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00:00:18,813\n2022年《精神衛生法修法》引入了社區支持的服務概念,等於承認了長期支持病患的重要性,並且要求地方政府提出相應的服務,我認為非常好。\n\n3\n00:00:36,224 --> 00:00:36,244\n是,謝謝\n\n4\n00:00:57,592 --> 00:01:24,400\n那部長我知道心理健康是近年有所謂的精神病有多元社會生活方案社區生活方案的發展計畫那他這個服務形式限制比較少那比較多元那我也認為是一個很棒的方向部長可以看一下這個左圖他的服務項目包括各管服務就業服務社區居住服務還有同儕支持服務可以讓這些需要幫助的精神病有獲得更全面的照顧我也非常肯定這個計畫\n\n5\n00:01:25,720 --> 00:01:47,835\n所以這是我第二個肯定。部長這就是以來我很少一開始就給他這麼多的肯定。這個是對的方向。但是我們還是要知道說再好的計畫都還有要進步的地方。那有兩個點我想請部長或市長參考。第一個我覺得總預算是不足的。因為你目前現在每一個團體只能提一個案。\n\n6\n00:01:48,675 --> 00:02:02,502\n提個案那非常可惜我覺得這個部分可以到衛環委員會來討論應該給的應該給民眾的幫忙就是說我覺得像本席一定支持就是說你這個預算編的不夠那麼限制一個團體議案\n\n7\n00:02:03,823 --> 00:02:29,808\n第二個問題就是說民間組織他需要每年重新提案部長就會讓團體跟這個在其中的工作服務者他會掉一顆心的懸著一顆心的他不知道明年下一年還能不能繼續做這個服務那能不能做下去我們都知道服務不中斷是一個很重要的原則所以想請問部長是不是可能在一個前提就是我們執行好這個執行成果的把關\n\n8\n00:02:30,948 --> 00:02:31,008\n可行嗎?部長?\n\n9\n00:02:52,870 --> 00:03:18,322\n謝謝委員關心我們這個精神病友的一個多元的社區在生活的方案除了你重視醫療以外又關心到他生未來的多元化的生活的支持那我想我們都很清楚所有的工作團體包括我們自己研究者每年在這計畫明年明年有的有的不可以變成長期了所以我們覺得真的好的工作\n\n10\n00:03:20,904 --> 00:03:41,340\n部長連那麼苛刻的健保,我們對於藥物治療部分就長效的這些藥物幫助這病人,我們那邊都OK的。那個比例已經相當高了。這是醫療,但是生活上的幫助是更重要的。所以我們是這樣子,我們在115年期可行嗎?\n\n11\n00:03:44,162 --> 00:03:59,214\n那你需要預算大家可以幫忙啊,大家我們...我們為了擴大去爭取穩定裁員,從...穩定的裁員對,那工作人員全力以赴我們把他併入這個照顧,併入身心障礙照顧服務支援部隊計畫,從113年到117年這個計畫然後針對精神病人及其家族以5年內將會投資有13億謝謝部長這件事非常重要我們會注意到他的一個聯繫性\n\n12\n00:04:09,141 --> 00:04:10,322\n他其實是包含很多,我覺得有點包山包海,很辛苦。\n\n13\n00:04:35,302 --> 00:04:56,509\n所以有專家會指出說我們都要做到什麼程度目前不太明確例如司法精神醫學會理事長楊天偉院長他有點隱憂就是說心理衛生中心工作人員他大部分年資比較淺心法的實踐有點像把蔡淼推到最前線去當狙擊手\n\n14\n00:04:57,969 --> 00:05:02,373\n找出散落在社區需要幫助的人部長、市長針對楊院長提出的引憂衛福部或新建市有沒有什麼改進的方針\n\n15\n00:05:10,540 --> 00:05:39,660\n好謝謝委員的關心也謝謝楊院長長期以來對司法精神方面的投入那因為心理健康中心心理衛生中心我們是這幾年的一個比較新興的一個努力的計畫對於方向呢所以基本上比較難拚到所謂有困難資深那當然我們不是說之前的不好而是說很多這個人生很多有一些歷練之後也許他能夠幫助的而且你內容太廣了太廣了\n\n16\n00:05:40,120 --> 00:05:46,461\n我會不會請那個我們那個新鑑師代理師長鄭師長謝謝委員關切我們的這個新衛中心的這個人員如果年資太之前的話恐怕沒有能力來推動這麼繁雜的業務那事實上我們在新衛中心裡面我們部件的除了我們的這個心理師、診療師、護理師還有關懷訪視員之外還有這個心理衛生社工其實他是多職類的那我們會透過說的這個專業的一個訓練\n\n17\n00:06:10,086 --> 00:06:10,126\n陳昭姿議員\n\n18\n00:06:25,183 --> 00:06:30,086\n市長請回那部長我相信上次上週我進行預算總質詢提了很多問題但時間不夠還是要繼續請教部長部長今天這個健保說高推估增加大概5.5%這樣有500多億然後他又說主計長說的\n\n19\n00:06:41,334 --> 00:07:05,965\n他又說這個健保這個財務協助方案有300多億加起來800多億已經可以來補足點值0.95但是部長我不知道是主計長是被衛福部騙了還是他信口開河部長您知道不是這樣嘛那個非協商因素500多億每年都有啊那個跟點值不相關啊但是這300多億裡面當中有很多是專款欸那個專款就用完還流回像罕病啊還有變了11億的那個生理食鹽水啊\n\n20\n00:07:08,266 --> 00:07:08,366\n陳昭姿議員\n\n21\n00:07:26,601 --> 00:07:26,721\n陳昭姿議員\n\n22\n00:07:46,936 --> 00:08:05,013\n所以你如果這些不做的話那看不出為什麼明年6月底有辦法達到0.95%好嗎部長?