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09:48:11","會議時間":"2026-05-28T09:00:00+08:00","會議名稱":"立法院第11屆第5會期社會福利及衛生環境委員會第12次全體委員會議（事由：審查\n一、國民黨黨團擬具「失智症基本法草案」案。\n二、台灣民眾黨黨團擬具「失智症基本法草案」案。\n三、委員林月琴等19人擬具「失智症基本法草案」案。\n【僅詢答】【第三案如經復議則不予審查】）","transcript":{"pyannote":[{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":6.072218750000001,"end":6.764093750000001,"speaker_score":0.977},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":7.50659375,"end":9.61596875,"speaker_score":0.977},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":10.25721875,"end":10.98284375,"speaker_score":0.977},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":14.273468750000003,"end":14.89784375,"speaker_score":0.977},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":15.26909375,"end":74.51721875,"speaker_score":0.977},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":74.82096875,"end":79.47846875,"speaker_score":0.977},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":79.81596875000001,"end":85.94159375000001,"speaker_score":0.977},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":86.17784375000001,"end":87.49409375,"speaker_score":0.977},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":87.66284375000001,"end":103.12034375,"speaker_score":0.977},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":103.37346875,"end":129.20909375,"speaker_score":0.977},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":129.36096875,"end":130.98096875000002,"speaker_score":0.977},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":131.30159375,"end":133.52909375000002,"speaker_score":0.977},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":133.74846875,"end":151.12971875000002,"speaker_score":0.977},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":151.72034375,"end":153.52596875,"speaker_score":0.977},{"speaker":"SPEAKER_02","speaker_name":"石部長崇良","start":154.82534375,"end":206.32784375,"speaker_score":0.859},{"speaker":"SPEAKER_00","start":168.54471875000002,"end":169.01721875},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":189.50346875000002,"end":191.39346875,"speaker_score":0.977},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":206.10846875000001,"end":208.82534375,"speaker_score":0.977},{"speaker":"SPEAKER_02","speaker_name":"石部長崇良","start":206.81721875000002,"end":212.70659375000002,"speaker_score":0.859},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":214.24221875,"end":224.28284375,"speaker_score":0.977},{"speaker":"SPEAKER_01","speaker_name":"祝司長健芳","start":219.25409375,"end":219.59159375000002,"speaker_score":0.926},{"speaker":"SPEAKER_01","speaker_name":"祝司長健芳","start":222.13971875000001,"end":222.15659375,"speaker_score":0.926},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":224.82284375,"end":225.44