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00:00:12,272\n好謝謝蘇委員對我叫余承培余只是都二聲大家不是那麼確定怎麼念好那有請次長謝謝我們中午不休息啊我是肚子餓自己吃便當\n\n2\n00:00:18,325 --> 00:00:45,311\n好辛苦了辛苦了謝謝大家好呃次長我快速跟您討論我們之前追蹤衛福部的一些議題哦那如果呃您沒有接觸到相關業務沒關係就再拜託您帶回去演繹好嗎好是呃第一個是關於安置機構裡面的兒少身心狀況其實需要更多的協助之前在3月13號的時候我們曾經拜託邱部長針對原生家庭出了狀況的孩子必須要送到安置機構去的這些所謂家外安置的兒少\n\n3\n00:00:45,791 --> 00:00:52,695\n因為原生家庭出了狀況進到安置機構裡面他們除了第一時間受到照顧之外更多心理健康的支持那當時3月13號質詢之後我們知道衛福部好像在5月初有召開相關會議但是我們沒有收到相關的進度跟結論我不知道在當次的討論結論當中是什麼不過我相信既然已經有相關專家學者在研商會議給予結論我想要知道在我們之前所要求的如何增加所謂安置機構對於\n\n4\n00:01:15,507 --> 00:01:33,878\n这些原生家庭脆弱的孩子给予更多心理健康的支持当天的会议结论现在有机会跟我们说吗还是说还在研议中手上有相关的会议结论好太好了先跟委员做个报告也非常谢谢委员关心因为这是非常脆弱而且是很少数的孩子但是我们一定要顾虑到这些孩子的需求是\n\n5\n00:01:34,178 --> 00:01:58,261\n那在我們上次的這個會議上面談到大概有幾個比較簡單的部分跟委員先報告就是說第一針對特殊需求的兒少我們要去發展分級分類的照顧模式那當然希望在機構裡面能夠去調整照顧人力跟資源的配比第二個部分就是說他這中間可能我們還是要希望能夠發展一些比較簡易的評估工具讓他在安置初期就能夠先知道哪幾個孩子可能我們要先給一些特殊的照顧\n\n6\n00:01:59,062 --> 00:02:17,247\n第三個部分在專業人員這邊當然我們第一個部分是希望繼續督導地方政府來持續精進而少安置單位的專業人員培訓那而且第二部分希望這些機構第一個事情是來跟我們的醫療機構能夠有醫療系統能夠有個連結也就是說基本上是建立他們的需求假設有綠色通道這個是所謂綠色通道的部分\n\n7\n00:02:19,127 --> 00:02:46,635\n我剛剛講的這些我大概知道次長的意思那先回答我一個問題好不好機構內部的這個心理健康的機制因為當時我們是希望說透過心理師法如果不要修法來不及修法在短時間內可以協助這些孩子在機構內就可以得到身心健康的支持方案的話有一個機會是透過衛福部的函式當時我們聽到在相關專家學者會議上他們有提出這個建議有沒有機會往這裡發展\n\n8\n00:02:47,415 --> 00:03:14,033\n我跟委員先報告第一個部分就是說現在在機構內能夠讓我們專業的心理師或諮詢心理師他能夠來做這個業務做職業登記的部分的話他做外展做職登是可以對我知道但是如果是要他專責在內部就是說在機構內部專責來進行服務的話現實上面來講當然如果他要機構內他要變成是符合我們的這個心理師職業\n\n9\n00:03:14,974 --> 00:03:33,719\n没错没错职业登记他如果符合职业登记我们当然可以允许但是成本上面来讲可能对机构来说会有点大因为他做了一个机构那他可能内部服务他应该是做内部服务的那服务量可能不足以让这个机构而让他在内部的这个心理师他的足够量能那这个部分可能机构会比较有这个考量\n\n10\n00:03:34,339 --> 00:03:49,657\n這個是一個部分但是我的意思是說如果衛福部可以掀開這個可能性讓機構內不管是公立的機構或是私立的機構因為目前確實越來越多的孩子因為原生家庭出了狀況他不得不被送到機構去如果機構他們有辦法自籌裁員\n\n11\n00:03:50,618 --> 00:04:08,203\n但是需要你們的法規範開了這個門讓他們在機構裡面除了透過所謂的外展方案之外還可以在機構內內聘專業的心理師讓他可以長期的對於這一群孩子提供服務但需要你們衛福部開這個可能性自己機構內部要聘心理師是可以的\n\n12\n00:04:08,843 --> 00:04:28,637\n只是他心理他聘了心理師如果心理師這個心理師他要以職業登記為心理師的服務的話那這個機構要去申請職業登記對但是因為現在的心理書法是不行的對那這個設置標準在他內部的設置標準怎麼樣可以去調整是不是可以符合哪些細節可以處理我們再來後續跟委員這邊去對還有還有需求的團隊是不是來跟我們討論一下我們把他的設置標準看他能不能符合設置標準好不好\n\n13\n00:04:33,561 --> 00:04:53,468\n所以次長你的建議是一個是我們先跟這些機構對話聽聽看他們目前的需求是不是如同我們辦公室所收集到資訊是這樣那再來透過跟心理師學工會的討論跟這些案子機構討論不管是你認為需要透過個案申請還是衛福部給一個公開的函說明符合心理師法情況下這些機構可以成為心理師職業機構對不對\n\n14\n00:04:55,049 --> 00:05:15,671\n因為現在如果他是外展或報備資源他現在是已經可以運行我們也盡量讓這個部分可以運作但是如果他這個安置機構內部自己就要去設置心理師的這個服務的機構的話那他自己內部要這個機構的設置要符合我們的設置標準因為在機構內他設置標準他才提供的就是我們心理師法所規範的心理師的服務\n\n15\n00:05:16,171 --> 00:05:33,504\n這個我沒有疑問我沒有要你們放寬這個標準我認為是跟更多的討論跟溝通因為目前他們所能夠職業機構是醫療機構心理治療所心理諮商所其他經主管機關認可之機構所以我們希望主管機關也就是衛福部在這個議題上可以開始考慮跟這些安置機構對話\n\n16\n00:05:35,125 --> 00:05:59,340\n那這機構內他如果要設心理諮詢我們來協助他配合符合我們的設計標準這個議題我們辦公室會再持續追蹤那看起來確實還需要一些討論不過很感謝你們已經召開相關會議從我們3月13日質詢到現在第二個是關於這些機構裡面還有非常多特殊需求而造的困境一個是剛剛次長你有快速提到所謂他們要去就診的時候可能一次需要兩三位機構的人力共同\n\n17\n00:06:00,280 --> 00:06:28,651\n去看診而且看診的科目可能很多時間很長需要一整天的時間那目前安置機構希望衛福部可以協助醫院設立所謂綠色通道減少就醫的等待時間我知道目前有一些縣市的早療評估我們用早療這個概念來看已經有綠色通道像新北那衛福部有沒有機會跟地方社政單位討論針對這些安置機構的孩子外出就醫也可以設置綠色通道當然還需要時間\n\n18\n00:06:29,431 --> 00:06:33,776\n我們一直都有在補助醫療機構去辦理嚴重情緒行為障礙者精神醫療就醫障礙改善方案我們把這個114年到現在我們總共有15家醫院在辦理尤其是針對嚴重情緒這時候經障者的特別門診\n\n19\n00:06:48,152 --> 00:07:16,851\n那還他這裡面我們當然就是跟他結合機構然後身心障礙福利機構兒少安置機構矯正學校等好我們來提供外展服務不過我想委員也知道我們在做尤其是這一塊兒少的醫療資源他他真的是我們也專業人員的部分是明顯的比較比較吃緊一點的那所以我們不論現在在新電視這邊我們是持續來會支持學校支持醫療機構來做這樣子的服務那我想很多的機構他們也都如果說他跟安置機構有\n\n20\n00:07:18,332 --> 00:07:34,843\n配合的這個機制的話那在內部它可以產生出這樣子的一個協助剛剛次長你說的都對但是我要跟次長報告現場第一線的實務是大部分現在有提供你剛剛說不管是綠色通道或是嚴重情緒行為精神醫療就醫障礙改善計畫這些都是在公立的機構\n\n21\n00:07:35,663 --> 00:07:56,941\n目前有非常多私立的機構其實承擔了照顧很多孩子的責任我不確定我這邊的資訊跟你們那邊對不對起來不過因為我時間有限我想我還是把這個問題先丟出來後續我們辦公室希望可以找新建司積極討論如何協助這些安置機構的孩子在外出就醫的時候可以有更多積極的協助就是所謂綠色通道或是早期介入計畫好最後一個\n\n22\n00:07:58,982 --> 00:08:23,814\n機構裡面現在照顧量能不足的問題我們希望可以協助機構發展所謂的分級分類讓更多在照顧這些兒童的機構在你們的支持底下可以把孩子照顧得更好因為我認為凱凱案可能看見的是0到2歲的困境但事實上遠離這個年紀之後很多孩子從原生家庭被接出來我們希望在第一時間提供他們更好的照顧不管是身心健康或是生理的議題上\n\n23\n00:08:24,614 --> 00:08:52,310\n所以我也這邊要拜託衛福部我們先把問題拋出來這是第一個再來很多這些機構的工作人員他們其實長期的壓力非常非常大我們有沒有機會提供更積極的心理健康支持方案給這些在照顧孩子們的社工也好機構工作人員也督導更多的喘息服務當然我知道需要討論需要時間我先把問題拋出來謝謝委員注意到我想助人者的支持跟助人者後續的協助也是一個非常重要的方案對\n\n24\n00:08:52,850 --> 00:09:06,315\n好那最後今天其實很多委員提到外聘獨老的事情我就簡單的說而且我今天早上聽了很多委員的質詢確實在相關制度上我們需要更多的精進跟討論因為目前看起來行之多年的方法大家認為有檢討的必要那我認為我想後續為輔部你們會在這個部分精進對嗎是好謝謝謝謝主席謝謝次長謝謝委員\n\n","tsv":"start\tend\ttext\n4568\t12272\t好謝謝蘇委員對我叫余承培余只是都二聲大家不是那麼確定怎麼念好那有請次長謝謝我們中午不休息啊我是肚子餓自己吃便當\n18325\t45311\t好辛苦了辛苦了謝謝大家好呃次長我快速跟您討論我們之前追蹤衛福部的一些議題哦那如果呃您沒有接觸到相關業務沒關係就再拜託您帶回去演繹好嗎好是呃第一個是關於安置機構裡面的兒少身心狀況其實需要更多的協助之前在3月13號的時候我們曾經拜託邱部長針對原生家庭出了狀況的孩子必須要送到安置機構去的這些所謂家外安置的兒少\n45791\t52695\t因為原生家庭出了狀況進到安置機構裡面他們除了第一時間受到照顧之外更多心理健康的支持那當時3月13號質詢之後我們知道衛福部好像在5月初有召開相關會議但是我們沒有收到相關的進度跟結論我不知道在當次的討論結論當中是什麼不過我相信既然已經有相關專家學者在研商會議給予結論我想要知道在我們之前所要求的如何增加所謂安置機構對於\n75507\t93878\t这些原生家庭脆弱的孩子给予更多心理健康的支持当天的会议结论现在有机会跟我们说吗还是说还在研议中手上有相关的会议结论好太好了先跟委员做个报告也非常谢谢委员关心因为这是非常脆弱而且是很少数的孩子但是我们一定要顾虑到这些孩子的需求是\n94178\t118261\t那在我們上次的這個會議上面談到大概有幾個比較簡單的部分跟委員先報告就是說第一針對特殊需求的兒少我們要去發展分級分類的照顧模式那當然希望在機構裡面能夠去調整照顧人力跟資源的配比第二個部分就是說他這中間可能我們還是要希望能夠發展一些比較簡易的評估工具讓他在安置初期就能夠先知道哪幾個孩子可能我們要先給一些特殊的照顧\n119062\t137247\t第三個部分在專業人員這邊當然我們第一個部分是希望繼續督導地方政府來持續精進而少安置單位的專業人員培訓那而且第二部分希望這些機構第一個事情是來跟我們的醫療機構能夠有醫療系統能夠有個連結也就是說基本上是建立他們的需求假設有綠色通道這個是所謂綠色通道的部分\n139127\t166635\t我剛剛講的這些我大概知道次長的意思那先回答我一個問題好不好機構內部的這個心理健康的機制因為當時我們是希望說透過心理師法如果不要修法來不及修法在短時間內可以協助這些孩子在機構內就可以得到身心健康的支持方案的話有一個機會是透過衛福部的函式當時我們聽到在相關專家學者會議上他們有提出這個建議有沒有機會往這裡發展\n167415\t194033\t我跟委員先報告第一個部分就是說現在在機構內能夠讓我們專業的心理師或諮詢心理師他能夠來做這個業務做職業登記的部分的話他做外展做職登是可以對我知道但是如果是要他專責在內部就是說在機構內部專責來進行服務的話現實上面來講當然如果他要機構內他要變成是符合我們的這個心理師職業\n194974\t213719\t没错没错职业登记他如果符合职业登记我们当然可以允许但是成本上面来讲可能对机构来说会有点大因为他做了一个机构那他可能内部服务他应该是做内部服务的那服务量可能不足以让这个机构而让他在内部的这个心理师他的足够量能那这个部分可能机构会比较有这个考量\n214339\t229657\t這個是一個部分但是我的意思是說如果衛福部可以掀開這個可能性讓機構內不管是公立的機構或是私立的機構因為目前確實越來越多的孩子因為原生家庭出了狀況他不得不被送到機構去如果機構他們有辦法自籌裁員\n230618\t248203\t但是需要你們的法規範開了這個門讓他們在機構裡面除了透過所謂的外展方案之外還可以在機構內內聘專業的心理師讓他可以長期的對於這一群孩子提供服務但需要你們衛福部開這個可能性自己機構內部要聘心理師是可以的\n248843\t268637\t只是他心理他聘了心理師如果心理師這個心理師他要以職業登記為心理師的服務的話那這個機構要去申請職業登記對但是因為現在的心理書法是不行的對那這個設置標準在他內部的設置標準怎麼樣可以去