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\"start\": 629.807, \"end\": 630.007, \"score\": 0.754}, {\"word\": \"宜\", \"start\": 630.007, \"end\": 630.147, \"score\": 0.713}, {\"word\": \"我\", \"start\": 630.147, \"end\": 630.467, \"score\": 0.79}, {\"word\": \"這\"}, {\"word\": \"邊\"}, {\"word\": \"有\", \"start\": 630.467, \"end\": 630.887, \"score\": 0.747}, {\"word\": \"寫\"}, {\"word\": \"了\", \"start\": 630.887, \"end\": 631.447, \"score\": 0.79}, {\"word\": \"還\"}, {\"word\": \"有\", \"start\": 631.447, \"end\": 631.607, \"score\": 0.664}, {\"word\": \"有\", \"start\": 631.607, \"end\": 631.727, \"score\": 0.775}, {\"word\": \"沒\", \"start\": 631.727, \"end\": 631.848, \"score\": 0.716}, {\"word\": \"有\", \"start\": 631.848, \"end\": 631.948, \"score\": 0.646}, {\"word\": \"按\", \"start\": 631.948, \"end\": 632.088, \"score\": 0.746}, {\"word\": \"量\", \"start\": 632.088, \"end\": 632.288, \"score\": 0.717}, {\"word\": \"管\", \"start\": 632.288, \"end\": 632.488, \"score\": 0.739}, {\"word\": \"制\", \"start\": 632.488, 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733.446, \"score\": 0.0}, {\"word\": \"員\"}], \"language\": \"zh\"}","srt":"1\n00:00:00,029 --> 00:00:01,570\n好謝謝主席那有請衛福部部長跟長照司謝謝長照司有來嗎好好謝謝市長好市長那個部長我是請市長上來回答問題但你聽聽看因為這個問題事情很大條來\n\n2\n00:00:26,837 --> 00:00:45,923\n好部長你前一陣子說我們長照3.0要納入癌末腦中風外疾等三大對象擴大辦理我認為這是得證很好我們非常期待在3.0的部分但是現在在2.0出現了一個問題我不確定長照4有沒有跟您反映就是關於\n\n3\n00:00:48,244 --> 00:00:57,309\n長照專員他們在接電話這件事情我們可以看到你們的計劃裡面寫的是說每一個照管員就是照顧管理專員服務量是150個到200個配置照管專員一名\n\n4\n00:01:03,192 --> 00:01:24,130\n但是實際上我們看到現在所有在網路上他們自己就是當事人他們就是所謂每天在做這些事情的照顧管理專員他們說他們的案量遠遠超過你們當時的規劃常常每一個人要負擔三百案五百案甚至有人到六百案到九百案都有而且我們辦公室就接到非常多的陳情\n\n5\n00:01:25,251 --> 00:01:48,867\n那我們來看一下衛福部當時的設計是這樣部長我現在把右邊這個框起來是在2024年的12月平均每一個照管員他手上所負擔的專案從新北的272啊台北的183部長一定你一定會說沒有啊這看起來還好嘛以嘉義來說來到313你也覺得好像只有超出一點點可是部長你往回頭看前面兩欄113年12月的照專人數\n\n6\n00:01:55,531 --> 00:02:18,562\n这个例如说新北市230台北市244桃园市142这个是你们合订的原额可是实际上因为他的工作量太大薪水太低常常加班以台北市为例他就没有聘足244你这样听懂我的意思吗所以这个平均每人按量这个漂亮的数字是假的\n\n7\n00:02:19,383 --> 00:02:33,038\n也就是說以台北市為例他罰訂的錢可以讓他聘244台湾市可以聘142台中可以聘221可是因為他聘不到所以每一個照管員所服務的案量遠超過現在這個統計數字\n\n8\n00:02:35,546 --> 00:03:04,950\n也就是数字的背后看见更多是照管员的辛苦跟心酸那我们来看一下他们在做哪些事情他们接到电话之后呢要在一日内电访两日内完成家访然后计划拧定报告撰写甚至遇到紧急的案子还要在八小时内完成访试然后在一天以内评估完成然后照管员才把这个案子交给A个管做后续的工作A个管一样工作量都爆量\n\n9\n00:03:05,796 --> 00:03:27,383\n好那新的案子他們的評估加訪時間是90分鐘就案每年負評一次是60分鐘可是呢部長我們要去做加訪對不對要交通來回回來要趕快寫報告再評估要趕快交出去而且我們的法定規定他們要在四天內完成可是我剛剛說他的資料還要交給A個管假設我們有給A個管兩天的時間然後這個照管專員兩天的時間他一天可以完成三案是極限喔\n\n10\n00:03:35,595 --> 00:04:00,936\n然後所以他們薪水非常低扣掉勞健保現在大部分的人薪水是在4萬塊以下而且工時非常長導致流動率非常非常高這個是現在的慘況有這麼慘的陳情我們做了非常多的研究我跟部長報告我們去問了你們衛福部說你們知不知道各縣市政府的照管專員現在的離職率是什麼\n\n11\n00:04:02,579 --> 00:04:20,544\n狀態如何答案是沒有數字因為我猜想吼這個經費應該是撥給地方政府之後衛福部就只收相關的數字對不對成案的數字啦然後協助完成長照2.0申請的數字啦但是我們並不真的知道基層的工作人員發生了什麼事情\n\n12\n00:04:21,124 --> 00:04:38,258\n那為什麼我要在這裡幫他們追這個事情因為部長當人一再的流動離職所有要進來申請長照的所有包括我們辦公室過去一直在關注的特教生然後身心障礙的朋友們他們所必須要申請的長照後面就會卡住啊因為前端處理的人不夠嘛好所以部長怎麼辦\n\n13\n00:04:45,057 --> 00:04:47,179\n所以我請長照司啦我們也很關心的事情請司長來回應一下\n\n14\n00:04:53,275 --> 00:05:22,355\n好謝謝委員那我這邊可能先跟委員說明一下對於照專的目前的這個核定額度的這件事情好我們回到上一章你要跟我講核定額度好來核定額度這件事情可以看得出來從112年跟113年其實整個各縣市的人數都有拉高那就是因為我們在112年發現這個人數的計算上過往在2.0是用150案這樣的方式去算可是事實上沒有辦法回應到地方真正的一個狀況\n\n15\n00:05:23,796 --> 00:05:41,733\n對所以我們就是讓在照專核定上面是尊重由地方政府我們跟他們共同討論出來每一個照專一天的工作量會做一些什麼樣的工作內容那每一項事情不包括委員剛剛關注到的一些交通的所耗費的時間跟評估會來打記錄的時間這些都跟地方政府共同討論出來之後\n\n16\n00:05:46,878 --> 00:06:05,211\n把那样一个计算人力的所耗的时间算出来之后回到他们自己的一个考量需要多少不在意案件数不再去看案件数所以113年的这些造砖的核定数都是由尊重地方政府按照这样的一个耗时的计算\n\n17\n00:06:06,031 --> 00:06:31,846\n報上來他的需求數那今天問題出現的是因為趙正我們在12年也把他從臨時人員納為政府的聘僱人員是所以他們現在的一個勞動權益是更有保障可是因為一旦納為政府的聘僱人員他就是跟工人一樣他今天不管你佔什麼樣的這個新等職位其實從台北一路到屏東薪資待遇是一樣的\n\n18\n00:06:32,847 --> 00:06:50,465\n這是公務人員的一個目前我們的人事機關的規範的一個要求就是這樣那所以現階段會有這些都會區人員流動比較大就是因為目前的這個薪資待遇對都會區比較缺乏競爭力可是我們\n\n19\n00:06:51,265 --> 00:07:17,432\n過半的縣市其他的人員的禁用其實是穩定的那我們全國的平均大概是照專這邊有78%就是扣除一些流動的那事實上可是已經有超過10個縣市他的禁用率其實非常的穩定甚至有100%那高於這個有10個縣市都高於九成所以他的流動率其實不高最嚴重的就是在這個雙北是\n\n20\n00:07:19,372 --> 00:07:40,774\n所以其實你是知道問題的嘛但是我請教你一個事情你說這是跟地方政府討論後大家共同討論對不對然後他們爆出這個數目那我想問一下這些所謂的政府聘僱人員享有政府的相關勞動權利的保障的這些人他們的薪資是中央跟地方怎麼分工\n\n21\n00:07:41,955 --> 00:07:55,711\n這個薪資是我們用312薪點來來企算然後7級就是照專進來之後他可以有每年調薪的這個機制只要烤雞甲等是往上調的機制\n\n22\n00:07:56,892 --> 00:08:18,699\n所以現在312新點也按照我們衛福部目前的這些折合率其實一點是135元那我們近期也看到社安網那邊也有福利服務中心的社工其實的新點有拉高到140所以我們現在也在努力朝比照這部分能夠把新點再拉高重點是我問你這個錢是誰出的啦\n\n23\n00:08:23,261 --> 00:08:34,568\n錢的部分是中央主要負責然後地方政府是按照我們的財力分級分3到5財力分級3到5是3%然後二級是5%一級是一成那也就是說最多那我舉個例子六都應該都是算財務狀況好的那所以地方政府的負擔大概就是一成最多一成台北市一成台北市一成那所以90%是你們出的是\n\n24\n00:08:50,399 --> 00:08:57,993\n是哇如果是這樣那之後因為前一輪的預算的亂象回到這件事情有沒有影響\n\n25\n00:09:00,065 --> 00:09:27,219\n還是你還沒有辦法評估出來因為財化法之後長照基金這邊的收入也會有短收尤其是防疫合一稅那市長我認為這件事情非同小可大概不是我們一次諮詢完就可以解決的事情如果他又因為財化法會影響到後續中央跟地方的分別必須要支付這個預算的比例的話我認為我們要從長計議不能讓地方的這些照專\n\n26\n00:09:28,039 --> 00:09:45,373\n他们的过量的工作量然后导致于后面所有申请需要长照2.0服务的这些民众受到影响我认为他们现在是卯足了力在服务所有有需求的民众但是确实你刚刚说了只有超过只有10都左右的\n\n27\n00:09:46,253 --> 00:10:12,983\n在殖旅是穩定的也就是說14個縣市只有14個縣市就是過半過半的縣市那那些loading很重的縣市我認為我們還是要回過頭來解決所以這一塊我們其實也在跟人事單位在討論有沒有一些可以因為約聘僱人就是要按照人事總部規範我認同我沒有要破壞你們的薪資結構的法規範他沒有辦法額外再給任何的津貼\n\n28\n00:10:13,823 --> 00:10:33,428\n我都知道但是我們要解決嘛所以不管是從錢的方向來解決還是有什麼特別的條款可以來解決還是我來問啦每一個人平均按量要不要做調整還有不要只涵蓋率跟按量作為KPI各地的狀況必須因地制宜我這邊有寫了還有有沒有按量管制SOP的可能\n\n29\n00:10:33,988 --> 00:10:56,484\n然後我們如何掌握第一線的人力狀況因為如果按照司長你剛剛信誓旦旦的說超過14個縣市的在職率是穩定的可是為什麼我們辦公室之前跟你們問服務要資料的時候是要不到的你們不給我們還是你們根本沒有統計還是我們問了你們才整理出來我不確定但是看起來對於第一線人力的掌握它並不能只丟給地方政府\n\n30\n00:10:56,684 --> 00:11:16,332\n因為如果地方政府在這件事情上也沒有太有積極的作為我認為那你們又是出錢的人你們應該更要去協助這些地方上工作的照管專員他們的工作狀況會是好的好嗎就是沒問題現在就是其實最大困境像台北市它的禁用率我們的了解大概不到一半\n\n31\n00:11:16,892 --> 00:11:31,432\n所以他的負責人那你要想不到一半原因就是很簡單因為這個loading太重嘛我認為啦不是他聘不到人聘不到人阿為什麼這台北市聘不到人那他們也想要用他們的一些錢去給可是整個政府的規定是不允許\n\n32\n00:11:32,574 --> 00:12:00,057\n那我們看起來需要中央跟地方坐下來一起想辦法所以這個可能人事的法規可能需要合法好那我們一起努力那我要提醒你們其實也有人告訴我們因為現在長照四包錢全部都是要打進這個電話去申請但是有沒有必要來簡化這個流程或者是不必要都是他們來承擔我認為這個實質的工作內容我們可能也可以來討論是也跟委員報告1966這支專線不是照專在接的其實我們另外還有給他們行政人力\n\n33\n00:12:01,206 --> 00:12:13,446\n好所以看起來你們真的已經做了很多努力可是在第一線的工作狀態真的還是很差你認同嗎對其實你是清楚的是是好那我們一起來努力我們會一起再來跟人事總處我們辦公室會再持續追蹤這個議題好謝謝司長謝謝部長謝謝主席謝謝陳委員\n\n","tsv":"start\tend\ttext\n29\t1570\t好謝謝主席那有請衛福部部長跟長照司謝謝長照司有來嗎好好謝謝市長好市長那個部長我是請市長上來回答問題但你聽聽看因為這個問題事情很大條來\n26837\t45923\t好部長你前一陣子說我們長照3.0要納入癌末腦中風外疾等三大對象擴大辦理我認為這是得證很好我們非常期待在3.0的部分但是現在在2.0出現了一個問題我不確定長照4有沒有跟您反映就是關於\n48244\t57309\t長照專員他們在接電話這件事情我們可以看到你們的計劃裡面寫的是說每一個照管員就是照顧管理專員服務量是150個到200個配置照管專員一名\n63192\t84130\t但是實際上我們看到現在所有在網路上他們自己就是當事人他們就是所謂每天在做這些事情的照顧管理專員他們說他們的案量遠遠超過你們當時的規劃常常每一個人要負擔三百案五百案甚至有人到六百案到九百案都有而且我們辦公室就接到非常多的陳情\n85251\t108867\t那我們來看一下衛福部當時的設計是這樣部長我現在把右邊這個框起來是在2024年的12月平均每一個照管員他手上所負擔的專案從新北的272啊台北的183部長一定你一定會說沒有啊這看起來還好嘛以嘉義來說來到313你也覺得好像只有超出一點點可是部長你往回頭看前面兩欄113年12月的照專人數\n115531\t138562\t这个例如说新北市230台北市244桃园市142这个是你们合订的原额可是实际上因为他的工作量太大薪水太低常常加班以台北市为例他就没有聘足244你这样听懂我的意思吗所以这个平均每人按量这个漂亮的数字是假的\n139383\t153038\t也就是說以台北市為例他罰訂的錢可以讓他聘244 