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00:00:21,006\n時間有限齁自己要覺醒啦好謝謝主席主席請一下長照師市長來請長照師市長朱市長來來請請你不用緊張啦委員好市長好市長我們接續上一次的\n\n2\n00:00:32,256 --> 00:00:51,685\n執行就是上一次市長的答詢內容認為台灣不是福利國家那我也覺得長照是家庭責任對不對\n\n3\n00:00:52,764 --> 00:01:06,851\n應該是說國家跟家庭一起來照顧老人一起照顧不是家庭責任我剛剛是說無法替代無法替代家人照顧貴蒙責任嘛\n\n4\n00:01:10,673 --> 00:01:32,398\n那其實我看賴總統曾經講過要把台灣打造成老人福利國那長壽3.0大概也是為了因應國家來支持家庭共同照護老人這樣子的一個責任因應而生的\n\n5\n00:01:36,621 --> 00:02:00,865\n譬如說直系血親之間互相負有撫養的義務家庭也有撫養的責任但是不代表家庭有能力提供足夠的照顧特別是現在少子化那麼嚴重啊政府未來如何提高替代性或者普通性的服務能量分擔家庭責任\n\n6\n00:02:02,703 --> 00:02:28,820\n目前確實我們在長照的這些相關的措施裡面其實也是在協助家人一起來照顧所以包括提供家人可以有一些喘息家人需要工作的話我們也在佈建這些相關的居家服務社區式的服務來讓家人可以放心可以去安心\n\n7\n00:02:29,840 --> 00:02:56,185\n發揮他的專業那讓照顧長輩的交給專業的人來做照顧這個政策方向都是跟委員這邊剛剛垂詢的是一致的那現在長照的政策呢就是造成了長照悲歌啊悲劇啊一再發生長照政策把照顧者視為工具人\n\n8\n00:02:57,335 --> 00:03:18,150\n那國家呢有很多學者跟團體一直在呼籲國家應該保護照顧者那其實也應該要就是受照顧者必須要得到國家的支持照顧者也需要\n\n9\n00:03:19,505 --> 00:03:27,061\n頻繁的長照杯葛不應該是台灣老化的宿命長照3.0的部分\n\n10\n00:03:32,064 --> 00:03:51,559\n假如以市長上一次答詢的時候回答照顧需要照顧者的責任是家庭的話那顯然跟民團和學者的看法不大一樣現在你們長照3.0要怎麼亡羊補牢\n\n11\n00:03:53,161 --> 00:04:03,268\n跟委員再一次的澄清說明上一次的詢答我沒有說這個是家人的責任我一直強調是說我們的長照制度在我們的稅收規模下我們無法替代完全替代家人照顧概念上\n\n12\n00:04:12,034 --> 00:04:32,648\n意思就是說今天如果家因為我們在我們的民法本來就有父父撫養義務所以本來在我們的國情裡面其實家人扮演很重要的支持角色那政府就是很重要的除了被照顧者在長福法裡面也已經在立法院通過的長福法已經把\n\n13\n00:04:33,268 --> 00:04:48,744\n支持照顧者也入法所以對於長照制度的建構裡面除了被照顧者的服務我們也同步關注照顧者要有支持市長我講兩點第一點就是說所有的政策入法\n\n14\n00:04:49,905 --> 00:05:12,959\n並不能解決一切的問題這個是第一個觀念第二個就是你上一次怎麼詢答的呢因為今天時間太短了我下一次回放給你看好了我問繼續問市長台灣因為稅收太低所以不是福利國家這個可能是可以探討的\n\n15\n00:05:14,502 --> 00:05:40,622\n那長照的責任在於家庭那政府也願意分擔一定的工作那要長照長照森林要加深加廣服務的網絡必須要有更多的支出稅收制的長照制度顯然沒有辦法因應一切\n\n16\n00:05:43,638 --> 00:05:57,007\n市長你對於把台灣的長照資金來源從現在的稅收制改成保險稅收雙軌制的看法是怎麼樣?\n\n17\n00:06:02,134 --> 00:06:28,840\n跟委員說明目前其實我們的長照基金去年年底是累積還有2039億那累積到今年的3月底現在是2200多億還有那麼多錢啊是是是我跟委員說明還有那麼多錢啊是是那所以目前沒有減薪就沒得做了沒有減薪就沒得做了我們的服務涵蓋率非常高我們服務涵蓋率已經達到去年年底就達到84%點多了\n\n18\n00:06:35,102 --> 00:06:52,530\n我拿一個行政院的報告跟市長做個探討就是說監察院目前的報告就是說目前的長照政策對於減輕重度失能家庭負擔的注意不大\n\n19\n00:06:54,308 --> 00:07:13,062\n監委指出112年各目標群體長照服務的涵蓋率顯然有落差近八成的長照幾支部服務使用的對象為輕中度失能者\n\n20\n00:07:14,885 --> 00:07:34,485\n這個恐怕就是重度的失能者用不到恐怕是基金還有那麼多錢的主要原因就最需要的反而用不到我們的制度然後基金還有三千億兩千多億\n\n21\n00:07:37,052 --> 00:07:42,236\n也跟有人說明事實上我們現在確實給支付是鼓勵因為我們國內的長輩\n\n22\n00:07:53,606 --> 00:08:06,538\n都一直嚮往就是留在自己最熟悉的社區中老那其實所以整個的給支付的政策也回應我們國人的一個嚮往跟需求所以對於居家跟社區的目前有納入給支付那\n\n23\n00:08:08,600 --> 00:08:25,721\n住宿型24小時照顧機構目前確實調查下來無法生活自理的老人被問到的時候大概只有三成六說願意到這24小時住宿機構這邊來接受中老那所以這樣的一個比例其實還有待提升所以我們一直\n\n24\n00:08:26,221 --> 00:08:31,946\n努力的也運用長照基金在針對現在全國有1800家的這些住宿機構能夠強化他的照顧品質那把品質這邊提升上來之後我們也希望老人在被問到的時候他的優先選擇可以到住宿型機構\n\n25\n00:08:42,734 --> 00:09:05,271\n如果這個時間到了或許在住宿型機構我們可以把它導入給支付那所以現階段我們才用定額補助的方式來補助這些住民那現階段是一年12萬那賴總統也有提出要一年提高到18萬那我們這個部分會整體配合整個的一個政府的政策來把它提高\n\n26\n00:09:06,064 --> 00:09:22,350\n市長我們有在112年我們有22萬左右的失能者是聘僱外籍看護工那這些人裡面只有4成\n\n27\n00:09:23,590 --> 00:09:43,471\n曾經使用過長照服務現況在使用長照服務其中超過三分之一只使用一項那這一項最多的就是喘息服務也就是說其實我們的長照制度並沒有辦法很普遍的覆蓋到\n\n28\n00:09:46,707 --> 00:10:04,635\n最需要的人假如說我們有辦法覆蓋到最需要使用到長照制度的這些人呢我想長照背歌不會一再的演唱這個是一個事實那\n\n29\n00:10:07,828 --> 00:10:34,453\n怎麼讓使用者更方便可以使用到長照提供的需求怎麼去找到需求的人我覺得這個都是長照師必須要去做的事情不要等到悲劇發生了再說什麼都來不及\n\n30\n00:10:34,972 --> 00:10:53,241\n是跟委員報告聘外籍看護工這一塊其實本來大概使用都不到兩成所以我們經過這幾年一直努力那我們也把這個這樣的指標列為考核地方政府的一個長照的考核指標所以近期已經攀升到\n\n31\n00:10:54,661 --> 