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.