台湾市可以聘142台中可以聘221可是因為他聘不到所以每一個照管員所服務的案量遠超過現在這個統計數字\n155546\t184950\t也就是数字的背后看见更多是照管员的辛苦跟心酸那我们来看一下他们在做哪些事情他们接到电话之后呢要在一日内电访两日内完成家访然后计划拧定报告撰写甚至遇到紧急的案子还要在八小时内完成访试然后在一天以内评估完成然后照管员才把这个案子交给A个管做后续的工作A个管一样工作量都爆量\n185796\t207383\t好那新的案子他們的評估加訪時間是90分鐘就案每年負評一次是60分鐘可是呢部長我們要去做加訪對不對要交通來回回來要趕快寫報告再評估要趕快交出去而且我們的法定規定他們要在四天內完成可是我剛剛說他的資料還要交給A個管假設我們有給A個管兩天的時間然後這個照管專員兩天的時間他一天可以完成三案是極限喔\n215595\t240936\t然後所以他們薪水非常低扣掉勞健保現在大部分的人薪水是在4萬塊以下而且工時非常長導致流動率非常非常高這個是現在的慘況有這麼慘的陳情我們做了非常多的研究我跟部長報告我們去問了你們衛福部說你們知不知道各縣市政府的照管專員現在的離職率是什麼\n242579\t260544\t狀態如何答案是沒有數字因為我猜想吼這個經費應該是撥給地方政府之後衛福部就只收相關的數字對不對成案的數字啦然後協助完成長照2.0申請的數字啦但是我們並不真的知道基層的工作人員發生了什麼事情\n261124\t278258\t那為什麼我要在這裡幫他們追這個事情因為部長當人一再的流動離職所有要進來申請長照的所有包括我們辦公室過去一直在關注的特教生然後身心障礙的朋友們他們所必須要申請的長照後面就會卡住啊因為前端處理的人不夠嘛好 所以部長怎麼辦\n285057\t287179\t所以我請長照司啦我們也很關心的事情請司長來回應一下\n293275\t322355\t好 謝謝委員那我這邊可能先跟委員說明一下對於照專的目前的這個核定額度的這件事情好 我們回到上一章你要跟我講核定額度好 來核定額度這件事情可以看得出來從112年跟113年其實整個各縣市的人數都有拉高那就是因為我們在112年發現這個人數的計算上過往在2.0是用150案這樣的方式去算可是事實上沒有辦法回應到地方真正的一個狀況\n323796\t341733\t對 所以我們就是讓在照專核定上面是尊重由地方政府我們跟他們共同討論出來每一個照專一天的工作量會做一些什麼樣的工作內容那每一項事情不包括委員剛剛關注到的一些交通的所耗費的時間跟評估會來打記錄的時間這些都跟地方政府共同討論出來之後\n346878\t365211\t把那样一个计算人力的所耗的时间算出来之后回到他们自己的一个考量需要多少不在意案件数不再去看案件数所以113年的这些造砖的核定数都是由尊重地方政府按照这样的一个耗时的计算\n366031\t391846\t報上來他的需求數那今天問題出現的是因為趙正我們在12年也把他從臨時人員納為政府的聘僱人員是所以他們現在的一個勞動權益是更有保障可是因為一旦納為政府的聘僱人員他就是跟工人一樣他今天不管你佔什麼樣的這個新等職位其實從台北一路到屏東薪資待遇是一樣的\n392847\t410465\t這是公務人員的一個目前我們的人事機關的規範的一個要求就是這樣那所以現階段會有這些都會區人員流動比較大就是因為目前的這個薪資待遇對都會區比較缺乏競爭力可是我們\n411265\t437432\t過半的縣市其他的人員的禁用其實是穩定的那我們全國的平均大概是照專這邊有78%就是扣除一些流動的那事實上可是已經有超過10個縣市他的禁用率其實非常的穩定甚至有100%那高於這個有10個縣市都高於九成所以他的流動率其實不高最嚴重的就是在這個雙北是\n439372\t460774\t所以其實你是知道問題的嘛但是我請教你一個事情你說這是跟地方政府討論後大家共同討論對不對然後他們爆出這個數目那我想問一下這些所謂的政府聘僱人員享有政府的相關勞動權利的保障的這些人他們的薪資是中央跟地方怎麼分工\n461955\t475711\t這個薪資是我們用312薪點來來企算然後7級就是照專進來之後他可以有每年調薪的這個機制只要烤雞甲等是往上調的機制\n476892\t498699\t所以現在312新點也按照我們衛福部目前的這些折合率其實一點是135元那我們近期也看到社安網那邊也有福利服務中心的社工其實的新點有拉高到140所以我們現在也在努力朝比照這部分能夠把新點再拉高重點是我問你這個錢是誰出的啦\n503261\t514568\t錢的部分是中央主要負責然後地方政府是按照我們的財力分級分3到5 財力分級3到5是3%然後二級是5%一級是一成那也就是說最多那我舉個例子六都應該都是算財務狀況好的那所以地方政府的負擔大概就是一成最多一成台北市一成台北市一成那所以90%是你們出的是\n530399\t537993\t是哇如果是這樣那之後因為前一輪的預算的亂象回到這件事情有沒有影響\n540065\t567219\t還是你還沒有辦法評估出來因為財化法之後長照基金這邊的收入也會有短收尤其是防疫合一稅那市長我認為這件事情非同小可大概不是我們一次諮詢完就可以解決的事情如果他又因為財化法會影響到後續中央跟地方的分別必須要支付這個預算的比例的話我認為我們要從長計議不能讓地方的這些照專\n568039\t585373\t他们的过量的工作量然后导致于后面所有申请需要长照2.0服务的这些民众受到影响我认为他们现在是卯足了力在服务所有有需求的民众但是确实你刚刚说了只有超过只有10都左右的\n586253\t612983\t在殖旅是穩定的也就是說14個縣市只有14個縣市就是過半過半的縣市那那些loading很重的縣市我認為我們還是要回過頭來解決所以這一塊我們其實也在跟人事單位在討論有沒有一些可以因為約聘僱人就是要按照人事總部規範我認同我沒有要破壞你們的薪資結構的法規範他沒有辦法額外再給任何的津貼\n613823\t633428\t我都知道但是我們要解決嘛所以不管是從錢的方向來解決還是有什麼特別的條款可以來解決還是我來問啦每一個人平均按量要不要做調整還有不要只涵蓋率跟按量作為KPI各地的狀況必須因地制宜我這邊有寫了還有有沒有按量管制SOP的可能\n633988\t656484\t然後我們如何掌握第一線的人力狀況因為如果按照司長你剛剛信誓旦旦的說超過14個縣市的在職率是穩定的可是為什麼我們辦公室之前跟你們問服務要資料的時候是要不到的你們不給我們還是你們根本沒有統計還是我們問了你們才整理出來我不確定但是看起來對於第一線人力的掌握它並不能只丟給地方政府\n656684\t676332\t因為如果地方政府在這件事情上也沒有太有積極的作為我認為那你們又是出錢的人你們應該更要去協助這些地方上工作的照管專員他們的工作狀況會是好的好嗎就是沒問題現在就是其實最大困境像台北市它的禁用率我們的了解大概不到一半\n676892\t691432\t所以他的負責人那你要想不到一半原因就是很簡單因為這個loading太重嘛我認為啦不是他聘不到人聘不到人阿為什麼這台北市聘不到人那他們也想要用他們的一些錢去給可是整個政府的規定是不允許\n692574\t720057\t那我們看起來需要中央跟地方坐下來一起想辦法所以這個可能人事的法規可能需要合法好 那我們一起努力那我要提醒你們其實也有人告訴我們因為現在長照四包錢全部都是要打進這個電話去申請但是有沒有必要來簡化這個流程或者是不必要都是他們來承擔我認為這個實質的工作內容我們可能也可以來討論是 也跟委員報告1966這支專線不是照專在接的其實我們另外還有給他們行政人力\n721206\t733446\t好所以看起來你們真的已經做了很多努力可是在第一線的工作狀態真的還是很差你認同嗎對其實你是清楚的是是好那我們一起來努力我們會一起再來跟人事總處我們辦公室會再持續追蹤這個議題好謝謝司長謝謝部長謝謝主席謝謝陳委員\n","txt":"好謝謝主席那有請衛福部部長跟長照司謝謝長照司有來嗎好好謝謝市長好市長那個部長我是請市長上來回答問題但你聽聽看因為這個問題事情很大條來\n好部長你前一陣子說我們長照3.0要納入癌末腦中風外疾等三大對象擴大辦理我認為這是得證很好我們非常期待在3.0的部分但是現在在2.0出現了一個問題我不確定長照4有沒有跟您反映就是關於\n長照專員他們在接電話這件事情我們可以看到你們的計劃裡面寫的是說每一個照管員就是照顧管理專員服務量是150個到200個配置照管專員一名\n但是實際上我們看到現在所有在網路上他們自己就是當事人他們就是所謂每天在做這些事情的照顧管理專員他們說他們的案量遠遠超過你們當時的規劃常常每一個人要負擔三百案五百案甚至有人到六百案到九百案都有而且我們辦公室就接到非常多的陳情\n那我們來看一下衛福部當時的設計是這樣部長我現在把右邊這個框起來是在2024年的12月平均每一個照管員他手上所負擔的專案從新北的272啊台北的183部長一定你一定會說沒有啊這看起來還好嘛以嘉義來說來到313你也覺得好像只有超出一點點可是部長你往回頭看前面兩欄113年12月的照專人數\n这个例如说新北市230台北市244桃园市142这个是你们合订的原额可是实际上因为他的工作量太大薪水太低常常加班以台北市为例他就没有聘足244你这样听懂我的意思吗所以这个平均每人按量这个漂亮的数字是假的\n也就是說以台北市為例他罰訂的錢可以讓他聘244 