00:11:20,737\n外籍看護工提高到4成你可能也不用拿出來這邊講因為外籍看護工就是因為移工的勞動意識也強了啦所以早期沒有再讓人家休假現在休假當然會所以才會說喘息服務是最多被申請的項目交通接送也很多懂我意思嗎\n\n32\n00:11:22,618 --> 00:11:49,770\n對教訓接受然後還有那個復聚護障今天還有預算解凍要處理所以我們先討論到這邊那有關長照的問題呢我覺得是民進黨執政不可迴避的責任那也希望市長這邊不管在政策的擬定或是政策的落實都必須要加把勁是好謝謝委員謝謝市長謝謝主席\n\n33\n00:11:52,779 --> 00:11:55,104\n可以了你可以了\n\n","tsv":"start\tend\ttext\n4833\t21006\t時間有限齁自己要覺醒啦好 謝謝主席主席請一下長照師市長來請長照師市長 朱市長來來 請請 你不用緊張啦委員好市長好 市長我們接續上一次的\n32256\t51685\t執行就是上一次市長的答詢內容認為台灣不是福利國家那我也覺得長照是家庭責任對不對\n52764\t66851\t應該是說國家跟家庭一起來照顧老人一起照顧不是家庭責任我剛剛是說無法替代無法替代家人照顧貴蒙責任嘛\n70673\t92398\t那其實我看賴總統曾經講過要把台灣打造成老人福利國那長壽3.0大概也是為了因應國家來支持家庭共同照護老人這樣子的一個責任因應而生的\n96621\t120865\t譬如說直系血親之間互相負有撫養的義務家庭也有撫養的責任但是不代表家庭有能力提供足夠的照顧特別是現在少子化那麼嚴重啊政府未來如何提高替代性或者普通性的服務能量分擔家庭責任\n122703\t148820\t目前確實我們在長照的這些相關的措施裡面其實也是在協助家人一起來照顧所以包括提供家人可以有一些喘息家人需要工作的話我們也在佈建這些相關的居家服務社區式的服務來讓家人可以放心可以去安心\n149840\t176185\t發揮他的專業那讓照顧長輩的交給專業的人來做照顧這個政策方向都是跟委員這邊剛剛垂詢的是一致的那現在長照的政策呢就是造成了長照悲歌啊悲劇啊一再發生長照政策把照顧者視為工具人\n177335\t198150\t那國家呢 有很多學者跟團體一直在呼籲國家應該保護照顧者那其實也應該要 就是受照顧者必須要得到國家的支持照顧者也需要\n199505\t207061\t頻繁的長照杯葛不應該是台灣老化的宿命長照3.0的部分\n212064\t231559\t假如以市長上一次答詢的時候回答照顧需要照顧者的責任是家庭的話那顯然跟民團和學者的看法不大一樣現在你們長照3.0要怎麼亡羊補牢\n233161\t243268\t跟委員再一次的澄清說明上一次的詢答我沒有說這個是家人的責任我一直強調是說我們的長照制度在我們的稅收規模下我們無法替代完全替代家人照顧概念上\n252034\t272648\t意思就是說今天如果家因為我們在我們的民法本來就有父父撫養義務所以本來在我們的國情裡面其實家人扮演很重要的支持角色那政府就是很重要的除了被照顧者在長福法裡面也已經在立法院通過的長福法已經把\n273268\t288744\t支持照顧者也入法所以對於長照制度的建構裡面除了被照顧者的服務我們也同步關注照顧者要有支持市長我講兩點第一點就是說所有的政策入法\n289905\t312959\t並不能解決一切的問題這個是第一個觀念第二個就是你上一次怎麼詢答的呢因為今天時間太短了我下一次回放給你看好了我問繼續問市長台灣因為稅收太低所以不是福利國家這個可能是可以探討的\n314502\t340622\t那長照的責任在於家庭那政府也願意分擔一定的工作那要長照長照森林要加深加廣服務的網絡必須要有更多的支出稅收制的長照制度顯然沒有辦法因應一切\n343638\t357007\t市長你對於把台灣的長照資金來源從現在的稅收制改成保險稅收雙軌制的看法是怎麼樣?\n362134\t388840\t跟委員說明目前其實我們的長照基金去年年底是累積還有2039億那累積到今年的3月底現在是2200多億還有那麼多錢啊是是是我跟委員說明還有那麼多錢啊是是那所以目前沒有減薪就沒得做了沒有減薪就沒得做了我們的服務涵蓋率非常高我們服務涵蓋率已經達到去年年底就達到84%點多了\n395102\t412530\t我拿一個行政院的報告跟市長做個探討就是說監察院目前的報告就是說目前的長照政策對於減輕重度失能家庭負擔的注意不大\n414308\t433062\t監委指出112年各目標群體長照服務的涵蓋率顯然有落差近八成的長照幾支部服務使用的對象為輕中度失能者\n434885\t454485\t這個恐怕就是重度的失能者用不到恐怕是基金還有那麼多錢的主要原因就最需要的反而用不到我們的制度然後基金還有三千億兩千多億\n457052\t462236\t也跟有人說明事實上我們現在確實給支付是鼓勵因為我們國內的長輩\n473606\t486538\t都一直嚮往就是留在自己最熟悉的社區中老那其實所以整個的給支付的政策也回應我們國人的一個嚮往跟需求所以對於居家跟社區的目前有納入給支付那\n488600\t505721\t住宿型24小時照顧機構目前確實調查下來無法生活自理的老人被問到的時候大概只有三成六說願意到這24小時住宿機構這邊來接受中老那所以這樣的一個比例其實還有待提升所以我們一直\n506221\t511946\t努力的也運用長照基金在針對現在全國有1800家的這些住宿機構能夠強化他的照顧品質那把品質這邊提升上來之後我們也希望老人在被問到的時候他的優先選擇可以到住宿型機構\n522734\t545271\t如果這個時間到了或許在住宿型機構我們可以把它導入給支付那所以現階段我們才用定額補助的方式來補助這些住民那現階段是一年12萬那賴總統也有提出要一年提高到18萬那我們這個部分會整體配合整個的一個政府的政策來把它提高\n546064\t562350\t市長我們有在112年我們有22萬左右的失能者是聘僱外籍看護工那這些人裡面只有4成\n563590\t583471\t曾經使用過長照服務現況在使用長照服務其中超過三分之一只使用一項那這一項最多的就是喘息服務也就是說其實我們的長照制度並沒有辦法很普遍的覆蓋到\n586707\t604635\t最需要的人假如說我們有辦法覆蓋到最需要使用到長照制度的這些人呢我想長照背歌不會一再的演唱這個是一個事實那\n607828\t634453\t怎麼讓使用者更方便可以使用到長照提供的需求怎麼去找到需求的人我覺得這個都是長照師必須要去做的事情不要等到悲劇發生了再說什麼都來不及\n634972\t653241\t是 跟委員報告 聘外籍看護工這一塊其實本來大概使用都不到兩成所以我們經過這幾年一直努力那我們也把這個這樣的指標列為考核地方政府的一個長照的考核指標所以近期已經攀升到\n654661\t680737\t外籍看護工提高到4成你可能也不用拿出來這邊講因為外籍看護工就是因為移工的勞動意識也強了啦所以早期沒有再讓人家休假現在休假當然會所以才會說喘息服務是最多被申請的項目交通接送也很多懂我意思嗎\n682618\t709770\t對 教訓接受 然後還有那個復聚護障今天還有預算解凍要處理所以我們先討論到這邊那有關長照的問題呢我覺得是民進黨執政不可迴避的責任那也希望市長這邊不管在政策的擬定或是政策的落實都必須要加把勁是 好 謝謝委員謝謝市長 謝謝主席\n712779\t715104\t可以了 你可以了\n","txt":"時間有限齁自己要覺醒啦好 謝謝主席主席請一下長照師市長來請長照師市長 朱市長來來 請請 你不用緊張啦委員好市長好 