調整是不是可以符合哪些細節可以處理我們再來後續跟委員這邊去對還有還有需求的團隊是不是來跟我們討論一下我們把他的設置標準看他能不能符合設置標準好不好\n273561\t293468\t所以次長你的建議是一個是我們先跟這些機構對話聽聽看他們目前的需求是不是如同我們辦公室所收集到資訊是這樣那再來透過跟心理師學工會的討論跟這些案子機構討論不管是你認為需要透過個案申請還是衛福部給一個公開的函說明符合心理師法情況下這些機構可以成為心理師職業機構對不對\n295049\t315671\t因為現在如果他是外展或報備資源他現在是已經可以運行我們也盡量讓這個部分可以運作但是如果他這個安置機構內部自己就要去設置心理師的這個服務的機構的話那他自己內部要這個機構的設置要符合我們的設置標準因為在機構內他設置標準他才提供的就是我們心理師法所規範的心理師的服務\n316171\t333504\t這個我沒有疑問我沒有要你們放寬這個標準我認為是跟更多的討論跟溝通因為目前他們所能夠職業機構是醫療機構心理治療所心理諮商所其他經主管機關認可之機構所以我們希望主管機關也就是衛福部在這個議題上可以開始考慮跟這些安置機構對話\n335125\t359340\t那這機構內他如果要設心理諮詢我們來協助他配合符合我們的設計標準這個議題我們辦公室會再持續追蹤那看起來確實還需要一些討論不過很感謝你們已經召開相關會議從我們3月13日質詢到現在第二個是關於這些機構裡面還有非常多特殊需求而造的困境一個是剛剛次長你有快速提到所謂他們要去就診的時候可能一次需要兩三位機構的人力共同\n360280\t388651\t去看診而且看診的科目可能很多時間很長需要一整天的時間那目前安置機構希望衛福部可以協助醫院設立所謂綠色通道減少就醫的等待時間我知道目前有一些縣市的早療評估我們用早療這個概念來看已經有綠色通道像新北那衛福部有沒有機會跟地方社政單位討論針對這些安置機構的孩子外出就醫也可以設置綠色通道當然還需要時間\n389431\t393776\t我們一直都有在補助醫療機構去辦理嚴重情緒行為障礙者精神醫療就醫障礙改善方案我們把這個114年到現在我們總共有15家醫院在辦理尤其是針對嚴重情緒這時候經障者的特別門診\n408152\t436851\t那還他這裡面我們當然就是跟他結合機構然後身心障礙福利機構兒少安置機構矯正學校等好我們來提供外展服務不過我想委員也知道我們在做尤其是這一塊兒少的醫療資源他他真的是我們也專業人員的部分是明顯的比較比較吃緊一點的那所以我們不論現在在新電視這邊我們是持續來會支持學校支持醫療機構來做這樣子的服務那我想很多的機構他們也都如果說他跟安置機構有\n438332\t454843\t配合的這個機制的話那在內部它可以產生出這樣子的一個協助剛剛次長你說的都對但是我要跟次長報告現場第一線的實務是大部分現在有提供你剛剛說不管是綠色通道或是嚴重情緒行為精神醫療就醫障礙改善計畫這些都是在公立的機構\n455663\t476941\t目前有非常多私立的機構其實承擔了照顧很多孩子的責任我不確定我這邊的資訊跟你們那邊對不對起來不過因為我時間有限我想我還是把這個問題先丟出來後續我們辦公室希望可以找新建司積極討論如何協助這些安置機構的孩子在外出就醫的時候可以有更多積極的協助就是所謂綠色通道或是早期介入計畫好最後一個\n478982\t503814\t機構裡面現在照顧量能不足的問題我們希望可以協助機構發展所謂的分級分類讓更多在照顧這些兒童的機構在你們的支持底下可以把孩子照顧得更好因為我認為凱凱案可能看見的是0到2歲的困境但事實上遠離這個年紀之後很多孩子從原生家庭被接出來我們希望在第一時間提供他們更好的照顧不管是身心健康或是生理的議題上\n504614\t532310\t所以我也這邊要拜託衛福部我們先把問題拋出來這是第一個再來很多這些機構的工作人員他們其實長期的壓力非常非常大我們有沒有機會提供更積極的心理健康支持方案給這些在照顧孩子們的社工也好機構工作人員也督導更多的喘息服務當然我知道需要討論需要時間我先把問題拋出來謝謝委員注意到我想助人者的支持跟助人者後續的協助也是一個非常重要的方案對\n532850\t546315\t好那最後今天其實很多委員提到外聘獨老的事情我就簡單的說而且我今天早上聽了很多委員的質詢確實在相關制度上我們需要更多的精進跟討論因為目前看起來行之多年的方法大家認為有檢討的必要那我認為我想後續為輔部你們會在這個部分精進對嗎是好謝謝謝謝主席謝謝次長謝謝委員\n","txt":"好謝謝蘇委員對我叫余承培余只是都二聲大家不是那麼確定怎麼念好那有請次長謝謝我們中午不休息啊我是肚子餓自己吃便當\n好辛苦了辛苦了謝謝大家好呃次長我快速跟您討論我們之前追蹤衛福部的一些議題哦那如果呃您沒有接觸到相關業務沒關係就再拜託您帶回去演繹好嗎好是呃第一個是關於安置機構裡面的兒少身心狀況其實需要更多的協助之前在3月13號的時候我們曾經拜託邱部長針對原生家庭出了狀況的孩子必須要送到安置機構去的這些所謂家外安置的兒少\n因為原生家庭出了狀況進到安置機構裡面他們除了第一時間受到照顧之外更多心理健康的支持那當時3月13號質詢之後我們知道衛福部好像在5月初有召開相關會議但是我們沒有收到相關的進度跟結論我不知道在當次的討論結論當中是什麼不過我相信既然已經有相關專家學者在研商會議給予結論我想要知道在我們之前所要求的如何增加所謂安置機構對於\n这些原生家庭脆弱的孩子给予更多心理健康的支持当天的会议结论现在有机会跟我们说吗还是说还在研议中手上有相关的会议结论好太好了先跟委员做个报告也非常谢谢委员关心因为这是非常脆弱而且是很少数的孩子但是我们一定要顾虑到这些孩子的需求是\n那在我們上次的這個會議上面談到大概有幾個比較簡單的部分跟委員先報告就是說第一針對特殊需求的兒少我們要去發展分級分類的照顧模式那當然希望在機構裡面能夠去調整照顧人力跟資源的配比第二個部分就是說他這中間可能我們還是要希望能夠發展一些比較簡易的評估工具讓他在安置初期就能夠先知道哪幾個孩子可能我們要先給一些特殊的照顧\n第三個部分在專業人員這邊當然我們第一個部分是希望繼續督導地方政府來持續精進而少安置單位的專業人員培訓那而且第二部分希望這些機構第一個事情是來跟我們的醫療機構能夠有醫療系統能夠有個連結也就是說基本上是建立他們的需求假設有綠色通道這個是所謂綠色通道的部分\n我剛剛講的這些我大概知道次長的意思那先回答我一個問題好不好機構內部的這個心理健康的機制因為當時我們是希望說透過心理師法如果不要修法來不及修法在短時間內可以協助這些孩子在機構內就可以得到身心健康的支持方案的話有一個機會是透過衛福部的函式當時我們聽到在相關專家學者會議上他們有提出這個建議有沒有機會往這裡發展\n我跟委員先報告第一個部分就是說現在在機構內能夠讓我們專業的心理師或諮詢心理師他能夠來做這個業務做職業登記的部分的話