{"id":150041,"url":"https://ivod.ly.gov.tw/Play/Clip/1M/150041","video_url":"https://ivod-lyvod.cdn.hinet.net/vod_1/_definst_/mp4:1MClips/14550b3f67fe733a5067a51c101e461825cd79889bed64eaf8ba9b0039caa7a6a6b46b472f9b5d055ea18f28b6918d91.mp4/playlist.m3u8","委員名稱":"林淑芬","委員發言時間":"14:56:51 - 15:14:48","影片長度":"00:17:57","會議時間":"2024-03-18T09:00:00+08:00","會議名稱":"立法院第11屆第1會期社會福利及衛生環境委員會第6次全體委員會議（事由：邀請衛生福利部部長、教育部、法務部、內政部警政署就「社會安全網推動情形及策進作為」進行專題報告，並備質詢。）","meet":{"tmpMeeting":null,"title":"第11屆第1會期社會福利及衛生環境委員會第6次全體委員會議","term":11,"type":"委員會","sessionPeriod":1,"sessionTimes":6,"committees":[26],"id":"委員會-11-1-26-6"},"date":"2024-03-18","duration":1077,"end_time":"2024-03-18T15:14:48+08:00","start_time":"2024-03-18T14:56:51+08:00","features":["ai-transcript","gazette"],"type":"Clip","gazette":{"lineno":1858,"blocks":[["林委員淑芬：（14時56分）主席、各位大家好。是不是還是先就教於我們薛部長？"],["主席：薛部長請。"],["薛部長瑞元：委員好。"],["林委員淑芬：部長，今天大家討論了很多，其實你們的報告裡面也承認，這個不是社會安全網漏接，沒有漏接的問題，而是社會安全網本身破洞、不安全，這個是社會安全網不安全的問題，它也是相當嚴重的問題。我們都以為只要進入安全網，進入這個安全體系，我們將其接起來了就好了，沒想到接起來了，網破洞讓他摔死了。所以就這個部分我們是覺得，非要一條人命才讓我們看見這個安全網是有破洞的，這個代價太慘痛！今天在這裡我們也發現，大家在檢討收出養媒合機構的社工的問題、對於社工的檢討，比如說在相關機制方面，大家都會強調要增加訪視的頻率，除此以外，還有提升對訪視案件的敏感度，大家都有提到敏感度，可是大家也都知道說什麼是敏感度，敏感度要怎麼提升，對不對？"],["薛部長瑞元：這一個部分其實有二個重點，第一個重點就是要多重的去做訪視，所以所謂的訪視頻率並不是單一的社工本來1個月去一次變成1個月去兩次，這不是主要重點，重點是負責的這些單位要怎麼樣去double check，對於這種有惡意的，若沒有靠這樣子的……"],["林委員淑芬：社工的總量是固定的，你多做一個double check，就是排擠了另外一個訪視的時間，畢竟社工的時間也是固定的啊！"],["薛部長瑞元：所以所謂增加訪視率這一個部分，要去做double check的話，對象必須要明確。"],["林委員淑芬：你今天一直講double check，我剛剛也說，總量、人數是固定的，工時也是固定的，他的案件數其實是很多的，你這樣子是會有排擠的……"],["薛部長瑞元：如果有需要，就要增加總量。"],["林委員淑芬：我跟你講，因為我們找過專業的，像是彭婉如文教基金會，他們負責保母和社區托育主管人員等情事，他們其實也一直反映了幾件事情，第一個，訪視的次數固然是可以增加，你要double check也沒有關係，但是如果訪視的品質沒有提升，只是讓訪視人員疲於奔命、增加工作時間、增加次數、double再check，觀察的時間會不會相對減少？重點也不是你去幾次、有沒有double check，時間以外還有品質，大家都知道品質，而訪視品質的高低在於如何察覺風險、預見風險，我問你這個問題就是第二個，如何增加訪視員的敏感度？"],["薛部長瑞元：這一個部分當然第一個要透過教育訓練，第二個就必須用一個比較系統化的做法。"],["林委員淑芬：部長，我們社工的教育訓練本來都是專業的，理論上大家都有專業，理論上是這樣沒錯，但是你看你們社家署提供的「居家托育服務中心訪視輔導工作指引」，你自己去看你們的指引內容，訪視前、訪視中、訪視後，訪視中你叫人家到現場時要表明身分、要表明訪視的目的、要熱忱、要積極、要真誠，訪視的時候口齒要清晰不疾不徐，訪視的時候要跟保母、居家服務員建立信任關係，稱呼要適當，不能叫阿姨，要叫大姐，這叫適當嗎？由一般性的社會會談進入主題性的會談要以受訪者、托育對象為中心，然後要尊重接納同理受訪者、要同理保母，透過生活化的舉例提出專業知識的建議。我的意思是說，看你們的指引照樣做這樣就可以增加敏感度嗎？"],["薛部長瑞元：沒有，這只是其中的一部分，因為你這邊所提的是對於接受訪視的成人，也就是保母，但是沒有提到小孩子，你要去看小孩子，這才是重點。"],["林委員淑芬：對啦，這本來就應該要看的，但是保母也很重要，我現在在跟你講，我是在回饋你，這個是我剛剛所講的第一線主管人員所反映的，訪視的品質高低要察覺風險；那他的敏感度其實是要擴大訪視面向的廣度，還有透過提問探詢日常托育細節流程確認，還有保母的說辭是否為真，如果組織或訪員敷衍了事，只能看到表面和客觀事實，你說第一次去看小孩，你把孩子脫光光來看。我跟你講這一個個案剴剴他有沒有去看醫生？沒有規定他要健康檢查，但他有去啊！他看了牙醫耶，他不是沒有看耶，難道牙醫就沒有敏感度嗎？牙醫檢查他牙齒，然後還可以說這四顆牙齒的脫落可能是因為磨牙。牙醫師回報提供的意見可能是磨牙嚴重、可能受過刺激、不平等待遇或癲癇，OK，他也有回應，有看過醫師並不是沒有。所以我的意思是，我在講的是第一線的人的回饋，彭婉如基金會的主管們一直希望社家署要創造定期的、跨單位的不同居家托育服務中心承辦單位及跨縣市的經驗交流機會，要擴大分享的風險資料庫。因為一個社工員幾個個案，尤其是他看了這個個案，加上自身經驗，加上學習時間的長短不一，你提升所有第一線的從業人員的風險辨識敏感度，從這些不同的個案大家共同分享，建立一個風險資料庫。結果他們檢討的結果是每次社家署去舉辦的會議都流於形式，都不是第一線工作的社工員去發言回饋，都交給不在第一線的專家學者發言。所以你們製作出來的手冊沒有跟上實務需求，如果個別的居托中心承辦的單位組織內，如果社家署是這樣子讓學者專家發言而沒有第一線的共享風險資料庫，承辦單位的內部比如兒福聯盟，他們內部有沒有督導會議？他們有沒有定期的社工檢討會議？如果沒有，又不常讓訪員間交流分享，沒有發揮監督職責，他們整個督導沒有發揮監督的職責，機構內也沒有共同分享的風險資料庫的教育等等，這樣訪視的品質一定很差。所以我們要求社家署一定要擴大各居托中心經驗交流，不要讓各居家托育中心的工作經驗停留在個人、個別中心或單一縣市，我覺得這個回饋的意見非常好啊。"],["薛部長瑞元：對啊，我們可以這樣來進行。"],["林委員淑芬：對，因為第一線去訪視，就是收集資料作為風險辨識的依據。但敏感度是關鍵啊，如果沒有敏感度，怎麼收集很多資料？如果不會問也沒辦法收集很多資料，所以敏感度是相當、相當要緊的。但是我也要跟部長分享某個居家托育服務中心其他督導的心得，在社家署社區發展季刊的文章有一篇叫：建構安全居家托育服務，安全居家托育服務的建構，如何做到風險辨識，文中有提到幾個點，第一，確保足夠的資訊量以供精準判斷；第二，他們有發現提問資料的豐厚度、提高訊息來源和察覺風險，也要電訪，這兩者對新收托案例行性的電訪也要做，他們又發現有一點是什麼，你知道嗎？這個中心督導透過多年運作的經驗發現有時候真相要收托結束之後才會發現，為什麼？因為家長跟保母之間要維持合作關係，有求於保母所以有時候不敢講真話，家長不一定會馬上全盤托出，跟中心說保母有什麼問題，不會馬上就反映，但是等到收托結束、合作關係結束他可能會講。所以這個小孩子的托育過程結束了，可是保母繼續要帶其他小孩啊，他存在具有風險的照顧行為不會因為這個個案結束而消失，還會延續到下一個收托的兒童，但是這個風險及真相沒有被揭露。所以他就說，在收托關係結束的時候，受理保母的居托通報以外，也要求必須要終托電訪當事家長，透過核對家長跟保母回報的結束托育日期是否一致，更重要的是要藉此了解家長對於整體送托經驗的感受，如果查到風險訊息，中心便可以處理托育人員不適當、有風險的照顧行為，所以終托電訪很重要，這個督導怎麼分享終托電訪的內容，他說我們剛開始給家長打停托電話，家長就想說既然中心來問了，而且已經終止收托了，我就講吧。他講了兩點：第一，保母會大聲罵小孩，第二，保爸會拿膠帶貼小孩的嘴巴，還跟家長炫耀。這個是媽媽在收托結束以後才告訴他們的。所以你說定期的有意義、有目的的電訪很重要，但是從收托結束的終托電訪也很重要，這些都是一種機制，但是必須要有敏感性，而且你們有規定要終托電訪嗎？"],["薛部長瑞元：目前是沒有。"],["林委員淑芬：沒有，對。所以人家做得好的還有終托電訪，我小孩還在你手頭上，還要拜託你顧，我不敢說，終止托育、托育結束以後才會發現真相，這個就是我們在這裡告訴你的。我今天還有一點要請教部長，講這麼久我還是有點不了解，付費給剴剴保母的是誰，誰付費的？他的保母費是誰付的？"],["薛部長瑞元：按照機制來講，應該是兒福聯盟付給他的。"],["林委員淑芬：兒福聯盟沒有拿到補助，為什麼會願意幫這個小孩付錢？會不會有道德風險？如果他沒有被人家收養仍要幫這個小孩付錢，那時間越拖越長要幫他付的錢越多，所以就越找品質越差、越便宜。"],["薛部長瑞元：這就是我在我們檢討報告的內容提到……"],["林委員淑芬：不是啦，這個機制運作了這麼多年，怎麼會這個樣子呢？他有沒有政府的補助進去，完全都沒有嗎？這麼多年都沒有嗎？"],["薛部長瑞元：目前對……說實話沒有。"],["林委員淑芬：我也百思不得其解，兒盟將剴剴交付給這個保母的時候，為什麼是由他的外婆跟保母簽約？