721875000002,"speaker_score":0.977},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":226.29096875000002,"end":227.15159375000002,"speaker_score":0.977},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":227.43846875000003,"end":239.67284375000003,"speaker_score":0.977},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":241.02284375000002,"end":241.46159375000002,"speaker_score":0.977},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":243.01409375000003,"end":251.90721875000003,"speaker_score":0.977},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":252.68346875,"end":255.24846875000003,"speaker_score":0.977},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":255.38346875000002,"end":297.04784375,"speaker_score":0.977},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":297.99284375,"end":347.99346875000003,"speaker_score":0.977},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":348.87096875000003,"end":351.25034375,"speaker_score":0.977},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":351.89159375,"end":352.46534375000005,"speaker_score":0.977},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":353.66346875000005,"end":353.68034375,"speaker_score":0.977},{"speaker":"SPEAKER_02","speaker_name":"石部長崇良","start":353.68034375,"end":354.16971875,"speaker_score":0.859},{"speaker":"SPEAKER_02","speaker_name":"石部長崇良","start":354.40596875,"end":370.23471875,"speaker_score":0.859},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":361.61159375,"end":362.03346875,"speaker_score":0.977},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":369.62721875,"end":379.22909375,"speaker_score":0.977},{"speaker":"SPEAKER_02","speaker_name":"石部長崇良","start":376.19159375000004,"end":376.56284375,"speaker_score":0.859},{"speaker":"SPEAKER_02","speaker_name":"石部長崇良","start":378.03096875,"end":380.54534375000003,"speaker_score":0.859},{"speaker":"SPEAKER_03","speaker_name":"林委員月琴","start":379.49909375000004,"end":398.95596875,"speaker_score":0.977},{"speaker":"SPEAKER_02","speaker_name":"石部長崇良","start":383.21159375,"end":383.53221875,"speaker_score":0.859},{"speaker":"SPEAKER_00","start":399.76596875,"end":423.89721875000004},{"speaker":"SPEAKER_00","start":424.35284375000003,"end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目前我們實務上也都確實有在進行這樣的程序可是失任的狀態跟一般那種失能的不太一樣 它是漸進式的所以如果現今依然是全面固定式的監護制度的話司法院是否已啟動成年監護的制度的一個檢討因為目前這個失任的狀態就是跟一般的不太一樣那是否朝向一個個案需求來做部分限制而不是全面剝奪能力方向來演繹"},{"start":452.898,"end":471.548,"text":"跟委員報告因為目前監護宣告跟輔助宣告的這個實體法的制度是訂定在民法總則裡面這個民法總則的規定並不是本院主管的那所以這個目前關於這個如果當事人如果受了監護宣告他的法律上的行為能力會完全喪失這件事情也是訂在民法裡面的"},{"start":472.088,"end":490.498,"text":"那這個部分我們司法院這邊我們能處理的就是我們會依照法律的規定來進行審理那當然我們做了監務宣告或輔助宣告裁定之後的那個效果也會依照法律的規定來發生但是至於說監務宣告或輔助宣告制度要不要去做修改這個可能不是本院所執掌的範圍"},{"start":491.912,"end":507.737,"text":"因為我為什麼會問這個因為以馬前總統近期引發的社會討論來看一個人