「個人助理是居服的補充包」？地方政府執行身心障礙者自立生活支持／個助服務的迷思與困境

“Is Personal Assistance a Supplement to Homecare?＂ Myths and Barriers Related to the Provision of Personal Assistance by Local Authorities to People with Disabilities

聯合國《身心障礙者權利公約》（CRPD）第19條指出個人協助（personal assistance，以下簡稱個助）是障礙者自立生活與社區融入重要條件。自2011年地方政府須依法提供個助服務。以非結構性訪談大綱，深度訪談11位來自十個地方政府相關人員，探討其提供個助看法及執行。發現：對自立生活及個助概念不清楚；個助與居服難釐清；執行困境。認知迷思：使用個助要擬定自立生活計畫書、個助和居服不能重疊、常態性服務是居服不是自立生活、個助不能協助障礙者執行社會角色、個助訓練時數不足欠專業度。個助與居服難釐清：個助與居服競合、個助為居服補充包、個助是另一形式的居服。主要困境為經費不足。建議：依CRPD第五號一般性建議速修條文／辦法，個助和居服區隔極待釐清並編公務預算。

Article 19 of the Convention on the Rights of Persons with Disabilities (CRPD) outlines the equal rights of all persons with disabilities to live in the community; these rights extend to social inclusion and participation. According to this convention, access to personal assistance (PA) is crucial for preventing social isolation or community segregation. In Taiwan, since 2011, people with disabilities have been granted access to PA services by local authorities. Drawing upon in-depth interviews with 11 staff members from 10 local authorities, this paper explores how current PA services were implemented and operationalized at the regional level. Three themes emerged from the interviews: (1) having no straightforward understanding of independent living and PA services; (2) confusion between PA and homecare; and (3) having difficulties in PA implementation. The questionable practices of local authorities in providing PA services include requiring an independent living plan to use a PA, stipulating that the services provided by a personal assistant and those provided by a homecare worker cannot be the same, not allowing personal assistants to provide regular or daily services (e.g., assistance in eating and dressing), and not allowing personal assistants to help service users engage in their social roles (e.g., motherhood). Furthermore, against the spirit of IL movement and CRPD, personal assistants are required to receive a certain number of hours of regulated training, and PA is viewed as a supplement to homecare in Taiwan. Currently, budget shortages are the main barrier to implementing PA. Following the General Comments section of Article 19 of the CRPD, the Taiwan Disability Act and Individual Care Regulation should be amended, the concepts of PA and homecare should be better clarified, and an official national budget for PA must be established.