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介護支援専門員のための介護保険NEWS

介護基盤の緊急整備、第4期計画とは「別枠」で-厚労省

 5月28日の全国介護保険担当課長会議で厚生労働省は、介護基盤の緊急整備について説明した。今回の緊急整備では、小規模の介護施設などを中心に第4期介護保険計画(2009-11年度)における介護施設の整備計画を4万人分上乗せし、3年間で16万人分を目標としている。

 2212億円の予算を計上している「介護基盤の緊急整備特別対策事業」では、小規模(定員29人以下)
特別養護老人ホーム、小規模老人保健施設、小規模ケアハウス、グループホーム、小規模多機能型居宅介護事業所などの介護拠点を整備する。
 定員30人以上の特養、老健、ケアハウスについては、都道府県などの施設整備費補助に対する地方財政措置の拡充により、整備支援を行うとしている。
 また、特養や老健などの開設準備に必要な経費を助成する「施設開設準備経費助成特別対策事業」では、オープン当初からの安定運営を支えるため、開設前に看護師や介護職員を雇い上げて、最大6か月間の訓練を行うことなどを支援する。
 このほか、広報誌の発行や就職説明会の開催など職員の募集に必要な経費や、経営コンサルタントを依頼する場合に必要な経費についても、同事業での助成対象になる。助成は60万円×「定員数」が上限。
 用地取得が困難な大都市部においても特養などを整備するため、定期借地権を利用した整備促進特別対策事業も実施される。借地権の設定期間は50年以上を想定しており、助成額は一時金の半額、助成の上限は敷地の路線価格評価額の2分の1。

■参酌標準に縛られず、高優賃なども

 厚労省は今回の介護基盤の緊急整備について、第5期介護保険計画(12-14年度)以降もニーズが見込まれる施設を先取りして整備するとしたほか、必要入所(利用)定員総数を上回る認可や指定を行うことも、都道府県や市町村の判断により可能であるとの考え方を示した。
 ただ、介護施設の整備には、地元との調整や用地確保などに相当の時間がかかることから、第4期計画を上回る部分については、「別枠」扱いで整備するよう要請している。また、策定済みの第4期計画を変更する必要はないとしている。
 参酌標準についても、今回の事業は緊急的・例外的措置として変更しないとしたほか、今回の緊急整備は第5期以降の将来の各地域のニーズを見通して実施するもので、参酌標準との関係に縛られないとしている。
 高齢者向け優良賃貸住宅(高優賃)や介護付き有料老人ホームなどは、今回の緊急整備の支援対象となっていないが、厚労省は、各地方自治体で特定施設入居者生活介護の指定を前提に整備を緊急に進める場合、第4期計画を上回る部分について同様に「別枠」扱いもあり得るとの考えを示している。
 また、特養ホームを整備する場合には経営効率に配慮し、既存の特養ホームの増床対応も積極的に検討するよう要請している。5月29日
医療介護CBニュース

【参酌標準】
 14年度に介護保険三施設(特養、老健、介護療養型医療施設)、認知症高齢者グループホーム、介護専用型特定施設などにおける要介護2-5の利用者の割合を37%以下とする目標。(毎日新聞)

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