建置社區巷弄長照站的培力與治理策略：水沙連區域的行動研究

Strategies for Empowerment and Governance of Establishing the “Alley Service Station”: An Action Research in the Shui Sha Lian Area

衛生福利部自2016 年起積極推動長照2.0 政策，其目的在於期望全臺各地建構出「以社區為基礎的整體照顧模式」。綜觀最近幾年的政策規劃，衛生福利部陸續推出許多政策方案，希望能逐步培力與厚植社區的照顧能量，但現實狀況卻是許多社區組織對於辦理長照據點意願不高；究其原因，主要在於辦理長照據點涉及醫護專業等服務能力，並非社區組織與志工們的既有設施及人力資源所能承擔。本行動研究團隊有鑑於此，乃規劃「培力社區組織建置巷弄長照站」等方案，並以南投縣埔里鎮、魚池鄉、國姓鄉、仁愛鄉等四鄉鎮作為主要行動場域，從2017 年開始進行社區資源調查，循序推展在地化的社區培力與治理策略，期待提升社區辦理長照據點的意願與能力，厚植整體照顧能量。歸納本研究行動經驗，筆者認為推動社區組織的培力與治理策略，應可區分為：形成共識的願景目標、培力的教育學習、能力的建構與轉移、提升地方治理生態等四個階段來進行。

Launched in 2016, Taiwan’s Long-Term Care (LTC) plan involves organizing a community-based service network. The addition of “Alley Service Station (Tire C)” is one of the primary elements of the LTC system 2.0 but not as expected eventually. It is augured that medical professionals, devices and equipment all are important for providing quality Alley Service Station in community, but the government do not ensure that all providers will have the capacity to offer professional medical resources sufficiently. To investigate how to assist community-capacity building or to offer substantial supports that enable community to bridge institution and supervising agency (Tier B and Tier A) in a unified system, we designed a series of demand-driven action projects according to previous LTC-demand survey results executed in 2017, and conducted an action research fieldwork from Shui Sha Lian area gathering the four Nantou townships of Puli, Yuchi, Guoxing, and Renai to determinate strategies for empowerment and governance of establishing the “Alley Service Station”.. The results of this study indicate that “reaching a consensus”, “empowering through education/training programs”, “self-capacity building and self-transformation” and “strengthening the dynamics and interactions within the local governance ecosystem” were crucial processes, which directly impact implementation relating to strategies for empowerment and governance of establishing the LTC service station in lanes and alleys.