即使還能夠表達意願做出判斷安排自己生活如果進入全面固定式的監護制度的話會不會原本還存在的一些權利也一起被制度拿走"},{"start":508.417,"end":528.686,"text":"像德國日本韓國等國的那個制度的改革方向已逐步逐步的由全面限制能力轉向支持決策模式所以我認為有必要要進行全面的檢討來修正比較符合我們生權公約的制度那司法院請回那部長繼續留著接下來我們就想針對"},{"start":530.508,"end":546.082,"text":"據點的分流政策來討論因為分流政策原本的目的是希望中度以上的失智或中度以下的失能的失智者能從失智據點到我們立案的長照機構來提升照顧的一個層級讓照顧的品質能真正升級"},{"start":547.043,"end":565.109,"text":"可是這個政策方向我相信大家都支持可是回顧我們看114年年底官方的數據實際執行情況跟政策原先預定的目標有似乎很大的落差因為資料顯示共有4246名的失智者因制度調整離開原本的熟悉的失智據點"},{"start":566.81,"end":584.112,"text":"我想部長也知道事實上應該讓他是在他最熟悉的環境就現在離開 可真正依照政策能夠成功銜接到日照中心的只有730人佔了17.2%即使把居家服務 住宿機構等一併納入計算"},{"start":585.829,"end":603.474,"text":"進入到長照體系的也只有33.5%換句話說大約三分之二的失智者在離開原本服務後並沒有持續進入到我們的後續的長照服務體系所以部長這樣的結果真的是符合你當初政策原先規劃的目標嗎這個為什麼會離開我是不是請長照司司長來說明"},{"start":607.964,"end":630.538,"text":"好 委員這邊跟委員 其實剛剛委員一剛開始有提到 主要我們失職證是不可逆所以當他的情況越來越重 失職越重的時候 會伴隨失能那我們這邊的政策 主要考量是 因為我們的據點其實我們設定目標是預防他這個認知出境 我剛剛講三分之二的私人就離開原本服務之後就"},{"start":631.218,"end":660.478,"text":"不是不是不是不是委員說的這樣那事實上事實上這個我們目前這個屬於0.5CD20.5到1分的這個部分佔六成大概40萬裡面的六成那目前進到我們的500多處的失智據點的人數大概只有不到1萬人所以我們才覺得如果已經是失能四級的要讓他分流到我們的日照中心那邊其實有專業的人也有無障礙的環境空間其實對失智症的照顧會更好"},{"start":661.438,"end":676.478,"text":"市長如果不是我講的那樣的話那我覺得很特別就你們數據呈現的就是這樣狀態委員有一些誤會我們會後再跟委員說明部長如果這三分之二未成功轉型的個案衛福部"},{"start":677.018,"end":701.015,"text":"能不能分析原因 如果事長剛剛講 那就請給我報告如果障礙者究竟是什麼 到底是部分中度失智者未達失能的標準因此進不了長照體系嗎 否則為什麼後來他們沒有順利那還是這部分的地區的日照中心的量能不足還是現行的日照服務模式本身沒有真正符合失智者的需求"},{"start":701.835,"end":722.657,"text":"所以我希望衛福部能夠對這結果分析然後重新檢視現在的整個的收案跟結案的條件是否增加彈性來提出具體的改善措施的時程所以希望部長這個多久可以給我一個報告我想跟委員說明一下因為這裡有兩個問題我們要釐清一個是失智的程度"},{"start":723.437,"end":736.252,"text":"一個是失能的程度這是兩個不同的分析失智的程度當然我們以CDR來看的話0.5跟1這個是屬於極輕度或輕度的這邊大概是佔65%"},{"start":738.114,"end":753.691,"text":"另外的35%是二以上就中度跟重度的這邊可是呢跟失能這邊又是另外一種狀況我們的分級的方式又把它分成八個等級所以這兩個如何去match所以有失智不見的等於有失能"},{"start":754.412,"end":782.55,"text":"那當然剛剛市長講的是說私能市級以上的我們盡量把它導引到我們的這個社區這個日照啦或者是進入到我們的廠照體系當然還有一些屬於輕度的我們剛剛也提到希望用私製的供照去減緩它的這個疾病進程的推進我們來看一下把這兩個做一些這個matching之後那看看"},{"start":783.25,"end":795.288,"text":"到底我們應該要怎麼樣去分流因為我們看你們的數據就是這樣4246名因為你們當初要做這種分流政策然後請他們離開熟悉的獅子巨田然後最後"},{"start":796.513,"end":822.099,"text":"看起來只有因為三分之二的失智者離開原本的服務就沒有進入到你們認知的說腸道體系我有想知道發生什麼事那就麻煩部長我們來回頭去看剛剛說的這個三分之二他是屬於失能到什麼樣的等級來適當的再麻煩多久那個報告可以給我那個多久我們盤一下一個月可以啦我們一個月我們盤一下好謝謝部長謝謝"}],"gazette":[{"speaker":"林委員月琴","start":"2026-05-28T09:34:34.805000+08:00","guessed":false,"end":"2026-05-28T09:34:36.333000+08:00","text":"主席，麻煩有請石部長。","quality":0.556},{"speaker":"主席","start":"2026-05-28T09:34:37.278000+08:00","guessed":false,"end":"2026-05-28T09:34:37.761000+08:00","text":"有請石部長。","quality":0.4},{"speaker":"石部長崇良","start":"2026-05-28T09:34:41.295000+08:00","guessed":false,"end":"2026-05-28T09:34:43.336000+08:00","text":"林委員早。","quality":0.75},{"speaker":"林委員月琴","start":"2026-05-28T09:34:43.336000+08:00","guessed":false,"end":"2026-05-28T09:34:43.336000+08:00","text":"部長早。","quality":0.333},{"speaker":"林委員月琴","start":"2026