因為你要回答我知道有點困難我這個有些可能先回答一下好不好第一個就是說生理生水因為以前真的是很便宜那在這次談價以後供應會議裡面可能從20幾塊現在已經40幾塊嘛\n\n23\n00:08:09,737 --> 00:08:23,089\n那所以整個成本就增高,我們不能去提擠壓到總額嘛,所以我就拜託衛生部就拜託行政院,說這11頁,既開這11頁,如果沒有政府補助,就是在健保要出路。\n\n24\n00:08:27,672 --> 00:08:46,086\n部長,我想醫界最擔心的就是請你不要再用斷頭攤扣這個比較誇張的手法來努力讓點值,因為大家最怕攤扣啊,最怕斷頭啊,到了額度就斷掉啊,然後到這個不到目標就事先叫大家繳回錢啊但是你不能因為要達到我們期待的0.95,然後把攤扣弄得更誇張\n\n25\n00:08:52,631 --> 00:08:52,811\n報告委員那個我想我們\n\n26\n00:09:08,322 --> 00:09:10,964\n主席一直在看我,他覺得我該下去,我今天話太多了。\n\n27\n00:09:32,302 --> 00:09:37,331\n不要讓他用斷頭跟這個攤扣來處理啦,我覺得還有很多其他的事情我未來之前再繼續請教部長啦,謝謝部長\n\n","tsv":"start\tend\ttext\n6589\t7151\t麻煩邱部長\n16291\t18813\t2022年《精神衛生法修法》引入了社區支持的服務概念,等於承認了長期支持病患的重要性,並且要求地方政府提出相應的服務,我認為非常好。\n36224\t36244\t是,謝謝\n57592\t84400\t那部長我知道心理健康是近年有所謂的精神病有多元社會生活方案社區生活方案的發展計畫那他這個服務形式限制比較少那比較多元那我也認為是一個很棒的方向部長可以看一下這個左圖他的服務項目包括各管服務就業服務社區居住服務還有同儕支持服務可以讓這些需要幫助的精神病有獲得更全面的照顧我也非常肯定這個計畫\n85720\t107835\t所以這是我第二個肯定。部長這就是以來我很少一開始就給他這麼多的肯定。這個是對的方向。但是我們還是要知道說再好的計畫都還有要進步的地方。那有兩個點我想請部長或市長參考。第一個我覺得總預算是不足的。因為你目前現在每一個團體只能提一個案。\n108675\t122502\t提個案那非常可惜我覺得這個部分可以到衛環委員會來討論應該給的應該給民眾的幫忙就是說我覺得像本席一定支持就是說你這個預算編的不夠那麼限制一個團體議案\n123823\t149808\t第二個問題就是說民間組織他需要每年重新提案部長就會讓團體跟這個在其中的工作服務者他會掉一顆心的懸著一顆心的他不知道明年下一年還能不能繼續做這個服務那能不能做下去我們都知道服務不中斷是一個很重要的原則所以想請問部長是不是可能在一個前提就是我們執行好這個執行成果的把關\n150948\t151008\t可行嗎?部長?\n172870\t198322\t謝謝委員關心我們這個精神病友的一個多元的社區在生活的方案除了你重視醫療以外又關心到他生未來的多元化的生活的支持那我想我們都很清楚所有的工作團體包括我們自己研究者每年在這計畫明年明年有的有的不可以變成長期了所以我們覺得真的好的工作\n200904\t221340\t部長連那麼苛刻的健保,我們對於藥物治療部分就長效的這些藥物幫助這病人,我們那邊都OK的。那個比例已經相當高了。這是醫療,但是生活上的幫助是更重要的。所以我們是這樣子,我們在115年期可行嗎?\n224162\t239214\t那你需要預算大家可以幫忙啊,大家我們...我們為了擴大去爭取穩定裁員,從...穩定的裁員對,那工作人員全力以赴我們把他併入這個照顧,併入身心障礙照顧服務支援部隊計畫,從113年到117年這個計畫然後針對精神病人及其家族以5年內將會投資有13億謝謝部長這件事非常重要我們會注意到他的一個聯繫性\n249141\t250322\t他其實是包含很多,我覺得有點包山包海,很辛苦。