市長我們接續上一次的\n執行就是上一次市長的答詢內容認為台灣不是福利國家那我也覺得長照是家庭責任對不對\n應該是說國家跟家庭一起來照顧老人一起照顧不是家庭責任我剛剛是說無法替代無法替代家人照顧貴蒙責任嘛\n那其實我看賴總統曾經講過要把台灣打造成老人福利國那長壽3.0大概也是為了因應國家來支持家庭共同照護老人這樣子的一個責任因應而生的\n譬如說直系血親之間互相負有撫養的義務家庭也有撫養的責任但是不代表家庭有能力提供足夠的照顧特別是現在少子化那麼嚴重啊政府未來如何提高替代性或者普通性的服務能量分擔家庭責任\n目前確實我們在長照的這些相關的措施裡面其實也是在協助家人一起來照顧所以包括提供家人可以有一些喘息家人需要工作的話我們也在佈建這些相關的居家服務社區式的服務來讓家人可以放心可以去安心\n發揮他的專業那讓照顧長輩的交給專業的人來做照顧這個政策方向都是跟委員這邊剛剛垂詢的是一致的那現在長照的政策呢就是造成了長照悲歌啊悲劇啊一再發生長照政策把照顧者視為工具人\n那國家呢 有很多學者跟團體一直在呼籲國家應該保護照顧者那其實也應該要 就是受照顧者必須要得到國家的支持照顧者也需要\n頻繁的長照杯葛不應該是台灣老化的宿命長照3.0的部分\n假如以市長上一次答詢的時候回答照顧需要照顧者的責任是家庭的話那顯然跟民團和學者的看法不大一樣現在你們長照3.0要怎麼亡羊補牢\n跟委員再一次的澄清說明上一次的詢答我沒有說這個是家人的責任我一直強調是說我們的長照制度在我們的稅收規模下我們無法替代完全替代家人照顧概念上\n意思就是說今天如果家因為我們在我們的民法本來就有父父撫養義務所以本來在我們的國情裡面其實家人扮演很重要的支持角色那政府就是很重要的除了被照顧者在長福法裡面也已經在立法院通過的長福法已經把\n支持照顧者也入法所以對於長照制度的建構裡面除了被照顧者的服務我們也同步關注照顧者要有支持市長我講兩點第一點就是說所有的政策入法\n並不能解決一切的問題這個是第一個觀念第二個就是你上一次怎麼詢答的呢因為今天時間太短了我下一次回放給你看好了我問繼續問市長台灣因為稅收太低所以不是福利國家這個可能是可以探討的\n那長照的責任在於家庭那政府也願意分擔一定的工作那要長照長照森林要加深加廣服務的網絡必須要有更多的支出稅收制的長照制度顯然沒有辦法因應一切\n市長你對於把台灣的長照資金來源從現在的稅收制改成保險稅收雙軌制的看法是怎麼樣?\n跟委員說明目前其實我們的長照基金去年年底是累積還有2039億那累積到今年的3月底現在是2200多億還有那麼多錢啊是是是我跟委員說明還有那麼多錢啊是是那所以目前沒有減薪就沒得做了沒有減薪就沒得做了我們的服務涵蓋率非常高我們服務涵蓋率已經達到去年年底就達到84%點多了\n我拿一個行政院的報告跟市長做個探討就是說監察院目前的報告就是說目前的長照政策對於減輕重度失能家庭負擔的注意不大\n監委指出112年各目標群體長照服務的涵蓋率顯然有落差近八成的長照幾支部服務使用的對象為輕中度失能者\n這個恐怕就是重度的失能者用不到恐怕是基金還有那麼多錢的主要原因就最需要的反而用不到我們的制度然後基金還有三千億兩千多億\n也跟有人說明事實上我們現在確實給支付是鼓勵因為我們國內的長輩\n都一直嚮往就是留在自己最熟悉的社區中老那其實所以整個的給支付的政策也回應我們國人的一個嚮往跟需求所以對於居家跟社區的目前有納入給支付那\n住宿型24小時照顧機構目前確實調查下來無法生活自理的老人被問到的時候大概只有三成六說願意到這24小時住宿機構這邊來接受中老那所以這樣的一個比例其實還有待提升所以我們一直\n努力的也運用長照基金在針對現在全國有1800家的這些住宿機構能夠強化他的照顧品質那把品質這邊提升上來之後我們也希望老人在被問到的時候他的優先選擇可以到住宿型機構\n如果這個時間到了或許在住宿型機構我們可以把它導入給支付那所以現階段我們才用定額補助的方式來補助這些住民那現階段是一年12萬那賴總統也有提出要一年提高到18萬那我們這個部分會整體配合整個的一個政府的政策來把它提高\n市長我們有在112年我們有22萬左右的失能者是聘僱外籍看護工那這些人裡面只有4成\n曾經使用過長照服務現況在使用長照服務其中超過三分之一只使用一項那這一項最多的就是喘息服務也就是說其實我們的長照制度並沒有辦法很普遍的覆蓋到\n最需要的人假如說我們有辦法覆蓋到最需要使用到長照制度的這些人呢我想長照背歌不會一再的演唱這個是一個事實那\n怎麼讓使用者更方便可以使用到長照提供的需求怎麼去找到需求的人我覺得這個都是長照師必須要去做的事情不要等到悲劇發生了再說什麼都來不及\n是 跟委員報告 聘外籍看護工這一塊其實本來大概使用都不到兩成所以我們經過這幾年一直努力那我們也把這個這樣的指標列為考核地方政府的一個長照的考核指標所以近期已經攀升到\n外籍看護工提高到4成你可能也不用拿出來這邊講因為外籍看護工就是因為移工的勞動意識也強了啦所以早期沒有再讓人家休假現在休假當然會所以才會說喘息服務是最多被申請的項目交通接送也很多懂我意思嗎\n對 教訓接受 然後還有那個復聚護障今天還有預算解凍要處理所以我們先討論到這邊那有關長照的問題呢我覺得是民進黨執政不可迴避的責任那也希望市長這邊不管在政策的擬定或是政策的落實都必須要加把勁是 好 謝謝委員謝謝市長 謝謝主席\n可以了 你可以了\n","vtt":"WEBVTT\n\n00:04.833 --> 00:21.006\n時間有限齁自己要覺醒啦好謝謝主席主席請一下長照師市長來請長照師市長朱市長來來請請你不用緊張啦委員好市長好市長我們接續上一次的\n\n00:32.256 --> 00:51.685\n執行就是上一次市長的答詢內容認為台灣不是福利國家那我也覺得長照是家庭責任對不對\n\n00:52.764 --> 01:06.851\n應該是說國家跟家庭一起來照顧老人一起照顧不是家庭責任我剛剛是說無法替代無法替代家人照顧貴蒙責任嘛\n\n01:10.673 --> 01:32.398\n那其實我看賴總統曾經講過要把台灣打造成老人福利國那長壽3.0大概也是為了因應國家來支持家庭共同照護老人這樣子的一個責任因應而生的\n\n01:36.621 --> 02:00.865\n譬如說直系血親之間互相負有撫養的義務家庭也有撫養的責任但是不代表家庭有能力提供足夠的照顧特別是現在少子化那麼嚴重啊政府未來如何提高替代性或者普通性的服務能量分擔家庭責任\n\n02:02.703 --> 02:28.820\n目前確實我們在長照的這些相關的措施裡面其實也是在協助家人一起來照顧所以包括提供家人可以有一些喘息家人需要工作的話我們也在佈建這些相關的居家服務社區式的服務來讓家人可以放心可以去安心\n\n02:29.840 --> 02:56.185\n發揮他的專業那讓照顧長輩的交給專業的人來做照顧這個政策方向都是跟委員這邊剛剛垂詢的是一致的那現在長照的政策呢就是造成了長照悲歌啊悲劇啊一再發生長照政策把照顧者視為工具人\n\n02:57.335 --> 03:18.150\n那國家呢有很多學者跟團體一直在呼籲國家應該保護照顧者那其實也應該要就是受照顧者必須要得到國家的支持照顧者也需要\n\n03:19.505 --> 03:27.061\n頻繁的長照杯葛不應該是台灣老化的宿命長照3.0的部分\n\n03:32.064 --> 03:51.559\n假如以市長上一次答詢的時候回答照顧需要照顧者的責任是家庭的話那顯然跟民團和學者的看法不大一樣現在你們長照3.0要怎麼亡羊補牢\n\n03:53.161 --> 04:03.268\n跟委員再一次的澄清說明上一次的詢答我沒有說這個是家人的責任我一直強調是說我們的長照制度在我們的稅收規模下我們無法替代完全替代家人照顧概念上\n\n04:12.034 --> 04:32.648\n意思就是說今天如果家因為我們在我們的民法本來就有父父撫養義務所以本來在我們的國情裡面其實家人扮演很重要的支持角色那政府就是很重要的除了被照顧者在長福法裡面也已經在立法院通過的長福法已經把\n\n04:33.268 --> 04:48.744\n支持照顧者也入法所以對於長照制度的建構裡面除了被照顧者的服務我們也同步關注照顧者要有支持市長我講兩點第一點就是說所有的政策入法\n\n04:49.905 --> 05:12.959\n並不能解決一切的問題這個是第一個觀念第二個就是你上一次怎麼詢答的呢因為今天時間太短了我下一次回放給你看好了我問繼續問市長台灣因為稅收太低所以不是福利國家這個可能是可以探討的\n\n05:14.502 --> 05:40.622\n那長照的責任在於家庭那政府也願意分擔一定的工作那要長照長照森林要加深加廣服務的網絡必須要有更多的支出稅收制的長照制度顯然沒有辦法因應一切\n\n05:43.638 --> 05:57.007\n市長你對於把台灣的長照資金來源從現在的稅收制改成保險稅收雙軌制的看法是怎麼樣?