可是付錢的是兒福聯盟，這個對價關係不太對啊。"],["薛部長瑞元：對，所以這一個部分就是我們在檢討報告裡面提到未來要去改的機制，我們就希望它走的是委託安置的流程，然後就不是……"],["林委員淑芬：請問媒合機構怎麼會有這麼多錢可以幫忙安置這麼多小孩，你不會覺得疑問嗎？"],["薛部長瑞元：對啊，但最後如果媒合成功的話是有收費，是對收養者收費。"],["林委員淑芬：好，收費標準是怎麼樣？以兒福聯盟為例，現在收費標準是怎麼樣？"],["薛部長瑞元：大概十萬元。"],["林委員淑芬：第一個階段只要去申請就要繳費兩萬元，所以要收養小孩也要花很多錢的，不是說免費的。第二階段進行收養評估審查要兩萬五，第三和第四階段要收多少？第三階段收養五萬五，但我知道外國人收養要繳兩次的美金四千元，所以給外國人收養可以收到美金八千元。臺灣人收養成功要繳十萬元，外國人要收養臺灣小孩要繳八千塊美金，所以靠這個收入來cover那個支出。"],["薛部長瑞元：對。"],["林委員淑芬：顯然支出的時間要越短越好，所以難以做到最好的評估，所以你們才說這個有道德風險，因為出養是一個評估，要經過專業的評估才能出養。如果照這種道理，我要付出養這些小孩的錢，我要保證他出養，如果沒有保證他出養，養這些小孩的錢都要倒貼，怎麼世間有這種事情？怎麼有媒合機構要做這種事情？要保證每個小孩都要出養，不管他是不是需要出養，不管專業評估出養對小孩是不是最好的，都勢必要讓他出養，是這樣子？"],["薛部長瑞元：對，所以我們這次要改的就是這個部分。"],["林委員淑芬：可是運作了這麼多年，付出了人命以後，這麼荒謬的事情我們現在才知道。"],["薛部長瑞元：這個已經有討論過，其實在兒權法修法的時候也有討論過。"],["林委員淑芬：就媒合機構而言出養越多收入越多，當然為了節省成本，還沒有媒合成功、還沒有出養出去的，當然是要找成本比較低的，所以才找這種很惡質的保母，便宜就好，現在帶整天小孩是要付多少？"],["薛部長瑞元：差不多兩萬五。"],["林委員淑芬：到底是收多少？"],["薛部長瑞元：好像是兩萬六。"],["林委員淑芬：兩萬六顧24小時，顧好幾個月這樣。"],["薛部長瑞元：對。"],["林委員淑芬：然後兒福聯盟也不能太挑剔，因為錢是要自己付，所以他找品質好的可能要付更高更多的錢，有這種風險？"],["薛部長瑞元：對，有這個風險，因為他原來的保母一個月是三萬元。"],["林委員淑芬：一開始設計這種制度就是一個大錯誤，這社會安全網不安全，這不是社會安全網，這一開始就是一個社會漏洞網，真的是……"],["薛部長瑞元：我們發現問題，就是把它糾正過來。"],["林委員淑芬：對啦，可是我們執政八年了，你現在還跟我講現在發現問題就把它糾正過來，我是覺得蠻遺憾的，因為這個在道德上風險太大了，這在運作上也是會讓整個保母的服務是尋求最便宜的，當然風險就更大，尋求最便宜的風險更大，然後在專業出養的評估上，也勢必一定要評估出出養，不然媒合機構就賠錢了，如果是外國人來收養更好，因為可以收八千塊錢美金，臺灣人收養的話才收十萬元，每一個收養小孩的人必須第一階段就要收兩萬，第二階段收兩萬五，分階段就要繳費，若不成功就收不到那麼多錢，所以都要保證成功。這樣子真的是把要出養的兒童小孩送入深淵裡面，聽起來整個制度不是一個社會安全網，反而是把小孩推入深淵、深坑裡面。真的啦，這種道德性的風險太大、瑕疵太大了，令人相當遺憾，你說這次全都要改了？"],["薛部長瑞元：對。"],["林委員淑芬：你這次都要改了？"],["薛部長瑞元：是。"],["林委員淑芬：好吧，我們就看一下你拿出來的方案是什麼。"],["主席：好，謝謝林淑芬委員的質詢，休息5分鐘。","休息（15時14分）","繼續開會（15時19分）"],["主席：大家請回座，我們繼續開會。","接下來請李彥秀委員進行質詢。"]],"agenda":{"page_end":206,"meet_id":"委員會-11-1-26-6","speakers":["王育敏","黃秀芳","蘇清泉","吳思瑤","洪孟楷","林月琴","廖偉翔","陳昭姿","陳菁徽","盧縣一","邱鎮軍","王正旭","李彥秀","徐巧芯","涂權吉","羅廷瑋","陳玉珍","柯建銘","傅崐萁","劉建國","伍麗華Saidhai‧Tahovecahe","楊曜","陳瑩","林淑芬","陳培瑜","賴士葆","郭昱晴","范雲","黃國昌","牛煦庭","吳春城","顏寬恒","沈伯洋","林德福","陳冠廷","張雅琳","葉元之","羅智強"],"page_start":61,"meetingDate":["2024-03-18"],"gazette_id":"1131501","agenda_lcidc_ids":["1131501_00003"],"meet_name":"立法院第11屆第1會期社會福利及衛生環境委員會第6次全體委員會議紀錄","content":"邀請衛生福利部部長、教育部、法務部、內政部警政署就「社會安全網推動情形及策進作為」進\n行專題報告，並備質詢","agenda_id":"1131501_00002"}},"transcript":{"id":"150041","pyannote":{"name":"ronny","tool":"pyannote","data":{"url":"https://ivod.ly.gov.tw/Play/Clip/1M/150041","tool":"pyannote","id":"150041-pyannote"},"job_id":"DPTl9MTaT5OUWHq8","queued_at":"2024-06-02 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\"給\"}, {\"word\": \"他\", \"start\": 886.682, \"end\": 886.863, \"score\": 0.713}, {\"word\": \"出\", \"start\": 886.863, \"end\": 887.103, \"score\": 0.932}, {\"word\": \"洋\", \"start\": 887.103, \"end\": 887.363, \"score\": 0.776}, {\"word\": \",\"}, {\"word\": \"不\", \"start\": 887.363, \"end\": 887.523, \"score\": 0.835}, {\"word\": \"管\", \"start\": 887.523, \"end\": 887.723, \"score\": 0.846}, {\"word\": \"他\", \"start\": 887.723, \"end\": 888.203, \"score\": 0.873}, {\"word\": \"是\", \"start\": 888.203, \"end\": 888.344, \"score\": 0.752}, {\"word\": \"不\", \"start\": 888.344, \"end\": 888.504, \"score\": 0.998}, {\"word\": \"是\", \"start\": 888.504, \"end\": 888.744, \"score\": 0.985}, {\"word\": \"需\", \"start\": 888.744, \"end\": 889.104, \"score\": 0.972}, {\"word\": \"要\", \"start\": 889.104, \"end\": 889.444, \"score\": 0.881}, {\"word\": \"出\", \"start\": 889.444, \"end\": 889.664, \"score\": 0.916}, {\"word\": \"洋\", \"start\": 889.664, \"end\": 890.645, \"score\": 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{\"word\": \"深\", \"start\": 1056.472, \"end\": 1057.093, \"score\": 0.806}, {\"word\": \"淵\"}, {\"word\": \"深\", \"start\": 1057.093, \"end\": 1057.373, \"score\": 0.633}, {\"word\": \"坑\", \"start\": 1057.373, \"end\": 1057.793, \"score\": 0.86}, {\"word\": \"裡\"}, {\"word\": \"面\", \"start\": 1057.793, \"end\": 1057.813, \"score\": 0.964}, {\"word\": \"林\", \"start\": 1059.121, \"end\": 1059.161, \"score\": 0.5}, {\"word\": \"淑\", \"start\": 1059.161, \"end\": 1059.361, \"score\": 0.9}, {\"word\": \"芬\", \"start\": 1059.361, \"end\": 1059.481, \"score\": 0.833}, {\"word\": \"委\", \"start\": 1059.481, \"end\": 1059.501, \"score\": 0.0}, {\"word\": \"員\"}], \"language\": \"zh\"}","srt":"1\n00:00:04,777 --> 00:00:10,767\n主席各位大家好是不是還是先就教育我們這個薛部長薛部長請\n\n2\n00:00:14,932 --> 00:00:34,250\n委員好部長今天大家討論了很多其實這個裡面你們的報告裡面也承認這個不是社會安全網漏接沒有漏接的問題是社會安全網本身破動不安全這個是社會安全網不安全的問題\n\n3\n00:00:36,172 --> 