\n275302\t296509\t所以有專家會指出說我們都要做到什麼程度目前不太明確例如司法精神醫學會理事長楊天偉院長他有點隱憂就是說心理衛生中心工作人員他大部分年資比較淺心法的實踐有點像把蔡淼推到最前線去當狙擊手\n297969\t302373\t找出散落在社區需要幫助的人部長、市長針對楊院長提出的引憂衛福部或新建市有沒有什麼改進的方針\n310540\t339660\t好謝謝委員的關心也謝謝楊院長長期以來對司法精神方面的投入那因為心理健康中心心理衛生中心我們是這幾年的一個比較新興的一個努力的計畫對於方向呢所以基本上比較難拚到所謂有困難資深那當然我們不是說之前的不好而是說很多這個人生很多有一些歷練之後也許他能夠幫助的而且你內容太廣了太廣了\n340120\t346461\t我會不會請那個我們那個新鑑師代理師長 鄭師長謝謝委員關切我們的這個新衛中心的這個人員如果年資太之前的話恐怕沒有能力來推動這麼繁雜的業務那事實上我們在新衛中心裡面我們部件的除了我們的這個心理師、診療師、護理師還有關懷訪視員之外還有這個心理衛生社工其實他是多職類的那我們會透過說的這個專業的一個訓練\n370086\t370126\t陳昭姿議員\n385183\t390086\t市長請回那部長我相信上次上週我進行預算總質詢提了很多問題但時間不夠還是要繼續請教部長部長今天這個健保說高推估增加大概5.5%這樣有500多億然後他又說主計長說的\n401334\t425965\t他又說這個健保這個財務協助方案有300多億加起來800多億已經可以來補足點值0.95但是部長我不知道是主計長是被衛福部騙了還是他信口開河部長您知道不是這樣嘛那個非協商因素500多億每年都有啊那個跟點值不相關啊但是這300多億裡面當中有很多是專款欸那個專款就用完還流回像罕病啊還有變了11億的那個生理食鹽水啊\n428266\t428366\t陳昭姿議員\n446601\t446721\t陳昭姿議員\n466936\t485013\t所以你如果這些不做的話那看不出為什麼明年6月底有辦法達到0.95%好嗎部長?因為你要回答我知道有點困難我這個有些可能先回答一下好不好第一個就是說生理生水因為以前真的是很便宜那在這次談價以後供應會議裡面可能從20幾塊現在已經40幾塊嘛\n489737\t503089\t那所以整個成本就增高,我們不能去提擠壓到總額嘛,所以我就拜託衛生部就拜託行政院,說這11頁,既開這11頁,如果沒有政府補助,就是在健保要出路。\n507672\t526086\t部長,我想醫界最擔心的就是請你不要再用斷頭攤扣這個比較誇張的手法來努力讓點值,因為大家最怕攤扣啊,最怕斷頭啊,到了額度就斷掉啊,然後到這個不到目標就事先叫大家繳回錢啊但是你不能因為要達到我們期待的0.95,然後把攤扣弄得更誇張\n532631\t532811\t報告委員那個我想我們\n548322\t550964\t主席一直在看我,他覺得我該下去,我今天話太多了。\n572302\t577331\t不要讓他用斷頭跟這個攤扣來處理啦,我覺得還有很多其他的事情我未來之前再繼續請教部長啦,謝謝部長\n","txt":"麻煩邱部長\n2022年《精神衛生法修法》引入了社區支持的服務概念,等於承認了長期支持病患的重要性,並且要求地方政府提出相應的服務,我認為非常好。\n是,謝謝\n那部長我知道心理健康是近年有所謂的精神病有多元社會生活方案社區生活方案的發展計畫那他這個服務形式限制比較少那比較多元那我也認為是一個很棒的方向部長可以看一下這個左圖他的服務項目包括各管服務就業服務社區居住服務還有同儕支持服務可以讓這些需要幫助的精神病有獲得更全面的照顧我也非常肯定這個計畫\n所以這是我第二個肯定。部長這就是以來我很少一開始就給他這麼多的肯定。這個是對的方向。但是我們還是要知道說再好的計畫都還有要進步的地方。那有兩個點我想請部長或市長參考。第一個我覺得總預算是不足的。因為你目前現在每一個團體只能提一個案。\n提個案那非常可惜我覺得這個部分可以到衛環委員會來討論應該給的應該給民眾的幫忙就是說我覺得像本席一定支持就是說你這個預算編的不夠那麼限制一個團體議案\n第二個問題就是說民間組織他需要每年重新提案部長就會讓團體跟這個在其中的工作服務者他會掉一顆心的懸著一顆心的他不知道明年下一年還能不能繼續做這個服務那能不能做下去我們都知道服務不中斷是一個很重要的原則所以想請問部長是不是可能在一個前提就是我們執行好這個執行成果的把關\n可行嗎?部長?\n謝謝委員關心我們這個精神病友的一個多元的社區在生活的方案除了你重視醫療以外又關心到他生未來的多元化的生活的支持那我想我們都很清楚所有的工作團體包括我們自己研究者每年在這計畫明年明年有的有的不可以變成長期了所以我們覺得真的好的工作\n部長連那麼苛刻的健保,我們對於藥物治療部分就長效的這些藥物幫助這病人,我們那邊都OK的。那個比例已經相當高了。這是醫療,但是生活上的幫助是更重要的。所以我們是這樣子,我們在115年期可行嗎?\n那你需要預算大家可以幫忙啊,大家我們...我們為了擴大去爭取穩定裁員,從...穩定的裁員對,那工作人員全力以赴我們把他併入這個照顧,併入身心障礙照顧服務支援部隊計畫,從113年到117年這個計畫然後針對精神病人及其家族以5年內將會投資有13億謝謝部長這件事非常重要我們會注意到他的一個聯繫性\n他其實是包含很多,我覺得有點包山包海,很辛苦。