\n\n06:02.134 --> 06:28.840\n跟委員說明目前其實我們的長照基金去年年底是累積還有2039億那累積到今年的3月底現在是2200多億還有那麼多錢啊是是是我跟委員說明還有那麼多錢啊是是那所以目前沒有減薪就沒得做了沒有減薪就沒得做了我們的服務涵蓋率非常高我們服務涵蓋率已經達到去年年底就達到84%點多了\n\n06:35.102 --> 06:52.530\n我拿一個行政院的報告跟市長做個探討就是說監察院目前的報告就是說目前的長照政策對於減輕重度失能家庭負擔的注意不大\n\n06:54.308 --> 07:13.062\n監委指出112年各目標群體長照服務的涵蓋率顯然有落差近八成的長照幾支部服務使用的對象為輕中度失能者\n\n07:14.885 --> 07:34.485\n這個恐怕就是重度的失能者用不到恐怕是基金還有那麼多錢的主要原因就最需要的反而用不到我們的制度然後基金還有三千億兩千多億\n\n07:37.052 --> 07:42.236\n也跟有人說明事實上我們現在確實給支付是鼓勵因為我們國內的長輩\n\n07:53.606 --> 08:06.538\n都一直嚮往就是留在自己最熟悉的社區中老那其實所以整個的給支付的政策也回應我們國人的一個嚮往跟需求所以對於居家跟社區的目前有納入給支付那\n\n08:08.600 --> 08:25.721\n住宿型24小時照顧機構目前確實調查下來無法生活自理的老人被問到的時候大概只有三成六說願意到這24小時住宿機構這邊來接受中老那所以這樣的一個比例其實還有待提升所以我們一直\n\n08:26.221 --> 08:31.946\n努力的也運用長照基金在針對現在全國有1800家的這些住宿機構能夠強化他的照顧品質那把品質這邊提升上來之後我們也希望老人在被問到的時候他的優先選擇可以到住宿型機構\n\n08:42.734 --> 09:05.271\n如果這個時間到了或許在住宿型機構我們可以把它導入給支付那所以現階段我們才用定額補助的方式來補助這些住民那現階段是一年12萬那賴總統也有提出要一年提高到18萬那我們這個部分會整體配合整個的一個政府的政策來把它提高\n\n09:06.064 --> 09:22.350\n市長我們有在112年我們有22萬左右的失能者是聘僱外籍看護工那這些人裡面只有4成\n\n09:23.590 --> 09:43.471\n曾經使用過長照服務現況在使用長照服務其中超過三分之一只使用一項那這一項最多的就是喘息服務也就是說其實我們的長照制度並沒有辦法很普遍的覆蓋到\n\n09:46.707 --> 10:04.635\n最需要的人假如說我們有辦法覆蓋到最需要使用到長照制度的這些人呢我想長照背歌不會一再的演唱這個是一個事實那\n\n10:07.828 --> 10:34.453\n怎麼讓使用者更方便可以使用到長照提供的需求怎麼去找到需求的人我覺得這個都是長照師必須要去做的事情不要等到悲劇發生了再說什麼都來不及\n\n10:34.972 --> 10:53.241\n是跟委員報告聘外籍看護工這一塊其實本來大概使用都不到兩成所以我們經過這幾年一直努力那我們也把這個這樣的指標列為考核地方政府的一個長照的考核指標所以近期已經攀升到\n\n10:54.661 --> 11:20.737\n外籍看護工提高到4成你可能也不用拿出來這邊講因為外籍看護工就是因為移工的勞動意識也強了啦所以早期沒有再讓人家休假現在休假當然會所以才會說喘息服務是最多被申請的項目交通接送也很多懂我意思嗎\n\n11:22.618 --> 11:49.770\n對教訓接受然後還有那個復聚護障今天還有預算解凍要處理所以我們先討論到這邊那有關長照的問題呢我覺得是民進黨執政不可迴避的責任那也希望市長這邊不管在政策的擬定或是政策的落實都必須要加把勁是好謝謝委員謝謝市長謝謝主席\n\n11:52.779 --> 11:55.104\n可以了你可以了\n\n","segments":[{"start":4.833,"end":21.006,"text":"時間有限齁自己要覺醒啦好 謝謝主席主席請一下長照師市長來請長照師市長 朱市長來來 請請 你不用緊張啦委員好市長好 市長我們接續上一次的"},{"start":32.256,"end":51.685,"text":"執行就是上一次市長的答詢內容認為台灣不是福利國家那我也覺得長照是家庭責任對不對"},{"start":52.764,"end":66.851,"text":"應該是說國家跟家庭一起來照顧老人一起照顧不是家庭責任我剛剛是說無法替代無法替代家人照顧貴蒙責任嘛"},{"start":70.673,"end":92.398,"text":"那其實我看賴總統曾經講過要把台灣打造成老人福利國那長壽3.0大概也是為了因應國家來支持家庭共同照護老人這樣子的一個責任因應而生的"},{"start":96.621,"end":120.865,"text":"譬如說直系血親之間互相負有撫養的義務家庭也有撫養的責任但是不代表家庭有能力提供足夠的照顧特別是現在少子化那麼嚴重啊政府未來如何提高替代性或者普通性的服務能量分擔家庭責任"},{"start":122.703,"end":148.82,"text":"目前確實我們在長照的這些相關的措施裡面其實也是在協助家人一起來照顧所以包括提供家人可以有一些喘息家人需要工作的話我們也在佈建這些相關的居家服務社區式的服務來讓家人可以放心可以去安心"},{"start":149.84,"end":176.185,"text":"發揮他的專業那讓照顧長輩的交給專業的人來做照顧這個政策方向都是跟委員這邊剛剛垂詢的是一致的那現在長照的政策呢就是造成了長照悲歌啊悲劇啊一再發生長照政策把照顧者視為工具人"},{"start":177.335,"end":198.15,"text":"那國家呢 有很多學者跟團體一直在呼籲國家應該保護照顧者那其實也應該要 就是受照顧者必須要得到國家的支持照顧者也需要"},{"start":199.505,"end":207.061,"text":"頻繁的長照杯葛不應該是台灣老化的宿命長照3.0的部分"},{"start":212.064,"end":231.559,"text":"假如以市長上一次答詢的時候回答照顧需要照顧者的責任是家庭的話那顯然跟民團和學者的看法不大一樣現在你們長照3.0要怎麼亡羊補牢"},{"start":233.161,"end":243.268,"text":"跟委員再一次的澄清說明上一次的詢答我沒有說這個是家人的責任我一直強調是說我們的長照制度在我們的稅收規模下我們無法替代完全替代家人照顧概念上"},{"start":252.034,"end":272.648,"text":"意思就是說今天如果家因為我們在我們的民法本來就有父父撫養義務所以本來在我們的國情裡面其實家人扮演很重要的支持角色那政府就是很重要的除了被照顧者在長福法裡面也已經在立法院通過的長福法已經把"},{"start":273.268,"end":288.744,"text":"支持照顧者也入法所以對於長照制度的建構裡面除了被照顧者的服務我們也同步關注照顧者要有支持市長我講兩點第一點就是說所有的政策入法"},{"start":289.905,"end":312.959,"text":"並不能解決一切的問題這個是第一個觀念第二個就是你上一次怎麼詢答的呢因為今天時間太短了我下一次回放給你看好了我問繼續問市長台灣因為稅收太低所以不是福利國家這個可能是可以探討的"},{"start":314.502,"end":340.622,"text":"那長照的責任在於家庭那政府也願意分擔一定的工作那要長照長照森林要加深加廣服務的網絡必須要有更多的支出稅收制的長照制度顯然沒有辦法因應一切"},{"start":343.638,"end":357.007,"text":"市長你對於把台灣的長照資金來源從現在的稅收制改成保險稅收雙軌制的看法是怎麼樣?"