身心障礙者個案管理及生涯轉銜服務現況分析檢討與發展

The Case Management and Career Transition Service for Disability-Analysis, Review and it’s future Development

台灣身心障礙者個案管理服務在發展多年之後，由於法規變動與社會情勢改變，近年來與轉銜服務之間產生了諸多問題。包括各地方政府對於轉銜個管的分工認知差異、工作內容混淆模糊、缺乏資源轉介、中央政府缺乏明確導引與標準作業流程等。本文討論個案管理與轉銜服務的學理概念與各種觀點類型，釐清當前服務運作的背景知識。為了解目前台灣相關工作運作情形，藉由全國性的資料收集，分析釐清現行身障個管與轉銜服務的工作現況與困境。
本研究結論指出現行個案管理與轉銜服務值得反思的現況困境有五點：大個管與小轉銜形成的混沌、都市差異與資源投入產生的困境、在地化與委外服務引發的挑戰、服務模式與資源特性形成的門檻、服務焦點與理論系統構成的斷層等問題。本文建議生涯轉銜應審慎思考積極轉銜與成功轉銜的可能性，並慎重釐清與個案管理之間的服務邏輯；個管服務未來應考量障礙者家庭的照顧壓力，調整可行的服務模式；而整體服務及流程應透過更具邏輯性與理論性的討論將相關表格系統加以發展整併。最終，本文認為應透過修法界定及簡化身心障礙轉銜服務與個案管理的功能，調整轉銜概念並強化個管服務內涵，使障礙者獲得全生涯與全人的服務。

After so many years of developing career transition service for the disable in Taiwan, numerous problems have aroused in recent years due to the regulatory and social changes. These include the cognitive difference of labor division in case management by the different local governments, the lack of clarity of the work content, the lack of resource referrals, and the lack of clear guidance and standard operation procedure from the central government. This study aims to discuss the theoretical concepts and the types of views of disabled case management and transition service as to clarify the background knowledge of the current operation. Through a national data collection, we had a further understanding of the disabled case management and transition service at different cities and counties, and discussed about the predicament of the operations as well as the recommendations.
In the conclusion of this research, it is pointed out that there are five current predicaments on the current case management and transition service that required further reflections: the chaos between big case management and small transition, the predicament generated by the urban differences and resource inputs, the challenges of localization and outsourced services, the threshold created by the service model and resource feature, and the fault constituted by service focus and theoretical system. It is recommended to careful ponder about the possibility of active and successful transition, and clarify the service logics of disabled case management. In the future, the caregiving pressure of the family shall be taken into consideration for the case management, and adjust a more feasible service model. The overall service and the procedure shall be developed and integrated with more logical and theoretical discussions with the relevant table system. Finally, this study believes that in order to allow the disable to obtain a fully humanized career and service, law shall be amended to define and simplify the function of case management and transition service for disabilities and the concept of transition shall be adjusted, while the case management service shall be fortified.