\n所以有專家會指出說我們都要做到什麼程度目前不太明確例如司法精神醫學會理事長楊天偉院長他有點隱憂就是說心理衛生中心工作人員他大部分年資比較淺心法的實踐有點像把蔡淼推到最前線去當狙擊手\n找出散落在社區需要幫助的人部長、市長針對楊院長提出的引憂衛福部或新建市有沒有什麼改進的方針\n好謝謝委員的關心也謝謝楊院長長期以來對司法精神方面的投入那因為心理健康中心心理衛生中心我們是這幾年的一個比較新興的一個努力的計畫對於方向呢所以基本上比較難拚到所謂有困難資深那當然我們不是說之前的不好而是說很多這個人生很多有一些歷練之後也許他能夠幫助的而且你內容太廣了太廣了\n我會不會請那個我們那個新鑑師代理師長 鄭師長謝謝委員關切我們的這個新衛中心的這個人員如果年資太之前的話恐怕沒有能力來推動這麼繁雜的業務那事實上我們在新衛中心裡面我們部件的除了我們的這個心理師、診療師、護理師還有關懷訪視員之外還有這個心理衛生社工其實他是多職類的那我們會透過說的這個專業的一個訓練\n陳昭姿議員\n市長請回那部長我相信上次上週我進行預算總質詢提了很多問題但時間不夠還是要繼續請教部長部長今天這個健保說高推估增加大概5.5%這樣有500多億然後他又說主計長說的\n他又說這個健保這個財務協助方案有300多億加起來800多億已經可以來補足點值0.95但是部長我不知道是主計長是被衛福部騙了還是他信口開河部長您知道不是這樣嘛那個非協商因素500多億每年都有啊那個跟點值不相關啊但是這300多億裡面當中有很多是專款欸那個專款就用完還流回像罕病啊還有變了11億的那個生理食鹽水啊\n陳昭姿議員\n陳昭姿議員\n所以你如果這些不做的話那看不出為什麼明年6月底有辦法達到0.95%好嗎部長?因為你要回答我知道有點困難我這個有些可能先回答一下好不好第一個就是說生理生水因為以前真的是很便宜那在這次談價以後供應會議裡面可能從20幾塊現在已經40幾塊嘛\n那所以整個成本就增高,我們不能去提擠壓到總額嘛,所以我就拜託衛生部就拜託行政院,說這11頁,既開這11頁,如果沒有政府補助,就是在健保要出路。\n部長,我想醫界最擔心的就是請你不要再用斷頭攤扣這個比較誇張的手法來努力讓點值,因為大家最怕攤扣啊,最怕斷頭啊,到了額度就斷掉啊,然後到這個不到目標就事先叫大家繳回錢啊但是你不能因為要達到我們期待的0.95,然後把攤扣弄得更誇張\n報告委員那個我想我們\n主席一直在看我,他覺得我該下去,我今天話太多了。\n不要讓他用斷頭跟這個攤扣來處理啦,我覺得還有很多其他的事情我未來之前再繼續請教部長啦,謝謝部長\n","vtt":"WEBVTT\n\n00:06.589 --> 00:07.151\n麻煩邱部長\n\n00:16.291 --> 00:18.813\n2022年《精神衛生法修法》引入了社區支持的服務概念,等於承認了長期支持病患的重要性,並且要求地方政府提出相應的服務,我認為非常好。\n\n00:36.224 --> 00:36.244\n是,謝謝\n\n00:57.592 --> 01:24.400\n那部長我知道心理健康是近年有所謂的精神病有多元社會生活方案社區生活方案的發展計畫那他這個服務形式限制比較少那比較多元那我也認為是一個很棒的方向部長可以看一下這個左圖他的服務項目包括各管服務就業服務社區居住服務還有同儕支持服務可以讓這些需要幫助的精神病有獲得更全面的照顧我也非常肯定這個計畫\n\n01:25.720 --> 01:47.835\n所以這是我第二個肯定。部長這就是以來我很少一開始就給他這麼多的肯定。這個是對的方向。但是我們還是要知道說再好的計畫都還有要進步的地方。那有兩個點我想請部長或市長參考。第一個我覺得總預算是不足的。因為你目前現在每一個團體只能提一個案。\n\n01:48.675 --> 02:02.502\n提個案那非常可惜我覺得這個部分可以到衛環委員會來討論應該給的應該給民眾的幫忙就是說我覺得像本席一定支持就是說你這個預算編的不夠那麼限制一個團體議案\n\n02:03.823 --> 02:29.808\n第二個問題就是說民間組織他需要每年重新提案部長就會讓團體跟這個在其中的工作服務者他會掉一顆心的懸著一顆心的他不知道明年下一年還能不能繼續做這個服務那能不能做下去我們都知道服務不中斷是一個很重要的原則所以想請問部長是不是可能在一個前提就是我們執行好這個執行成果的把關\n\n02:30.948 --> 02:31.008\n可行嗎?部長?\n\n02:52.870 --> 03:18.322\n謝謝委員關心我們這個精神病友的一個多元的社區在生活的方案除了你重視醫療以外又關心到他生未來的多元化的生活的支持那我想我們都很清楚所有的工作團體包括我們自己研究者每年在這計畫明年明年有的有的不可以變成長期了所以我們覺得真的好的工作\n\n03:20.904 --> 03:41.340\n部長連那麼苛刻的健保,我們對於藥物治療部分就長效的這些藥物幫助這病人,我們那邊都OK的。那個比例已經相當高了。這是醫療,但是生活上的幫助是更重要的。所以我們是這樣子,我們在115年期可行嗎?\n\n03:44.162 --> 03:59.214\n那你需要預算大家可以幫忙啊,大家我們...我們為了擴大去爭取穩定裁員,從...穩定的裁員對,那工作人員全力以赴我們把他併入這個照顧,併入身心障礙照顧服務支援部隊計畫,從113年到117年這個計畫然後針對精神病人及其家族以5年內將會投資有13億謝謝部長這件事非常重要我們會注意到他的一個聯繫性\n\n04:09.141 --> 04:10.322\n他其實是包含很多,我覺得有點包山包海,很辛苦。