},{"start":362.134,"end":388.84,"text":"跟委員說明目前其實我們的長照基金去年年底是累積還有2039億那累積到今年的3月底現在是2200多億還有那麼多錢啊是是是我跟委員說明還有那麼多錢啊是是那所以目前沒有減薪就沒得做了沒有減薪就沒得做了我們的服務涵蓋率非常高我們服務涵蓋率已經達到去年年底就達到84%點多了"},{"start":395.102,"end":412.53,"text":"我拿一個行政院的報告跟市長做個探討就是說監察院目前的報告就是說目前的長照政策對於減輕重度失能家庭負擔的注意不大"},{"start":414.308,"end":433.062,"text":"監委指出112年各目標群體長照服務的涵蓋率顯然有落差近八成的長照幾支部服務使用的對象為輕中度失能者"},{"start":434.885,"end":454.485,"text":"這個恐怕就是重度的失能者用不到恐怕是基金還有那麼多錢的主要原因就最需要的反而用不到我們的制度然後基金還有三千億兩千多億"},{"start":457.052,"end":462.236,"text":"也跟有人說明事實上我們現在確實給支付是鼓勵因為我們國內的長輩"},{"start":473.606,"end":486.538,"text":"都一直嚮往就是留在自己最熟悉的社區中老那其實所以整個的給支付的政策也回應我們國人的一個嚮往跟需求所以對於居家跟社區的目前有納入給支付那"},{"start":488.6,"end":505.721,"text":"住宿型24小時照顧機構目前確實調查下來無法生活自理的老人被問到的時候大概只有三成六說願意到這24小時住宿機構這邊來接受中老那所以這樣的一個比例其實還有待提升所以我們一直"},{"start":506.221,"end":511.946,"text":"努力的也運用長照基金在針對現在全國有1800家的這些住宿機構能夠強化他的照顧品質那把品質這邊提升上來之後我們也希望老人在被問到的時候他的優先選擇可以到住宿型機構"},{"start":522.734,"end":545.271,"text":"如果這個時間到了或許在住宿型機構我們可以把它導入給支付那所以現階段我們才用定額補助的方式來補助這些住民那現階段是一年12萬那賴總統也有提出要一年提高到18萬那我們這個部分會整體配合整個的一個政府的政策來把它提高"},{"start":546.064,"end":562.35,"text":"市長我們有在112年我們有22萬左右的失能者是聘僱外籍看護工那這些人裡面只有4成"},{"start":563.59,"end":583.471,"text":"曾經使用過長照服務現況在使用長照服務其中超過三分之一只使用一項那這一項最多的就是喘息服務也就是說其實我們的長照制度並沒有辦法很普遍的覆蓋到"},{"start":586.707,"end":604.635,"text":"最需要的人假如說我們有辦法覆蓋到最需要使用到長照制度的這些人呢我想長照背歌不會一再的演唱這個是一個事實那"},{"start":607.828,"end":634.453,"text":"怎麼讓使用者更方便可以使用到長照提供的需求怎麼去找到需求的人我覺得這個都是長照師必須要去做的事情不要等到悲劇發生了再說什麼都來不及"},{"start":634.972,"end":653.241,"text":"是 跟委員報告 聘外籍看護工這一塊其實本來大概使用都不到兩成所以我們經過這幾年一直努力那我們也把這個這樣的指標列為考核地方政府的一個長照的考核指標所以近期已經攀升到"},{"start":654.661,"end":680.737,"text":"外籍看護工提高到4成你可能也不用拿出來這邊講因為外籍看護工就是因為移工的勞動意識也強了啦所以早期沒有再讓人家休假現在休假當然會所以才會說喘息服務是最多被申請的項目交通接送也很多懂我意思嗎"},{"start":682.618,"end":709.77,"text":"對 教訓接受 然後還有那個復聚護障今天還有預算解凍要處理所以我們先討論到這邊那有關長照的問題呢我覺得是民進黨執政不可迴避的責任那也希望市長這邊不管在政策的擬定或是政策的落實都必須要加把勁是 好 謝謝委員謝謝市長 謝謝主席"},{"start":712.779,"end":715.104,"text":"可以了 你可以了"}]}}},"gazette":{"lineno":2031,"blocks":[["楊委員曜：（14時47分）謝謝主席。主席，請一下長照司司長。"],["主席：請長照司祝司長。"],["祝司長健芳：委員好。"],["楊委員曜：司長好。司長，我們接續上一次的質詢，其實上一次司長的答詢內容，認為臺灣不是福利國家，也覺得長照是家庭責任，對不對？"],["祝司長健芳：應該是說國家跟家庭一起來照顧老人。"],["楊委員曜：一起照顧。"],["祝司長健芳：對，一起照顧。"],["楊委員曜：不是家庭責任？因為你上一次……"],["祝司長健芳：我上次是說無法替代……"],["楊委員曜：沒有，我們回去有重新……"],["祝司長健芳：無法替代家人照顧。"],["楊委員曜：好，沒有關係，共同責任嘛！"],["祝司長健芳：是。"],["楊委員曜：其實我看賴總統曾經講過，要把臺灣打造成老人福利國，那長照3.0大概也是為了因應國家來支持家庭共同照護老人這樣子的一個責任……"],["祝司長健芳：是。"],["楊委員曜：因應而生的，譬如說直系血親之間互相負有扶養的義務，家庭也有扶養的責任，但是不代表家庭有能力提供足夠的照顧，特別是現在少子化那麼嚴重，政府未來如何提高替代性或者是補充性的服務能量來分擔家庭責任？怎麼提高？"],["祝司長健芳：目前確實我們在長照這些相關的措施裡面，其實也是在協助家人一起來照顧，包括提供家人可以有一些喘息，那家人需要工作的話，我們也在布建相關的居家服務、社區式的服務來讓家人可以放心，可以安心去發揮他的專業，將長輩交給專業的人來做照顧，這個政策方向與委員剛剛的垂詢是一致的。"],["楊委員曜：好，現在長照的政策造成長照悲歌、悲劇一再發生，長照政策把照顧者視為工具人，有很多學者和團體一直在呼籲國家應該要保護照顧者，就是受照顧者必須要得到國家的支持，照顧者也需要，頻繁的長照悲歌不應該是臺灣老化的宿命。長照3.0的部分，假如以司長上一次答詢的時候，回答照顧需要照顧者的責任是家庭的話，顯然跟民團和學者的看法不大一樣，現在你們長照3.0要怎麼亡羊補牢？"],["祝司長健芳：是，向委員再一次澄清說明，上一次的詢答我沒有說這個是家人的責任，我一直強調的是，長照制度在我們的稅收規模下，無法完全替代家人照顧。