-05-28T09:34:43.896000+08:00","guessed":false,"end":"2026-05-28T09:34:46.957000+08:00","text":"對於失智症議題的嚴重性，我相信部長非常地清楚。","quality":0.762},{"speaker":"林委員月琴","start":"2026-05-28T09:34:48.757000+08:00","guessed":false,"end":"2026-05-28T09:35:08.063000+08:00","text":"從擔任厚生會失智症政策召集人以來，我就不斷地提醒、也建議衛福部，不能只把失智症視為單一疾病或者是醫療問題，而應視為涉及人口的結構、長照制度、家庭照顧、司法制度、人權保障跟國家發展的重要政策議題。","quality":0.875},{"speaker":"林委員月琴","start":"2026-05-28T09:35:09.823000+08:00","guessed":false,"end":"2026-05-28T09:35:32.492000+08:00","text":"當然，每次我們在委員會提到要制定失智症基本法的時候，你就會講說我們本來就有失智症政策綱領2.0，現在要到3.0，可是我們看到3.0內容大概都是2.0的延續，而且內容仍然遵循聯合國失智症行動計畫七大策略。","quality":0.874},{"speaker":"林委員月琴","start":"2026-05-28T09:35:32.852000+08:00","guessed":false,"end":"2026-05-28T09:35:48.281000+08:00","text":"的確你們也達到七大策略，而且甚至做得不錯，可是聯合國認為這七大策略並沒有顯著的成效，所以如果要繼續延續著做，在沒有基本法的架構下，政策綱領是否會要繼續延續？","quality":0.972},{"speaker":"林委員月琴","start":"2026-05-28T09:35:48.281000+08:00","guessed":false,"end":"2026-05-28T09:35:51.964000+08:00","text":"是否足夠能夠接住未來越來越多的失智症患者？","quality":0.95},{"speaker":"林委員月琴","start":"2026-05-28T09:35:52.524000+08:00","guessed":false,"end":"2026-05-28T09:36:20.886000+08:00","text":"我想部長應該知道，125年我國即將進入極高齡社會，如果推估下來，130年我們的失智症患者大概將近47萬，140年會突破80萬，失智海嘯就要來臨了，所以我們認為臺灣沒有能力等聯合國的指引，為什麼？","quality":0.842},{"speaker":"林委員月琴","start":"2026-05-28T09:36:20.886000+08:00","guessed":false,"end":"2026-05-28T09:36:46.586000+08:00","text":"因為臺灣超高齡社會的速度是全球最快的、出生率是全球最低的，失智症照顧的問題不能等到聯合國公布指引、指標，面對臺灣社會這種型態，我們應該提出更具體的失智症綱領，建立更穩定、更具延續性的國家戰略架構，而且到底能不能支撐到未來5年、10年、甚至更長期制度的需求？","quality":0.895},{"speaker":"林委員月琴","start":"2026-05-28T09:36:47.107000+08:00","guessed":false,"end":"2026-05-28T09:36:52.473000+08:00","text":"我覺得應該避免政策隨行政措施調整，而出現斷裂或者碎片化。","quality":0.923},{"speaker":"林委員月琴","start":"2026-05-28T09:36:53.214000+08:00","guessed":false,"end":"2026-05-28T09:36:59.442000+08:00","text":"所以我想問部長，你是不是可以回去盤點一下，到底有沒有需要這個基本法？","quality":0.968},{"speaker":"林委員月琴","start":"2026-05-28T09:36:59.822000+08:00","guessed":false,"end":"2026-05-28T09:37:00.283000+08:00","text":"有沒有必要性？","quality":0.5},{"speaker":"石部長崇良","start":"2026-05-28T09:37:02.759000+08:00","guessed":false,"end":"2026-05-28T09:37:36.096000+08:00","text":"我想確實失智的問題會越來越嚴重，過去在失智症綱領2.0的時代確實是按照聯合國當時頒布的指引訂定，後來聯合國也評估過全球落實的情形並不是很理想，所以把政策本來預期的目標往後延到2031年，但是我們並沒有因此停下來，因為前面的七大綱領……","quality":0.913},{"speaker":"林委員月琴","start":"2026-05-28T09:37:36.356000+08:00","guessed":false,"end":"2026-05-28T09:37:36.837000+08:00","text":"可是你們的3.0到現在……","quality":0.889},{"speaker":"石部長崇良","start":"2026-05-28T09:37:39.379000+08:00","guessed":false,"end":"2026-05-28T09:37:44.242000+08:00","text":"今年3.0大概在下個月就會發布了，我們會納入長照3.0裡面繼續推動，會進入到3.0的方案裡頭來。","quality":0.949},{"speaker":"林委員月琴","start":"2026-05-28T09:37:44.242000+08:00","guessed":true,"end":"2026-05-28T09:37:45.242000+08:00","text":"這中間事實上還有斷掉的時間……","quality":0