Top > ご連絡など > ケアマネジャーの介護保険NEWS > 【介護支援専門員 NEWS】やさしい手が法改正で生活援助切り捨てを示唆
【介護支援専門員 NEWS】やさしい手が法改正で生活援助切り捨てを示唆
昨年11月25日、社会保障審議会介護保険部会がまとめた「介護保険制度の見直しに関する意見」には、要支援者や軽度の要介護者への生活援助サービスについては介護保険の対象外とする意見と削減に反対する意見の両論が併記され、12月24日に開催された社会保障審議会介護給付費分科会では、「保険者判断による予防給付と生活支援サービスの総合化」が盛り込まれている。
染谷氏は、こうした制度改革の経緯を参加者らに説きながら、厚生労働省が推進する地域包括ケアの概要を示すとともに、見守り、配食、買い物などの生活支援サービスについて「次期改正を受けて2012年4月以降、これら生活支援サービスは介護保険から切り離され、受けられなくなる可能性がある」と述べた。講演後の質疑応答でも参加者から"生活援助切り捨て"への質問が飛んだが、染谷氏は「まだ厚生労働省で検討中だが」と前置きしながらも、「ほぼなくなると言われている」との見解を示した。
続いて、地域包括ケアシステムの構築モデルとして、居宅介護支援事業所のケアマネジャーが作る地域支援ネットワークの中に、介護保険サービスのほか福祉・権利擁護のジャンルに含まれる「日常生活自立支援事業」を紹介した。
2007年に地域福祉用具権利擁護事業から日常生活自立支援事業に名称を変更した同事業は、全国の社会福祉協議会を中心に展開され、福祉サービスの利用援助を基本に、判断能力が衰えた人に代わり、年金を中心とした日常的な金銭管理を行い、通帳・印鑑を預かることもできる。
費用は、東京都の場合、福祉サービスの利用援助は1回1時間まで1,000円、社会福祉協議会が利用者の通帳を保管している場合の日常的金銭管理サービスは1回1時間まで2,500円となっている。
染谷氏は、利用希望者の自宅を訪問し、生活状況や契約締結能力を把握する同事業の専門員の役割について「介護保険でいうところのケアマネジャー」と例えたが、「日常生活自立支援事業は、介護保険に比べればまだまだ認知度は低い」と語った。
染谷氏は、この日常生活自立支援事業や成年後見制度と同種のサービスとして、同社が展開する今年4月販売を予定している「おまかせソーシャルワーク(仮称)」を紹介。おまかせソーシャルワークは、同社所属の社会福祉士が月1回定期訪問してプランを作成し、遠隔地にいる家族とインターネットを通じてケース記録を閲覧できるシステム。また、同社の生活支援サービス「おまかせさん」では介護保険では対応できない換気扇やガスコンロの掃除といった"おまかせ家事コース"、お墓参りや観劇への同行や入浴・食事・排泄介助に対応する"おまかせケアコース"などが1時間3,000円前後で利用できることも紹介され、公的なサービスではかなえられない私費による高齢者支援サービスの多様性を提案した。
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