台湾市可以聘142台中可以聘221可是因為他聘不到所以每一個照管員所服務的案量遠超過現在這個統計數字\n也就是数字的背后看见更多是照管员的辛苦跟心酸那我们来看一下他们在做哪些事情他们接到电话之后呢要在一日内电访两日内完成家访然后计划拧定报告撰写甚至遇到紧急的案子还要在八小时内完成访试然后在一天以内评估完成然后照管员才把这个案子交给A个管做后续的工作A个管一样工作量都爆量\n好那新的案子他們的評估加訪時間是90分鐘就案每年負評一次是60分鐘可是呢部長我們要去做加訪對不對要交通來回回來要趕快寫報告再評估要趕快交出去而且我們的法定規定他們要在四天內完成可是我剛剛說他的資料還要交給A個管假設我們有給A個管兩天的時間然後這個照管專員兩天的時間他一天可以完成三案是極限喔\n然後所以他們薪水非常低扣掉勞健保現在大部分的人薪水是在4萬塊以下而且工時非常長導致流動率非常非常高這個是現在的慘況有這麼慘的陳情我們做了非常多的研究我跟部長報告我們去問了你們衛福部說你們知不知道各縣市政府的照管專員現在的離職率是什麼\n狀態如何答案是沒有數字因為我猜想吼這個經費應該是撥給地方政府之後衛福部就只收相關的數字對不對成案的數字啦然後協助完成長照2.0申請的數字啦但是我們並不真的知道基層的工作人員發生了什麼事情\n那為什麼我要在這裡幫他們追這個事情因為部長當人一再的流動離職所有要進來申請長照的所有包括我們辦公室過去一直在關注的特教生然後身心障礙的朋友們他們所必須要申請的長照後面就會卡住啊因為前端處理的人不夠嘛好 所以部長怎麼辦\n所以我請長照司啦我們也很關心的事情請司長來回應一下\n好 謝謝委員那我這邊可能先跟委員說明一下對於照專的目前的這個核定額度的這件事情好 我們回到上一章你要跟我講核定額度好 來核定額度這件事情可以看得出來從112年跟113年其實整個各縣市的人數都有拉高那就是因為我們在112年發現這個人數的計算上過往在2.0是用150案這樣的方式去算可是事實上沒有辦法回應到地方真正的一個狀況\n對 所以我們就是讓在照專核定上面是尊重由地方政府我們跟他們共同討論出來每一個照專一天的工作量會做一些什麼樣的工作內容那每一項事情不包括委員剛剛關注到的一些交通的所耗費的時間跟評估會來打記錄的時間這些都跟地方政府共同討論出來之後\n把那样一个计算人力的所耗的时间算出来之后回到他们自己的一个考量需要多少不在意案件数不再去看案件数所以113年的这些造砖的核定数都是由尊重地方政府按照这样的一个耗时的计算\n報上來他的需求數那今天問題出現的是因為趙正我們在12年也把他從臨時人員納為政府的聘僱人員是所以他們現在的一個勞動權益是更有保障可是因為一旦納為政府的聘僱人員他就是跟工人一樣他今天不管你佔什麼樣的這個新等職位其實從台北一路到屏東薪資待遇是一樣的\n這是公務人員的一個目前我們的人事機關的規範的一個要求就是這樣那所以現階段會有這些都會區人員流動比較大就是因為目前的這個薪資待遇對都會區比較缺乏競爭力可是我們\n過半的縣市其他的人員的禁用其實是穩定的那我們全國的平均大概是照專這邊有78%就是扣除一些流動的那事實上可是已經有超過10個縣市他的禁用率其實非常的穩定甚至有100%那高於這個有10個縣市都高於九成所以他的流動率其實不高最嚴重的就是在這個雙北是\n所以其實你是知道問題的嘛但是我請教你一個事情你說這是跟地方政府討論後大家共同討論對不對然後他們爆出這個數目那我想問一下這些所謂的政府聘僱人員享有政府的相關勞動權利的保障的這些人他們的薪資是中央跟地方怎麼分工\n這個薪資是我們用312薪點來來企算然後7級就是照專進來之後他可以有每年調薪的這個機制只要烤雞甲等是往上調的機制\n所以現在312新點也按照我們衛福部目前的這些折合率其實一點是135元那我們近期也看到社安網那邊也有福利服務中心的社工其實的新點有拉高到140所以我們現在也在努力朝比照這部分能夠把新點再拉高重點是我問你這個錢是誰出的啦\n錢的部分是中央主要負責然後地方政府是按照我們的財力分級分3到5 財力分級3到5是3%然後二級是5%一級是一成那也就是說最多那我舉個例子六都應該都是算財務狀況好的那所以地方政府的負擔大概就是一成最多一成台北市一成台北市一成那所以90%是你們出的是\n是哇如果是這樣那之後因為前一輪的預算的亂象回到這件事情有沒有影響\n還是你還沒有辦法評估出來因為財化法之後長照基金這邊的收入也會有短收尤其是防疫合一稅那市長我認為這件事情非同小可大概不是我們一次諮詢完就可以解決的事情如果他又因為財化法會影響到後續中央跟地方的分別必須要支付這個預算的比例的話我認為我們要從長計議不能讓地方的這些照專\n他们的过量的工作量然后导致于后面所有申请需要长照2.0服务的这些民众受到影响我认为他们现在是卯足了力在服务所有有需求的民众但是确实你刚刚说了只有超过只有10都左右的\n在殖旅是穩定的也就是說14個縣市只有14個縣市就是過半過半的縣市那那些loading很重的縣市我認為我們還是要回過頭來解決所以這一塊我們其實也在跟人事單位在討論有沒有一些可以因為約聘僱人就是要按照人事總部規範我認同我沒有要破壞你們的薪資結構的法規範他沒有辦法額外再給任何的津貼\n我都知道但是我們要解決嘛所以不管是從錢的方向來解決還是有什麼特別的條款可以來解決還是我來問啦每一個人平均按量要不要做調整還有不要只涵蓋率跟按量作為KPI各地的狀況必須因地制宜我這邊有寫了還有有沒有按量管制SOP的可能\n然後我們如何掌握第一線的人力狀況因為如果按照司長你剛剛信誓旦旦的說超過14個縣市的在職率是穩定的可是為什麼我們辦公室之前跟你們問服務要資料的時候是要不到的你們不給我們還是你們根本沒有統計還是我們問了你們才整理出來我不確定但是看起來對於第一線人力的掌握它並不能只丟給地方政府\n因為如果地方政府在這件事情上也沒有太有積極的作為我認為那你們又是出錢的人你們應該更要去協助這些地方上工作的照管專員他們的工作狀況會是好的好嗎就是沒問題現在就是其實最大困境像台北市它的禁用率我們的了解大概不到一半\n所以他的負責人那你要想不到一半原因就是很簡單因為這個loading太重嘛我認為啦不是他聘不到人聘不到人阿為什麼這台北市聘不到人那他們也想要用他們的一些錢去給可是整個政府的規定是不允許\n那我們看起來需要中央跟地方坐下來一起想辦法所以這個可能人事的法規可能需要合法好 那我們一起努力那我要提醒你們其實也有人告訴我們因為現在長照四包錢全部都是要打進這個電話去申請但是有沒有必要來簡化這個流程或者是不必要都是他們來承擔我認為這個實質的工作內容我們可能也可以來討論是 也跟委員報告1966這支專線不是照專在接的其實我們另外還有給他們行政人力\n好所以看起來你們真的已經做了很多努力可是在第一線的工作狀態真的還是很差你認同嗎對其實你是清楚的是是好那我們一起來努力我們會一起再來跟人事總處我們辦公室會再持續追蹤這個議題好謝謝司長謝謝部長謝謝主席謝謝陳委員\n","vtt":"WEBVTT\n\n00:00.029 --> 00:01.570\n好謝謝主席那有請衛福部部長跟長照司謝謝長照司有來嗎好好謝謝市長好市長那個部長我是請市長上來回答問題但你聽聽看因為這個問題事情很大條來\n\n00:26.837 --> 00:45.923\n好部長你前一陣子說我們長照3.0要納入癌末腦中風外疾等三大對象擴大辦理我認為這是得證很好我們非常期待在3.0的部分但是現在在2.0出現了一個問題我不確定長照4有沒有跟您反映就是關於\n\n00:48.244 --> 00:57.309\n長照專員他們在接電話這件事情我們可以看到你們的計劃裡面寫的是說每一個照管員就是照顧管理專員服務量是150個到200個配置照管專員一名\n\n01:03.192 --> 01:24.130\n但是實際上我們看到現在所有在網路上他們自己就是當事人他們就是所謂每天在做這些事情的照顧管理專員他們說他們的案量遠遠超過你們當時的規劃常常每一個人要負擔三百案五百案甚至有人到六百案到九百案都有而且我們辦公室就接到非常多的陳情\n\n01:25.251 --> 01:48.867\n那我們來看一下衛福部當時的設計是這樣部長我現在把右邊這個框起來是在2024年的12月平均每一個照管員他手上所負擔的專案從新北的272啊台北的183部長一定你一定會說沒有啊這看起來還好嘛以嘉義來說來到313你也覺得好像只有超出一點點可是部長你往回頭看前面兩欄113年12月的照專人數\n\n01:55.531 --> 02:18.562\n这个例如说新北市230台北市244桃园市142这个是你们合订的原额可是实际上因为他的工作量太大薪水太低常常加班以台北市为例他就没有聘足244你这样听懂我的意思吗所以这个平均每人按量这个漂亮的数字是假的\n\n02:19.383 --> 02:33.038\n也就是說以台北市為例他罰訂的錢可以讓他聘244台湾市可以聘142台中可以聘221可是因為他聘不到所以每一個照管員所服務的案量遠超過現在這個統計數字\n\n02:35.546 --> 03:04.950\n也就是数字的背后看见更多是照管员的辛苦跟心酸那我们来看一下他们在做哪些事情他们接到电话之后呢要在一日内电访两日内完成家访然后计划拧定报告撰写甚至遇到紧急的案子还要在八小时内完成访试然后在一天以内评估完成然后照管员才把这个案子交给A个管做后续的工作A个管一样工作量都爆量\n\n03:05.796 --> 03:27.383\n好那新的案子他們的評估加訪時間是90分鐘就案每年負評一次是60分鐘可是呢部長我們要去做加訪對不對要交通來回回來要趕快寫報告再評估要趕快交出去而且我們的法定規定他們要在四天內完成可是我剛剛說他的資料還要交給A個管假設我們有給A個管兩天的時間然後這個照管專員兩天的時間他一天可以完成三案是極限喔\n\n03:35.595 --> 04:00.936\n然後所以他們薪水非常低扣掉勞健保現在大部分的人薪水是在4萬塊以下而且工時非常長導致流動率非常非常高這個是現在的慘況有這麼慘的陳情我們做了非常多的研究我跟部長報告我們去問了你們衛福部說你們知不知道各縣市政府的照管專員現在的離職率是什麼\n\n04:02.579 --> 04:20.544\n狀態如何答案是沒有數字因為我猜想吼這個經費應該是撥給地方政府之後衛福部就只收相關的數字對不對成案的數字啦然後協助完成長照2.0申請的數字啦但是我們並不真的知道基層的工作人員發生了什麼事情\n\n04:21.124 --> 04:38.258\n那為什麼我要在這裡幫他們追這個事情因為部長當人一再的流動離職所有要進來申請長照的所有包括我們辦公室過去一直在關注的特教生然後身心障礙的朋友們他們所必須要申請的長照後面就會卡住啊因為前端處理的人不夠嘛好所以部長怎麼辦\n\n04:45.057 --> 04:47.179\n所以我請長照司啦我們也很關心的事情請司長來回應一下\n\n04:53.275 --> 05:22.355\n好謝謝委員那我這邊可能先跟委員說明一下對於照專的目前的這個核定額度的這件事情好我們回到上一章你要跟我講核定額度好來核定額度這件事情可以看得出來從112年跟113年其實整個各縣市的人數都有拉高那就是因為我們在112年發現這個人數的計算上過往在2.0是用150案這樣的方式去算可是事實上沒有辦法回應到地方真正的一個狀況\n\n05:23.796 --> 05:41.733\n對所以我們就是讓在照專核定上面是尊重由地方政府我們跟他們共同討論出來每一個照專一天的工作量會做一些什麼樣的工作內容那每一項事情不包括委員剛剛關注到的一些交通的所耗費的時間跟評估會來打記錄的時間這些都跟地方政府共同討論出來之後\n\n05:46.878 --> 06:05.211\n把那样一个计算人力的所耗的时间算出来之后回到他们自己的一个考量需要多少不在意案件数不再去看案件数所以113年的这些造砖的核定数都是由尊重地方政府按照这样的一个耗时的计算\n\n06:06.031 --> 06:31.846\n報上來他的需求數那今天問題出現的是因為趙正我們在12年也把他從臨時人員納為政府的聘僱人員是所以他們現在的一個勞動權益是更有保障可是因為一旦納為政府的聘僱人員他就是跟工人一樣他今天不管你佔什麼樣的這個新等職位其實從台北一路到屏東薪資待遇是一樣的\n\n06:32.847 --> 06:50.465\n這是公務人員的一個目前我們的人事機關的規範的一個要求就是這樣那所以現階段會有這些都會區人員流動比較大就是因為目前的這個薪資待遇對都會區比較缺乏競爭力可是我們\n\n06:51.265 --> 07:17.432\n過半的縣市其他的人員的禁用其實是穩定的那我們全國的平均大概是照專這邊有78%就是扣除一些流動的那事實上可是已經有超過10個縣市他的禁用率其實非常的穩定甚至有100%那高於這個有10個縣市都高於九成所以他的流動率其實不高最嚴重的就是在這個雙北是\n\n07:19.372 --> 07:40.774\n所以其實你是知道問題的嘛但是我請教你一個事情你說這是跟地方政府討論後大家共同討論對不對然後他們爆出這個數目那我想問一下這些所謂的政府聘僱人員享有政府的相關勞動權利的保障的這些人他們的薪資是中央跟地方怎麼分工\n\n07:41.955 --> 07:55.711\n這個薪資是我們用312薪點來來企算然後7級就是照專進來之後他可以有每年調薪的這個機制只要烤雞甲等是往上調的機制\n\n07:56.892 --> 08:18.699\n所以現在312新點也按照我們衛福部目前的這些折合率其實一點是135元那我們近期也看到社安網那邊也有福利服務中心的社工其實的新點有拉高到140所以我們現在也在努力朝比照這部分能夠把新點再拉高重點是我問你這個錢是誰出的啦\n\n08:23.261 --> 08:34.568\n錢的部分是中央主要負責然後地方政府是按照我們的財力分級分3到5財力分級3到5是3%然後二級是5%一級是一成那也就是說最多那我舉個例子六都應該都是算財務狀況好的那所以地方政府的負擔大概就是一成最多一成台北市一成台北市一成那所以90%是你們出的是\n\n08:50.399 --> 08:57.993\n是哇如果是這樣那之後因為前一輪的預算的亂象回到這件事情有沒有影響\n\n09:00.065 --> 09:27.219\n還是你還沒有辦法評估出來因為財化法之後長照基金這邊的收入也會有短收尤其是防疫合一稅那市長我認為這件事情非同小可大概不是我們一次諮詢完就可以解決的事情如果他又因為財化法會影響到後續中央跟地方的分別必須要支付這個預算的比例的話我認為我們要從長計議不能讓地方的這些照專\n\n09:28.039 --> 09:45.373\n他们的过量的工作量然后导致于后面所有申请需要长照2.0服务的这些民众受到影响我认为他们现在是卯足了力在服务所有有需求的民众但是确实你刚刚说了只有超过只有10都左右的\n\n09:46.253 --> 10:12.983\n在殖旅是穩定的也就是說14個縣市只有14個縣市就是過半過半的縣市那那些loading很重的縣市我認為我們還是要回過頭來解決所以這一塊我們其實也在跟人事單位在討論有沒有一些可以因為約聘僱人就是要按照人事總部規範我認同我沒有要破壞你們的薪資結構的法規範他沒有辦法額外再給任何的津貼\n\n10:13.823 --> 10:33.428\n我都知道但是我們要解決嘛所以不管是從錢的方向來解決還是有什麼特別的條款可以來解決還是我來問啦每一個人平均按量要不要做調整還有不要只涵蓋率跟按量作為KPI各地的狀況必須因地制宜我這邊有寫了還有有沒有按量管制SOP的可能\n\n10:33.988 --> 10:56.484\n然後我們如何掌握第一線的人力狀況因為如果按照司長你剛剛信誓旦旦的說超過14個縣市的在職率是穩定的可是為什麼我們辦公室之前跟你們問服務要資料的時候是要不到的你們不給我們還是你們根本沒有統計還是我們問了你們才整理出來我不確定但是看起來對於第一線人力的掌握它並不能只丟給地方政府\n\n10:56.684 --> 11:16.332\n因為如果地方政府在這件事情上也沒有太有積極的作為我認為那你們又是出錢的人你們應該更要去協助這些地方上工作的照管專員他們的工作狀況會是好的好嗎就是沒問題現在就是其實最大困境像台北市它的禁用率我們的了解大概不到一半\n\n11:16.892 --> 11:31.432\n所以他的負責人那你要想不到一半原因就是很簡單因為這個loading太重嘛我認為啦不是他聘不到人聘不到人阿為什麼這台北市聘不到人那他們也想要用他們的一些錢去給可是整個政府的規定是不允許\n\n11:32.574 --> 12:00.057\n那我們看起來需要中央跟地方坐下來一起想辦法所以這個可能人事的法規可能需要合法好那我們一起努力那我要提醒你們其實也有人告訴我們因為現在長照四包錢全部都是要打進這個電話去申請但是有沒有必要來簡化這個流程或者是不必要都是他們來承擔我認為這個實質的工作內容我們可能也可以來討論是也跟委員報告1966這支專線不是照專在接的其實我們另外還有給他們行政人力\n\n12:01.206 --> 12:13.446\n好所以看起來你們真的已經做了很多努力可是在第一線的工作狀態真的還是很差你認同嗎對其實你是清楚的是是好那我們一起來努力我們會一起再來跟人事總處我們辦公室會再持續追蹤這個議題好謝謝司長謝謝部長謝謝主席謝謝陳委員\n\n","segments":[{"start":0.029,"end":1.57,"text":"好謝謝主席那有請衛福部部長跟長照司謝謝長照司有來嗎好好謝謝市長好市長那個部長我是請市長上來回答問題但你聽聽看因為這個問題事情很大條來"},{"start":26.837,"end":45.923,"text":"好部長你前一陣子說我們長照3.0要納入癌末腦中風外疾等三大對象擴大辦理我認為這是得證很好我們非常期待在3.0的部分但是現在在2.0出現了一個問題我不確定長照4有沒有跟您反映就是關於"},{"start":48.244,"end":57.309,"text":"長照專員他們在接電話這件事情我們可以看到你們的計劃裡面寫的是說每一個照管員就是照顧管理專員服務量是150個到200個配置照管專員一名"},{"start":63.192,"end":84.13,"text":"但是實際上我們看到現在所有在網路上他們自己就是當事人他們就是所謂每天在做這些事情的照顧管理專員他們說他們的案量遠遠超過你們當時的規劃常常每一個人要負擔三百案五百案甚至有人到六百案到九百案都有而且我們辦公室就接到非常多的陳情"},{"start":85.251,"end":108.867,"text":"那我們來看一下衛福部當時的設計是這樣部長我現在把右邊這個框起來是在2024年的12月平均每一個照管員他手上所負擔的專案從新北的272啊台北的183部長一定你一定會說沒有啊這看起來還好嘛以嘉義來說來到313你也覺得好像只有超出一點點可是部長你往回頭看前面兩欄113年12月的照專人數"},{"start":115.531,"end":138.562,"text":"这个例如说新北市230台北市244桃园市142这个是你们合订的原额可是实际上因为他的工作量太大薪水太低常常加班以台北市为例他就没有聘足244你这样听懂我的意思吗所以这个平均每人按量这个漂亮的数字是假的"},{"start":139.383,"end":153.038,"text":"也就是說以台北市為例他罰訂的錢可以讓他聘244 台湾市可以聘142台中可以聘221可是因為他聘不到所以每一個照管員所服務的案量遠超過現在這個統計數字"},{"start":155.546,"end":184.95,"text":"也就是数字的背后看见更多是照管员的辛苦跟心酸那我们来看一下他们在做哪些事情他们接到电话之后呢要在一日内电访两日内完成家访然后计划拧定报告撰写甚至遇到紧急的案子还要在八小时内完成访试然后在一天以内评估完成然后照管员才把这个案子交给A个管做后续的工作A个管一样工作量都爆量"},{"start":185.796,"end":207.383,"text":"好那新的案子他們的評估加訪時間是90分鐘就案每年負評一次是60分鐘可是呢部長我們要去做加訪對不對要交通來回回來要趕快寫報告再評估要趕快交出去而且我們的法定規定他們要在四天內完成可是我剛剛說他的資料還要交給A個管假設我們有給A個管兩天的時間然後這個照管專員兩天的時間他一天可以完成三案是極限喔"},{"start":215.595,"end":240.936,"text":"然後所以他們薪水非常低扣掉勞健保現在大部分的人薪水是在4萬塊以下而且工時非常長導致流動率非常非常高這個是現在的慘況有這麼慘的陳情我們做了非常多的研究我跟部長報告我們去問了你們衛福部說你們知不知道各縣市政府的照管專員現在的離職率是什麼"},{"start":242.579,"end":260.544,"text":"狀態如何答案是沒有數字因為我猜想吼這個經費應該是撥給地方政府之後衛福部就只收相關的數字對不對成案的數字啦然後協助完成長照2.0申請的數字啦但是我們並不真的知道基層的工作人員發生了什麼事情"},{"start":261.124,"end":278.258,"text":"那為什麼我要在這裡幫他們追這個事情因為部長當人一再的流動離職所有要進來申請長照的所有包括我們辦公室過去一直在關注的特教生然後身心障礙的朋友們他們所必須要申請的長照後面就會卡住啊因為前端處理的人不夠嘛好 所以部長怎麼辦"},{"start":285.057,"end":287.179,"text":"所以我請長照司啦我們也很關心的事情請司長來回應一下"},{"start":293.275,"end":322.355,"text":"好 謝謝委員那我這邊可能先跟委員說明一下對於照專的目前的這個核定額度的這件事情好 我們回到上一章你要跟我講核定額度好 來核定額度這件事情可以看得出來從112年跟113年其實整個各縣市的人數都有拉高那就是因為我們在112年發現這個人數的計算上過往在2.0是用150案這樣的方式去算可是事實上沒有辦法回應到地方真正的一個狀況"},{"start":323.796,"end":341.733,"text":"對 所以我們就是讓在照專核定上面是尊重由地方政府我們跟他們共同討論出來每一個照專一天的工作量會做一些什麼樣的工作內容那每一項事情不包括委員剛剛關注到的一些交通的所耗費的時間跟評估會來打記錄的時間這些都跟地方政府共同討論出來之後"},{"start":346.878,"end":365.211,"text":"把那样一个计算人力的所耗的时间算出来之后回到他们自己的一个考量需要多少不在意案件数不再去看案件数所以113年的这些造砖的核定数都是由尊重地方政府按照这样的一个耗时的计算"},{"start":366.031,"end":391.846,"text":"報上來他的需求數那今天問題出現的是因為趙正我們在12年也把他從臨時人員納為政府的聘僱人員是所以他們現在的一個勞動權益是更有保障可是因為一旦納為政府的聘僱人員他就是跟工人一樣他今天不管你佔什麼樣的這個新等職位其實從台北一路到屏東薪資待遇是一樣的"},{"start":392.847,"end":410.465,"text":"這是公務人員的一個目前我們的人事機關的規範的一個要求就是這樣那所以現階段會有這些都會區人員流動比較大就是因為目前的這個薪資待遇對都會區比較缺乏競爭力可是我們"},{"start":411.265,"end":437.432,"text":"過半的縣市其他的人員的禁用其實是穩定的那我們全國的平均大概是照專這邊有