\n\n04:35.302 --> 04:56.509\n所以有專家會指出說我們都要做到什麼程度目前不太明確例如司法精神醫學會理事長楊天偉院長他有點隱憂就是說心理衛生中心工作人員他大部分年資比較淺心法的實踐有點像把蔡淼推到最前線去當狙擊手\n\n04:57.969 --> 05:02.373\n找出散落在社區需要幫助的人部長、市長針對楊院長提出的引憂衛福部或新建市有沒有什麼改進的方針\n\n05:10.540 --> 05:39.660\n好謝謝委員的關心也謝謝楊院長長期以來對司法精神方面的投入那因為心理健康中心心理衛生中心我們是這幾年的一個比較新興的一個努力的計畫對於方向呢所以基本上比較難拚到所謂有困難資深那當然我們不是說之前的不好而是說很多這個人生很多有一些歷練之後也許他能夠幫助的而且你內容太廣了太廣了\n\n05:40.120 --> 05:46.461\n我會不會請那個我們那個新鑑師代理師長鄭師長謝謝委員關切我們的這個新衛中心的這個人員如果年資太之前的話恐怕沒有能力來推動這麼繁雜的業務那事實上我們在新衛中心裡面我們部件的除了我們的這個心理師、診療師、護理師還有關懷訪視員之外還有這個心理衛生社工其實他是多職類的那我們會透過說的這個專業的一個訓練\n\n06:10.086 --> 06:10.126\n陳昭姿議員\n\n06:25.183 --> 06:30.086\n市長請回那部長我相信上次上週我進行預算總質詢提了很多問題但時間不夠還是要繼續請教部長部長今天這個健保說高推估增加大概5.5%這樣有500多億然後他又說主計長說的\n\n06:41.334 --> 07:05.965\n他又說這個健保這個財務協助方案有300多億加起來800多億已經可以來補足點值0.95但是部長我不知道是主計長是被衛福部騙了還是他信口開河部長您知道不是這樣嘛那個非協商因素500多億每年都有啊那個跟點值不相關啊但是這300多億裡面當中有很多是專款欸那個專款就用完還流回像罕病啊還有變了11億的那個生理食鹽水啊\n\n07:08.266 --> 07:08.366\n陳昭姿議員\n\n07:26.601 --> 07:26.721\n陳昭姿議員\n\n07:46.936 --> 08:05.013\n所以你如果這些不做的話那看不出為什麼明年6月底有辦法達到0.95%好嗎部長?因為你要回答我知道有點困難我這個有些可能先回答一下好不好第一個就是說生理生水因為以前真的是很便宜那在這次談價以後供應會議裡面可能從20幾塊現在已經40幾塊嘛\n\n08:09.737 --> 08:23.089\n那所以整個成本就增高,我們不能去提擠壓到總額嘛,所以我就拜託衛生部就拜託行政院,說這11頁,既開這11頁,如果沒有政府補助,就是在健保要出路。\n\n08:27.672 --> 08:46.086\n部長,我想醫界最擔心的就是請你不要再用斷頭攤扣這個比較誇張的手法來努力讓點值,因為大家最怕攤扣啊,最怕斷頭啊,到了額度就斷掉啊,然後到這個不到目標就事先叫大家繳回錢啊但是你不能因為要達到我們期待的0.95,然後把攤扣弄得更誇張\n\n08:52.631 --> 08:52.811\n報告委員那個我想我們\n\n09:08.322 --> 09:10.964\n主席一直在看我,他覺得我該下去,我今天話太多了。\n\n09:32.302 --> 09:37.331\n不要讓他用斷頭跟這個攤扣來處理啦,我覺得還有很多其他的事情我未來之前再繼續請教部長啦,謝謝部長\n\n","segments":[{"start":6.589,"end":7.151,"text":"麻煩邱部長"},{"start":16.291,"end":18.813,"text":"2022年《精神衛生法修法》引入了社區支持的服務概念,等於承認了長期支持病患的重要性,並且要求地方政府提出相應的服務,我認為非常好。"},{"start":36.224,"end":36.244,"text":"是,謝謝"},{"start":57.592,"end":84.4,"text":"那部長我知道心理健康是近年有所謂的精神病有多元社會生活方案社區生活方案的發展計畫那他這個服務形式限制比較少那比較多元那我也認為是一個很棒的方向部長可以看一下這個左圖他的服務項目包括各管服務就業服務社區居住服務還有同儕支持服務可以讓這些需要幫助的精神病有獲得更全面的照顧我也非常肯定這個計畫"},{"start":85.72,"end":107.835,"text":"所以這是我第二個肯定。部長這就是以來我很少一開始就給他這麼多的肯定。這個是對的方向。但是我們還是要知道說再好的計畫都還有要進步的地方。那有兩個點我想請部長或市長參考。第一個我覺得總預算是不足的。因為你目前現在每一個團體只能提一個案。"