},{"speaker":"石部長崇良","start":"2026-05-28T09:37:44.322000+08:00","guessed":false,"end":"2026-05-28T09:37:44.742000+08:00","text":"當然，我們還是會持續地盤點、推進，還是會的。","quality":0.944},{"speaker":"林委員月琴","start":"2026-05-28T09:38:01.921000+08:00","guessed":false,"end":"2026-05-28T09:38:21.650000+08:00","text":"我剛剛也提過，我們在125年就將進入極高齡化的社會，尤其我們是出生率低、長輩也逐漸多的時候，失智的問題就一定勢必要有國家完整的政策來處理。","quality":0.967},{"speaker":"林委員月琴","start":"2026-05-28T09:38:22.931000+08:00","guessed":false,"end":"2026-05-28T09:38:26.152000+08:00","text":"司法院代表也在，主席，可不可以請司法院代表？","quality":0.579},{"speaker":"林委員月琴","start":"2026-05-28T09:38:30.032000+08:00","guessed":false,"end":"2026-05-28T09:38:43.749000+08:00","text":"我想討論跟失智者權利非常密切相關的議題，最近因為馬前總統的風波，又引起失智症監護輔制度的討論。","quality":0.864},{"speaker":"林委員月琴","start":"2026-05-28T09:38:44.849000+08:00","guessed":false,"end":"2026-05-28T09:39:05.394000+08:00","text":"其實最近幾年來國際上不斷在討論監護輔制度是否符合身權公約的精神，尤其失智症者監護輔的制度可能跟CRPD的精神上存在落差，問題不在於要不要保護失智者，而是究竟我們是在支持當事人做決定，還是在替當事人做決定？","quality":0.907},{"speaker":"林委員月琴","start":"2026-05-28T09:39:06.658000+08:00","guessed":false,"end":"2026-05-28T09:39:08.881000+08:00","text":"我想這也是身權法討論的重點之一。","quality":0.867},{"speaker":"林委員月琴","start":"2026-05-28T09:39:09.501000+08:00","guessed":false,"end":"2026-05-28T09:39:20.531000+08:00","text":"我們回顧一下，臺灣在2014年將CRPD正式國內法化，我相信在座部長也應該知道當時是誰簽署的，就是馬前總統。","quality":0.935},{"speaker":"林委員月琴","start":"2026-05-28T09:39:20.732000+08:00","guessed":false,"end":"2026-05-28T09:39:22.113000+08:00","text":"我們來看CRPD的相關規定。","quality":0.615},{"speaker":"林委員月琴","start":"2026-05-28T09:39:23.054000+08:00","guessed":false,"end":"2026-05-28T09:39:52.750000+08:00","text":"第十二條講的「在法律之前獲得平等承認」明確指出，身心障礙者在生活各面向應享有跟其他人平等的法律上權利，國家也應該提供必要的協助，使其能夠行使權利，而不是因為能力受限，就直接由他人完全取代其決定；另外，第五條也明定不得因身心障礙而受到差別待遇，強調平等跟不歧視的原則。","quality":0.943},{"speaker":"林委員月琴","start":"2026-05-28T09:39:52.750000+08:00","guessed":false,"end":"2026-05-28T09:40:03.695000+08:00","text":"但目前我國在這個制度下，一旦受監護宣告就可能全面喪失行為能力，許多財產、法律，甚至生活上的重要決定，都直接要由他人代理。","quality":1},{"speaker":"林委員月琴","start":"2026-05-28T09:40:04.535000+08:00","guessed":false,"end":"2026-05-28T09:40:19.160000+08:00","text":"所以這樣全面性、固定式的限制方式，我先問部長，有沒有符合CRPD第十二條所強調的比例原則跟個別化的支持原則，等一下請司法院也說明一下，來，部長。","quality":0.969},{"speaker":"石部長崇良","start":"2026-05-28T09:40:21.966000+08:00","guessed":false,"end":"2026-05-28T09:40:35.722000+08:00","text":"當然CRPD的精神，對於如果失智症患者已經進入某個程度的失能狀態，應該也要按照CRPD……","quality":0.902},{"speaker":"林委員月琴","start":"2026-05-28T09:40:36.823000+08:00","guessed":false,"end":"2026-05-28T09:40:46.902000+08:00","text":"可是前期的時候並不是這樣，如果一旦是……應該是協助他怎麼去做決定，而不是全面地幫他做決定，不是嗎？","quality":0.977},{"speaker":"石部長崇良","start":"2026-05-28T09:40:46.902000+08:00","guessed":true,"end":"2026-05-28T09:40:47.902000+08:00","text":"對，沒有錯，這個要尊重他。","quality":0},{"speaker":"林委員月琴","start":"2026-05-28T09:40:46.902000+08:00","guessed":false,"end":"2026-05-28T09:40:50.383000+08:00","text":"那就會變成不符合CRPD第十二條的精神。