78%就是扣除一些流動的那事實上可是已經有超過10個縣市他的禁用率其實非常的穩定甚至有100%那高於這個有10個縣市都高於九成所以他的流動率其實不高最嚴重的就是在這個雙北是"},{"start":439.372,"end":460.774,"text":"所以其實你是知道問題的嘛但是我請教你一個事情你說這是跟地方政府討論後大家共同討論對不對然後他們爆出這個數目那我想問一下這些所謂的政府聘僱人員享有政府的相關勞動權利的保障的這些人他們的薪資是中央跟地方怎麼分工"},{"start":461.955,"end":475.711,"text":"這個薪資是我們用312薪點來來企算然後7級就是照專進來之後他可以有每年調薪的這個機制只要烤雞甲等是往上調的機制"},{"start":476.892,"end":498.699,"text":"所以現在312新點也按照我們衛福部目前的這些折合率其實一點是135元那我們近期也看到社安網那邊也有福利服務中心的社工其實的新點有拉高到140所以我們現在也在努力朝比照這部分能夠把新點再拉高重點是我問你這個錢是誰出的啦"},{"start":503.261,"end":514.568,"text":"錢的部分是中央主要負責然後地方政府是按照我們的財力分級分3到5 財力分級3到5是3%然後二級是5%一級是一成那也就是說最多那我舉個例子六都應該都是算財務狀況好的那所以地方政府的負擔大概就是一成最多一成台北市一成台北市一成那所以90%是你們出的是"},{"start":530.399,"end":537.993,"text":"是哇如果是這樣那之後因為前一輪的預算的亂象回到這件事情有沒有影響"},{"start":540.065,"end":567.219,"text":"還是你還沒有辦法評估出來因為財化法之後長照基金這邊的收入也會有短收尤其是防疫合一稅那市長我認為這件事情非同小可大概不是我們一次諮詢完就可以解決的事情如果他又因為財化法會影響到後續中央跟地方的分別必須要支付這個預算的比例的話我認為我們要從長計議不能讓地方的這些照專"},{"start":568.039,"end":585.373,"text":"他们的过量的工作量然后导致于后面所有申请需要长照2.0服务的这些民众受到影响我认为他们现在是卯足了力在服务所有有需求的民众但是确实你刚刚说了只有超过只有10都左右的"},{"start":586.253,"end":612.983,"text":"在殖旅是穩定的也就是說14個縣市只有14個縣市就是過半過半的縣市那那些loading很重的縣市我認為我們還是要回過頭來解決所以這一塊我們其實也在跟人事單位在討論有沒有一些可以因為約聘僱人就是要按照人事總部規範我認同我沒有要破壞你們的薪資結構的法規範他沒有辦法額外再給任何的津貼"},{"start":613.823,"end":633.428,"text":"我都知道但是我們要解決嘛所以不管是從錢的方向來解決還是有什麼特別的條款可以來解決還是我來問啦每一個人平均按量要不要做調整還有不要只涵蓋率跟按量作為KPI各地的狀況必須因地制宜我這邊有寫了還有有沒有按量管制SOP的可能"},{"start":633.988,"end":656.484,"text":"然後我們如何掌握第一線的人力狀況因為如果按照司長你剛剛信誓旦旦的說超過14個縣市的在職率是穩定的可是為什麼我們辦公室之前跟你們問服務要資料的時候是要不到的你們不給我們還是你們根本沒有統計還是我們問了你們才整理出來我不確定但是看起來對於第一線人力的掌握它並不能只丟給地方政府"},{"start":656.684,"end":676.332,"text":"因為如果地方政府在這件事情上也沒有太有積極的作為我認為那你們又是出錢的人你們應該更要去協助這些地方上工作的照管專員他們的工作狀況會是好的好嗎就是沒問題現在就是其實最大困境像台北市它的禁用率我們的了解大概不到一半"},{"start":676.892,"end":691.432,"text":"所以他的負責人那你要想不到一半原因就是很簡單因為這個loading太重嘛我認為啦不是他聘不到人聘不到人阿為什麼這台北市聘不到人那他們也想要用他們的一些錢去給可是整個政府的規定是不允許"},{"start":692.574,"end":720.057,"text":"那我們看起來需要中央跟地方坐下來一起想辦法所以這個可能人事的法規可能需要合法好 那我們一起努力那我要提醒你們其實也有人告訴我們因為現在長照四包錢全部都是要打進這個電話去申請但是有沒有必要來簡化這個流程或者是不必要都是他們來承擔我認為這個實質的工作內容我們可能也可以來討論是 也跟委員報告1966這支專線不是照專在接的其實我們另外還有給他們行政人力"},{"start":721.206,"end":733.446,"text":"好所以看起來你們真的已經做了很多努力可是在第一線的工作狀態真的還是很差你認同嗎對其實你是清楚的是是好那我們一起來努力我們會一起再來跟人事總處我們辦公室會再持續追蹤這個議題好謝謝司長謝謝部長謝謝主席謝謝陳委員"}]}}},"gazette":{"lineno":1176,"blocks":[["陳委員培瑜：（12時53分）謝謝主席，有請衛福部部長跟長照司，長照司有來嘛？好，司長，謝謝。"],["邱部長泰源：委員好。"],["陳委員培瑜：部長好。部長，我是請司長上來回答問題，但你聽聽看，因為這個問題事情很大條。部長，你前一陣子說長照3.0要納入癌末、腦中風、外籍等三大對象擴大辦理，我認為這是德政，很好，我們非常期待3.0的部分，但是現在2.0出現了一個問題，我不確定長照司有沒有跟您反映，就是關於長照專員在接電話這件事情。我們可以看到你們的計畫裡面寫的是，每一個照管員（就是照顧管理專員）服務量是150個到200個配置照管專員一名，但是實際上我們看到現在所有在網路上，他們自己就是當事人，就是每天在做這些事情的照顧管理專員他們說，他們的案量遠遠超過你們當時的規劃，常常每一個人要負擔300案、500案，甚至有人到600案、到900案都有，而且我們辦公室就接到非常多的陳情。","我們看一下衛福部當時的設計是這樣，部長，我現在把右邊這個框起來是在2024年12月平均每一個照管員手上所負擔的專案，從新北的272、臺北的183，部長你一定會說，沒有啊，這看起來還好嘛，以嘉義來說來到313，你可能也覺得好像只有超出一點點，可是部長你往回頭看前面兩欄，113年12月的照專人數例如說新北市230、臺北市244、桃園市142，這個是你們核定的員額喔，可是實際上因為他的工作量太大，薪水太低，常常加班，以臺北市為例，他就沒有聘足244，這樣你聽懂我的意思嗎？所以平均每人案量這個漂亮的數字是假的，就是說以臺北市為例，法定的錢可以讓他聘244，桃園市可以聘142，臺中可以聘221，可是因為他聘不到，所以每一個照管員所服務的案量遠超過現在這個統計數字，也就是從數字的背後我們看見更多的是照管員的辛苦跟辛酸。","我們看一下他們在做哪些事情，他們接到電話之後要在一日內電訪，兩日內完成家訪，然後計畫擬定報告撰寫，甚至遇到緊急的案子，還要在8小時內完成訪視，在一天以內評估完成，然後照管員才把這個案子交給A個管做後續的工作。A個管一樣，工作量都爆量。新的案子他們的評估家訪時間是90分鐘，舊案每年複評一次是60分鐘，可是，部長，我們要去做家訪對不對，要交通來回的時間，回來要趕快寫報告、做評估然後趕快交出去，而且我們的法定規定他們要在四天內完成，可是我剛剛說他的資料還要交給A個管，假設我們留給A個管兩天的時間，然後照管專員兩天的時間，他一天可以完成三案是極限喔。","所以他們的薪水非常低，扣掉勞健保，現在大部分的人薪水是在4萬塊以下，而且工時非常長，導致流動率非常非常高，這是現在的慘況。有這麼慘的陳情，我們做了非常多的研究，我跟部長報告，我們去問過衛福部知不知道各縣市政府照管專員現在的離職率、狀態如何，答案是沒有數字。因為我猜想，這個經費應該是撥給地方政府之後，衛福部就只收相關的數字，對不對？