},{"start":108.675,"end":122.502,"text":"提個案那非常可惜我覺得這個部分可以到衛環委員會來討論應該給的應該給民眾的幫忙就是說我覺得像本席一定支持就是說你這個預算編的不夠那麼限制一個團體議案"},{"start":123.823,"end":149.808,"text":"第二個問題就是說民間組織他需要每年重新提案部長就會讓團體跟這個在其中的工作服務者他會掉一顆心的懸著一顆心的他不知道明年下一年還能不能繼續做這個服務那能不能做下去我們都知道服務不中斷是一個很重要的原則所以想請問部長是不是可能在一個前提就是我們執行好這個執行成果的把關"},{"start":150.948,"end":151.008,"text":"可行嗎?部長?"},{"start":172.87,"end":198.322,"text":"謝謝委員關心我們這個精神病友的一個多元的社區在生活的方案除了你重視醫療以外又關心到他生未來的多元化的生活的支持那我想我們都很清楚所有的工作團體包括我們自己研究者每年在這計畫明年明年有的有的不可以變成長期了所以我們覺得真的好的工作"},{"start":200.904,"end":221.34,"text":"部長連那麼苛刻的健保,我們對於藥物治療部分就長效的這些藥物幫助這病人,我們那邊都OK的。那個比例已經相當高了。這是醫療,但是生活上的幫助是更重要的。所以我們是這樣子,我們在115年期可行嗎?"},{"start":224.162,"end":239.214,"text":"那你需要預算大家可以幫忙啊,大家我們...我們為了擴大去爭取穩定裁員,從...穩定的裁員對,那工作人員全力以赴我們把他併入這個照顧,併入身心障礙照顧服務支援部隊計畫,從113年到117年這個計畫然後針對精神病人及其家族以5年內將會投資有13億謝謝部長這件事非常重要我們會注意到他的一個聯繫性"},{"start":249.141,"end":250.322,"text":"他其實是包含很多,我覺得有點包山包海,很辛苦。"},{"start":275.302,"end":296.509,"text":"所以有專家會指出說我們都要做到什麼程度目前不太明確例如司法精神醫學會理事長楊天偉院長他有點隱憂就是說心理衛生中心工作人員他大部分年資比較淺心法的實踐有點像把蔡淼推到最前線去當狙擊手"},{"start":297.969,"end":302.373,"text":"找出散落在社區需要幫助的人部長、市長針對楊院長提出的引憂衛福部或新建市有沒有什麼改進的方針"},{"start":310.54,"end":339.66,"text":"好謝謝委員的關心也謝謝楊院長長期以來對司法精神方面的投入那因為心理健康中心心理衛生中心我們是這幾年的一個比較新興的一個努力的計畫對於方向呢所以基本上比較難拚到所謂有困難資深那當然我們不是說之前的不好而是說很多這個人生很多有一些歷練之後也許他能夠幫助的而且你內容太廣了太廣了"},{"start":340.12,"end":346.461,"text":"我會不會請那個我們那個新鑑師代理師長 鄭師長謝謝委員關切我們的這個新衛中心的這個人員如果年資太之前的話恐怕沒有能力來推動這麼繁雜的業務那事實上我們在新衛中心裡面我們部件的除了我們的這個心理師、診療師、護理師還有關懷訪視員之外還有這個心理衛生社工其實他是多職類的那我們會透過說的這個專業的一個訓練"},{"start":370.086,"end":370.126,"text":"陳昭姿議員"},{"start":385.183,"end":390.086,"text":"市長請回那部長我相信上次上週我進行預算總質詢提了很多問題但時間不夠還是要繼續請教部長部長今天這個健保說高推估增加大概5.5%這樣有500多億然後他又說主計長說的"},{"start":401.334,"end":425.965,"text":"他又說這個健保這個財務協助方案有300多億加起來800多億已經可以來補足點值0.95但是部長我不知道是主計長是被衛福部騙了還是他信口開河部長您知道不是這樣嘛那個非協商因素500多億每年都有啊那個跟點值不相關啊但是這300多億裡面當中有很多是專款欸那個專款就用完還流回像罕病啊還有變了11億的那個生理食鹽水啊"},{"start":428.266,"end":428.366,"text":"陳昭姿議員"},{"start":446.601,"end":446.721,"text":"陳昭姿議員"},{"start":466.936,"end":485.013,"text":"所以你如果這些不做的話那看不出為什麼明年6月底有辦法達到0.95%好嗎部長?因為你要回答我知道有點困難我這個有些可能先回答一下好不好第一個就是說生理生水因為以前真的是很便宜那在這次談價以後供應會議裡面可能從20幾塊現在已經40幾塊嘛"},{"start":489.737,"end":503.089,"text":"那所以整個成本就增高,我們不能去提擠壓到總額嘛,所以我就拜託衛生部就拜託行政院,說這11頁,既開這11頁,如果沒有政府補助,就是在健保要出路。"