專業自主？組織自利？－論少年安置機構契約委託的篩案問題

Professional Autonomy? Organizational Self-interest?-Creaming Issues in the Contracting of Placement Services for the Disadvantaged Youth

劉淑瓊(Joanne S. C. Liu) ； 彭惠(Hui Peng)

《臺大社會工作學刊》 14期 (2007/01) Pp. 61-121

摘要

公共服務民營化政策下最受關注者莫過於公平的近用性。批評者認為在契約委託制度下，受託者傾向挑選較容易服務的個案，設法規避那些較困難或是成本較高的個案。本文將以地方政府的公設民營少年安置機構為例，探討契約委託是否會造成某些特定的案主，尤其是問題多元、複雜、慢性而最需要服務者只能得到較差的服務或甚至被拒於應得服務之外，形成所謂的「社服人球」。透過深度訪談與檔案文件分析，本文獲得以下幾項結論：地方政府少年安置服務的委外，是一個比第三方契約理論所描述的更為複雜的四角關係，公部門內部不同科室之間的成見與隔閡，使得受託者自主空間更大，有效的契約管理更形困難，而個案的服務近用性也更得不到應有的保障。受託者藉由收容前會談蒐集具體豐富的個案資訊，透過專業與經驗優勢挑選個案；即使個案進住後受託者仍可因其權控式的管理使個案因無法適應而要求離開。受託者在機構經營的財務考量下，摸索出以「最高專業服務費下的最少個案數」為最適收容規模。本文認為少年安置機構的篩案現象是受託者依實務經驗與專業判斷，在委託者提供的人力配備、設施資源與承諾不足下的所展現的專業自主與組織自保因應行為。而地方政府主管機關在少年安置上的承諾與資源投入，也直接影響篩案發生的可能性與契約管理者對篩案行為所能採取的行動。最後本文提出個案分類分級，合理計算服務成本、務實補助照顧人力，保留公辦公營機構以資因應，建立中央轉介系統，以及建構有意義的績效評量制度等五項契約管理建議。

關鍵字

篩案 ； 契約委託 ； 少年安置 ； 第三方契約 ； 組織自利

並列摘要

Fair and equal accessibility is an issue that attracts most attention in the privatization of social services. Often criticized under the contracting regime is the contractor's tendency to avoid those cases that are more difficult or cost more. This paper, using Placement Services for the Disadvantaged Youth (PSDY) as an example, explores whether the contracting process favors certain type of clients, resulting in those clients with multiple, complex, and chronic problems can only receive less quality services or worse even are refused of services, creating the so-called ”social service passed-over”. This paper's conclusion includes several points: the contracting process of PSDY is a quadripartite relationship that is more complex than the ”third party contracts”. Differences in professional decisions and poor collaboration between the departments within the Department of Social Welfare leads to insufficient definition of service, makes effective contract management difficult, provides minimum protection of client accessibility. Consequently, contractors, by using their information collected at the interview sessions as well as their professional expertise, were able to choose cases, i.e. ”creaming”. After allowing clients' inhabitation, contractors are still able to manipulate and create situations for clients to withdraw. With an objective to maximize profits, contractor's model for operation becomes ”maximum professional fee with minimum caseload”. The authors's opinion is that the performance evaluation or performance-based contracting may not be the reasons for contractor's case picking. Defining service requirements without considering specific needs of individual clients may be the cause for contractor's opportunist behavior. The resources made available and attention paid by the Placement Services of the local government have direct bearing on the clout the contract managers have in dealing with contractor's performance. This paper presents four recommendations: classifications of service requirements (cases); maintaining an in-house production of services within the government; reasonable cost accounting to ensure sufficient resources, establishing a central referral system, and designing a meaningful performance evaluation mechanism.

並列關鍵字

creaming ； contracting-out ； placement Services for the disadvantaged youth ； third-party contracts ； organizational self-interest

參考文獻

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