成案的數字啦，然後協助完成長照2.0申請的數字啦，但是我們並不真的知道基層的工作人員發生了什麼事情。","為什麼我要在這裡幫他們追這件事？因為部長，當人員一再地流動離職，要進來申請長照的所有人，包含我們辦公室過去一直在關注的特教生，然後身心障礙的朋友們，他們所必須要申請的長照後面就會卡住，因為前端處理的人不夠嘛，所以，部長，怎麼辦？所以我請長照司。"],["邱部長泰源：謝謝委員提這個說實在我們也很關心的事情，請司長來回應一下。"],["祝司長健芳：謝謝委員，我這邊先跟委員說明一下，對於照專目前的核定額度這件事。"],["陳委員培瑜：好，我們回到上一張，你要跟我講核定額度，好，來。"],["祝司長健芳：是。核定額度這件事情可以看得出來，從112年跟113年其實各縣市的人數都有拉高，就是因為我們在112年發現在人數的計算上，過往在2.0是用150案這樣的方式去算，可是事實上沒有辦法回應地方真正的狀況……"],["陳委員培瑜：實際上的需求量非常大。"],["祝司長健芳：對，所以我們在照專核定上是尊重地方政府，我們跟他們共同討論出來，每一個照專一天的工作量會做什麼樣的工作內容，然後每一項事情，包括委員剛剛關注的交通所耗費的時間跟評估回來打紀錄的時間等等，都跟地方政府共同討論出來，把照管員處理個案所耗時間算出來之後，回歸由地方政府自己考量需要多少人力，不再去看案件數，所以113年照專人員的核定數，都是尊重地方政府按照這樣的耗時的計算，報上來各自的需求數。","今天會出現問題是因為，我們在112年也把照專從臨時人員納為政府的聘僱人員，現在他們的勞動權益固然更有保障，可是因為一旦納為政府的聘僱人員，就跟公務人員一樣，今天不管占什麼樣的薪等職位，從臺北一路到屏東薪資待遇都是一樣的。目前公務人員人事機關的規範、要求就是這樣，所以現階段都會區的人員流動率會比較大，就是因為目前的薪資待遇對於都會區比較缺乏競爭力，可是過半縣市的人員進用其實是穩定的，全國的平均來講，照專有78%，就是扣除一些流動的，但已經有超過10個縣市的進用率其實是非常的穩定，甚至有百分之百，有10個縣市都高於九成，所以它的流動率不高，最嚴重的就是在雙北。"],["陳委員培瑜：是，所以你是知道問題的嘛！但是我請教你一件事，你說這是跟地方政府討論後、大家共同討論，然後他們報出這個數目。"],["祝司長健芳：是。"],["陳委員培瑜：那我想問一下，這些所謂的政府聘僱人員、享有政府相關勞動權利保障這些人的薪資，中央跟地方是怎麼分工？"],["祝司長健芳：這個薪資我們是用312薪點來起算，然後7級，就是照專進來之後，只要考績甲等，有每年可以調薪、往上調的機制。現在312薪點按照衛福部目前這些折合率，其實1點是135元。我們近期也看到社安網有福利服務中心的社工薪點拉高到140元，所以我們現在也在努力，好比照這部分，能夠把薪點再拉高。"],["陳委員培瑜：重點是我問你，這個錢是誰出的？"],["祝司長健芳：錢的部分是中央主要負責，然後地方政府是按照財力分級，財力分級三到五級是3%、然後二級是5%，一級是一成。不過後續也會因為財劃法的關係……"],["陳委員培瑜：好，那我舉個例子，六都應該都是算財務狀況好的，所以地方政府的負擔大概就是一成、最多一成？"],["祝司長健芳：臺北市一成、新北市5%。"],["陳委員培瑜：臺北市一成，所以90%是你們出的？"],["祝司長健芳：是。"],["陳委員培瑜：哇！如果是這樣，因為前一輪的預算亂象，之後回到這件事情有沒有影響？還是你還沒有辦法評估出來？"],["祝司長健芳：因為財劃法之後，長照基金的收入也會有短收，尤其是房地合一稅，所以這個部分也會有影響。"],["陳委員培瑜：好，司長，我認為這件事情非同小可，大概不是我們一次質詢完就可以解決的事情。如果又因為財劃法會影響到後續中央跟地方分別必須要支付這個預算比例的話，我認為我們要從長計議，不能讓地方這些照專過量的工作量導致後面所有申請需要長照2.0服務的民眾受到影響。我認為他們現在是卯足了力在服務所有有需求的民眾，但是你剛剛說了，確實只有超過10都左右的在職率是穩定的……"],["祝司長健芳：14個縣市是穩定的。"],["陳委員培瑜：14個縣市，好，只有14個縣市……"],["祝司長健芳：就是過半、過半的縣市。"],["陳委員培瑜：那些loading很重的縣市，我認為我們還要回過頭來解決。"],["祝司長健芳：所以這一塊我們其實也在跟人事單位討論有沒有一些可以……因為約聘僱人員就是要按照人事總處規範的……"],["陳委員培瑜：是，我認同，我沒有要破壞你們的薪資結構的法規範。"],["祝司長健芳：它沒有辦法額外再給任何的津貼。"],["陳委員培瑜：好，我都知道，但是我們要解決，所以不管是從錢的方向來解決，還是有什麼特別的條款可以來解決，每一個人的平均案量要不要調整？還有不要只以涵蓋率跟案量來計算KPI，各地的狀況必須因地制宜，我這邊有寫了，還有，有沒有按量管制SOP的可能？然後我們如何掌握第一線的人力狀況？因為如果按照司長剛剛信誓旦旦說超過14個縣市的在職率是穩定的，可是為什麼我們辦公室之前跟衛福部要資料的時候是要不到的？你們不給我們，是你們根本沒有統計？還是我們問了你們才整理出來？我不確定，但是看起來對於第一線人力的掌握，並不能只丟給地方政府，因為如果地方政府在這件事情上也沒有太有積極的作為，你們又是出錢的人，那我認為你們更應該要去協助這些地方上工作的照管專員，他們的工作狀況才會是好的，好嗎？"],["祝司長健芳：這是沒問題，現在最大的困境是，像臺北市的進用率，就我們的瞭解大概不到一半，所以它的負責……"],["陳委員培瑜：那你要去想它不到一半的原因，很簡單，我認為是因為loading太重。"],["祝司長健芳：不是，它聘不到人。"],["陳委員培瑜：聘不到人？為什麼在北市聘不到人？"],["祝司長健芳：他們也想要用他們的一些錢去給，可是整個政府的規定是不允許的。"],["陳委員培瑜：那我們看起來是需要中央跟地方坐下來一起想辦法囉？"],["祝司長健芳：這個可能人事的法規必須要修法……"],["陳委員培瑜：好，我們一起努力。那我要提醒你們，其實也有人告訴我們，因為現在長照四包錢全部都是要打進這個電話去申請，但是有沒有必要來簡化這個流程或者是不必要都是他們來承擔，我認為這個實質的工作內容，我們可能也可以來討論。"],["祝司長健芳：也跟委員報告，「1966」這支專線不是照專在接的，其實我們另外還有給他們行政人力。"],["陳委員培瑜：好，所以看起來你們真的已經做了很多努力，可是在第一線的工作狀態真的還是很差，對嗎？你認同嗎？","其實你是清楚的。"],["祝司長健芳：是。"],["陳委員培瑜：好，我們一起來努力。"],["祝司長健芳：我們會一起來跟人事總處……"],["陳委員培瑜：我們辦公室會再持續追蹤這個議題。謝謝司長、謝謝部長、謝謝主席。"],["邱部長泰源：謝謝。"],["主席：謝謝陳委員、謝謝部長。","鄭正鈐、鄭正鈐、鄭正鈐委員不在。","請張雅琳委員質詢。"]],"agenda":{"page_end":370,"meet_id":"委員會-11-3-26-7","speakers":["蘇清泉","陳昭姿","林月琴","葛如鈞","劉建國","王育敏","邱鎮軍","廖偉翔","林淑芬","王正旭","黃秀芳","羅廷瑋","鍾佳濱","陳菁徽","盧縣一","李坤城","陳培瑜","張雅琳","莊瑞雄","楊曜","陳瑩","林楚茵","林德福"],"page_start":287,"meetingDate":["2025-04-23"],"gazette_id":"1144101","agenda_lcidc_ids":["1144101_00005"],"meet_name":"立法院第11屆第3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":"邀請衛生福利部部長、財政部次長就「國家社會福利政策財源檢討及偏鄉兒童發展篩檢執行情\n形」進行專題報告，並備質詢","agenda_id":"1144101_00004"}}}