},{"start":507.672,"end":526.086,"text":"部長,我想醫界最擔心的就是請你不要再用斷頭攤扣這個比較誇張的手法來努力讓點值,因為大家最怕攤扣啊,最怕斷頭啊,到了額度就斷掉啊,然後到這個不到目標就事先叫大家繳回錢啊但是你不能因為要達到我們期待的0.95,然後把攤扣弄得更誇張"},{"start":532.631,"end":532.811,"text":"報告委員那個我想我們"},{"start":548.322,"end":550.964,"text":"主席一直在看我,他覺得我該下去,我今天話太多了。"},{"start":572.302,"end":577.331,"text":"不要讓他用斷頭跟這個攤扣來處理啦,我覺得還有很多其他的事情我未來之前再繼續請教部長啦,謝謝部長"}]}}},"gazette":{"lineno":109,"blocks":[["陳委員昭姿：（9時22分）麻煩邱部長。"],["邱部長泰源：委員早。"],["陳委員昭姿：現在才有時間跟你說早安。"],["邱部長泰源：早。"],["陳委員昭姿：2022年精神衛生法修法，引入了社區支持服務的概念，等於承認了長期支持病患的重要性，並且要求地方政府也提出相應的服務，我認為這個非常好。過去政府的社區支持服務比較偏向由醫事體系來做，所以是比較靠向治療為主的作法，忽視了生活的支援，修法後算是走出了第一步，正視病友跟家屬實際生活的需求。這是我第一個肯定。"],["邱部長泰源：謝謝。"],["陳委員昭姿：我知道心理健康師近年有所謂的精神病友多元社會生活方案、社區生活方案的發展計畫，這個服務形式限制比較少、比較多元，我也認為是一個很棒的方向。部長可以看一下左圖，它的服務項目包括個管服務、就業服務、社區居住服務，還有同儕支持服務，可以讓這些需要幫助的精神病友獲得更全面的照顧，我也非常肯定這個計畫，所以這是我第二個肯定。部長，我就職以來，很少一開始就給這麼多的肯定。"],["邱部長泰源：謝謝。"],["陳委員昭姿：這個是對的方向，但我們還是要知道，再好的計畫都還有要進步的地方。有兩個點，我想請部長或司長參考，第一個，我覺得總預算是不足的，因為目前限制每一個團體只能提一個案，非常可惜！我覺得這個部分可以到衛環委員會來討論，對於應該給民眾的幫忙，本席一定支持，就是這個預算不必編得那麼限制一個團體一案。第二個問題就是民間組織需要每年重新提案，此舉就會讓團體跟在其中的工作服務者懸著一顆心，他不知道明年、下一年度還能不能繼續做這個服務、能不能做下去。我們都知道服務不中斷是一個很重要的原則，所以想請問部長，是不是可能在執行好這個執行成果把關的前提之下，把它改成長期計畫？不要讓大家提心吊膽，病人不知道隔年會不會繼續接受照顧，工作人員也不知道能不能繼續這樣做下去，是不是可以讓他們不要有這種擔憂，可以全力以赴、專心的來照顧病友？這樣可行嗎？"],["邱部長泰源：謝謝委員關心精神病友的多元社區生活方案，你除了重視醫療以外，又關心到他未來多元化生活的支持。我想我們都很清楚，所有的工作團體，包括我們自己研究者，每年在接計畫，明年有或沒有不一定，都可能會中斷。"],["陳委員昭姿：可以變成長期嗎？"],["邱部長泰源：我們覺得真的好的工作，就應該讓它一直持續不斷。"],["陳委員昭姿：連那麼苛刻的健保，對於幫助病人長效治療的這些藥物，我們都OK的。"],["邱部長泰源：都OK，現在那個比例也已經相當高了，應該高達百分之八十幾。"],["陳委員昭姿：這是醫療，但是生活上的幫助是更重要的。"],["邱部長泰源：對，所以我們從115年起……"],["陳委員昭姿：可行嗎？可以變成更長……"],["邱部長泰源：可行。"],["陳委員昭姿：你需要預算，大家可以幫忙，本席一定支持。"],["邱部長泰源：我們為了擴大爭取穩定財源，從115年……"],["陳委員昭姿：對，穩定的財源。工作人員全力以赴……"],["邱部長泰源：我們把這個照護併入身心障礙照顧服務資源布建計畫，這個計畫從113年到117年，針對精神病人及其家族，5年內將會投注13.92億。"],["陳委員昭姿：謝謝部長，這件事非常重要。"],["邱部長泰源：我們會注意到它的連續性，除非那個團體出了大狀況……"],["陳委員昭姿：病人跟工作人員也都有穩定性，能夠互相……"],["邱部長泰源：不然工作人員不曉得再來可不可以繼續做這個工作。"],["陳委員昭姿：謝謝部長。心理健康師現在在執行廣建社區心理衛生中心，它的內容很多，我就不一一唸出來，包括辦理個案管理、心理衛生促進、教育訓練等等，它其實包含很多，我覺得有點包山包海、很辛苦，所以就有專家指出要做到什麼程度。目前不太明確，例如司法精神醫學會理事長楊添圍院長有一點隱憂，就是心理衛生中心的工作人員大部分年資比較淺，新法的實踐有一點像把菜鳥推到最前線當狙擊手，找出散落在社區需要幫助的人。部長、司長，針對楊院長提出的這個隱憂，他是專家，衛福部或心健司有沒有什麼改進的方針？"],["邱部長泰源：好，謝謝委員關心，也謝謝楊院長長期以來對司法精神方面的投入，因為心理衛生中心是這幾年比較新興、努力的計畫……"],["陳委員昭姿：方向呢？"],["邱部長泰源：基本上，比較難聘到所謂資深……"],["陳委員昭姿：有困難？"],["邱部長泰源：當然，我們一定……"],["陳委員昭姿：不是資淺的不好，而是人生有一些歷練之後，也許他能夠幫助的……"],["邱部長泰源：當然。"],["陳委員昭姿：而且內容太廣了！"],["邱部長泰源：我可不可以請心健司代理司長……"],["陳委員昭姿：簡單回答一下，好不好？"],["邱部長泰源：鄭司長來回答。"],["鄭代理司長淑心：謝謝委員關切心衛中心的人員如果年資太淺，恐怕沒有能力來推動這麼繁雜的業務。