Evaluation of the Care Programs for the Disabled

Published on Nov. 15, 2024
Published by Social Administrative Program Evaluation Division, Budget Analysis Department

   As of 2023, there are 2.642 million people with disabilities in Korea, and despite the overall population decline, this number has been increasing each year. In response, the government has identified "Activity assistant services for persons with disabilities" and "Care for people with developmental disabilities" as key fiscal programs. These policies aim to alleviate the caregiving burden on families and empower people with disabilities to lead autonomous, proactive lives.
   This report aims to evaluate and analyze the government’s fiscal investment and effectiveness, the appropriateness of budget planning and execution, and the suitability of laws and systems related to the careprograms for the disabled that have been implemented to date. It also seeks to propose relevant improvement measures. The main findings from the analysis are as follows.
   First, in the sector of activity assistant services for persons with disabilities, the following key issues and improvement measures have been identified: ① Many individuals with disabilities are unaware of the available activity assistant services and, as a result, are unable to apply for them. To address this, increased education and promotion of the program are necessary. ② The "comprehensive service support survey" currently focuses primarily on physical functions. However, it is important to broaden the scope to consider the full range of disabilities, the varying levels of need for services, and the specific characteristics of different disabilities. ③ In the case of some severely disabled individuals, a lack of consistent care occurs due to activity support workers avoiding contact with certain individuals. To address this, it is crucial to establish an incentive structure that facilitates better matching between care recipients and workers, ensuring that individuals with disabilities receive the support they need. Additionally, it is important to ensure the safety of activity support workers, as their well-being is essential for effective service delivery. Furthermore, when gaps in care arise due to avoidance, especially depending on the type or severity of disability, a system should be implemented to allow for benefit for support services from family members, providing a more practical and realistic solution to care continuity. ④ Due to the crisis of local extinction, there is a shortage of activity support workers compared to disabled population in some areas, such as rural regions compared to large and metropolitan cities. This discrepancy, along with variations in the scale of activity support organizations, requires improvements. Additionally, measures should be implemented to prevent fraud in the receipt of activity support services and ensure the thorough recovery of any fraudulent payments. ⑤ The method for calculating support benefits for people with disabilities should be made more precise. When preparing for appropriated benefit support program budgets, it is important to closely estimate the number of beneficiaries to avoid over- or under-estimation, ensuring that funding is accurately aligned with actual needs.
   Second, in the sector of care for individuals with developmental disabilities, ① it is important to investigate and identify the reasons behind the low budget execution rate for developmental disability daytime activity services and after-school activity services. Additionally, the low utilization rate of services among selected beneficiaries needs to be addressed to devise ways for improvement. ② There is a need to strengthen the education and promotion of the daytime activity service and after-school activity service programs. Additionally, while the age criteria for eligibility for the daytime activity service are currently set at "18 years or older but under 65 years old," there is a need to review the lack of a legal basis for this age restriction. ③ There are concerns about potential trial and error in the early stages of the program, such as the lack of a survey of the severely developmentally disabled before the start of the Integrated Care Service Support Program, and the pilot program’s implementation of only one of the three planned integrated care services prior to the main program rollout. ④ To secure adequate caregivers for individuals with the most severe developmental disabilities, it is necessary to assess the appropriate level of care required and thoroughly examine the actual conditions of this group. ⑤ Although the age criteria for the integrated care service for the most severely developmentally disabled is set at "18 years or older but under 65 years old," there is no clear legal basis for this restriction. It is important to review the age eligibility for the service by considering both the necessity of support and the fiscal needs.
   Third, in the sector of support for families of persons with disabilities, Korea lags behind major European countries in providing economic support, such as allowances for children with disabilities, and in offering time-based support, such as leave of absence for the care of children with disabilities. Therefore, it is necessary to explore ways to reduce the caregiving burden on families by conducting a comparative analysis with policies from leading countries.
   By providing comprehensive support for the care of individuals with disabilities, it is essential to eliminate blind spots in disability care, integrate individuals with disabilities into the community, and empower them to lead fulfilling and happy lives.