概念上，意思就是說，因為在民法本來就有互負扶養義務，所以本來在我們的國情裡面，其實家人扮演很重要的支持角色，那政府很重要的就是，除了被照顧者，在立法院通過的長服法已經把支持照顧者也入法，所以對於長照制度的建構裡面，除了被照顧者的一些服務，我們也同步關注照顧者要有支持。"],["楊委員曜：司長，我講兩點，第一點，所有的政策入法並不能解決一切的問題，這是第一個觀念。第二個，你上一次怎麼詢答的呢？因為今天的時間太短，我下一次回放給你看好了。我繼續問司長，臺灣因為稅收太低，所以不是福利國家，這個是可以探討的，那長照的責任在於家庭，政府也願意分擔一定的工作。"],["祝司長健芳：對，跟家人共同來照顧。"],["楊委員曜：長照3.0要加深加廣服務的網絡，必須要有更多的支出，稅收制的長照制度顯然沒有辦法因應一切，司長，對於臺灣的長照資金來源，從現在的稅收制改成保險稅收雙軌制，你的看法是怎麼樣？"],["祝司長健芳：跟委員說明，長照基金在去年年底累積還有2,039億，累積到今年的3月底是兩千兩百多億，現在的長照基金。"],["楊委員曜：還有那麼多錢啊！"],["祝司長健芳：是，也跟委員說明……"],["楊委員曜：還有那麼多錢啊！"],["祝司長健芳：是，所以目前……"],["楊委員曜：不缺錢的話就是沒有在做，不缺錢更嚴重。"],["祝司長健芳：沒有，我們的服務涵蓋率非常高，服務涵蓋率在去年年底就達到百分之八十四點多了。"],["楊委員曜：司長這樣子講，我拿一個報告跟司長做個探討，監察院的報告說目前的長照政策對於減輕重度失能家庭負擔的助益不大，監委指出，112年各目標群體長照服務的涵蓋率顯然有落差，近八成的長照給支付服務使用對象為輕中度失能者，重度的失能者用不到，這個恐怕是基金還有那麼多錢的主要原因，就是最需要的反而用不到我們的制度，然後基金還有3,000億啊？"],["主席：兩千多億。"],["祝司長健芳：兩千多億。"],["楊委員曜：兩千多億，沒有在問你啦！"],["祝司長健芳：謝謝召委補充說明。也跟委員說明，事實上我們現在確實給支付是鼓勵，因為國內的長輩一直想望的就是留在自己最熟悉的社區終老，所以整個給支付的政策也回應國人的想望與需求，目前對於居家和社區的有納入給支付。至於住宿型24小時的照顧機構，目前確實調查下來，無法生活自理的老人被問到的時候，大概只有三成六說願意到24小時住宿機構來接受終老，這樣的一個比例其實還有待提升，所以我們一直努力地，也運用長照基金，針對現在全國1,800家的住宿機構能夠強化它的照顧品質。把品質提升上來之後，我們也希望老人在被問到的時候，他的優先選擇可以到住宿型機構，如果這個時間到了，或許在住宿型機構我們可以把它導入給支付，所以現階段我們才用定額補助的方式來補助這些住民，現階段是一年12萬，賴總統也有提出一年要提高到18萬，我們這個部分會整體配合政府的政策來把它提高。"],["楊委員曜：司長，在112年有22萬左右的失能者是聘僱外籍看護移工。"],["祝司長健芳：外籍看護工。"],["楊委員曜：這些人裡面只有四成曾經使用過長照服務。"],["祝司長健芳：現況在使用長照服務。"],["楊委員曜：對，其中超過三分之一只使用一項，最多的一項就是喘息服務。"],["祝司長健芳：喘息服務。"],["楊委員曜：也就是說，其實長照制度並沒有辦法很普遍地覆蓋到最需要的人，假如我們有辦法覆蓋到最需要使用長照制度的這些人，我想長照悲歌不會一再地演唱，這是一個事實，怎麼讓使用者可以更方便地使用到長照提供的服務、怎麼去找到有需求的人，我覺得這個都是長照司必須要去做的事情。"],["祝司長健芳：是。"],["楊委員曜：不要等到悲劇發生了，再說什麼都來不及。"],["祝司長健芳：是，跟委員報告，聘外籍看護工這一塊，其實本來大概使用都不到兩成，我們經過這幾年一直努力，也把這樣的指標列為考核地方政府長照的指標，所以近期已經攀升到接近四成。"],["楊委員曜：不是啦！外籍看護工提高到四成，你可能也不用拿出來在這邊講，因為移工的勞動意識也強了，早期沒有在讓人家休假，現在有休假當然會提高，所以才會說喘息服務是最多被申請的項目。"],["祝司長健芳：交通接送也很多。"],["楊委員曜：懂我的意思哦？"],["祝司長健芳：對，交通接送，還有輔具、無障礙……"],["楊委員曜：沒有關係，因為今天還有預算解凍要處理，所以我們先討論到這邊，有關長照的問題我覺得是民進黨執政不可迴避的責任，也希望司長這邊，不管在政策的擬定或是政策的落實都必須要加把勁。"],["祝司長健芳：是，好，謝謝委員。"],["楊委員曜：謝謝司長，謝謝主席。"],["主席：本日會議詢答全部結束。委員陳昭姿、張嘉郡、林德福、廖偉翔、涂權吉、李坤城所提書面質詢，列入紀錄，刊登公報。"],["委員陳昭姿書面質詢：","衛福部解凍報告援引九年前家庭與生育調查結果作為政策依據，未能反映當前社會風氣與法制環境之變遷。倘若反對代孕的民意主因為法律配套不足、金錢糾紛憂慮及保障機制不明，則衛福部更應積極推動立法，透過制度化保障代理孕母及委託人雙方權益。以偏頗民調作為政策拖延藉口，無異以社會觀感剝奪個人生育權，違反平等原則與基本人權保障，本席對其報告理由表達遺憾，請衛福部提出更新調查時程及人工生殖法法制研議進度說明。","一、醫護工會指出，目前我國醫護及教保人力配置長期不足，導致基層人員長期處於高壓、過勞狀態，工會要求「修法保障醫護人員工時與休息權」並落實勞基法工時上限、保障加班費，請問衛福部如何與勞動部合作，檢討現行責任制制度之適用對象與適用範圍？強化醫護教保等責任制行業之勞動條件檢查與執行？","二、衛生福利部雖已於2024年公告三班護病比標準，並自3月1日起採取獎勵先行實施，惟工會調查指出，九成醫院未符合公告標準，且多數醫院並未採取補人力或調整床數之實際作為，甚至對護理人員表示「未入法無罰則，無須遵守」。請衛福部說明目前推行成果，並公告「三班護病比」正式入法之期程與配套措施。","三、現行「獎勵實施」制度僅為過渡措施，缺乏具體獎勵機制、金額、發放時間及預算來源，導致醫院缺乏動機落實護病比標準。且目前三班護病比政策僅適用於一般急性病房，對於精神病房、急診、慢性病房、洗腎室等特殊單位未設有明確標準。工會調查亦顯示逾九成護理人員認為應涵蓋特殊單位。請問衛福部是否已啟動規劃作業？請說明公告期程，並承諾邀集護理工會與基層代表共同研擬，建構完整制度。","四、工會反映部分醫院以符合護病比為由禁止休假、強迫跨科支援、壓迫護理人員放棄特休等行為，已涉違勞動法令。請問衛福部與勞動部有無掌握相關情事？如何強化勞檢與通報處置機制？","一、依據歷年總額、藥費占比及藥價差比例推估，近年藥價差已達700餘億元，此筆款項來自全民繳交的健保費，原該用於病患照護及藥品管理，卻成為醫療院所彌補醫事費用不足所致之虧損之來源。基於健保署未能有效管控醫療院所超出合理範圍之藥價差，監察院亦曾於104年對衛福部及健保署提出糾正；於108年國衛院亦召開論壇，建議建立健保藥價差管控機制，惟迄今具體措施及中長期改革目標仍未落實。若政府對醫藥撥補仍不足，在不調整健保費率情形下，藥價差越顯著健保就越吃緊，造成惡性循環。","圖一：歷年推估之藥價差金額（億元）","註：依據健保署歷年藥費資料、98年至108年藥費占比（108年後以108年進行推估）、平均藥價差以30%及15%推估","二、藥價差長期被視為彌補不足醫療服務點值的手段，醫療服務點值已於2024年底撥補至每點0.9元，衛福部於本年六月確保每點0.95元之點值，應連動縮減藥價差並訂定中短期目標；在醫療服務報酬（診療費、手術費等）合理調整下，使醫院營運回歸以醫療本業尋求永續經營。","三、現行藥費支出目標制合理藥價差（R-zone）為15%，係參考日本所訂定的合理藥價差範圍，藥價差現況以偏離多時。