對。","quality":0.85},{"speaker":"林委員月琴","start":"2026-05-28T09:40:52.044000+08:00","guessed":false,"end":"2026-05-28T09:41:04.608000+08:00","text":"我想細問一下司法院，目前法院在監護宣告案件當中，除了醫療鑑定之外，如何確認本人真實意願是否有支持決策或是意願表達的機制？","quality":0.982},{"speaker":"何法官効鋼","start":"2026-05-28T09:41:06.930000+08:00","guessed":false,"end":"2026-05-28T09:41:34.855000+08:00","text":"跟委員報告，目前在要進行監護宣告或輔助宣告之前，我們的法律有明定法官應該要委請專業的精神科醫生來做鑑定，在鑑定的時候，法官也必須要親自訊問受監護宣告或受輔助宣告的當事人，在精神科醫師面前對他做直接意願的確認跟詢問，這是法律有明定的，目前我們實務上也都確實有在進行這樣的程序。","quality":0.992},{"speaker":"林委員月琴","start":"2026-05-28T09:41:34.975000+08:00","guessed":false,"end":"2026-05-28T09:41:47.224000+08:00","text":"可是失智症的狀態跟一般失能不太一樣，他是漸進式的，所以如果現今依然是全面、固定式的監護制度的話，司法院是否已啟動成人監護制度的檢討？","quality":0.934},{"speaker":"林委員月琴","start":"2026-05-28T09:41:47.224000+08:00","guessed":false,"end":"2026-05-28T09:41:57.311000+08:00","text":"因為目前失智症的狀態就是跟一般的不太一樣，是否朝向依個案需求做部分限制，而不是全面剝奪能力的方向研議？","quality":0.875},{"speaker":"何法官効鋼","start":"2026-05-28T09:41:59.898000+08:00","guessed":false,"end":"2026-05-28T09:42:18.528000+08:00","text":"跟委員報告，因為目前監護宣告跟輔助宣告實體法的制度是訂定在民法總則，民法總則的規定並不是本院主管的，當事人如果受了監護宣告，他法律上的行為能力會完全喪失，這件事情也是訂在民法裡面的。","quality":1},{"speaker":"何法官効鋼","start":"2026-05-28T09:42:19.828000+08:00","guessed":false,"end":"2026-05-28T09:42:29.814000+08:00","text":"這個部分，司法院能處理的就是我們會依照法律規定進行審理，當然我們做了監護宣告或輔助宣告裁定之後的效果，也會依照法律規定而發生。","quality":0.966},{"speaker":"何法官効鋼","start":"2026-05-28T09:42:30.635000+08:00","guessed":false,"end":"2026-05-28T09:42:37.498000+08:00","text":"至於監護宣告或輔助宣告制度要不要修改，這個可能不是本院所執掌的範圍。","quality":0.969},{"speaker":"林委員月琴","start":"2026-05-28T09:42:39.372000+08:00","guessed":false,"end":"2026-05-28T09:42:40.152000+08:00","text":"我為什麼問這個？","quality":1},{"speaker":"林委員月琴","start":"2026-05-28T09:42:40.152000+08:00","guessed":false,"end":"2026-05-28T09:42:54.717000+08:00","text":"因為以馬前總統近期引發的社會討論來看，一個人即使還能夠表達意願、做出判斷、安排自己的生活，如果進入全面、固定式的監護制度的話，會不會原本還存在的一些權利也一起被制度拿走？","quality":0.987},{"speaker":"林委員月琴","start":"2026-05-28T09:42:55.417000+08:00","guessed":false,"end":"2026-05-28T09:43:09.003000+08:00","text":"像德國、日本、韓國等國的制度改革方向，已逐步由全面限制能力轉向支持決策模式，所以我認為有必要進行全面的檢討，修正比較符合身權公約的制度。","quality":0.984},{"speaker":"林委員月琴","start":"2026-05-28T09:43:10.044000+08:00","guessed":false,"end":"2026-05-28T09:43:12.425000+08:00","text":"司法院請回，部長繼續留著。","quality":1},{"speaker":"林委員月琴","start":"2026-05-28T09:43:14.926000+08:00","guessed":false,"end":"2026-05-28T09:43:19.309000+08:00","text":"部長，接下來我們就針對失智據點的分流政策討論。","quality":0.81},{"speaker":"林委員月琴","start":"2026-05-28T09:43:19.630000+08:00","guessed":false,"end":"2026-05-28T09:43:36.164000+08:00","text":"分流政策原本的目的是希望中度以上的失智或中度以下失能的失智者，能從失智據點到立案的長照機構提升照顧的層級，讓照顧的品質能真正升級，這個政策方向相信大家都支持。","quality":1},{"speaker":"林委員月琴","start":"2026-05-28