00:00:56,317\n他也是相當嚴重的問題我們都以為只要安全網進入這個安全體系我們接起來就好了沒想到接起來那個網破洞讓他摔死了所以在這裡我們覺得在這個部分非要一條人命才讓我們看見這個安全網是有破洞的這個代價太慘痛那所以今天在這裡呢我們也發現說大家在檢討這個說出養媒合機構的社工的問題\n\n4\n00:01:04,019 --> 00:01:26,359\n那收出養媒和機構大家對於社工的檢討大概比如說在這個機制方面大家都會強調說這個要增加這個訪視的頻率啦還有這個提高訪視頻率以外提升對訪視案件的敏感度大家都有提到敏感度可是大家也都知道說什麼是敏感度敏感度要怎麼提升\n\n5\n00:01:29,338 --> 00:01:53,395\n這一個部分的話其實有兩個重點第一個重點就是要多重的去做這個訪視所謂的訪視頻率並不是單一的社工要本來一個月去一次變成一個月去兩次這不是主要重點重點是說那你負責的這些單位的話要怎麼樣去doublecheck\n\n6\n00:01:54,239 --> 00:02:13,953\n對於這種有惡意的你沒有靠這樣子的社工的總量是固定的那你多做一個doublecheck那就是排擠了另外一個房市的時間他的社工的時間也是固定的所以這一個所謂的增加房市的這一個部分的話要去做doublecheck的對象的話必須要明確\n\n7\n00:02:17,355 --> 00:02:38,286\n總量人數是固定的,公時也是固定的,那他的案件數其實是很多的,你這樣是排擠那我跟你講,因為我們找過專業的,像是彭婉如文教基金會,他們負責保姆和社區托育的主管人員請示,他們其實一直也反映了幾件事情,第一個\n\n8\n00:02:38,946 --> 00:02:53,774\n反噬的次數固然是可以增加好了你要doublecheck也沒有關係但是如果反噬的品質沒有提升只是讓反噬人員這樣子大家疲於奔命增加工作時間增加次數double再check觀察的時間\n\n9\n00:02:54,915 --> 00:02:57,157\n這一個部分的話當然第一個要透過教育信任第二個的話我們必須用一個比較系統化的一個做法\n\n10\n00:03:26,239 --> 00:03:43,125\n我們的社工的教育訓練這本來都是專業的這大家都理論上都有專業啊但是呢理論上是這樣沒錯但是你看你們社家屬提供的這個居家特育服務中心訪事輔導工作指引你看你們的指引的內容\n\n11\n00:03:44,345 --> 00:04:09,874\n訪試前、訪試中、訪試後訪試中你叫人家到現場說你告訴人家表明身份、表明這次訪試的目的要熱誠、要積極、要真誠訪試的時候口齒要清晰、不疾不徐訪試的時候要跟保姆、居家服務員要信任關係稱呼要適當不能叫他阿姨,要叫大姊這叫適當嗎?由一般性的社會會談進入主題性的會談\n\n12\n00:04:11,355 --> 00:04:35,956\n然後要跟受訪者推立對象為中心然後要尊重、接納、同理受訪者這個保姆要同理他透過生活化的舉例提出專業的知識的建議我的意思是說看你們的指引這樣就可以增加敏感度嗎沒有這一個部分的話只是一部分因為你這邊所寫的是對於這一個接受訪視的這些成人也就是保姆但是\n\n13\n00:04:37,065 --> 00:04:40,966\n沒有提到小孩子,你要去看小孩子這才是重點對啦,這本來就應該要看,但是保姆也很重要我現在再回饋你這個是我剛剛講的第一線的主管人員他們反映的,訪視的品質高低,要察覺風險\n\n14\n00:04:59,611 --> 00:05:19,055\n那他的敏感度其實要擴大訪視面向的廣度：還有透過提問探尋日常托育細節：流程確認：還有保姆的說辭是否為真：如果組織或訪員敷衍了事只能看到表面和客觀事實你說小孩第一次去看你還要再看我跟你講這一個凱凱的個案他有沒有去看醫生沒有規定要健康檢查但他有去阿\n\n15\n00:05:25,296 --> 00:05:44,381\n他看了牙醫欸,他不是沒有看欸難道牙醫就沒有敏感度嗎?牙醫去看他檢查牙齒然後還可以說他這個四顆牙齒的脫落可能是因為磨牙牙醫師回報提供的意見可能是磨牙嚴重可能受過刺激不平等待遇或癲癇OK他也有回這個也有醫生看過並不是沒有所以我的意思是說其實\n\n16\n00:05:55,560 --> 00:05:58,643\n社家屬要創造定期的、跨單位的、不同的居家托育服務中心承辦單位、跨縣市的經驗交流機會,要擴大分享的風險資料庫\n\n17\n00:06:17,063 --> 00:06:33,074\n因為一個社工員幾個個案尤其是他看了這個個案他加上自身經驗加上這個學習的這個呃這個呃呈時間的長短不一那你提升所有第一線的從業人員的風險辨識的敏感度那風險分這些個案大家不斷的來共同分享建立一個風險資料庫結果他們檢討的是說可是每次社家屬去舉辦的會議都流於形式\n\n18\n00:06:47,003 --> 00:07:02,584\n都不是第一線工作的社工委員發言回饋都交給不是第一線的專家學者發言所以你們製作出來的手冊沒有跟上實務需求\n\n19\n00:07:03,405 --> 00:07:27,230\n如果個別的居托中心承辦的單位組織內如果你們社交組織這樣子讓學者專家發言沒有第一線的共享風險資料庫但是這個承辦單位的內部比如說兒福聯盟他內部他們有沒有督導會議他們有沒有定期的社工檢討會議如果沒有不常讓訪員間交流分享\n\n20\n00:07:28,490 --> 00:07:33,816\n沒有發揮監督職責,機構內也沒有共同分享的這個風險資料庫的教育等等,房市的品質一定很差所以我們在講說社交屬一定要擴大各居托中心經驗交流\n\n21\n00:07:48,052 --> 00:07:55,640\n不要讓各居家托育中心的工作經驗停留在個人、個別中心或單一縣市。\n\n22\n00:08:06,258 --> 00:08:34,258\n對,因為第一線去訪視,它就是收集資料作為風險辨識的依據,但敏感度是關鍵啊你如果沒有敏感度,你要收集很多資料,你如果不用忙,你也沒有辦法收集很多資料所以這個敏感度是相當要緊的但是呢,我也要跟這個部長你分享,某個居家托育服務中心其他督導的心得\n\n23\n00:08:35,391 --> 00:08:53,407\n這個在社家屬社區發展記刊的文章有一篇叫建構安全居家托育服務安全居家托育服務的建構你如何做到風險辨識文中有提到幾個點第一確保足夠的資訊量要以公精準判斷\n\n24\n00:08:54,708 --> 00:09:22,085\n然後第二個他們有發現提問的資料的豐厚度提高這個訊息來源和察覺風險電房也要這兩者這個對新收拖案例行性的電房他們也要但是他們發現有一點什麼你知道嗎這個中興督導他都透過多年運作的經驗發現有時候真相啊要收拖結束才會發現為什麼\n\n25\n00:09:24,468 --> 00:09:39,824\n因為家長跟保姆之間要維持合作關係所以要有求於保姆有時候不敢講真話他不一定會馬上全盤脫出跟中心說這個保姆有什麼問題馬上就反應\n\n26\n00:09:41,089 --> 00:10:01,428\n但是等到收拖結束、合作關係結束,他可能會講喔,所以托育的過程,這個小孩子結束了,可是保母繼續在帶小孩啊,他存在的具有風險的照顧行為,不會因為這個個案結束而消失,還會延續到下一個收拖的兒童。\n\n27\n00:10:02,449 --> 00:10:15,598\n但是呢可是這個風險沒有被真相沒有被揭露所以他就說有時候呢在收拖更新結束的時候受理保姆的拘托通報以外他們也要求你們要中拖電訪這個家那個家長\n\n28\n00:10:21,414 --> 00:10:49,020\n透過和對家長跟保母回報的結束托育的日期是否一致更重要是要藉此瞭解家長對於整體送托經驗的感受若查到風險的訊息中心便可以處理托育人員不適當有風險的照顧行為所以中托電訪很重要那這個督導他怎麼分享這個中托電訪的內容\n\n29\n00:10:50,441 --> 00:11:14,364\n他說我們剛開始打家長停拖電話家長就想說既然中心來問了而且已經終止收拖了我就講吧他講了兩點第一保母會大聲罵小孩第二寶爸會拿膠帶貼小孩的嘴巴還跟我們家長炫耀這個是媽媽在收拖結束以後才告訴他們的\n\n30\n00:11:15,771 --> 00:11:31,678\n所以說你說定期的有意義有目的的這個電訪很重要但是從收託結束中拖的這個電訪也很重要所以這些都是一種機制啊但是必須要有敏感性而且你們有規定要中拖電訪嗎目前是沒有沒有對所以人家做的好的還有中拖電訪\n\n31\n00:11:40,910 --> 00:11:46,793\n這個關係結束以後,我孩子在你手上拜託你給我,我不跟他說。終止這個托育以後,結束,才會發現真相。這個就是我們在這裡告訴你的。但我今天還有一點要請教這個部長,講這麼久我還是有點不了解。這個凱凱的付費給保姆的是誰?誰付費的?\n\n32\n00:12:05,080 --> 00:12:25,860\n就是他的保姆費是誰付的?目前應該按照機制來講應該是俄府聯盟付給他了阿俄府聯盟沒有拿到補助他為什麼會願意幫這個小孩付錢?會不會有道德風險要幫那個小孩付錢如果他沒有被人家收養時間越拖越長要幫他付的錢越多所以他就越找那個品質越差越便宜的\n\n33\n00:12:26,300 --> 00:12:30,842\n這個機制運作了這麼多年,怎麼會這個樣子呢?他有沒有政府的補助進去?完全都沒有嗎?這麼多年都沒有嗎?我以為百思不得其解,因為兒盟將凱凱交付給這個保姆的時候,為什麼是由他的外婆跟這個保姆簽約的?\n\n34\n00:12:54,053 --> 00:13:17,806\n可是目前的是兒婦聯盟這個關係對價關係不太對啊對所以這一個部分就是我們在檢討報告裡面提到的然後我們未來要去改的這個機制我們就希望他走的是委託安置的一個流程然後就不是我說媒合機構怎麼會有這麼多錢可以去幫你安置這麼多小孩你不會覺得疑問嗎\n\n35\n00:13:19,790 --> 00:13:48,055\n當然因為他後面最後如果媒合成功的話是有收費啦對於收養者去做收費好但收費標準是怎麼樣以兒福聯盟為例現在收費標準是怎麼樣大概是10萬嘛第一個階段只要去申請就要繳費2萬所以要收養也要花很多錢的不是免費的喔第二階段進行收養評估審查要2萬5第3案第4階段要收多少\n\n36\n00:13:49,386 --> 00:14:14,539\n下一張有沒有第三階段收養五萬五但我知道那個外國人收養要繳兩次繳兩次的那個美金四千元所以給外國人收養可以收到美金八千元台灣人收養可以收養成功他要繳十萬元外國人要收養台灣小孩繳八千塊美金所以靠這個收入來cover那個支出\n\n37\n00:14:15,800 --> 00:14:36,015\n那所以顯然支柱的時間要越短越好,所以他難以做到最好的評估,所以你們才說這個有道德風險,因為大家都覺得出洋是一個評估,要經過專業的評估才能出洋。