應以現行基準作為台灣合理藥價差，同時在額度中同時考量藥品管理成本；對於超出合理藥價差的額度應適度回歸總額或實質調整健保價格反饋給民眾。請國衛院等研究機構針對台灣藥價差與醫療支出管理政策進行深入研究，包含藥價三合一政策或仿照日本進行階梯式調整藥價差之形式。","四、請衛福部就如何與醫界、產業界、病友團體開啟協商機制，共同界定合理藥價差的基準及其中藥品的管理費用，針對不同藥品類型（如製造成本與藥品生命週期）、藥品管理難度（如儲藏方式）等面向，提出具體規劃與時程表。","一、依據玉姐案及劉哲彰案等行政訴訟實例，現行由地方政府設上限的個人助理服務時數缺乏法源依據與評估邏輯、公式，易淪為排除資源責任之工具。衛福部是否已就現行制度進行檢討，並規劃提出合理評估工具？請說明研究進度及預計完成期程。","二、各界質疑現行個人助理制度已與原始「障礙者為主體」的精神背離，淪為長照制度之補充，且因財源主要依賴公益彩券而無法穩定支持重度使用者需求。請衛福部說明是否有短中長期之財政規劃，以確保服務可近性？","三、參考日本、韓國等國，對個人助理服務均有獨立立法、穩定財源與明確保障標準。我國《身心障礙者權益保障法》已逾17年未修，衛福部是否已彙整各國立法與制度比較研究？是否規劃召開研商會議，廣納障礙者與學者實務工作者意見，提出符合台灣脈絡之制度重建藍圖？請提供相關會議規劃與時程表。","四、目前我國無關於個人助理制度之專章或專法，導致各縣市政府詮釋不一、資源分配不均。衛福部是否已著手研議將個人助理服務納入《身心障礙者權益保障法》之專章立法？"],["委員張嘉郡書面質詢：","近日接連驗出三批含有萊克多巴胺的豬肉，消費者文教基金會針對進口萊豬進行一份嚴謹的民調，調查了1,054位消費者，調查結果高達90%消費者在意是否購買到含瘦肉精肉品；64%民眾支持進口肉品應「逐批檢驗」；76%的民眾表示「不同意」販售含瘦肉精肉品。產地標示部分，有80%民眾購買時會看產地標示，但實際上僅有11%曾看過萊劑相關標示，18%甚至未看到任何標示。","一、現今中央針對進口豬肉之邊境查驗，抽樣比例仍不足10%，引發社會大眾對政府食品安全管理作為之高度疑慮，尚需仰賴地方政府衛生局擴大檢驗，以安民心。惟食藥署過去曾表示具備執行100%逐批查驗之能力，請問現階段恢復逐批查驗是否有窒礙難行之處？","二、蔡英文政府於開放美國豬肉進口時曾宣示，「在保障民眾知情權與選擇權的前提下」所作之決策。然而現況為，萊豬流向資訊未公開、相關標示亦不透明，導致消費者難以做出明確判斷。請問，政府將如何強化資訊揭露及標示機制，以真正保障民眾選擇與知情之權益？"],["委員林德福書面質詢：","問題一","2025年公費四價流感疫苗採購案，總計採購686萬劑，分別向國光生，GSK、東洋、賽諾菲、高端等五家業者採購流感疫苗。","「流感」與「新冠」疫情最近有升溫的情況，請問疾管署，2025流感疫苗接種時間是否會如同往年於10月開始接種？或提早？","「衛福部」是否會再次加購「蛋白質次單元新冠疫苗」，接種流感疫苗的同時，是否也鼓勵民眾同步接種新冠疫苗？","問題二","另外，隨著年紀增加，人體免疫系統老化，導致接種流感疫苗的保護效果打折。2025年1月的數據顯示，65歲以上的人口數已達450萬8,419人，占總人口的19.27%，國內專家指出，應儘速將「免疫加強型疫苗」納入公費接種範疇。","請問衛福部，「免疫加強型疫苗」目前有哪些業者有能力供貨？","由於2025年流感疫苗已完成採購作業，衛福部是否會另外以專案方式公費採購流感「免疫加強型疫苗」嗎？預計可以涵蓋65歲以上人口數量有多少？","問題三","台灣已經是高齡化社會，政府鼓勵長者多出門走走，增進體能、情緒健康。但某些縣市鄉鎮，大眾運輸不足，部分高齡駕駛只能自駕，以滿足日常外出需求。","現行的長照給付，補助民眾使用「交通接送服務」，僅提供長照給付對象往返居家至社區式服務類長照機構或至醫療院所就醫、復健、透析治療之交通接送。","若希望長者不要自己騎車開車，方便的公共運輸就很重要，政府要拿出配套措施，與相關補助，協助高齡長者轉而使用其他交通替代工具。","本席建議「衛生福利部」檢討放寬「長照交通車」使用方式，研擬給予一定次數，試行彈性增加「醫院以外」的停靠點，以嘉惠高齡長者外出的需求。","問題四","根據「衛福部」統計112年1至10月，提供居家服務的居服員人數為5萬6,420人。","隨著台灣逐漸邁入超高齡社會，長照需求大增，然而居服員年齡偏中高齡，出現老老照護等長照困境。其中，女性與男性居服員年齡年逾55歲者，合計19,293人。","照護者在工作時經常需要進行平行移位、翻身、拍背及轉位等動作，這些負重的動作相當的頻繁。","建請「衛福部」會同「經濟部」與「勞動部」研擬「居服員」使用「輕型外骨骼輔具」推動路徑，以減輕照服員生理與心理上的照顧壓力，避免職業傷害，降低人力耗損，進而維護長照資源。"],["委員廖偉翔書面質詢：","鑒於「剴剴案」等虐童案件層出不窮，引起社會廣泛關注，顯示托育機構內部監督機制的不足。針對此類事件，衛福部監督機制顯有不足。朝野立委與行政院，皆有提出《兒童托育服務法》版本，為釐清該法案詳細內容與制度，爰向衛福部提出書面質詢。","說明：","1.根據行政院通過之衛福部版本《兒童托育服務法》草案，政府將放寬公有不動產以無償方式提供非營利性質法人使用，並明定運用學校餘裕空間辦理托育機構，免變更使用執照，以加速托育機構公共化。請問衛福部長，目前全國各縣市公共托育中心的分布情形為何？於法案通過後一年，衛福部自行評估加速效益為何？","2.於推動公共托育資源佈建的過程中，地方政府的配合度與執行力至關重要。請問衛福部如何協助地方政府克服在設置公共托育中心時可能面臨的困難，例如場地取得、經費不足、人力短缺等問題？是否有具體的輔導或獎勵措施？是否有建立中央與地方政府之間的溝通與協調機制，確保政策的順利推動與落實？","3.於諸多虐童、不當對待之案件中，事件之通報，藉由吹哨者通報之比例占近約半數。惟衛福部版本草案中，吹哨者條款未列於其中，衛福部對此態度如何？未列入草案之原因又如何？"],["委員涂權吉書面質詢：","本(5)月國內C0VID-19疫情再度升溫，據疾管署公告資料，第21週新冠就診人次達41,402例，較前一週上升，並較去年同期翻倍成長，已連續七週上升。新増本土重症個案102例、死亡19例，累計重症432例、死亡66例，其中逾九成未接種最新疫苗，另有一名年僅1個月大的男嬰重症送醫，顯示病毒對嬰幼兒之威脅仍不容忽視。","目前國內主流流行株為XBB亞型中的NB.1.8.1，具高度免疫逃脫與傳播力，近期亦陸續檢出KP.2與KP.3變異株，為美國CDC近期預警之高關注株。雖多數個案為輕症，惟高齡、慢性病與免疫低下者仍為重症與死亡主因，但嬰幼兒等族群雖為少數但風險仍不容輕忽。目前我國COVID-19疫苗接種涵蓋率已大幅下滑，第六劑（XBB疫苗）接種人數截至5月26日僅90餘萬人；然就兒童與婦女族群而言，現階段政策指引模糊，未見明確接種建議，尤以6歲以下嬰幼兒接種情形最為低落，社區端缺乏可近性施打場域與針對性衛教資訊，家長普遍無所適從，另孕產婦、晡乳期婦女之疫苗建議，至今缺乏專門評估與臨床溝通架構，容易導致接種遲疑，實為防疫破口之一。","本席注意到，美國CDC已建議健康兒童可不列入常規COVID-19疫苗接種對象。若未來我國衛福部比照辦理，將兒童排除於常規接種對象外，請問有何具體配套機制以防止其感染與重症風險？