T09:43:36.764000+08:00","guessed":false,"end":"2026-05-28T09:43:52.109000+08:00","text":"可是我們回顧看114年年底官方的數據，實際執行情況與政策原先預定的目標似乎有很大的落差，因為資料顯示，共有4,246名失智者因制度調整離開原本熟悉的失智據點。","quality":0.926},{"speaker":"林委員月琴","start":"2026-05-28T09:43:53.810000+08:00","guessed":false,"end":"2026-05-28T09:44:00.158000+08:00","text":"我想部長也知道，失智者應該讓他在最熟悉的環境，結果現在離開。","quality":0.815},{"speaker":"林委員月琴","start":"2026-05-28T09:44:00.158000+08:00","guessed":false,"end":"2026-05-28T09:44:15.870000+08:00","text":"可是真正依照政策能夠成功銜接到日照中心的只有730人，占了17.2%，即使把居家服務、住宿機構等一併納入計算，進入長照體系的也只有33.5%。","quality":0.965},{"speaker":"林委員月琴","start":"2026-05-28T09:44:15.870000+08:00","guessed":false,"end":"2026-05-28T09:44:28.193000+08:00","text":"換句話說，大約三分之二的失智者在離開原本服務後，並沒有持續進入後續的長照服務體系，所以，部長，這樣的結果真的符合當初政策原先規劃的目標嗎？","quality":1},{"speaker":"石部長崇良","start":"2026-05-28T09:44:28.193000+08:00","guessed":false,"end":"2026-05-28T09:44:34.964000+08:00","text":"為什麼會離開，我是不是請長照司司長來說明？好。","quality":1},{"speaker":"祝司長健芳","start":"2026-05-28T09:44:36.865000+08:00","guessed":false,"end":"2026-05-28T09:44:52.575000+08:00","text":"其實剛剛委員一開始有提到，主要失智症不可逆，所以當他的失智情況越來越重的時候會伴隨失能，我們的政策主要的考量是，我們據點設定的目標是預防他，讓他認知促進。","quality":0.859},{"speaker":"林委員月琴","start":"2026-05-28T09:44:55.096000+08:00","guessed":false,"end":"2026-05-28T09:44:57.518000+08:00","text":"司長，剛剛講三分之二的失智症離開原本服務之後就斷掉了。","quality":0.68},{"speaker":"祝司長健芳","start":"2026-05-28T09:44:59.619000+08:00","guessed":false,"end":"2026-05-28T09:45:27.458000+08:00","text":"不是，不是委員說的這樣，事實上目前屬於CDR 0.5到1分的部分占六成，大概40萬裡面的六成，目前進到五百多處失智據點的人數大概只有不到1萬人，所以我們才覺得如果已經是失能4級的，要讓他分流到日照中心，那邊其實有專業的人力，也有無障礙環境空間，其實對失智症的照顧會更好。","quality":0.957},{"speaker":"林委員月琴","start":"2026-05-28T09:45:28.559000+08:00","guessed":false,"end":"2026-05-28T09:45:35.528000+08:00","text":"司長，如果不是我講的那樣的話，我覺得很特別，你們數據呈現就是這樣的狀態，因為時間的關係……","quality":0.769},{"speaker":"祝司長健芳","start":"2026-05-28T09:45:35.528000+08:00","guessed":false,"end":"2026-05-28T09:45:38.311000+08:00","text":"可能委員有一些誤會，我們會後再跟委員說明。","quality":0.895},{"speaker":"林委員月琴","start":"2026-05-28T09:45:38.932000+08:00","guessed":false,"end":"2026-05-28T09:45:44.879000+08:00","text":"部長，這三分之二未成功轉銜的個案，衛福部能不能分析原因？","quality":0.96},{"speaker":"林委員月琴","start":"2026-05-28T09:45:45.920000+08:00","guessed":false,"end":"2026-05-28T09:45:50.903000+08:00","text":"如果是像司長剛剛這樣講的，就請給我報告，主要障礙究竟是什麼？","quality":0.704},{"speaker":"林委員月琴","start":"2026-05-28T09:45:50.903000+08:00","guessed":false,"end":"2026-05-28T09:45:57.307000+08:00","text":"到底是部分中度失智者未達失能標準，因此進不了長照體系嗎？","quality":1},{"speaker":"林委員月琴","start":"2026-05-28T09:45:57.307000+08:00","guessed":false,"end":"2026-05-28T09:45:58.708000+08:00","text":"否則為什麼後來他們沒有順利轉銜？","quality":0.867},{"speaker":"林委員月琴","start":"2026-05-28T09:45:59.509000+08:00","guessed":false,"end":"2026-05-28T09:46:02.651000+08:00","text":"還是這部分的地區日照