他做外展做職登是可以對我知道但是如果是要他專責在內部就是說在機構內部專責來進行服務的話現實上面來講當然如果他要機構內他要變成是符合我們的這個心理師職業\n没错没错职业登记他如果符合职业登记我们当然可以允许但是成本上面来讲可能对机构来说会有点大因为他做了一个机构那他可能内部服务他应该是做内部服务的那服务量可能不足以让这个机构而让他在内部的这个心理师他的足够量能那这个部分可能机构会比较有这个考量\n這個是一個部分但是我的意思是說如果衛福部可以掀開這個可能性讓機構內不管是公立的機構或是私立的機構因為目前確實越來越多的孩子因為原生家庭出了狀況他不得不被送到機構去如果機構他們有辦法自籌裁員\n但是需要你們的法規範開了這個門讓他們在機構裡面除了透過所謂的外展方案之外還可以在機構內內聘專業的心理師讓他可以長期的對於這一群孩子提供服務但需要你們衛福部開這個可能性自己機構內部要聘心理師是可以的\n只是他心理他聘了心理師如果心理師這個心理師他要以職業登記為心理師的服務的話那這個機構要去申請職業登記對但是因為現在的心理書法是不行的對那這個設置標準在他內部的設置標準怎麼樣可以去調整是不是可以符合哪些細節可以處理我們再來後續跟委員這邊去對還有還有需求的團隊是不是來跟我們討論一下我們把他的設置標準看他能不能符合設置標準好不好\n所以次長你的建議是一個是我們先跟這些機構對話聽聽看他們目前的需求是不是如同我們辦公室所收集到資訊是這樣那再來透過跟心理師學工會的討論跟這些案子機構討論不管是你認為需要透過個案申請還是衛福部給一個公開的函說明符合心理師法情況下這些機構可以成為心理師職業機構對不對\n因為現在如果他是外展或報備資源他現在是已經可以運行我們也盡量讓這個部分可以運作但是如果他這個安置機構內部自己就要去設置心理師的這個服務的機構的話那他自己內部要這個機構的設置要符合我們的設置標準因為在機構內他設置標準他才提供的就是我們心理師法所規範的心理師的服務\n這個我沒有疑問我沒有要你們放寬這個標準我認為是跟更多的討論跟溝通因為目前他們所能夠職業機構是醫療機構心理治療所心理諮商所其他經主管機關認可之機構所以我們希望主管機關也就是衛福部在這個議題上可以開始考慮跟這些安置機構對話\n那這機構內他如果要設心理諮詢我們來協助他配合符合我們的設計標準這個議題我們辦公室會再持續追蹤那看起來確實還需要一些討論不過很感謝你們已經召開相關會議從我們3月13日質詢到現在第二個是關於這些機構裡面還有非常多特殊需求而造的困境一個是剛剛次長你有快速提到所謂他們要去就診的時候可能一次需要兩三位機構的人力共同\n去看診而且看診的科目可能很多時間很長需要一整天的時間那目前安置機構希望衛福部可以協助醫院設立所謂綠色通道減少就醫的等待時間我知道目前有一些縣市的早療評估我們用早療這個概念來看已經有綠色通道像新北那衛福部有沒有機會跟地方社政單位討論針對這些安置機構的孩子外出就醫也可以設置綠色通道當然還需要時間\n我們一直都有在補助醫療機構去辦理嚴重情緒行為障礙者精神醫療就醫障礙改善方案我們把這個114年到現在我們總共有15家醫院在辦理尤其是針對嚴重情緒這時候經障者的特別門診\n那還他這裡面我們當然就是跟他結合機構然後身心障礙福利機構兒少安置機構矯正學校等好我們來提供外展服務不過我想委員也知道我們在做尤其是這一塊兒少的醫療資源他他真的是我們也專業人員的部分是明顯的比較比較吃緊一點的那所以我們不論現在在新電視這邊我們是持續來會支持學校支持醫療機構來做這樣子的服務那我想很多的機構他們也都如果說他跟安置機構有\n配合的這個機制的話那在內部它可以產生出這樣子的一個協助剛剛次長你說的都對但是我要跟次長報告現場第一線的實務是大部分現在有提供你剛剛說不管是綠色通道或是嚴重情緒行為精神醫療就醫障礙改善計畫這些都是在公立的機構\n目前有非常多私立的機構其實承擔了照顧很多孩子的責任我不確定我這邊的資訊跟你們那邊對不對起來不過因為我時間有限我想我還是把這個問題先丟出來後續我們辦公室希望可以找新建司積極討論如何協助這些安置機構的孩子在外出就醫的時候可以有更多積極的協助就是所謂綠色通道或是早期介入計畫好最後一個\n機構裡面現在照顧量能不足的問題我們希望可以協助機構發展所謂的分級分類讓更多在照顧這些兒童的機構在你們的支持底下可以把孩子照顧得更好因為我認為凱凱案可能看見的是0到2歲的困境但事實上遠離這個年紀之後很多孩子從原生家庭被接出來我們希望在第一時間提供他們更好的照顧不管是身心健康或是生理的議題上\n所以我也這邊要拜託衛福部我們先把問題拋出來這是第一個再來很多這些機構的工作人員他們其實長期的壓力非常非常大我們有沒有機會提供更積極的心理健康支持方案給這些在照顧孩子們的社工也好機構工作人員也督導更多的喘息服務當然我知道需要討論需要時間我先把問題拋出來謝謝委員注意到我想助人者的支持跟助人者後續的協助也是一個非常重要的方案對\n好那最後今天其實很多委員提到外聘獨老的事情我就簡單的說而且我今天早上聽了很多委員的質詢確實在相關制度上我們需要更多的精進跟討論因為目前看起來行之多年的方法大家認為有檢討的必要那我認為我想後續為輔部你們會在這個部分精進對嗎是好謝謝謝謝主席謝謝次長謝謝委員\n","vtt":"WEBVTT\n\n00:04.568 --> 00:12.272\n好謝謝蘇委員對我叫余承培余只是都二聲大家不是那麼確定怎麼念好那有請次長謝謝我們中午不休息啊我是肚子餓自己吃便當\n\n00:18.325 --> 00:45.311\n好辛苦了辛苦了謝謝大家好呃次長我快速跟您討論我們之前追蹤衛福部的一些議題哦那如果呃您沒有接觸到相關業務沒關係就再拜託您帶回去演繹好嗎好是呃第一個是關於安置機構裡面的兒少身心狀況其實需要更多的協助之前在3月13號的時候我們曾經拜託邱部長針對原生家庭出了狀況的孩子必須要送到安置機構去的這些所謂家外安置的兒少\n\n00:45.791 --> 00:52.695\n因為原生家庭出了狀況進到安置機構裡面他們除了第一時間受到照顧之外更多心理健康的支持那當時3月13號質詢之後我們知道衛福部好像在5月初有召開相關會議但是我們沒有收到相關的進度跟結論我不知道在當次的討論結論當中是什麼不過我相信既然已經有相關專家學者在研商會議給予結論我想要知道在我們之前所要求的如何增加所謂安置機構對於\n\n01:15.507 --> 01:33.878\n这些原生家庭脆弱的孩子给予更多心理健康的支持当天的会议结论现在有机会跟我们说吗还是说还在研议中手上有相关的会议结论好太好了先跟委员做个报告也非常谢谢委员关心因为这是非常脆弱而且是很少数的孩子但是我们一定要顾虑到这些孩子的需求是\n\n01:34.178 --> 