尤其托嬰、幼兒園與學校環境密閉、人員密集，口罩與個人衛生措施難以落實，若疫苗亦缺乏保護，形同讓最弱勢族群暴露於風險之中。","防疫政策不能僅仰賴疫苗施打與個人自主管理，對於尚無施打能力的嬰幼兒及家庭，政府有責任提出明確的防護策略與實質支援。請衛福部評估目前兒童與婦女接種建議，是否需因應美國施打政策而調整，並於兩週內提出完整因應方案，包含若未建議施打時，如何透過環境控制、公共衛教、快篩與抗病毒藥物取得等方式，保障該族群健康安全，以防未來疫情反撲時，社會最脆弱的一環首當其衝。"],["委員李坤城書面質詢：","案由：2023年底，等待出養的剴剴安置在保母家，因不當對待而離世，年僅1歲10個月的生命猝然結束，令人不捨。近日一審宣判，保母姊妹分判無期與18年有期徒刑，是至今兒虐案判刑最重的案例。更重要的是，在罪與罰之外，我們如何能避免下一個悲劇發生？","行政院會8日拍板通過《兒童托育服務法》草案，針對0到2歲托育規範單獨立法，總共有6章、78條文，另外托育及就業政策催生聯盟先前公布民間版「兒童托育服務法」修法版本，民間版草案與院版不同之處在於民間版明確提出法案價值目標，並規範中央政府資源發展任務。針對安全問題，民間版要求先行開罰再限期改善，且建立違規記點與退場機制，規定居家托育人員若兩年內違規達6點，需暫停新收托8個月並公布姓名。","在勞動權益方面，民間版加強基層托育人員保障，確保疑似違法時調查程序公正透明，同時推動偏遠及原住民族地區公共托育發展；居家托育方面，民間版將居家托育服務中心全面入法，明定工作責任義務，並要求中央制定收費標準，保障居家托育人員收入，與準公共機構式托育看齊；在收費審議機制部分，民間版要求中央主管機關審酌物價指數、當地收費情形、家庭可支配所得、公教及民間調薪幅度，並於每兩年公告各縣市居家托育收退費項目及基準。","此外，民間版條文加強基層托育人員勞動權益保障，確保疑似違法時的調查程序公正、透明，也希望普及偏遠地區及原住民族的公共托育發展，另將居家托育服務中心全面入法，明定工作責任義務，也要保障居家式托育人員收入，比照準公共機構式托育，由中央訂定。然而本法除了回應保母管理制度的缺漏之外，其實在更前緣還有一個值得探究的問題是：「保母制度，真的適合作為兒少安置系統的一環嗎？」","寄養家庭長期不足，居家保母成為安置服務選項","「家外安置」常是因為兒童原生家庭功能不足，可能因為家暴、父母生病或入獄、等待出養等原因，須另覓能讓孩子好好長大的穩定環境，所以才讓孩子移出原生家庭，尋求家外安置。通常「寄養家庭」因為具有家庭形式的成長環境，較能提供孩子穩定停泊的安定居所，而成為家外安置的優先選擇。","近年寄養家庭招募不易，以致於安置服務供給量長期不足，居家保母開始成為安置服務的一環。但是，「安置」代表的是全年無休的照顧需求，與居家保母原先的「托育」性質有極大的落差。托育預設是作為「家長工作時的照顧替手」，屬於「補充性服務」，保母會有「上、下班時段」，通常是平日白天照顧孩子，晚上與假日則將孩子交回由家長照顧。","相關法規要求保母在上班時段中要「專心托育」，必須專職而不得兼做他事（上銀行、寄信、添購日常用品等），更不得將孩子交給他人照顧。但安置兒童的照顧卻是24小時、全年無休，孩子等同於「搬進來一起生活」這樣的照顧需求，套用在一般居家托育，就像要保母得「一直上班」。原本安置時間長度依法「建議以6個月為原則」，但彭婉如文教基金會曾與幾個縣市的居托中心督導交流「由保母提供安置服務」的經驗，發現「超時安置」的現象普遍存在。","安置保母條件寬鬆，上課6小時就能收托安置兒","居家托育人員相對於寄養家庭，在收托安置兒童的人員資格認定上寬鬆得多。","如前節所述，制度想像的是合格登記的保母個人來提供照顧，因此在安置資格審查時，僅對保母「個人」設定簡單篩選門檻，包括無《兒童及少年福利與權益保障法》所定不得擔任者之情事、具有居托服務經驗且有意願照顧安置個案、依「居家式托育服務提供者登記及管理辦法」訪視輔導情況良好。","有居托中心督導表示，安置保母根本就是「只要你想，就可以做」，有意願的保母只要培訓上完僅6小時的課，就能收托安置兒童，資格門檻形同虛設。","相比之下，寄養家庭預設是「整個家庭」提供照顧，因此審查資格及程序相對嚴格，不僅以「家庭整體」作為評估對象，更須經縣市政府召開審查會議通過後，才能成為寄養家庭。","居家保母提供的主要是「一般托育」，無論在服務類型或收托時間上，都不同於「安置照顧」的需求。因此將一般托育的居家保母，轉銜成為安置照顧服務所用，而沒有相應的制度調整與支持下，可能引發諸多問題，請衛福部於兩周內就以下疑義回復本席國會辦公室：","一、如何解決寄養家庭長期不足，弱勢兒童家外安置問題？","二、如何解決提供安置服務的保母全年無休、過度勞動的狀況？"],["主席：先作以下決議：一、報告說明及詢答完畢。二、委員質詢未及答復或請補充資料者，請相關機關於兩週內以書面答復；委員另要求期限者，從其所定。","接下來處理討論事項預算凍結報告案計13案，請一併宣讀。"]],"agenda":{"page_end":548,"meet_id":"委員會-11-3-26-14","speakers":["劉建國","林淑芬","王育敏","何欣純","王正旭","林月琴","黃捷","陳菁徽","蘇清泉","邱鎮軍","黃秀芳","陳培瑜","李彥秀","楊瓊瓔","張雅琳","伍麗華Saidhai‧Tahovecahe","郭昱晴","陳瑩","楊曜","陳昭姿","張嘉郡","林德福","廖偉翔","涂權吉","李坤城"],"page_start":1,"meetingDate":["2025-05-28"],"gazette_id":"1145502","agenda_lcidc_ids":["1145502_00002","1145502_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14次全體委員會議紀錄","content":"一、處理114年度中央政府總預算決議有關衛生福利部主管預算凍結報告案 64案（含報告事項51\n案及討論事項13案）；二、審查(一)行政院函請審議「兒童托育服務法草案」案、(二)委員林月\n琴等16人擬具「兒童托育服務法草案」案、(三)委員何欣純等16人擬具「兒童托育服務法草案」\n案、(四)委員王育敏等24人擬具「兒童托育服務法草案」案、(五)委員邱若華等16人擬具「兒童\n托育服務法草案」案、(六)委員黃捷等21人擬具「兒童托育服務法草案」案、(七)委員蔡易餘等\n17人擬具「兒童托育服務法草案」案、(八)委員李坤城等22人擬具「兒童托育服務法草案」案、\n(九)委員陳培瑜等19人擬具「兒童托育服務法草案」案、(十)委員郭昱晴等21人擬具「兒童托育\n服務法草案」案、(十一)委員陳素月等16人擬具「兒童托育服務法草案」案、(十二)委員鄭天財\nSra Kacaw 等18人擬具「兒童托育服務法草案」案、(十三)委員王美惠等19人擬具「兒童托育服\n務法草案」案、(十四)委員林淑芬等25人擬具「兒童托育服務法草案」案、(十五)委員王正旭等\n18 人擬具「兒童托育服務法草案」案、( 十六) 委員吳沛憶等18 人擬具「兒童托育服務法草案」\n案；三、(一)繼續審查委員王育敏等18人擬具「病人自主權利法部分條文修正草案」案、(二)繼\n續審查委員劉建國等16人擬具「病人自主權利法部分條文修正草案」案、(三)繼續審查委員邱志\n偉等19人擬具「病人自主權利法第八條、第九條及第十五條條文修正草案」案、(四)審查委員李\n柏毅等16 人擬具「病人自主權利法第九條條文修正草案」案、 ( 五) 審查委員羅廷瑋等16 人擬具\n「病人自主權利法增訂第十六條之一條文草案」案","agenda_id":"1145502_00001"}}}