The Social Worker in a Mixed Welfare Economy: A Study of Long-Term Care Services in Taiwan

1
The Social Worker in a Mixed Welfare Economy A
Study of Long-Term Care Services in Taiwan

• Lin Jen Jen
• Fu Jen University

2
Mixed Welfare Economy

• Approach of New Public Management
• Reinventing government
• Collaboration between public and private sectors
• efficiency, effectiveness, diversity, choice,
  autonomy, and reassignment of the burdens of cost

3
A mixed welfare economy for social service
delivery in Taiwan

• The implementation of the Local Government
  Procurement Law in 1998
• The Promotion of the Private Participation in
  Infrastructure Projects in 2000
• The policy of reinventing government 2001
• Private sectors play an important role in the
  provision of public services in Taiwan.

4
Long-Term Care System in Taiwan

• 2001 the Pilot Program for the Development of
  Long-Term Care System
• 2002 the government developed the Plan of Care
  Service Industry
• 2005 the Six-Star Health Community Project
• 2007 the Ten-Years Plan for Long-Term Care

5
Study of the long-term Care Services in Wanhua

• 12 service providers
• 4 private caring institutions,
• 1 private center for home care nursing,
• 1 agencies for home help services.
• 1 community association
• 5 public and private operate services
  centers
• questions the role of social worker, the
  availability of resources for their clients and
  the implication of collaboration for social
  workers.

6
Case management under manpower shortage

• Task assessment, resource coordination, quality
  control, reassessment and case follow-up
• Increasing responsibility for evaluation for
  performance, efficiency and quality control
• Excessive caseload
• No established available resource networks
• Inadequacy resource was transferred from the
  government social welfare agencies to individual
  social workers. Social workers had to personally
  face this structural problem.

7
Job demands with little power to effect change

• Ambiguous policy and expanding services
• The low level of hierarchy to decision making
• This highlighted the conflicting dynamics of
  management culture intent on serving the
  interests of the new policy at the cost of
  individual need and the equity of resource
  distribution.

8
Collaboration under lack of institutional
arrangements

• Wanhua Community Collaboration Meeting
• Empowerment in the bottom-up collaboration
• the extent of trust necessary in order to have
  long-term cooperation. (the legitimacy ?)
• the extent of effect on building network of
  services. (fragmental services ?)
• In answering the two questions we found that the
  role of the public sector is crucial in
  integrating service resource

9
Conclusion

• According to the model of contract management
  like accountability, regulation in contract
  content and performance evaluation are seen as a
  method to promote efficiency of contracting-out
  services in a mixed welfare economy.

10

• Social worker as case manager sees the role
  becoming increasingly bureaucratic, focused on
  budgets, report writing and meeting.
• Little influence on services integrating and
  resource network building.
• Good working arrangements drive from more
  powerful position to access to decision making.
• A new governance model shall be conducted. In the
  model an institutional arrangement shall built
  formal and informal channel to bring the local
  collaboration to service planning and decision
  making process.