如果照這種道理,我愛互出是這孩子,我愛保證他出洋,如果沒保證他出洋,\n\n38\n00:14:38,897 --> 00:14:57,450\n我看這孩子的錢都要倒掉,怎麼會有這種事情,怎麼會沒有機構要做這種事情,所以就要保證每個孩子都要給他出洋,不管他是不是需要出洋,不管專業評估到底是不是出洋對這個小孩是最好的,他都勢必要讓他出洋\n\n39\n00:15:00,416 --> 00:15:02,438\n所以出養越多,收入越多,就沒有機構而言\n\n40\n00:15:21,295 --> 00:15:47,706\n當然為了節省成本他還沒有沒有成功還沒有收養出去還沒有這個出養出去所以他當然是要找成本成本比較低的所以在找這種很惡質的保姆的收的就好現在這是各位負責多少?差不多兩萬多他到底是收多少?好像是兩萬五兩萬六兩萬六?還有理事休息夠不夠了各位?\n\n41\n00:15:49,454 --> 00:16:02,423\n然後這個俄府聯盟也不能太挑剔因為他這個錢他還要自己付所以他找品質好的他可能要付更多的錢有這種風險對有這種風險因為原來的他的那個保姆的話一個月3萬一開始設計這種制度就是一個大錯誤社會安全網不安全這不是社會安全網這一開始就是一個社會漏洞網\n\n42\n00:16:20,938 --> 00:16:47,090\n我們發現問題就是把它糾正過來對啦可是我們只剩8年了你現在跟我講說現在發現問題我們就把它糾正過來我是覺得蠻遺憾的因為這個在道德上風險太大了然後在運作上也是你會讓它整個這個保姆的服務當然是尋求最便宜的當然風險就更大\n\n43\n00:16:48,744 --> 00:16:55,767\n尋求最便宜的風險更大,然後在專業的這個出養的評估上,也勢必一定要評估出出養,沒有這個機構,沒有機構就了不起啊,了不起啊。若是外國人來收養更好,因為可以收8000塊錢美金,那台灣人收養的話才收10萬元。\n\n44\n00:17:09,572 --> 00:17:37,813\n每一個收養小孩的人他必須就一開始第一階段就要收兩萬第二階段收兩萬五分階段就要繳費不成功呢不成功就是沒多少錢所以都要保證成功這樣子真的是我們把兒童要出養的兒童小孩送入深淵裡面聽起來整個制度不是一個社會安全網是反而把小孩推入深淵深坑裡面\n\n45\n00:17:39,121 --> 00:17:39,501\n林淑芬委員\n\n","tsv":"start\tend\ttext\n4777\t10767\t主席 各位大家好是不是還是先就教育我們這個薛部長薛部長請\n14932\t34250\t委員好部長今天大家討論了很多其實這個裡面你們的報告裡面也承認這個不是社會安全網漏接沒有漏接的問題是社會安全網本身破動不安全這個是社會安全網不安全的問題\n36172\t56317\t他也是相當嚴重的問題我們都以為只要安全網進入這個安全體系我們接起來就好了沒想到接起來那個網破洞讓他摔死了所以在這裡我們覺得在這個部分非要一條人命才讓我們看見這個安全網是有破洞的這個代價太慘痛那所以今天在這裡呢我們也發現說大家在檢討這個說出養媒合機構的社工的問題\n64019\t86359\t那收出養媒和機構大家對於社工的檢討大概比如說在這個機制方面大家都會強調說這個要增加這個訪視的頻率啦還有這個提高訪視頻率以外提升對訪視案件的敏感度大家都有提到敏感度可是大家也都知道說什麼是敏感度敏感度要怎麼提升\n89338\t113395\t這一個部分的話其實有兩個重點第一個重點就是要多重的去做這個訪視所謂的訪視頻率並不是單一的社工要本來一個月去一次變成一個月去兩次這不是主要重點重點是說那你負責的這些單位的話要怎麼樣去double check\n114239\t133953\t對於這種有惡意的你沒有靠這樣子的社工的總量是固定的那你多做一個double check那就是排擠了另外一個房市的時間他的社工的時間也是固定的所以這一個所謂的增加房市的這一個部分的話要去做double check的對象的話必須要明確\n137355\t158286\t總量人數是固定的,公時也是固定的,那他的案件數其實是很多的,你這樣是排擠那我跟你講,因為我們找過專業的,像是彭婉如文教基金會,他們負責保姆和社區托育的主管人員請示,他們其實一直也反映了幾件事情,第一個\n158946\t173774\t反噬的次數固然是可以增加好了你要double check也沒有關係但是如果反噬的品質沒有提升只是讓反噬人員這樣子大家疲於奔命增加工作時間增加次數double再check觀察的時間\n174915\t177157\t這一個部分的話當然第一個要透過教育信任第二個的話我們必須用一個比較系統化的一個做法\n206239\t223125\t我們的社工的教育訓練這本來都是專業的這大家都理論上都有專業啊但是呢理論上是這樣沒錯但是你看你們社家屬提供的這個居家特育服務中心訪事輔導工作指引你看你們的指引的內容\n224345\t249874\t訪試前、訪試中、訪試後訪試中你叫人家到現場說你告訴人家表明身份、表明這次訪試的目的要熱誠、要積極、要真誠訪試的時候口齒要清晰、不疾不徐訪試的時候要跟保姆、居家服務員要信任關係稱呼要適當不能叫他阿姨,要叫大姊這叫適當嗎?由一般性的社會會談進入主題性的會談\n251355\t275956\t然後要跟受訪者推立對象為中心然後要尊重、接納、同理受訪者這個保姆要同理他透過生活化的舉例提出專業的知識的建議我的意思是說看你們的指引這樣就可以增加敏感度嗎沒有這一個部分的話只是一部分因為你這邊所寫的是對於這一個接受訪視的這些成人也就是保姆但是\n277065\t280966\t沒有提到小孩子,你要去看小孩子這才是重點對啦,這本來就應該要看,但是保姆也很重要我現在再回饋你這個是我剛剛講的第一線的主管人員他們反映的,訪視的品質高低,要察覺風險\n299611\t319055\t那他的敏感度其實要擴大訪視面向的廣度：還有透過提問探尋日常托育細節：流程確認：還有保姆的說辭是否為真：如果組織或訪員敷衍了事只能看到表面和客觀事實你說小孩第一次去看你還要再看我跟你講這一個凱凱的個案他有沒有去看醫生沒有規定要健康檢查但他有去阿\n325296\t344381\t他看了牙醫欸,他不是沒有看欸難道牙醫就沒有敏感度嗎?牙醫去看他檢查牙齒然後還可以說他這個四顆牙齒的脫落可能是因為磨牙牙醫師回報提供的意見可能是磨牙嚴重可能受過刺激不平等待遇或癲癇OK他也有回這個也有醫生看過並不是沒有所以我的意思是說其實\n355560\t358643\t社家屬要創造定期的、跨單位的、不同的居家托育服務中心承辦單位、跨縣市的經驗交流機會,要擴大分享的風險資料庫\n377063\t393074\t因為一個社工員幾個個案尤其是他看了這個個案他加上自身經驗加上這個學習的這個呃這個呃呈時間的長短不一那你提升所有第一線的從業人員的風險辨識的敏感度那風險分這些個案大家不斷的來共同分享建立一個風險資料庫結果他們檢討的是說可是每次社家屬去舉辦的會議都流於形式\n407003\t422584\t都不是第一線工作的社工委員發言回饋都交給不是第一線的專家學者發言所以你們製作出來的手冊沒有跟上實務需求\n423405\t447230\t如果個別的居托中心承辦的單位組織內如果你們社交組織這樣子讓學者專家發言沒有第一線的共享風險資料庫但是這個承辦單位的內部比如說兒福聯盟他內部他們有沒有督導會議他們有沒有定期的社工檢討會議如果沒有不常讓訪員間交流分享\n448490\t453816\t沒有發揮監督職責,機構內也沒有共同分享的這個風險資料庫的教育等等,房市的品質一定很差所以我們在講說社交屬一定要擴大各居托中心經驗交流\n468052\t475640\t不要讓各居家托育中心的工作經驗停留在個人、個別中心或單一縣市。\n486258\t514258\t對,因為第一線去訪視,它就是收集資料作為風險辨識的依據,但敏感度是關鍵啊你如果沒有敏感度,你要收集很多資料,你如果不用忙,你也沒有辦法收集很多資料所以這個敏感度是相當要緊的但是呢,我也要跟這個部長你分享,某個居家托育服務中心其他督導的心得\n515391\t533407\t這個在社家屬社區發展記刊的文章有一篇叫建構安全居家托育服務安全居家托育服務的建構你如何做到風險辨識文中有提到幾個點第一確保足夠的資訊量要以公精準判斷\n534708\t562085\t然後第二個他們有發現提問的資料的豐厚度提高這個訊息來源和察覺風險電房也要這兩者這個對新收拖案例行性的電房他們也要但是他們發現有一點什麼你知道嗎這個中興督導他都透過多年運作的經驗發現有時候真相啊要收拖結束才會發現為什麼\n564468\t579824\t因為家長跟保姆之間要維持合作關係所以要有求於保姆有時候不敢講真話他不一定會馬上全盤脫出跟中心說這個保姆有什麼問題馬上就反應\n581089\t601428\t但是等到收拖結束、合作關係結束,他可能會講喔,所以托育的過程,這個小孩子結束了,可是保母繼續在帶小孩啊,他存在的具有風險的照顧行為,不會因為這個個案結束而消失,還會延續到下一個收拖的兒童。\n602449\t615598\t但是呢可是這個風險沒有被真相沒有被揭露所以他就說有時候呢在收拖更新結束的時候受理保姆的拘托通報以外他們也要求你們要中拖電訪這個家那個家長\n621414\t649020\t透過和對家長跟保母回報的結束托育的日期是否一致更重要是要藉此瞭解家長對於整體送托經驗的感受若查到風險的訊息中心便可以處理托育人員不適當有風險的照顧行為所以中托電訪很重要那這個督導他怎麼分享這個中托電訪的內容\n650441\t674364\t他說我們剛開始打家長停拖電話家長就想說既然中心來問了而且已經終止收拖了我就講吧他講了兩點第一保母會大聲罵小孩第二寶爸會拿膠帶貼小孩的嘴巴還跟我們家長炫耀這個是媽媽在收拖結束以後才告訴他們的\n675771\t691678\t所以說你說定期的有意義有目的的這個電訪很重要但是從收託結束中拖的這個電訪也很重要所以這些都是一種機制啊但是必須要有敏感性而且你們有規定要中拖電訪嗎目前是沒有沒有對所以人家做的好的還有中拖電訪\n700910\t706793\t這個關係結束以後,我孩子在你手上拜託你給我,我不跟他說。