中心量能不足？","quality":1},{"speaker":"林委員月琴","start":"2026-05-28T09:46:03.211000+08:00","guessed":false,"end":"2026-05-28T09:46:07.995000+08:00","text":"還是現行日照服務模式本身沒有真正符合失智者的需求？","quality":1},{"speaker":"林委員月琴","start":"2026-05-28T09:46:08.975000+08:00","guessed":false,"end":"2026-05-28T09:46:19.746000+08:00","text":"我希望衛福部能夠對這個結果分析，重新檢視現在整個收案跟結案的條件是否增加彈性，提出具體改善措施的時程。","quality":0.979},{"speaker":"林委員月琴","start":"2026-05-28T09:46:21.268000+08:00","guessed":false,"end":"2026-05-28T09:46:23.430000+08:00","text":"部長，這個多久可以給我一個報告？","quality":1},{"speaker":"石部長崇良","start":"2026-05-28T09:46:23.530000+08:00","guessed":false,"end":"2026-05-28T09:46:34.342000+08:00","text":"我想跟委員說明一下，因為這裡有兩個問題我們要釐清，一個是失智的程度，一個是失能的程度，這是兩個不同的分析。","quality":1},{"speaker":"石部長崇良","start":"2026-05-28T09:46:35.143000+08:00","guessed":false,"end":"2026-05-28T09:46:58.489000+08:00","text":"失智的程度，我們以CDR來看的話，0.1跟1是屬於極輕度或輕度，大概是占65%，另外的35%是2以上，就是中度跟重度，可是失能又是另外一種狀況，我們的分級方式又把它分成8個等級，這兩個如何去match？","quality":0.976},{"speaker":"石部長崇良","start":"2026-05-28T09:46:58.509000+08:00","guessed":false,"end":"2026-05-28T09:47:00.671000+08:00","text":"所以有失智不見得等於有失能。","quality":0.923},{"speaker":"石部長崇良","start":"2026-05-28T09:47:02.233000+08:00","guessed":false,"end":"2026-05-28T09:47:22.385000+08:00","text":"當然剛剛司長講的是，失能4級以上我們儘量把他導引到社區日照或者是進入長照體系，當然還有一些屬於輕度的，我們剛剛也提到，希望用失智的共照去減緩他疾病進程的推展。","quality":0.863},{"speaker":"石部長崇良","start":"2026-05-28T09:47:24.246000+08:00","guessed":false,"end":"2026-05-28T09:47:31.913000+08:00","text":"我們來看一下，把這兩個做一些matching之後，看看到底我們應該要怎麼樣去分流，提供這些服務。","quality":0.864},{"speaker":"林委員月琴","start":"2026-05-28T09:47:32.854000+08:00","guessed":false,"end":"2026-05-28T09:47:54.095000+08:00","text":"因為我們看你們的數據就是這樣，4,246名，因為你們當初要做分流政策，請他們離開熟悉的失智據點，最後看起來只有……因為三分之二的失智者離開原本的服務就沒有進到你們認知的長照體系，我想知道發生什麼事，就麻煩部長……","quality":0.924},{"speaker":"石部長崇良","start":"2026-05-28T09:47:54.095000+08:00","guessed":false,"end":"2026-05-28T09:48:00.757000+08:00","text":"對，我們來回頭去看剛剛說的三分之二是屬於失能到什麼樣的等級，適當的……","quality":0.968},{"speaker":"林委員月琴","start":"2026-05-28T09:48:00.857000+08:00","guessed":false,"end":"2026-05-28T09:48:03.978000+08:00","text":"再麻煩，報告多久可以給我？","quality":0.818},{"speaker":"石部長崇良","start":"2026-05-28T09:48:06.738000+08:00","guessed":false,"end":"2026-05-28T09:48:08.679000+08:00","text":"1個月可以，1個月我們盤一下。","quality":1},{"speaker":"林委員月琴","start":"2026-05-28T09:48:08.959000+08:00","guessed":false,"end":"2026-05-28T09:48:09.099000+08:00","text":"好，謝謝部長，謝謝。謝謝。","quality":0.778},{"speaker":"主席","start":"2026-05-28T09:48:09.599000+08:00","guessed":true,"end":"2026-05-28T09:48:11.599000+08:00","text":"謝謝林月琴委員。","quality":0},{"speaker":"主席","start":"2026-05-28T09:48:11.899000+08:00","guessed":true,"end":"2026-05-28T09:48:14.184714+08:00","text":"現在請陳菁徽委員。","quality":0}]}},"supported_relations":[],"relations":[]}