus on Reducing Care Burden

Advanced foreign countries that have shown interest in welfare services for people with developmental disabilities earlier than Korea support not only rehabilitation services for the individuals but also housing, employment, and focus on reducing the caregiving burden on families through their policies.

Among the 50 states in the U.S., California, where the largest number of people with developmental disabilities reside, has established a Developmental Services Department under the Department of Health and Human Services, which supports life-cycle services through 21 regional centers for people with developmental disabilities. The centers provide not only daytime care and vocational services but also housing provision such as home acquisition and independent living support, early education services including parent education, home visits, and speech therapy. Service costs are supported differentially based on parental income until the person with developmental disabilities becomes an adult. However, services are provided free of charge to low-income groups, and after adulthood, the state covers the service costs.

The 'Moore Center' designated in New Hampshire plans and manages services for people with developmental disabilities in the region. Children supported through the IHS (In Home Support) waiver program receive personal care, social adaptation, and daily living skills training services. It also offers 'transition services' to help adolescents aged 14 to 21 prepare properly for adulthood, 'employment services' guaranteeing opportunities through job placement, and 'family support services' for families caring for people with developmental disabilities.

Alberta, Canada, through the FMS (Family Managed Service), helps people with developmental disabilities aged 18 and over and their families select the services they need most and directly hire service providers. Services include respite, family life, employment, and community participation support, which help reduce family caregiving burdens. It is explained that people with developmental disabilities can expect quality services by receiving support from service providers that suit them well.

Park Jin-woo, a legislative researcher at the National Assembly Legislative Research Office who conducted the overseas case study, said, "In California, there is a system where neighbors who care for children with developmental disabilities are paid for their services," adding, "In Korea, even if neighbors care for them outside the family, there is no system to pay for such efforts, so institutional support to solve caregiving issues is urgently needed."

He also said, "Developmental Disability Support Centers should be established in local governments to transfer information sharing among families of people with developmental disabilities to institutions for better activation," and "Although Korea has support systems for people with developmental disabilities, it is desirable to expand them further." He pointed out, "Ultimately, the issue is budget. Even if such support content is included in enforcement decrees or laws, it is useless without budget support."

Lee Minkyeong, a senior researcher at the Disability Policy Research Center of the Korea Institute for Health and Social Affairs, emphasized that the core of support services for people with developmental disabilities is 'expanding care time' and 'supporting the independence of the person with developmental disabilities after the caregiver.' She said, "It is important to create a community system that combines residential facilities or services where people with developmental disabilities can live independently."