身心障礙鑑定與需求評估制度實施經驗探討

Exploring the Implementation Experiences of the System for Disability Evaluation and Needs Assessment for Persons with Disabilities

2012年我國正式實施身心障礙鑑定與需求評估制度，除了引進世界衛生組織頒布的「國際健康功能與身心障礙分類系統」作為身心障礙鑑定與需求評估架構外，整體服務申請流程也有變動。本文研究目的為探究身心障礙鑑定與需求評估制度的實施經驗。本文採用焦點團體法，針對各縣市第二鑑定人員、需求評估人員、個案管理人員、身心障礙團體代表（服務使用者）及相關學者專家，共舉行21場焦點團體。本研究發現，併同辦理流程對於障礙者生活資訊蒐集有所限制；公所人員未能發揮預期功效，進而對後續流程順暢造成影響；醫院身心障礙者鑑定尚未參採「活動與參與」鑑定資料，障礙者表示因進行多次到醫院鑑定造成交通往返之不便；福利服務的分流模式有修正的必要，同時，需求評估人員與個案管理人員未來亦應加強合作機制；專業團隊運作方面，出現審查委員訓練不足及缺乏身心障礙者參與的情況。依據研究結果，本文針對前述議題提出若干建議，希冀藉由研究建議的提出，增進身心障礙鑑定與需求評估制度運作順暢性。

The current system for disability evaluation and needs assessment for persons with disabilities was implemented in 2012. This system not only introduced the concepts of the International Classification of Functioning, Disability and Health (ICF), but also practiced new procedures in welfare services. The aim of this study was to explore the implementation experiences of the current system for disability evaluation and needs assessment for persons with disabilities, by using focus groups. Twenty-one focus groups with professional workers, disability group representatives, as well as services users, and experts were conducted to understand the implementation experiences. As for the findings, there were some limitations and some aspects within the system that need to be changed. It showed that the life experiences of persons with disabilities could not be completely collected if it followed the procedures of “consolidation of disability evaluation and needs assessment.” Local district affairs officers did not function as had been expected. In terms of disability evaluation institutions, the second disability evaluation had not yet been used within the disability qualifications, and was the cause of the transportation cost and inconvenience. Besides, the collaboration mechanism between needs assessment assessors and case managers should be strengthened. With the assessment team, not only did members receive insufficient training, but there was also a lack of participation on the part of persons with disabilities. Based on the above, several suggestions were recommended for future practice.