終止這個托育以後,結束,才會發現真相。這個就是我們在這裡告訴你的。但我今天還有一點要請教這個部長,講這麼久我還是有點不了解。這個凱凱的付費給保姆的是誰?誰付費的?\n725080\t745860\t就是他的保姆費是誰付的?目前應該按照機制來講應該是俄府聯盟付給他了阿俄府聯盟沒有拿到補助他為什麼會願意幫這個小孩付錢?會不會有道德風險要幫那個小孩付錢如果他沒有被人家收養時間越拖越長要幫他付的錢越多所以他就越找那個品質越差越便宜的\n746300\t750842\t這個機制運作了這麼多年,怎麼會這個樣子呢?他有沒有政府的補助進去?完全都沒有嗎?這麼多年都沒有嗎?我以為百思不得其解,因為兒盟將凱凱交付給這個保姆的時候,為什麼是由他的外婆跟這個保姆簽約的?\n774053\t797806\t可是目前的是兒婦聯盟這個關係對價關係不太對啊對所以這一個部分就是我們在檢討報告裡面提到的然後我們未來要去改的這個機制我們就希望他走的是委託安置的一個流程然後就不是我說媒合機構怎麼會有這麼多錢可以去幫你安置這麼多小孩你不會覺得疑問嗎\n799790\t828055\t當然因為他後面最後如果媒合成功的話是有收費啦對於收養者去做收費好 但收費標準是怎麼樣以兒福聯盟為例現在收費標準是怎麼樣大概是10萬嘛第一個階段只要去申請就要繳費2萬所以要收養也要花很多錢的不是免費的喔第二階段進行收養評估審查要2萬5第3案第4階段要收多少\n829386\t854539\t下一張有沒有第三階段收養五萬五但我知道那個外國人收養要繳兩次繳兩次的那個美金四千元所以給外國人收養可以收到美金八千元台灣人收養可以收養成功他要繳十萬元外國人要收養台灣小孩繳八千塊美金所以靠這個收入來cover那個支出\n855800\t876015\t那所以顯然支柱的時間要越短越好,所以他難以做到最好的評估,所以你們才說這個有道德風險,因為大家都覺得出洋是一個評估,要經過專業的評估才能出洋。如果照這種道理,我愛互出是這孩子,我愛保證他出洋,如果沒保證他出洋,\n878897\t897450\t我看這孩子的錢都要倒掉,怎麼會有這種事情,怎麼會沒有機構要做這種事情,所以就要保證每個孩子都要給他出洋,不管他是不是需要出洋,不管專業評估到底是不是出洋對這個小孩是最好的,他都勢必要讓他出洋\n900416\t902438\t所以出養越多,收入越多,就沒有機構而言\n921295\t947706\t當然為了節省成本他還沒有沒有成功還沒有收養出去還沒有這個出養出去所以他當然是要找成本成本比較低的所以在找這種很惡質的保姆的收的就好現在這是各位負責多少?差不多兩萬多他到底是收多少?好像是兩萬五兩萬六兩萬六?還有理事休息夠不夠了各位?\n949454\t962423\t然後這個俄府聯盟也不能太挑剔因為他這個錢他還要自己付所以他找品質好的他可能要付更多的錢有這種風險對 有這種風險因為原來的他的那個保姆的話一個月3萬一開始設計這種制度就是一個大錯誤社會安全網不安全這不是社會安全網這一開始就是一個社會漏洞網\n980938\t1007090\t我們發現問題就是把它糾正過來對啦可是我們只剩8年了你現在跟我講說現在發現問題我們就把它糾正過來我是覺得蠻遺憾的因為這個在道德上風險太大了然後在運作上也是你會讓它整個這個保姆的服務當然是尋求最便宜的當然風險就更大\n1008744\t1015767\t尋求最便宜的風險更大,然後在專業的這個出養的評估上,也勢必一定要評估出出養,沒有這個機構,沒有機構就了不起啊,了不起啊。若是外國人來收養更好,因為可以收8000塊錢美金,那台灣人收養的話才收10萬元。\n1029572\t1057813\t每一個收養小孩的人他必須就一開始第一階段就要收兩萬第二階段收兩萬五分階段就要繳費不成功呢不成功就是沒多少錢所以都要保證成功這樣子真的是我們把兒童要出養的兒童小孩送入深淵裡面聽起來整個制度不是一個社會安全網是反而把小孩推入深淵深坑裡面\n1059121\t1059501\t林淑芬委員\n","txt":"主席 各位大家好是不是還是先就教育我們這個薛部長薛部長請\n委員好部長今天大家討論了很多其實這個裡面你們的報告裡面也承認這個不是社會安全網漏接沒有漏接的問題是社會安全網本身破動不安全這個是社會安全網不安全的問題\n他也是相當嚴重的問題我們都以為只要安全網進入這個安全體系我們接起來就好了沒想到接起來那個網破洞讓他摔死了所以在這裡我們覺得在這個部分非要一條人命才讓我們看見這個安全網是有破洞的這個代價太慘痛那所以今天在這裡呢我們也發現說大家在檢討這個說出養媒合機構的社工的問題\n那收出養媒和機構大家對於社工的檢討大概比如說在這個機制方面大家都會強調說這個要增加這個訪視的頻率啦還有這個提高訪視頻率以外提升對訪視案件的敏感度大家都有提到敏感度可是大家也都知道說什麼是敏感度敏感度要怎麼提升\n這一個部分的話其實有兩個重點第一個重點就是要多重的去做這個訪視所謂的訪視頻率並不是單一的社工要本來一個月去一次變成一個月去兩次這不是主要重點重點是說那你負責的這些單位的話要怎麼樣去double check\n對於這種有惡意的你沒有靠這樣子的社工的總量是固定的那你多做一個double check那就是排擠了另外一個房市的時間他的社工的時間也是固定的所以這一個所謂的增加房市的這一個部分的話要去做double check的對象的話必須要明確\n總量人數是固定的,公時也是固定的,那他的案件數其實是很多的,你這樣是排擠那我跟你講,因為我們找過專業的,像是彭婉如文教基金會,他們負責保姆和社區托育的主管人員請示,他們其實一直也反映了幾件事情,第一個\n反噬的次數固然是可以增加好了你要double check也沒有關係但是如果反噬的品質沒有提升只是讓反噬人員這樣子大家疲於奔命增加工作時間增加次數double再check觀察的時間\n這一個部分的話當然第一個要透過教育信任第二個的話我們必須用一個比較系統化的一個做法\n我們的社工的教育訓練這本來都是專業的這大家都理論上都有專業啊但是呢理論上是這樣沒錯但是你看你們社家屬提供的這個居家特育服務中心訪事輔導工作指引你看你們的指引的內容\n訪試前、訪試中、訪試後訪試中你叫人家到現場說你告訴人家表明身份、表明這次訪試的目的要熱誠、要積極、要真誠訪試的時候口齒要清晰、不疾不徐訪試的時候要跟保姆、居家服務員要信任關係稱呼要適當不能叫他阿姨,要叫大姊這叫適當嗎?由一般性的社會會談進入主題性的會談\n然後要跟受訪者推立對象為中心然後要尊重、接納、同理受訪者這個保姆要同理他透過生活化的舉例提出專業的知識的建議我的意思是說看你們的指引這樣就可以增加敏感度嗎沒有這一個部分的話只是一部分因為你這邊所寫的是對於這一個接受訪視的這些成人也就是保姆但是\n沒有提到小孩子,你要去看小孩子這才是重點對啦,這本來就應該要看,但是保姆也很重要我現在再回饋你這個是我剛剛講的第一線的主管人員他們反映的,訪視的品質高低,要察覺風險\n那他的敏感度其實要擴大訪視面向的廣度：還有透過提問探尋日常托育細節：流程確認：還有保姆的說辭是否為真：如果組織或訪員敷衍了事只能看到表面和客觀事實你說小孩第一次去看你還要再看我跟你講這一個凱凱的個案他有沒有去看醫生沒有規定要健康檢查但他有去阿\n他看了牙醫欸,他不是沒有看欸難道牙醫就沒有敏感度嗎?牙醫去看他檢查牙齒然後還可以說他這個四顆牙齒的脫落可能是因為磨牙牙醫師回報提供的意見可能是磨牙嚴重可能受過刺激不平等待遇或癲癇OK他也有回這個也有醫生看過並不是沒有所以我的意思是說其實\n社家屬要創造定期的、跨單位的、不同的居家托育服務中心承辦單位、跨縣市的經驗交流機會,要擴大分享的風險資料庫\n因為一個社工員幾個個案尤其是他看了這個個案他加上自身經驗加上這個學習的這個呃這個呃呈時間的長短不一那你提升所有第一線的從業人員的風險辨識的敏感度那風險分這些個案大家不斷的來共同分享建立一個風險資料庫結果他們檢討的是說可是每次社家屬去舉辦的會議都流於形式\n都不是第一線工作的社工委員發言回饋都交給不是第一線的專家學者發言所以你們製作出來的手冊沒有跟上實務需求\n如果個別的居托中心承辦的單位組織內如果你們社交組織這樣子讓學者專家發言沒有第一線的共享風險資料庫但是這個承辦單位的內部比如說兒福聯盟他內部他們有沒有督導會議他們有沒有定期的社工檢討會議如果沒有不常讓訪員間交流分享\n沒有發揮監督職責,機構內也沒有共同分享的這個風險資料庫的教育等等,房市的品質一定很差所以我們在講說社交屬一定要擴大各居托中心經驗交流\n不要讓各居家托育中心的工作經驗停留在個人、個別中心或單一縣市。\n對,因為第一線去訪視,它就是收集資料作為風險辨識的依據,但敏感度是關鍵啊你如果沒有敏感度,你要收集很多資料,你如果不用忙,你也沒有辦法收集很多資料所以這個敏感度是相當要緊的但是呢,我也要跟這個部長你分享,某個居家托育服務中心其他督導的心得\n這個在社家屬社區發展記刊的文章有一篇叫建構安全居家托育服務安全居家托育服務的建構你如何做到風險辨識文中有提到幾個點第一確保足夠的資訊量要以公精準判斷\n然後第二個他們有發現提問的資料的豐厚度提高這個訊息來源和察覺風險電房也要這兩者這個對新收拖案例行性的電房他們也要但是他們發現有一點什麼你知道嗎這個中興督導他都透過多年運作的經驗發現有時候真相啊要收拖結束才會發現為什麼\n因為家長跟保姆之間要維持合作關係所以要有求於保姆有時候不敢講真話他不一定會馬上全盤脫出跟中心說這個保姆有什麼問題馬上就反應\n但是等到收拖結束、合作關係結束,他可能會講喔,所以托育的過程,這個小孩子結束了,可是保母繼續在帶小孩啊,他存在的具有風險的照顧行為,不會因為這個個案結束而消失,還會延續到下一個收拖的兒童。