01:58.261\n那在我們上次的這個會議上面談到大概有幾個比較簡單的部分跟委員先報告就是說第一針對特殊需求的兒少我們要去發展分級分類的照顧模式那當然希望在機構裡面能夠去調整照顧人力跟資源的配比第二個部分就是說他這中間可能我們還是要希望能夠發展一些比較簡易的評估工具讓他在安置初期就能夠先知道哪幾個孩子可能我們要先給一些特殊的照顧\n\n01:59.062 --> 02:17.247\n第三個部分在專業人員這邊當然我們第一個部分是希望繼續督導地方政府來持續精進而少安置單位的專業人員培訓那而且第二部分希望這些機構第一個事情是來跟我們的醫療機構能夠有醫療系統能夠有個連結也就是說基本上是建立他們的需求假設有綠色通道這個是所謂綠色通道的部分\n\n02:19.127 --> 02:46.635\n我剛剛講的這些我大概知道次長的意思那先回答我一個問題好不好機構內部的這個心理健康的機制因為當時我們是希望說透過心理師法如果不要修法來不及修法在短時間內可以協助這些孩子在機構內就可以得到身心健康的支持方案的話有一個機會是透過衛福部的函式當時我們聽到在相關專家學者會議上他們有提出這個建議有沒有機會往這裡發展\n\n02:47.415 --> 03:14.033\n我跟委員先報告第一個部分就是說現在在機構內能夠讓我們專業的心理師或諮詢心理師他能夠來做這個業務做職業登記的部分的話他做外展做職登是可以對我知道但是如果是要他專責在內部就是說在機構內部專責來進行服務的話現實上面來講當然如果他要機構內他要變成是符合我們的這個心理師職業\n\n03:14.974 --> 03:33.719\n没错没错职业登记他如果符合职业登记我们当然可以允许但是成本上面来讲可能对机构来说会有点大因为他做了一个机构那他可能内部服务他应该是做内部服务的那服务量可能不足以让这个机构而让他在内部的这个心理师他的足够量能那这个部分可能机构会比较有这个考量\n\n03:34.339 --> 03:49.657\n這個是一個部分但是我的意思是說如果衛福部可以掀開這個可能性讓機構內不管是公立的機構或是私立的機構因為目前確實越來越多的孩子因為原生家庭出了狀況他不得不被送到機構去如果機構他們有辦法自籌裁員\n\n03:50.618 --> 04:08.203\n但是需要你們的法規範開了這個門讓他們在機構裡面除了透過所謂的外展方案之外還可以在機構內內聘專業的心理師讓他可以長期的對於這一群孩子提供服務但需要你們衛福部開這個可能性自己機構內部要聘心理師是可以的\n\n04:08.843 --> 04:28.637\n只是他心理他聘了心理師如果心理師這個心理師他要以職業登記為心理師的服務的話那這個機構要去申請職業登記對但是因為現在的心理書法是不行的對那這個設置標準在他內部的設置標準怎麼樣可以去調整是不是可以符合哪些細節可以處理我們再來後續跟委員這邊去對還有還有需求的團隊是不是來跟我們討論一下我們把他的設置標準看他能不能符合設置標準好不好\n\n04:33.561 --> 04:53.468\n所以次長你的建議是一個是我們先跟這些機構對話聽聽看他們目前的需求是不是如同我們辦公室所收集到資訊是這樣那再來透過跟心理師學工會的討論跟這些案子機構討論不管是你認為需要透過個案申請還是衛福部給一個公開的函說明符合心理師法情況下這些機構可以成為心理師職業機構對不對\n\n04:55.049 --> 05:15.671\n因為現在如果他是外展或報備資源他現在是已經可以運行我們也盡量讓這個部分可以運作但是如果他這個安置機構內部自己就要去設置心理師的這個服務的機構的話那他自己內部要這個機構的設置要符合我們的設置標準因為在機構內他設置標準他才提供的就是我們心理師法所規範的心理師的服務\n\n05:16.171 --> 05:33.504\n這個我沒有疑問我沒有要你們放寬這個標準我認為是跟更多的討論跟溝通因為目前他們所能夠職業機構是醫療機構心理治療所心理諮商所其他經主管機關認可之機構所以我們希望主管機關也就是衛福部在這個議題上可以開始考慮跟這些安置機構對話\n\n05:35.125 --> 05:59.340\n那這機構內他如果要設心理諮詢我們來協助他配合符合我們的設計標準這個議題我們辦公室會再持續追蹤那看起來確實還需要一些討論不過很感謝你們已經召開相關會議從我們3月13日質詢到現在第二個是關於這些機構裡面還有非常多特殊需求而造的困境一個是剛剛次長你有快速提到所謂他們要去就診的時候可能一次需要兩三位機構的人力共同\n\n06:00.280 --> 06:28.651\n去看診而且看診的科目可能很多時間很長需要一整天的時間那目前安置機構希望衛福部可以協助醫院設立所謂綠色通道減少就醫的等待時間我知道目前有一些縣市的早療評估我們用早療這個概念來看已經有綠色通道像新北那衛福部有沒有機會跟地方社政單位討論針對這些安置機構的孩子外出就醫也可以設置綠色通道當然還需要時間\n\n06:29.431 --> 06:33.776\n我們一直都有在補助醫療機構去辦理嚴重情緒行為障礙者精神醫療就醫障礙改善方案我們把這個114年到現在我們總共有15家醫院在辦理尤其是針對嚴重情緒這時候經障者的特別門診\n\n06:48.152 --> 07:16.851\n那還他這裡面我們當然就是跟他結合機構然後身心障礙福利機構兒少安置機構矯正學校等好我們來提供外展服務不過我想委員也知道我們在做尤其是這一塊兒少的醫療資源他他真的是我們也專業人員的部分是明顯的比較比較吃緊一點的那所以我們不論現在在新電視這邊我們是持續來會支持學校支持醫療機構來做這樣子的服務那我想很多的機構他們也都如果說他跟安置機構有\n\n07:18.332 --> 07:34.843\n配合的這個機制的話那在內部它可以產生出這樣子的一個協助剛剛次長你說的都對但是我要跟次長報告現場第一線的實務是大部分現在有提供你剛剛說不管是綠色通道或是嚴重情緒行為精神醫療就醫障礙改善計畫這些都是在公立的機構\n\n07:35.663 --> 07:56.941\n目前有非常多私立的機構其實承擔了照顧很多孩子的責任我不確定我這邊的資訊跟你們那邊對不對起來不過因為我時間有限我想我還是把這個問題先丟出來後續我們辦公室希望可以找新建司積極討論如何協助這些安置機構的孩子在外出就醫的時候可以有更多積極的協助就是所謂綠色通道或是早期介入計畫好最後一個\n\n07:58.982 --> 08:23.814\n機構裡面現在照顧量能不足的問題我們希望可以協助機構發展所謂的分級分類讓更多在照顧這些兒童的機構在你們的支持底下可以把孩子照顧得更好因為我認為凱凱案可能看見的是0到2歲的困境但事實上遠離這個年紀之後很多孩子從原生家庭被接出來我們希望在第一時間提供他們更好的照顧不管是身心健康或是生理的議題上\n\n08:24.614 --> 