네덜란드 지역 통합돌봄지원법제 - 「2015년 사회지원법」을 중심으로 -

This study examined the Netherlands’ 2015 Social Support Act (Wmo 2015) in light of the recent enactment in South Korea of the Integrated Care Support Act. Both laws share the common goal of providing integrally the care individuals (elderly, people with disabilities, etc.) need to be able to continue living independently in their communities. However, while the Integrated Care Support Act focuses on the regulating coordination between care-related laws and organizations, the 2015 Social Support Act delegates substantial responsibilities (regulating and providing care services as well as ensuring government oversight) to municipal governments (gemeente). It, therefore, focuses on regulating the relations between the municipal government, care providers, and care recipients. This study aimed to analyze key aspects of the 2015 Social Support Act (eligibility criteria, service provision, oversight, and legal remedies) as a basis for informing the development of integrated care legislation in Korea. This study found the following. First, the 2015 Social Support Act grants municipalities much autonomy in providing care but also requires this to be regulated through local ordinances rather than just worked out in policy plans. As these are thus legal rights, judicial review of related decisions is common. Because litigation costs are minimal for individual applicants and a have relatively high success rate, Dutch social support policies can be characterized by a ‘vulnerablity’ to judicial review. Second, municipalities have significant discretion to regulate the local assessment of care needs c.q. eligibility requirements. From a disability rights perspective, this flexibility allows for more inclusive welfare. However, it has also exacerbated regional disparities in care services and reduced accessibility for certain vulnerable groups. Third, while municipalities have the policy discretion to organize service delivery with a couleur locale, insufficient financial support by the central government and inadequate oversight regarding care quality often frustrate the effective execution of local social support policy. Seven points were stressed. First, the Dutch model’s strength is that it explicitly makes municipalities primarily responsible for providing integrated care and that judicial review encourages proactive welfare administration. Second, it emphasizes that local policy autonomy and recipients’ rights should be balanced when allowing for diversity in municipal care policy. Third, it shows the importance of allocation principles for financial support to local governments that can mitigate welfare inequality between municipalities. Fourth, it highlights the importance of integrated government oversight over integrated care services as a means to ensure quality care. Fifth, the lack of legal obligations regarding the training and retention of specialized care professionals exacerbated workforce shortages. Sixth, integrated care-related information systems require detailed regulations to ensure robust data protection. Lastly, from a disability rights perspective it is problematic that Korea’s Integrated Care Support Act defines recipients as ‘objects of care’ because this can reduce participation and autonomy.