\n但是呢可是這個風險沒有被真相沒有被揭露所以他就說有時候呢在收拖更新結束的時候受理保姆的拘托通報以外他們也要求你們要中拖電訪這個家那個家長\n透過和對家長跟保母回報的結束托育的日期是否一致更重要是要藉此瞭解家長對於整體送托經驗的感受若查到風險的訊息中心便可以處理托育人員不適當有風險的照顧行為所以中托電訪很重要那這個督導他怎麼分享這個中托電訪的內容\n他說我們剛開始打家長停拖電話家長就想說既然中心來問了而且已經終止收拖了我就講吧他講了兩點第一保母會大聲罵小孩第二寶爸會拿膠帶貼小孩的嘴巴還跟我們家長炫耀這個是媽媽在收拖結束以後才告訴他們的\n所以說你說定期的有意義有目的的這個電訪很重要但是從收託結束中拖的這個電訪也很重要所以這些都是一種機制啊但是必須要有敏感性而且你們有規定要中拖電訪嗎目前是沒有沒有對所以人家做的好的還有中拖電訪\n這個關係結束以後,我孩子在你手上拜託你給我,我不跟他說。終止這個托育以後,結束,才會發現真相。這個就是我們在這裡告訴你的。但我今天還有一點要請教這個部長,講這麼久我還是有點不了解。這個凱凱的付費給保姆的是誰?誰付費的?\n就是他的保姆費是誰付的?目前應該按照機制來講應該是俄府聯盟付給他了阿俄府聯盟沒有拿到補助他為什麼會願意幫這個小孩付錢?會不會有道德風險要幫那個小孩付錢如果他沒有被人家收養時間越拖越長要幫他付的錢越多所以他就越找那個品質越差越便宜的\n這個機制運作了這麼多年,怎麼會這個樣子呢?他有沒有政府的補助進去?完全都沒有嗎?這麼多年都沒有嗎?我以為百思不得其解,因為兒盟將凱凱交付給這個保姆的時候,為什麼是由他的外婆跟這個保姆簽約的?\n可是目前的是兒婦聯盟這個關係對價關係不太對啊對所以這一個部分就是我們在檢討報告裡面提到的然後我們未來要去改的這個機制我們就希望他走的是委託安置的一個流程然後就不是我說媒合機構怎麼會有這麼多錢可以去幫你安置這麼多小孩你不會覺得疑問嗎\n當然因為他後面最後如果媒合成功的話是有收費啦對於收養者去做收費好 但收費標準是怎麼樣以兒福聯盟為例現在收費標準是怎麼樣大概是10萬嘛第一個階段只要去申請就要繳費2萬所以要收養也要花很多錢的不是免費的喔第二階段進行收養評估審查要2萬5第3案第4階段要收多少\n下一張有沒有第三階段收養五萬五但我知道那個外國人收養要繳兩次繳兩次的那個美金四千元所以給外國人收養可以收到美金八千元台灣人收養可以收養成功他要繳十萬元外國人要收養台灣小孩繳八千塊美金所以靠這個收入來cover那個支出\n那所以顯然支柱的時間要越短越好,所以他難以做到最好的評估,所以你們才說這個有道德風險,因為大家都覺得出洋是一個評估,要經過專業的評估才能出洋。如果照這種道理,我愛互出是這孩子,我愛保證他出洋,如果沒保證他出洋,\n我看這孩子的錢都要倒掉,怎麼會有這種事情,怎麼會沒有機構要做這種事情,所以就要保證每個孩子都要給他出洋,不管他是不是需要出洋,不管專業評估到底是不是出洋對這個小孩是最好的,他都勢必要讓他出洋\n所以出養越多,收入越多,就沒有機構而言\n當然為了節省成本他還沒有沒有成功還沒有收養出去還沒有這個出養出去所以他當然是要找成本成本比較低的所以在找這種很惡質的保姆的收的就好現在這是各位負責多少?差不多兩萬多他到底是收多少?好像是兩萬五兩萬六兩萬六?還有理事休息夠不夠了各位?\n然後這個俄府聯盟也不能太挑剔因為他這個錢他還要自己付所以他找品質好的他可能要付更多的錢有這種風險對 有這種風險因為原來的他的那個保姆的話一個月3萬一開始設計這種制度就是一個大錯誤社會安全網不安全這不是社會安全網這一開始就是一個社會漏洞網\n我們發現問題就是把它糾正過來對啦可是我們只剩8年了你現在跟我講說現在發現問題我們就把它糾正過來我是覺得蠻遺憾的因為這個在道德上風險太大了然後在運作上也是你會讓它整個這個保姆的服務當然是尋求最便宜的當然風險就更大\n尋求最便宜的風險更大,然後在專業的這個出養的評估上,也勢必一定要評估出出養,沒有這個機構,沒有機構就了不起啊,了不起啊。若是外國人來收養更好,因為可以收8000塊錢美金,那台灣人收養的話才收10萬元。\n每一個收養小孩的人他必須就一開始第一階段就要收兩萬第二階段收兩萬五分階段就要繳費不成功呢不成功就是沒多少錢所以都要保證成功這樣子真的是我們把兒童要出養的兒童小孩送入深淵裡面聽起來整個制度不是一個社會安全網是反而把小孩推入深淵深坑裡面\n林淑芬委員\n","vtt":"WEBVTT\n\n00:04.777 --> 00:10.767\n主席各位大家好是不是還是先就教育我們這個薛部長薛部長請\n\n00:14.932 --> 00:34.250\n委員好部長今天大家討論了很多其實這個裡面你們的報告裡面也承認這個不是社會安全網漏接沒有漏接的問題是社會安全網本身破動不安全這個是社會安全網不安全的問題\n\n00:36.172 --> 00:56.317\n他也是相當嚴重的問題我們都以為只要安全網進入這個安全體系我們接起來就好了沒想到接起來那個網破洞讓他摔死了所以在這裡我們覺得在這個部分非要一條人命才讓我們看見這個安全網是有破洞的這個代價太慘痛那所以今天在這裡呢我們也發現說大家在檢討這個說出養媒合機構的社工的問題\n\n01:04.019 --> 01:26.359\n那收出養媒和機構大家對於社工的檢討大概比如說在這個機制方面大家都會強調說這個要增加這個訪視的頻率啦還有這個提高訪視頻率以外提升對訪視案件的敏感度大家都有提到敏感度可是大家也都知道說什麼是敏感度敏感度要怎麼提升\n\n01:29.338 --> 01:53.395\n這一個部分的話其實有兩個重點第一個重點就是要多重的去做這個訪視所謂的訪視頻率並不是單一的社工要本來一個月去一次變成一個月去兩次這不是主要重點重點是說那你負責的這些單位的話要怎麼樣去doublecheck\n\n01:54.239 --> 02:13.953\n對於這種有惡意的你沒有靠這樣子的社工的總量是固定的那你多做一個doublecheck那就是排擠了另外一個房市的時間他的社工的時間也是固定的所以這一個所謂的增加房市的這一個部分的話要去做doublecheck的對象的話必須要明確\n\n02:17.355 --> 02:38.286\n總量人數是固定的,公時也是固定的,那他的案件數其實是很多的,你這樣是排擠那我跟你講,因為我們找過專業的,像是彭婉如文教基金會,他們負責保姆和社區托育的主管人員請示,他們其實一直也反映了幾件事情,第一個\n\n02:38.946 --> 02:53.774\n反噬的次數固然是可以增加好了你要doublecheck也沒有關係但是如果反噬的品質沒有提升只是讓反噬人員這樣子大家疲於奔命增加工作時間增加次數double再check觀察的時間\n\n02:54.915 --> 02:57.157\n這一個部分的話當然第一個要透過教育信任第二個的話我們必須用一個比較系統化的一個做法\n\n03:26.239 --> 03:43.125\n我們的社工的教育訓練這本來都是專業的這大家都理論上都有專業啊但是呢理論上是這樣沒錯但是你看你們社家屬提供的這個居家特育服務中心訪事輔導工作指引你看你們的指引的內容\n\n03:44.345 --> 04:09.874\n訪試前、訪試中、訪試後訪試中你叫人家到現場說你告訴人家表明身份、表明這次訪試的目的要熱誠、要積極、要真誠訪試的時候口齒要清晰、不疾不徐訪試的時候要跟保姆、居家服務員要信任關係稱呼要適當不能叫他阿姨,要叫大姊這叫適當嗎?由一般性的社會會談進入主題性的會談\n\n04:11.355 --> 04:35.956\n然後要跟受訪者推立對象為中心然後要尊重、接納、同理受訪者這個保姆要同理他透過生活化的舉例提出專業的知識的建議我的意思是說看你們的指引這樣就可以增加敏感度嗎沒有這一個部分的話只是一部分因為你這邊所寫的是對於這一個接受訪視的這些成人也就是保姆但是\n\n04:37.065 --> 04:40.966\n沒有提到小孩子,你要去看小孩子這才是重點對啦,這本來就應該要看,但是保姆也很重要我現在再回饋你這個是我剛剛講的第一線的主管人員他們反映的,訪視的品質高低,要察覺風險\n\n04:59.611 --> 05:19.055\n那他的敏感度其實要擴大訪視面向的廣度：還有透過提問探尋日常托育細節：流程確認：還有保姆的說辭是否為真：如果組織或訪員敷衍了事只能看到表面和客觀事實你說小孩第一次去看你還要再看我跟你講這一個凱凱的個案他有沒有去看醫生沒有規定要健康檢查但他有去阿\n\n05:25.296 --> 05:44.381\n他看了牙醫欸,他不是沒有看欸難道牙醫就沒有敏感度嗎?牙醫去看他檢查牙齒然後還可以說他這個四顆牙齒的脫落可能是因為磨牙牙醫師回報提供的意見可能是磨牙嚴重可能受過刺激不平等待遇或癲癇OK他也有回這個也有醫生看過並不是沒有所以我的意思是說其實\n\n05:55.560 --> 05:58.643\n社家屬要創造定期的、跨單位的、不同的居家托育服務中心承辦單位、跨縣市的經驗交流機會,要擴大分享的風險資料庫\n\n06:17.063 --> 06:33.074\n因為一個社工員幾個個案尤其是他看了這個個案他加上自身經驗加上這個學習的這個呃這個呃呈時間的長短不一那你提升所有第一線的從業人員的風險辨識的敏感度那風險分這些個案大家不斷的來共同分享建立一個風險資料庫結果他們檢討的是說可是每次社家屬去舉辦的會議都流於形式\n\n06:47.003 --> 07:02.584\n都不是第一線工作的社工委員發言回饋都交給不是第一線的專家學者發言所以你們製作出來的手冊沒有跟上實務需求\n\n07:03.405 --> 07:27.230\n如果個別的居托中心承辦的單位組織內如果你們社交組織這樣子讓學者專家發言沒有第一線的共享風險資料庫但是這個承辦單位的內部比如說兒福聯盟他內部他們有沒有督導會議他們有沒有定期的社工檢討會議如果沒有不常讓訪員間交流分享\n\n07:28.490 --> 07:33.816\n沒有發揮監督職責,機構內也沒有共同分享的這個風險資料庫的教育等等,房市的品質一定很差所以我們在講說社交屬一定要擴大各居托中心經驗交流\n\n07:48.052 --> 07:55.640\n不要讓各居家托育中心的工作經驗停留在個人、個別中心或單一縣市。