08:52.310\n所以我也這邊要拜託衛福部我們先把問題拋出來這是第一個再來很多這些機構的工作人員他們其實長期的壓力非常非常大我們有沒有機會提供更積極的心理健康支持方案給這些在照顧孩子們的社工也好機構工作人員也督導更多的喘息服務當然我知道需要討論需要時間我先把問題拋出來謝謝委員注意到我想助人者的支持跟助人者後續的協助也是一個非常重要的方案對\n\n08:52.850 --> 09:06.315\n好那最後今天其實很多委員提到外聘獨老的事情我就簡單的說而且我今天早上聽了很多委員的質詢確實在相關制度上我們需要更多的精進跟討論因為目前看起來行之多年的方法大家認為有檢討的必要那我認為我想後續為輔部你們會在這個部分精進對嗎是好謝謝謝謝主席謝謝次長謝謝委員\n\n","segments":[{"start":4.568,"end":12.272,"text":"好謝謝蘇委員對我叫余承培余只是都二聲大家不是那麼確定怎麼念好那有請次長謝謝我們中午不休息啊我是肚子餓自己吃便當"},{"start":18.325,"end":45.311,"text":"好辛苦了辛苦了謝謝大家好呃次長我快速跟您討論我們之前追蹤衛福部的一些議題哦那如果呃您沒有接觸到相關業務沒關係就再拜託您帶回去演繹好嗎好是呃第一個是關於安置機構裡面的兒少身心狀況其實需要更多的協助之前在3月13號的時候我們曾經拜託邱部長針對原生家庭出了狀況的孩子必須要送到安置機構去的這些所謂家外安置的兒少"},{"start":45.791,"end":52.695,"text":"因為原生家庭出了狀況進到安置機構裡面他們除了第一時間受到照顧之外更多心理健康的支持那當時3月13號質詢之後我們知道衛福部好像在5月初有召開相關會議但是我們沒有收到相關的進度跟結論我不知道在當次的討論結論當中是什麼不過我相信既然已經有相關專家學者在研商會議給予結論我想要知道在我們之前所要求的如何增加所謂安置機構對於"},{"start":75.507,"end":93.878,"text":"这些原生家庭脆弱的孩子给予更多心理健康的支持当天的会议结论现在有机会跟我们说吗还是说还在研议中手上有相关的会议结论好太好了先跟委员做个报告也非常谢谢委员关心因为这是非常脆弱而且是很少数的孩子但是我们一定要顾虑到这些孩子的需求是"},{"start":94.178,"end":118.261,"text":"那在我們上次的這個會議上面談到大概有幾個比較簡單的部分跟委員先報告就是說第一針對特殊需求的兒少我們要去發展分級分類的照顧模式那當然希望在機構裡面能夠去調整照顧人力跟資源的配比第二個部分就是說他這中間可能我們還是要希望能夠發展一些比較簡易的評估工具讓他在安置初期就能夠先知道哪幾個孩子可能我們要先給一些特殊的照顧"},{"start":119.062,"end":137.247,"text":"第三個部分在專業人員這邊當然我們第一個部分是希望繼續督導地方政府來持續精進而少安置單位的專業人員培訓那而且第二部分希望這些機構第一個事情是來跟我們的醫療機構能夠有醫療系統能夠有個連結也就是說基本上是建立他們的需求假設有綠色通道這個是所謂綠色通道的部分"},{"start":139.127,"end":166.635,"text":"我剛剛講的這些我大概知道次長的意思那先回答我一個問題好不好機構內部的這個心理健康的機制因為當時我們是希望說透過心理師法如果不要修法來不及修法在短時間內可以協助這些孩子在機構內就可以得到身心健康的支持方案的話有一個機會是透過衛福部的函式當時我們聽到在相關專家學者會議上他們有提出這個建議有沒有機會往這裡發展"},{"start":167.415,"end":194.033,"text":"我跟委員先報告第一個部分就是說現在在機構內能夠讓我們專業的心理師或諮詢心理師他能夠來做這個業務做職業登記的部分的話他做外展做職登是可以對我知道但是如果是要他專責在內部就是說在機構內部專責來進行服務的話現實上面來講當然如果他要機構內他要變成是符合我們的這個心理師職業"},{"start":194.974,"end":213.719,"text":"没错没错职业登记他如果符合职业登记我们当然可以允许但是成本上面来讲可能对机构来说会有点大因为他做了一个机构那他可能内部服务他应该是做内部服务的那服务量可能不足以让这个机构而让他在内部的这个心理师他的足够量能那这个部分可能机构会比较有这个考量"},{"start":214.339,"end":229.657,"text":"這個是一個部分但是我的意思是說如果衛福部可以掀開這個可能性讓機構內不管是公立的機構或是私立的機構因為目前確實越來越多的孩子因為原生家庭出了狀況他不得不被送到機構去如果機構他們有辦法自籌裁員"},{"start":230.618,"end":248.203,"text":"但是需要你們的法規範開了這個門讓他們在機構裡面除了透過所謂的外展方案之外還可以在機構內內聘專業的心理師讓他可以長期的對於這一群孩子提供服務但需要你們衛福部開這個可能性自己機構內部要聘心理師是可以的"},{"start":248.843,"end":268.637,"text":"只是他心理他聘了心理師如果心理師這個心理師他要以職業登記為心理師的服務的話那這個機構要去申請職業登記對但是因為現在的心理書法是不行的對那這個設置標準在他內部的設置標準怎麼樣可以去調整是不是可以符合哪些細節可以處理我們再來後續跟委員這邊去對還有還有需求的團隊是不是來跟我們討論一下我們把他的設置標準看他能不能符合設置標準好不好"},{"start":273.561,"end":293.468,"text":"所以次長你的建議是一個是我們先跟這些機構對話聽聽看他們目前的需求是不是如同我們辦公室所收集到資訊是這樣那再來透過跟心理師學工會的討論跟這些案子機構討論不管是你認為需要透過個案申請還是衛福部給一個公開的函說明符合心理師法情況下這些機構可以成為心理師職業機構對不對"},{"start":295.049,"end":315.671,"text":"因為現在如果他是外展或報備資源他現在是已經可以運行我們也盡量讓這個部分可以運作但是如果他這個安置機構內部自己就要去設置心理師的這個服務的機構的話那他自己內部要這個機構的設置要符合我們的設置標準因為在機構內他設置標準他才提供的就是我們心理師法所規範的心理師的服務"},{"start":316.171,"end":333.504,"text":"這個我沒有疑問我沒有要你們放寬這個標準我認為是跟更多的討論跟溝通因為目前他們所能夠職業機構是醫療機構心理治療所心理諮商所其他經主管機關認可之機構所以我們希望主管機關也就是衛福部在這個議題上可以開始考慮跟這些安置機構對話"},{"start":335.125,"end":359.34,"text":"那這機構內他如果要設心理諮詢我們來協助他配合符合我們的設計標準這個議題我們辦公室會再持續追蹤那看起來確實還需要一些討