就國內推動社會福利服務民營化的實施經驗而論,委託對象難求、行政人力不足、輔導監督未盡落實等是經常遭遇的困境,其中,尤以後者之問題最為嚴重。因應未來長期照護保險制度之實施,擴大民間營利與非營利部門的參與是實現照顧服務提供多元化政策目標的趨勢策略。根據我國長期照護保險制度的服務提供體系建構之構想,未來將趨向採取特約業者(包括公立機構、非營利團體及民間企業)的方式擴充服務資源。屆時,如何監督不同屬性機構維持穩定的服務品質,並避免不法業者之不法情事,相關監督機制之建構乃是必要的配套措施。本文從日本建構照顧服務提供單位的監督機制之過程與實施經驗探討實踐照顧服務提供多元化政策落實的基本配套條件。內容包括日本介護保險制度的法定指導監督之規範、業者”COMSN”(Community Medical Systems & Netword)的不法事件及因應措施、後續的監督機制強化、現行的監督機制之體系與內涵、課題等,最後針對未來我國長期照護保險制度實施的監督機制建構之方向與原則提出建議。
The difficulties in implementing the privatization of domestic social welfare services include requesting necessary objects and establishing a monitoring system. The second issue is especially serious. In accordance with the implementation of the care insurance system in the near future, the participation of profit and non-profit organizations would be expanded to realize the multiplication of care services. According to the perceptions of care service providers in Taiwan, contracts for special entrepreneurs (including public agencies, non-profit organizations, and profit enterprises) would be introduced. Simultaneously, the related state monitoring system should be established to monitor the service quality from different types of service providers and avoid illegal activity. This article discusses the basic terms of multiplication of care services by examining the experiences of the monitoring mechanism of care insurance in Japan. The content includes the legal regulations of care insurance law, illegal events of service providers ”COMSN (Community Medical Systems & Network)” methods of strengthening monitoring systems as the fallowing reaction from state, and the mechanisms of existing monitoring systems. Finally, methods regarding the orientation and principles for a monitoring system for implementing care insurance in Taiwan are proposed.