\n\n08:06.258 --> 08:34.258\n對,因為第一線去訪視,它就是收集資料作為風險辨識的依據,但敏感度是關鍵啊你如果沒有敏感度,你要收集很多資料,你如果不用忙,你也沒有辦法收集很多資料所以這個敏感度是相當要緊的但是呢,我也要跟這個部長你分享,某個居家托育服務中心其他督導的心得\n\n08:35.391 --> 08:53.407\n這個在社家屬社區發展記刊的文章有一篇叫建構安全居家托育服務安全居家托育服務的建構你如何做到風險辨識文中有提到幾個點第一確保足夠的資訊量要以公精準判斷\n\n08:54.708 --> 09:22.085\n然後第二個他們有發現提問的資料的豐厚度提高這個訊息來源和察覺風險電房也要這兩者這個對新收拖案例行性的電房他們也要但是他們發現有一點什麼你知道嗎這個中興督導他都透過多年運作的經驗發現有時候真相啊要收拖結束才會發現為什麼\n\n09:24.468 --> 09:39.824\n因為家長跟保姆之間要維持合作關係所以要有求於保姆有時候不敢講真話他不一定會馬上全盤脫出跟中心說這個保姆有什麼問題馬上就反應\n\n09:41.089 --> 10:01.428\n但是等到收拖結束、合作關係結束,他可能會講喔,所以托育的過程,這個小孩子結束了,可是保母繼續在帶小孩啊,他存在的具有風險的照顧行為,不會因為這個個案結束而消失,還會延續到下一個收拖的兒童。\n\n10:02.449 --> 10:15.598\n但是呢可是這個風險沒有被真相沒有被揭露所以他就說有時候呢在收拖更新結束的時候受理保姆的拘托通報以外他們也要求你們要中拖電訪這個家那個家長\n\n10:21.414 --> 10:49.020\n透過和對家長跟保母回報的結束托育的日期是否一致更重要是要藉此瞭解家長對於整體送托經驗的感受若查到風險的訊息中心便可以處理托育人員不適當有風險的照顧行為所以中托電訪很重要那這個督導他怎麼分享這個中托電訪的內容\n\n10:50.441 --> 11:14.364\n他說我們剛開始打家長停拖電話家長就想說既然中心來問了而且已經終止收拖了我就講吧他講了兩點第一保母會大聲罵小孩第二寶爸會拿膠帶貼小孩的嘴巴還跟我們家長炫耀這個是媽媽在收拖結束以後才告訴他們的\n\n11:15.771 --> 11:31.678\n所以說你說定期的有意義有目的的這個電訪很重要但是從收託結束中拖的這個電訪也很重要所以這些都是一種機制啊但是必須要有敏感性而且你們有規定要中拖電訪嗎目前是沒有沒有對所以人家做的好的還有中拖電訪\n\n11:40.910 --> 11:46.793\n這個關係結束以後,我孩子在你手上拜託你給我,我不跟他說。終止這個托育以後,結束,才會發現真相。這個就是我們在這裡告訴你的。但我今天還有一點要請教這個部長,講這麼久我還是有點不了解。這個凱凱的付費給保姆的是誰?誰付費的?\n\n12:05.080 --> 12:25.860\n就是他的保姆費是誰付的?目前應該按照機制來講應該是俄府聯盟付給他了阿俄府聯盟沒有拿到補助他為什麼會願意幫這個小孩付錢?會不會有道德風險要幫那個小孩付錢如果他沒有被人家收養時間越拖越長要幫他付的錢越多所以他就越找那個品質越差越便宜的\n\n12:26.300 --> 12:30.842\n這個機制運作了這麼多年,怎麼會這個樣子呢?他有沒有政府的補助進去?完全都沒有嗎?這麼多年都沒有嗎?我以為百思不得其解,因為兒盟將凱凱交付給這個保姆的時候,為什麼是由他的外婆跟這個保姆簽約的?\n\n12:54.053 --> 13:17.806\n可是目前的是兒婦聯盟這個關係對價關係不太對啊對所以這一個部分就是我們在檢討報告裡面提到的然後我們未來要去改的這個機制我們就希望他走的是委託安置的一個流程然後就不是我說媒合機構怎麼會有這麼多錢可以去幫你安置這麼多小孩你不會覺得疑問嗎\n\n13:19.790 --> 13:48.055\n當然因為他後面最後如果媒合成功的話是有收費啦對於收養者去做收費好但收費標準是怎麼樣以兒福聯盟為例現在收費標準是怎麼樣大概是10萬嘛第一個階段只要去申請就要繳費2萬所以要收養也要花很多錢的不是免費的喔第二階段進行收養評估審查要2萬5第3案第4階段要收多少\n\n13:49.386 --> 14:14.539\n下一張有沒有第三階段收養五萬五但我知道那個外國人收養要繳兩次繳兩次的那個美金四千元所以給外國人收養可以收到美金八千元台灣人收養可以收養成功他要繳十萬元外國人要收養台灣小孩繳八千塊美金所以靠這個收入來cover那個支出\n\n14:15.800 --> 14:36.015\n那所以顯然支柱的時間要越短越好,所以他難以做到最好的評估,所以你們才說這個有道德風險,因為大家都覺得出洋是一個評估,要經過專業的評估才能出洋。如果照這種道理,我愛互出是這孩子,我愛保證他出洋,如果沒保證他出洋,\n\n14:38.897 --> 14:57.450\n我看這孩子的錢都要倒掉,怎麼會有這種事情,怎麼會沒有機構要做這種事情,所以就要保證每個孩子都要給他出洋,不管他是不是需要出洋,不管專業評估到底是不是出洋對這個小孩是最好的,他都勢必要讓他出洋\n\n15:00.416 --> 15:02.438\n所以出養越多,收入越多,就沒有機構而言\n\n15:21.295 --> 15:47.706\n當然為了節省成本他還沒有沒有成功還沒有收養出去還沒有這個出養出去所以他當然是要找成本成本比較低的所以在找這種很惡質的保姆的收的就好現在這是各位負責多少?差不多兩萬多他到底是收多少?好像是兩萬五兩萬六兩萬六?還有理事休息夠不夠了各位?\n\n15:49.454 --> 16:02.423\n然後這個俄府聯盟也不能太挑剔因為他這個錢他還要自己付所以他找品質好的他可能要付更多的錢有這種風險對有這種風險因為原來的他的那個保姆的話一個月3萬一開始設計這種制度就是一個大錯誤社會安全網不安全這不是社會安全網這一開始就是一個社會漏洞網\n\n16:20.938 --> 16:47.090\n我們發現問題就是把它糾正過來對啦可是我們只剩8年了你現在跟我講說現在發現問題我們就把它糾正過來我是覺得蠻遺憾的因為這個在道德上風險太大了然後在運作上也是你會讓它整個這個保姆的服務當然是尋求最便宜的當然風險就更大\n\n16:48.744 --> 16:55.767\n尋求最便宜的風險更大,然後在專業的這個出養的評估上,也勢必一定要評估出出養,沒有這個機構,沒有機構就了不起啊,了不起啊。若是外國人來收養更好,因為可以收8000塊錢美金,那台灣人收養的話才收10萬元。\n\n17:09.572 --> 17:37.813\n每一個收養小孩的人他必須就一開始第一階段就要收兩萬第二階段收兩萬五分階段就要繳費不成功呢不成功就是沒多少錢所以都要保證成功這樣子真的是我們把兒童要出養的兒童小孩送入深淵裡面聽起來整個制度不是一個社會安全網是反而把小孩推入深淵深坑裡面\n\n17:39.121 --> 17:39.501\n林淑芬委員\n\n","segments":[{"start":4.777,"end":10.767,"text":"主席 各位大家好是不是還是先就教育我們這個薛部長薛部長請"},{"start":14.932,"end":34.25,"text":"委員好部長今天大家討論了很多其實這個裡面你們的報告裡面也承認這個不是社會安全網漏接沒有漏接的問題是社會安全網本身破動不安全這個是社會安全網不安全的問題"},{"start":36.172,"end":56.317,"text":"他也是相當嚴重的問題我們都以為只要安全網進入這個安全體系我們接起來就好了沒想到接起來那個網破洞讓他摔死了所以在這裡我們覺得在這個部分非要一條人命才讓我們看見這個安全網是有破洞的這個代價太慘痛那所以今天在這裡呢我們也發現說大家在檢討這個說出養媒合機構的社工的問題"},{"start":64.019,"end":86.359,"text":"那收出養媒和機構大家對於社工的檢討大概比如說在這個機制方面大家都會強調說這個要增加這個訪視的頻率啦還有這個提高訪視頻率以外提升對訪視案件的敏感度大家都有提到敏感度可是大家也都知道說什麼是敏感度敏感度要怎麼提升"},{"start":89.338,"end":113.395,"text":"這一個部分的話其實有兩個重點第一個重點就是要多重的去做這個訪視所謂的訪視頻率並不是單一的社工要本來一個月去一次變成一個月去兩次這不是主要重點重點是說那你負責的這些單位的話要怎麼樣去double check"},{"start":114.239,"end":133.953,"text":"對於這種有惡意的你沒有靠這樣子的社工的總量是固定的那你多做一個double check那就是排擠了另外一個房市的時間他的社工的時間也是固定的所以這一個所謂的增加房市的這一個部分的話要去做double check的對象的話必須要明確"},{"start":137.355,"end":158.286,"text":"總量人數是固定的,公時也是固定的,那他的案件數其實是很多的,你這樣是排擠那我跟你講,因為我們找過專業的,像是彭婉如文教基金會,他們負責保姆和社區托育的主管人員請示,他們其實一直也反映了幾件事情,第一個"},{"start":158.946,"end":173.774,"text":"反噬的次數固然是可以增加好了你要double check也沒有關係但是如果反噬的品質沒有提升只是讓反噬人員這樣子大家疲於奔命增加工作時間增加次數double再check觀察的時間"},{"start":174.915,"end":177.157,"text":"這一個部分的話當然第一個要透過教育信任第二個的話我們必須用一個比較系統化的一個做法"},{"start":206.239,"end":223.125,"text":"我們的社工的教育訓練這本來都是專業的這大家都理論上都有專業啊但是呢理論上是這樣沒錯但是你看你們社家屬提供的這個居家特育服務中心訪事輔導工作指引你看你們的指引的內容"},{"start":224.345,"end":249.874,"text":"訪試前、訪試中、訪試後訪試中你叫人家到現場說你告訴人家表明身份、表明這次訪試的目的要熱誠、要積極、要真誠訪試的時候口齒要清晰、不疾不徐訪試的時候要跟保姆、居家服務員要信任關係稱呼要適當不能叫他阿姨,要叫大姊這叫適當嗎?