論不過很感謝你們已經召開相關會議從我們3月13日質詢到現在第二個是關於這些機構裡面還有非常多特殊需求而造的困境一個是剛剛次長你有快速提到所謂他們要去就診的時候可能一次需要兩三位機構的人力共同"},{"start":360.28,"end":388.651,"text":"去看診而且看診的科目可能很多時間很長需要一整天的時間那目前安置機構希望衛福部可以協助醫院設立所謂綠色通道減少就醫的等待時間我知道目前有一些縣市的早療評估我們用早療這個概念來看已經有綠色通道像新北那衛福部有沒有機會跟地方社政單位討論針對這些安置機構的孩子外出就醫也可以設置綠色通道當然還需要時間"},{"start":389.431,"end":393.776,"text":"我們一直都有在補助醫療機構去辦理嚴重情緒行為障礙者精神醫療就醫障礙改善方案我們把這個114年到現在我們總共有15家醫院在辦理尤其是針對嚴重情緒這時候經障者的特別門診"},{"start":408.152,"end":436.851,"text":"那還他這裡面我們當然就是跟他結合機構然後身心障礙福利機構兒少安置機構矯正學校等好我們來提供外展服務不過我想委員也知道我們在做尤其是這一塊兒少的醫療資源他他真的是我們也專業人員的部分是明顯的比較比較吃緊一點的那所以我們不論現在在新電視這邊我們是持續來會支持學校支持醫療機構來做這樣子的服務那我想很多的機構他們也都如果說他跟安置機構有"},{"start":438.332,"end":454.843,"text":"配合的這個機制的話那在內部它可以產生出這樣子的一個協助剛剛次長你說的都對但是我要跟次長報告現場第一線的實務是大部分現在有提供你剛剛說不管是綠色通道或是嚴重情緒行為精神醫療就醫障礙改善計畫這些都是在公立的機構"},{"start":455.663,"end":476.941,"text":"目前有非常多私立的機構其實承擔了照顧很多孩子的責任我不確定我這邊的資訊跟你們那邊對不對起來不過因為我時間有限我想我還是把這個問題先丟出來後續我們辦公室希望可以找新建司積極討論如何協助這些安置機構的孩子在外出就醫的時候可以有更多積極的協助就是所謂綠色通道或是早期介入計畫好最後一個"},{"start":478.982,"end":503.814,"text":"機構裡面現在照顧量能不足的問題我們希望可以協助機構發展所謂的分級分類讓更多在照顧這些兒童的機構在你們的支持底下可以把孩子照顧得更好因為我認為凱凱案可能看見的是0到2歲的困境但事實上遠離這個年紀之後很多孩子從原生家庭被接出來我們希望在第一時間提供他們更好的照顧不管是身心健康或是生理的議題上"},{"start":504.614,"end":532.31,"text":"所以我也這邊要拜託衛福部我們先把問題拋出來這是第一個再來很多這些機構的工作人員他們其實長期的壓力非常非常大我們有沒有機會提供更積極的心理健康支持方案給這些在照顧孩子們的社工也好機構工作人員也督導更多的喘息服務當然我知道需要討論需要時間我先把問題拋出來謝謝委員注意到我想助人者的支持跟助人者後續的協助也是一個非常重要的方案對"},{"start":532.85,"end":546.315,"text":"好那最後今天其實很多委員提到外聘獨老的事情我就簡單的說而且我今天早上聽了很多委員的質詢確實在相關制度上我們需要更多的精進跟討論因為目前看起來行之多年的方法大家認為有檢討的必要那我認為我想後續為輔部你們會在這個部分精進對嗎是好謝謝謝謝主席謝謝次長謝謝委員"}]}}},"gazette":{"lineno":990,"blocks":[["陳委員培瑜：（12時18分）謝謝蘇委員。對，我叫陳培瑜，只是都二聲，大家不是那麼確定怎麼唸。有請次長，謝謝。"],["主席：請次長。我們中午不休息，肚子餓了自己吃便當。"],["陳委員培瑜：好，辛苦了，謝謝大家。"],["林次長靜儀：委員好。"],["陳委員培瑜：次長，我快速跟您討論我們之前追蹤衛福部的一些議題，如果您沒有接觸到相關業務也沒關係，再拜託您帶回去研議好嗎？"],["林次長靜儀：是。"],["陳委員培瑜：第一個是關於安置機構裡面的兒少身心狀況，其實需要更多的協助。之前在3月13號的時候，我們曾經拜託邱部長，針對原生家庭出了狀況的孩子，必須送到安置機構去的這些所謂家外安置的兒少，因為原生家庭出了狀況進到安置機構裡面，他們除了第一時間受到照顧之外，更多心理健康的支持。當時3月13號質詢之後，我們知道衛福部好像在5月初有召開相關會議，但是我們沒有收到相關的進度跟結論，我不知道當次討論的結論是什麼？不過我相信既然已經有相關專家學者在研商會議給予結論，我想要知道在我們之前所要求的，如何增加安置機構對於這些原生家庭脆弱的孩子給予更多心理健康的支持，當天的會議結論現在有機會跟我們說嗎？還是還在研議中？"],["林次長靜儀：有，手上有相關的會議結論。"],["陳委員培瑜：好，太好了。"],["林次長靜儀：先跟委員做個報告，也非常謝謝委員關心，因為這是非常脆弱而且是很少數的孩子，但是我們一定要顧慮到這些孩子的需求。我們在上次這個會議上談到，大概有幾個比較簡單的部分先跟委員報告：第一，針對特殊需求的兒少，我們要發展分級、分類的照顧模式，希望在機構裡面能夠去調整照顧人力跟資源的配比。第二個部分，就是這中間可能我們還是希望能夠發展一些比較簡易的評估工具，讓他在安置初期就能夠先知道，哪幾個孩子可能我們要先給予特殊照顧。第三個部分，在專業人員這邊當然我們第一是希望繼續督導地方政府持續精進兒少安置單位的專業人員培訓；第二是希望這些機構第一個事情是來跟我們的醫療系統能夠有一個連結，也就是說基本上是建立他們的需求，假設有綠色通道的話……"],["陳委員培瑜：這個是所謂綠色通道的部分。"],["林次長靜儀：對，這是綠色通道。"],["陳委員培瑜：剛剛講的這些，我大概知道次長的意思，那先回答我一個問題好不好？"],["林次長靜儀：機構內部的設置對不對？"],["陳委員培瑜：對，機構內部的心理健康的機制，因為當時我們是希望透過心理師法，如果不要修法，來不及修法，在短時間內可以協助這些孩子在機構內就可以得到身心健康的支持方案的話，有一個機會是透過衛福部的函示。當時我們聽到在相關的專家學者會議上，他們有提出這個建議，有沒有機會往這裡發展？"],["林次長靜儀：我跟委員先報告第一個部分，就是說現在在機構內能夠讓我們專業的心理師來做這個業務、做執業登記部分的話，他做外展、做執登是可以。"],["陳委員培瑜：對，我知道，我知道外展可以。"],["林次長靜儀：如果是要他在機構內部專責來進行服務的話，現實上面來講，當然如果他要在機構內變成符合我們的心理師執業登記，他如果符合執業登記，我們當然可以允許。