臺灣將於2026年邁入「超高齡化社會」，長期照顧需求快速增加。有鑑於此，政府近年來積極推動長期照顧政策，自2008年起執行「長期照顧十年計畫」；2015年6月，通過長期照顧服務法；近期，則全力推動「長期照顧十年計畫2.0」。政府體認到能力與資源有限，必須與企業或非營利組織協力，建立相關治理網絡平台，以期有效整合資源，提供更好的長照服務。然而，如何達到政府與非營利長照服務單位之間協力治理的效能，同時又能維持互惠的合夥關係，是一個值得探討的議題。基此，本研究將以公私協力治理觀點，分析非營利長照服務單位與政府間協力執行臺灣長照服務業務的過程，藉由文獻分析方式，探討公私協力治理的內涵與類型，尤其欲瞭解構成協力之基本要素。在實證上，則透過質性研究方式，訪談學者專家、政府機關及執行長照工作之非營利機構，檢視非營利長照機構與政府機關之間的協力狀況。研究發現：現今長照服務提供較屬於「委託」的型式與架構，較難營造平等互惠的協力夥伴關係；再者，行政作業的簡化、經費補助的方式為影響長照單位參與協力和投入多寡的重要因素；值得注意的是，長照服務「產業化」似乎是未來的趨勢，如何在私部門與非營利長照服務單位之間取得平衡合作，是另一值得思考的議題。
Implementation and Prospect of Long-term Care Policy in Taiwan: An Analysis Based on Public-Private Partnership Governance
Rong-Yang Huang, Yu-Han Chen
Abstract
Taiwan will enter the so-called “hyper-aged society” by 2026. The demand for long-term care has increased rapidly due to the rising elderly population. In view of this, the ROC government is actively promoting long-term care policies: implemented of the “Long-term Care Ten-year Plan” since 2008, introduced the “Long-term Care Service Act” and enacted on June 3 of 2017. The so-called “Long-term Care Ten-year Plan 2.0” has recently commenced since November 2016. Government recognized its limit of capacity and resources, and seeking to collaborate with private sectors or nonprofit organizations, through related networks or platforms for providing a better service with effective integration of resources. However, how to reach collaboration effectively between the public and the non-profit long-term care units, and also maintain this partnership of equality and mutual benefit, is a subject worth exploring. Based on this, this study makes an empirical analysis of Taiwan’s long-term care policy and service, discusses the relationship between nonprofit organizations and government within the implementation of the Long-term Care Ten-year Plan 2.0 policy. It uses literature review to explore the essence and type of public and private cooperation, and to understand the elements of their collaboration; in empirical, through the qualitative research, interviewed selected executive director of non-profit units, government agencies and specialists, for examining the interactions among organizations and government in policy implementation. The study found that nowadays long-term care service in Taiwan appears a type and structure of entrusted, so that non-profit long units and the government is not a reciprocal status, it is difficult to create equal and mutually beneficial partnership; Moreover, a simplified administrative and funding process, would be important factors that impact the effort and investment of long-term care units which participating in the business. It is worth noting that “commercialize” of long-term care service seems to be trend in the future. How to reach an equilibrium point between private sector and non-profit organizations in the long-term care policy would be another question to think about.
Keywords: collaborative governance; public-private partnership; nonprofit organization; Long-term Care Plan 2.0