事實上，我們在心衛中心裡面布建的，除了心理師、職能治療師、護理師及關懷訪視員之外，還有心理衛生社工，其實是多職類的，我們會透過專業的訓練跟……"],["陳委員昭姿：我了解，等於有一些不同專業的人才一起來做。"],["鄭代理司長淑心：對，我們也會督導來協助、帶領這些菜鳥們。"],["陳委員昭姿：謝謝司長，我大概了解。"],["鄭代理司長淑心：所以在專業知能部分，我們會設計、督導，會有內督跟外督的機制來提升他們的專業知能。"],["陳委員昭姿：要做就做到位，儘量到位。好，謝謝司長，司長請回。"],["鄭代理司長淑心：好，謝謝。"],["陳委員昭姿：部長，上週我進行預算總質詢提了很多問題，但時間不夠，還是要繼續請教部長。今年健保高推估增加大概5.5%，這樣有五百多億，這是主計長說的，他又說，健保財務協助方案有三百多億，加起來八百多億，已經可以來補足點值0.95。但是我不知道主計長是被衛福部騙，還是他信口開河，您知道不是這樣嘛！那個非協商因素五百多億每年都有，跟點值不相關，但是這三百多億當中有很多是專款，專款用完還流回，像罕病、還有編了11億的生理食鹽水，對不對？剛剛我才在這邊質疑，生理食鹽水又繼續編10億，表示明年還會更惡化嗎？你這樣往這邊做的話，請問要達到點值700億，預算在哪裡？我就是看不到！總質詢的時候，我有請教部長說我看不到，所以第一個，罕病的專款可不可能留在它的專款內？就是不要再流回所謂的基金，等於你編這麼多，但實質上沒有用。帳面的多，但是實質上沒有用！生理食鹽水編10億是做什麼？不然連報告一起來，就是在禮拜一的報告……你為什麼要編11億？準備明年再跟國外買更貴的生理食鹽水？還有健保已經連續虧損7年了，你要有檢討方案。如果這些不做的話，看不出為什麼明年6月底有辦法達到0.95，好嗎？部長，你要回答我知道有點困難。"],["邱部長泰源：報告委員，有些可能先回答一下，好不好？"],["陳委員昭姿：好。"],["邱部長泰源：第一個就是生理食鹽水以前真的是很便宜，在這次共擬會議中談價以後，現在可能從二十幾塊變成四十幾塊……"],["陳委員昭姿：我知道，我也在那個會裡面。"],["邱部長泰源：所以整個成本就增加，但我們不能去擠壓到總額嘛，所以我們衛福部就拜託行政院說多花這11億，如果沒有政府補助，就是健保要出喔！"],["陳委員昭姿：是，但剩下的會再回去啊！"],["邱部長泰源：這個醫界有意見嘛……"],["陳委員昭姿：部長，我想醫界最擔心的就是請你不要再用斷頭、攤扣這些比較誇張的手法來努力讓點值……因為大家最怕攤扣啊、最怕斷頭啊，到了額度就斷掉，不到目標就事先叫大家繳錢回去啊。"],["邱部長泰源：總額的制度，各區的管理就真的是他們自己管理，像臺北是攤扣……"],["陳委員昭姿：但是你不能因為要達到我們期待的0.95，然後把攤扣弄得更誇張、讓數字更漂亮，因為這兩件事都是為了讓數字漂亮嘛！但我們要的不是數字，我們要的是實質的，你先把大家的錢扣掉、叫他們還回來，然後再把數字弄到0.95，這個意義是不大的啦！"],["邱部長泰源：報告委員，我想我們健保資源有限，怎麼樣把健保用到刀口上，我們希望政府多的這些經費真的能夠給醫界……"],["陳委員昭姿：部長，如果總預算有機會再做協商的話，健保有關斷頭跟攤扣的部分可能還是要做說明，好嗎？"],["邱部長泰源：好，沒問題。"],["陳委員昭姿：主席一直在看我，他覺得我該下去，我今天話太多了。就是不要用斷頭跟攤扣來處理啦！還有很多其他事情我未來質詢再繼續請教部長。"],["邱部長泰源：大家都很關心怎麼樣讓健保永續，讓健保永續來照顧人民的健康。"],["陳委員昭姿：好，謝謝部長、謝謝署長。"],["邱部長泰源：謝謝委員。"],["主席：謝謝陳昭姿委員，講得非常好。","接續我們請陳菁薇委員質詢。"]],"agenda":{"page_end":272,"meet_id":"委員會-11-2-26-7","speakers":["蘇清泉","陳昭姿","陳菁徽","林月琴","廖偉翔","邱鎮軍","涂權吉","王正旭","鍾佳濱","林國成","楊瓊瓔","林淑芬","賴士葆","黃秀芳","陳雪生","王育敏","劉建國","牛煦庭","楊曜","陳瑩","黃國昌","盧縣一"],"page_start":199,"meetingDate":["2024-11-04"],"gazette_id":"1139301","agenda_lcidc_ids":["1139301_00004"],"meet_name":"立法院第11屆第2會期社會福利及衛生環境委員會第7次全體委員會議紀錄","content":"一、繼續處理中華民國113年度中央政府總預算有關衛生福利部主管預算凍結報告案1案；二、邀\n請衛生福利部部長針對「社區精神病患照護優化」進行專題報告，並備質詢","agenda_id":"1139301_00003"}}}