但是成本上面來講，可能對機構來說會有點大，因為做為一個機構，他應該是做內部服務的，在服務量能部分，可能不足以讓這個機構內部的心理師有足夠的量能，這個部分可能機構會比較有這個考量。"],["陳委員培瑜：這個是一個部分，但是我的意思是說，如果衛福部可以先開這個可能性，讓機構內……不管是公立的機構或是私立的機構，因為目前確實越來越多的孩子因為原生家庭出了狀況，他不得不被送到機構去，如果機構他們有辦法自籌財源，但是需要你們的法規範開這個門，讓他們在機構裡面除了透過所謂的外展方案之外，還可以在機構內內聘專業的心理師，讓他可以長期的對這一群孩子提供服務，但需要你們衛福部開這個可能性。"],["林次長靜儀：自己機構內部要聘心理師是可以的，只是他聘了心理師，如果這個心理師要以執業登記為心理師服務的話，那這個機構要去申請執業登記，這個指的是設置標準。"],["陳委員培瑜：對，但是因為現在的心理師法是不行的。"],["林次長靜儀：對，那這個設置標準，在他內部的設置標準怎麼樣可以去調整，是不是可以符合哪些細節，可以處理我們後續再來跟委員這邊去對。"],["陳委員培瑜：好，沒錯，我就是要這個。"],["林次長靜儀：還有需求的團隊是不是來跟我們討論一下，我們看他能不能符合設置標準好不好？"],["陳委員培瑜：所以次長的建議是，我們先跟這些機構對話，聽聽看他們目前的需求，是不是如同我們辦公室所蒐集到的資訊，再來透過跟心理師學公會跟這些安置機構的討論，不管是你認為需要透過個案申請，還是衛福部給一個公開的函，說明符合心理師法的情況下，這些機構可以成為心理師執業機構，對不對？"],["林次長靜儀：對，因為現在如果他是外展或報備資源，現在是已經可以運行了。"],["陳委員培瑜：沒錯。"],["林次長靜儀：我們盡量讓這個部分可以運作，但如果這個安置機構內部自己要去設置心理師的這個服務機構的話，那這個機構的設置要符合我們的設置標準，因為在機構內，他要符合設置標準，提供的就是我們心理師法所規範的心理師的服務。"],["陳委員培瑜：這個我沒有疑問，我沒有要你們放寬這個標準，我認為是更多的討論跟溝通，因為目前他們能夠執業的機構是醫療機構、心理治療所、心理諮商所、其他經主管機關認可之機構。所以我們希望主管機關，也就是衛福部在這個議題上，可以開始考慮跟這些安置機構對話。"],["林次長靜儀：就是安置機構內他如果要設心理諮商所，我們來協助他符合我們的設置標準。"],["陳委員培瑜：好，這個議題我們辦公室會再持續追蹤，看起來確實還需要一些討論，不過從我們3月13日質詢到現在，很感謝你們已經召開相關會議。","第二個是關於這些機構裡面，還有非常多特殊需求兒少的困境，一個是剛剛次長有快速提到，他們要去就診的時候可能一次需要兩三位機構的人力共同去看診，而且看診的科目可能很多，時間很長，需要一整天的時間。目前安置機構希望衛福部可以協助醫院設立所謂綠色通道，減少就醫的等待時間。我知道目前有一些縣市的早療評估，我們用早療這個概念來看，已經有綠色通道，像新北，那衛福部有沒有機會跟地方社政單位討論，針對這些安置機構的孩子外出就醫，也可以設置綠色通道？當然我知道還需要時間研議，有沒有機會往這裡去討論？"],["林次長靜儀：跟委員報告，我們其實一直都有在補助醫療機構去辦理嚴重情緒行為障礙者精神醫療就醫障礙改善方案，從114年到現在總共有15家醫院在辦理，尤其是針對精障者的特別門診，這裡面我們當然就是結合機構，包含身心障礙福利機構、兒少安置機構、矯正學校等，我們來提供外展服務。不過我想委員也知道，我們在兒少的醫療資源這一塊，我們在專業人員的部分真的是……"],["陳委員培瑜：不足的。"],["林次長靜儀：明顯的比較吃緊一點，所以現在我們不論在心健司這邊，都會持續來支持醫療機構做這樣子的服務。我想很多的機構，他們如果跟安置機構有配合機制的話，那在內部他可以產生出這樣子的一個協助。"],["陳委員培瑜：剛剛次長說的都對，但是我要跟次長報告，現場第一線的實務是，大部分現在有提供你剛剛說不管是綠色通道，或是嚴重情緒行為精神醫療就醫障礙改善計畫，這些都是在公立的機構，但目前有非常多私立的機構其實承擔了很多照顧孩子的責任。我不確定我這邊的資訊跟你們那邊對不對得起來，不過因為我的時間有限，我想我還是把這個問題先丟出來，後續我們辦公室希望可以找心健司積極討論，如何協助這些安置機構的孩子在外出就醫的時候可以有更多積極的協助，就是所謂綠色通道或是早期介入計畫。","最後一個是機構裡面現在照顧量能不足的問題，我們希望可以協助機構發展所謂的分級、分類，讓更多這些照顧兒少的機構在你們的支持下可以把孩子照顧得更好。因為我認為剴剴案可能看見的是0到2歲的困境，但事實上遠離這個年紀之後，很多孩子從原生家庭被接出來，我們希望在第一時間提供他們更好的照顧，不管是身心健康或是生理的議題上，所以我也要拜託衛福部，我們先把問題拋出來，這是第一個。再來很多這些機構的工作人員，他們其實長期的壓力非常非常大，我們有沒有機會提供更積極的心理健康支持方案，給這些照顧孩子們的社工、機構工作人員、督導更多的喘息服務？當然我知道需要討論、需要時間，我先把問題拋出來。"],["林次長靜儀：謝謝委員注意到，我想助人者的支持跟助人者後續的協助，也是一個非常重要的方案。"],["陳委員培瑜：對。今天其實很多委員提到外聘督導的事情，我就簡單的說，而且我今天早上聽了很多委員的質詢，確實在相關制度上我們需要更多的精進跟討論，因為目前看起來行之多年的方法，大家認為有檢討的必要。我想後續衛福部會在這個部分精進對嗎？"],["林次長靜儀：是。"],["陳委員培瑜：好，謝謝。謝謝主席、謝謝次長，謝謝。"],["林次長靜儀：謝謝委員。"],["主席：謝謝陳委員、謝謝次長。","接續我們請郭昱晴委員質詢。"]],"agenda":{"page_end":138,"meet_id":"委員會-11-3-26-12","speakers":["蘇清泉","林月琴","陳昭姿","徐巧芯","盧縣一","黃國昌","劉建國","涂權吉","林淑芬","陳菁徽","陳培瑜","郭昱晴","黃秀芳","洪孟楷","張啓楷","范雲","楊瓊瓔","陳瑩","楊曜","賴惠員","葉元之","王育敏","陳冠廷","邱鎮軍","廖偉翔","黃捷"],"page_start":43,"meetingDate":["2025-05-21"],"gazette_id":"1145201","agenda_lcidc_ids":["1145201_00003"],"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12次全體委員會議紀錄","content":"邀請衛生福利部、教育部就「性騷擾防治及外聘督導制度精進作為」進行專題報告，並備質詢","agenda_id":"1145201_00002"}}}