由一般性的社會會談進入主題性的會談"},{"start":251.355,"end":275.956,"text":"然後要跟受訪者推立對象為中心然後要尊重、接納、同理受訪者這個保姆要同理他透過生活化的舉例提出專業的知識的建議我的意思是說看你們的指引這樣就可以增加敏感度嗎沒有這一個部分的話只是一部分因為你這邊所寫的是對於這一個接受訪視的這些成人也就是保姆但是"},{"start":277.065,"end":280.966,"text":"沒有提到小孩子,你要去看小孩子這才是重點對啦,這本來就應該要看,但是保姆也很重要我現在再回饋你這個是我剛剛講的第一線的主管人員他們反映的,訪視的品質高低,要察覺風險"},{"start":299.611,"end":319.055,"text":"那他的敏感度其實要擴大訪視面向的廣度：還有透過提問探尋日常托育細節：流程確認：還有保姆的說辭是否為真：如果組織或訪員敷衍了事只能看到表面和客觀事實你說小孩第一次去看你還要再看我跟你講這一個凱凱的個案他有沒有去看醫生沒有規定要健康檢查但他有去阿"},{"start":325.296,"end":344.381,"text":"他看了牙醫欸,他不是沒有看欸難道牙醫就沒有敏感度嗎?牙醫去看他檢查牙齒然後還可以說他這個四顆牙齒的脫落可能是因為磨牙牙醫師回報提供的意見可能是磨牙嚴重可能受過刺激不平等待遇或癲癇OK他也有回這個也有醫生看過並不是沒有所以我的意思是說其實"},{"start":355.56,"end":358.643,"text":"社家屬要創造定期的、跨單位的、不同的居家托育服務中心承辦單位、跨縣市的經驗交流機會,要擴大分享的風險資料庫"},{"start":377.063,"end":393.074,"text":"因為一個社工員幾個個案尤其是他看了這個個案他加上自身經驗加上這個學習的這個呃這個呃呈時間的長短不一那你提升所有第一線的從業人員的風險辨識的敏感度那風險分這些個案大家不斷的來共同分享建立一個風險資料庫結果他們檢討的是說可是每次社家屬去舉辦的會議都流於形式"},{"start":407.003,"end":422.584,"text":"都不是第一線工作的社工委員發言回饋都交給不是第一線的專家學者發言所以你們製作出來的手冊沒有跟上實務需求"},{"start":423.405,"end":447.23,"text":"如果個別的居托中心承辦的單位組織內如果你們社交組織這樣子讓學者專家發言沒有第一線的共享風險資料庫但是這個承辦單位的內部比如說兒福聯盟他內部他們有沒有督導會議他們有沒有定期的社工檢討會議如果沒有不常讓訪員間交流分享"},{"start":448.49,"end":453.816,"text":"沒有發揮監督職責,機構內也沒有共同分享的這個風險資料庫的教育等等,房市的品質一定很差所以我們在講說社交屬一定要擴大各居托中心經驗交流"},{"start":468.052,"end":475.64,"text":"不要讓各居家托育中心的工作經驗停留在個人、個別中心或單一縣市。"},{"start":486.258,"end":514.258,"text":"對,因為第一線去訪視,它就是收集資料作為風險辨識的依據,但敏感度是關鍵啊你如果沒有敏感度,你要收集很多資料,你如果不用忙,你也沒有辦法收集很多資料所以這個敏感度是相當要緊的但是呢,我也要跟這個部長你分享,某個居家托育服務中心其他督導的心得"},{"start":515.391,"end":533.407,"text":"這個在社家屬社區發展記刊的文章有一篇叫建構安全居家托育服務安全居家托育服務的建構你如何做到風險辨識文中有提到幾個點第一確保足夠的資訊量要以公精準判斷"},{"start":534.708,"end":562.085,"text":"然後第二個他們有發現提問的資料的豐厚度提高這個訊息來源和察覺風險電房也要這兩者這個對新收拖案例行性的電房他們也要但是他們發現有一點什麼你知道嗎這個中興督導他都透過多年運作的經驗發現有時候真相啊要收拖結束才會發現為什麼"},{"start":564.468,"end":579.824,"text":"因為家長跟保姆之間要維持合作關係所以要有求於保姆有時候不敢講真話他不一定會馬上全盤脫出跟中心說這個保姆有什麼問題馬上就反應"},{"start":581.089,"end":601.428,"text":"但是等到收拖結束、合作關係結束,他可能會講喔,所以托育的過程,這個小孩子結束了,可是保母繼續在帶小孩啊,他存在的具有風險的照顧行為,不會因為這個個案結束而消失,還會延續到下一個收拖的兒童。"},{"start":602.449,"end":615.598,"text":"但是呢可是這個風險沒有被真相沒有被揭露所以他就說有時候呢在收拖更新結束的時候受理保姆的拘托通報以外他們也要求你們要中拖電訪這個家那個家長"},{"start":621.414,"end":649.02,"text":"透過和對家長跟保母回報的結束托育的日期是否一致更重要是要藉此瞭解家長對於整體送托經驗的感受若查到風險的訊息中心便可以處理托育人員不適當有風險的照顧行為所以中托電訪很重要那這個督導他怎麼分享這個中托電訪的內容"},{"start":650.441,"end":674.364,"text":"他說我們剛開始打家長停拖電話家長就想說既然中心來問了而且已經終止收拖了我就講吧他講了兩點第一保母會大聲罵小孩第二寶爸會拿膠帶貼小孩的嘴巴還跟我們家長炫耀這個是媽媽在收拖結束以後才告訴他們的"},{"start":675.771,"end":691.678,"text":"所以說你說定期的有意義有目的的這個電訪很重要但是從收託結束中拖的這個電訪也很重要所以這些都是一種機制啊但是必須要有敏感性而且你們有規定要中拖電訪嗎目前是沒有沒有對所以人家做的好的還有中拖電訪"},{"start":700.91,"end":706.793,"text":"這個關係結束以後,我孩子在你手上拜託你給我,我不跟他說。終止這個托育以後,結束,才會發現真相。這個就是我們在這裡告訴你的。但我今天還有一點要請教這個部長,講這麼久我還是有點不了解。這個凱凱的付費給保姆的是誰?誰付費的?"},{"start":725.08,"end":745.86,"text":"就是他的保姆費是誰付的?目前應該按照機制來講應該是俄府聯盟付給他了阿俄府聯盟沒有拿到補助他為什麼會願意幫這個小孩付錢?會不會有道德風險要幫那個小孩付錢如果他沒有被人家收養時間越拖越長要幫他付的錢越多所以他就越找那個品質越差越便宜的"},{"start":746.3,"end":750.842,"text":"這個機制運作了這麼多年,怎麼會這個樣子呢?他有沒有政府的補助進去?完全都沒有嗎?這麼多年都沒有嗎?我以為百思不得其解,因為兒盟將凱凱交付給這個保姆的時候,為什麼是由他的外婆跟這個保姆簽約的?"},{"start":774.053,"end":797.806,"text":"可是目前的是兒婦聯盟這個關係對價關係不太對啊對所以這一個部分就是我們在檢討報告裡面提到的然後我們未來要去改的這個機制我們就希望他走的是委託安置的一個流程然後就不是我說媒合機構怎麼會有這麼多錢可以去幫你安置這麼多小孩你不會覺得疑問嗎"},{"start":799.79,"end":828.055,"text":"當然因為他後面最後如果媒合成功的話是有收費啦對於收養者去做收費好 但收費標準是怎麼樣以兒福聯盟為例現在收費標準是怎麼樣大概是10萬嘛第一個階段只要去申請就要繳費2萬所以要收養也要花很多錢的不是免費的喔第二階段進行收養評估審查要2萬5第3案第4階段要收多少"},{"start":829.386,"end":854.539,"text":"下一張有沒有第三階段收養五萬五但我知道那個外國人收養要繳兩次繳兩次的那個美金四千元所以給外國人收養可以收到美金八千元台灣人收養可以收養成功他要繳十萬元外國人要收養台灣小孩繳八千塊美金所以靠這個收入來cover那個支出"},{"start":855.8,"end":876.015,"text":"那所以顯然支柱的時間要越短越好,所以他難以做到最好的評估,所以你們才說這個有道德風險,因為大家都覺得出洋是一個評估,要經過專業的評估才能出洋。如果照這種道理,我愛互出是這孩子,我愛保證他出洋,如果沒保證他出洋,"},{"start":878.897,"end":897.45,"text":"我看這孩子的錢都要倒掉,怎麼會有這種事情,怎麼會沒有機構要做這種事情,所以就要保證每個孩子都要給他出洋,不管他是不是需要出洋,不管專業評估到底是不是出洋對這個小孩是最好的,他都勢必要讓他出洋"},{"start":900.416,"end":902.438,"text":"所以出養越多,收入越多,就沒有機構而言"},{"start":921.295,"end":947.706,"text":"當然為了節省成本他還沒有沒有成功還沒有收養出去還沒有這個出養出去所以他當然是要找成本成本比較低的所以在找這種很惡質的保姆的收的就好現在這是各位負責多少?差不多兩萬多他到底是收多少?好像是兩萬五兩萬六兩萬六?還有理事休息夠不夠了各位?"},{"start":949.454,"end":962.423,"text":"然後這個俄府聯盟也不能太挑剔因為他這個錢他還要自己付所以他找品質好的他可能要付更多的錢有這種風險對 有這種風險因為原來的他的那個保姆的話一個月3萬一開始設計這種制度就是一個大錯誤社會安全網不安全這不是社會安全網這一開始就是一個社會漏洞網"},{"start":980.938,"end":1007.09,"text":"我們發現問題就是把它糾正過來對啦可是我們只剩8年了你現在跟我講說現在發現問題我們就把它糾正過來我是覺得蠻遺憾的因為這個在道德上風險太大了然後在運作上也是你會讓它整個這個保姆的服務當然是尋求最便宜的當然風險就更大"},{"start":1008.744,"end":1015.767,"text":"尋求最便宜的風險更大,然後在專業的這個出養的評估上,也勢必一定要評估出出養,沒有這個機構,沒有機構就了不起啊,了不起啊。若是外國人來收養更好,因為可以收8000塊錢美金,那台灣人收養的話才收10萬元。"},{"start":1029.572,"end":1057.813,"text":"每一個收養小孩的人他必須就一開始第一階段就要收兩萬第二階段收兩萬五分階段就要繳費不成功呢不成功就是沒多少錢所以都要保證成功這樣子真的是我們把兒童要出養的兒童小孩送入深淵裡面聽起來整個制度不是一個社會安全網是反而把小孩推入深淵深坑裡面"},{"start":1059.121,"end":1059.501,"text":"林淑芬委員"}]}}}}