Taiwan promotes 10-year long-term care 2.0 plan

  • Date: 2017-05-03

I. Background

Taiwan society is aging fast, and will likely meet the criteria for an “aged society” in 2018 when 14.5 percent of the population is age 65 or over, and a “super-aged society” in 2026 when that figure reaches 20.6 percent. The rapid growth in this segment of the population will create a greater need for long-term care and home-based care services, placing a heavier burden on families.

To forge a long-term care system that meets the needs of senior citizens and the mentally and physically challenged, the Executive Yuan on September 29, 2016 passed a “10-year long-term care 2.0 plan.” The new plan will retain the long-term care services provided under the previous 10-year plan, while expanding coverage to include people over the age of 50 with dementia, members of indigenous tribes from low-lying areas over 55 who suffer from disabilities, the mentally or physically challenged and those suffering from disabilities under 49, and infirm senior citizens over 65. The number of care recipients is thus projected to increase by 44 percent from approximately 511,000 to about 738,000 while the number of services offered will increase from eight to 17, creating 50,000 job opportunities in one year.

On the front end of the program, the 2.0 plan promotes preventative health care to minimize or delay the onset of disabilities. On the back end, it offers hospice services that provide comprehensive, personal and dignified care to those with diminished physical or mental capacities, while easing the burden on their families.

II. Create community-based long-term care services

A. Establish a comprehensive community care service system that promotes “aging in place”

1. The 2.0 plan will create an integrated community-based care system that promotes “aging in place” and offers diverse options to meet long-term care needs. Strategies include establishing a three-tier system consisting of community-based integrated service centers (Tier A “flagship stores”), combined service centers (Tier B “specialty stores”), and long-term care stations in alleys and lanes (Tier C “corner stores”). This system integrates health care services, preventive care, support for everyday needs, home-based services and medical care into a unified system that any senior citizen with diminished physical or mental capacities can access within a 30-minute drive. A future goal will be to make service sites even more accessible by setting up at least one alley or lane station for every one to three wards.

2. In 2016, 20 counties and cities implemented 23 trial runs successfully, setting up 17 Tier A, 44 Tier B, and 85 Tier C centers. In 2017, local governments will be encouraged to work with private service providers to cultivate the capabilities of Tier A centers, augment the resources of Tier B stores, and set up more Tier C centers. By promoting a comprehensive community care service system, the government hopes to involve more types of care providers, develop and integrate different long-term care resources, make long-term care services more flexible, increase the density of service points, and create jobs while cultivating the care service work force.

B. Expand long-term care services for indigenous peoples

1. Establish a long-term care network for Taiwan’s indigenous groups.

2. Set up an integrated care industry for indigenous communities, reinforce community care functions, and create an environment for aging in place.

3. Create a system that links resources, provide full subsidies to indigenous residents suffering from disabilities, and make long-term care services more accessible.

4. Provide incentives and subsidies to establish one long-term care branch station in each of 55 indigenous villages, townships and districts.

C. Integrate medical and care resources, and provide a single window for long-term care services

To offer convenient and accessible long-term care services, city and county governments will enhance their long-term care management centers and set up single windows to process applications, assess needs, and help families formulate care plans. Resources for the medical care and support services for daily living will also be linked. So far, 62 such management centers and branches have been set up in 22 cities and counties.

III. Train professional care providers

The 2.0 plan includes various measures to cultivate long-term care providers, including evaluation of the professional knowledge, abilities and compensation that long-term care providers require based on the type of venue in which they serve—home-based, community-based or institutional.

Higher remuneration and other incentives will be offered to attract more people to the field, and high-tech assistive devices and various publicity methods will be used to improve the professional image and public awareness of care providers.

IV. Improve needs assessment system, raise payment system efficiency

1. Develop a more efficient needs assessment system, adopt multifunctional evaluation instruments, and use smart devices to conduct assessments. Establish payment standards and a payment information system to improve the efficiency of assessments, care management, verification and payment services.

2. To make private companies more willing to provide long-term care services, service providers in the future may enter into cross-sector alliances or special contracts, and simplify their payment verification procedures.

V. Earmark tax revenues to stabilize long-term care funding

Taiwan’s rapidly aging population is driving an ever-increasing need for long-term care services, so the system will require a steady source of funding to meet rising expenses. After a thorough evaluation, the government will adjust estate, gift and tobacco taxes and use them to provide special funding for the long-term care system. The Long-term Care Services Act was therefore amended to include these funding sources, and the amendments were promulgated by the president on January 26, 2017.

1. Estate and gift tax: Amendments to the Estate and Gift Tax Act were passed by the Legislative Yuan on April 25, 2017, adjusting the estate and gift tax rate from a flat 10 percent to an incremental tax of 10, 15 and 20 percent. The change is expected to bring in an additional NT$6.3 billion (US$207.3 million) annually for the long-term care special fund.

2. Tobacco tax: Amendments to the Tobacco and Alcohol Tax Act were passed by the Legislative Yuan on April 21, 2017, raising the tobacco tax from NT$590 (US$19.41) to NT$1,590 (US$52.32) per 1,000 cigarettes or per kilogram of tobacco products. The change is expected to bring in an additional NT$23.3 billion (US$766.7 million) annually for the long-term care special fund.

VI. Conclusion

A community-based long-term care model will allow senior citizens to live in a familiar environment and age in place, utilizing local networks where people can care for themselves and their neighbors. The 10-year long-term care 2.0 plan therefore aims to create this type of localized, community-based model that integrates social care, medical care and preventive health resources.

The plan will establish a three-tier system comprising community-based integrated service centers, combination day care and service centers, and long-term care stations in alleys and lanes. This high-quality, affordable and accessible system will allow those with diminished physical or mental abilities to receive long-term care with dignity, and foster a compassionate society that respects and cares for all of its senior citizens.

※ Update: The long-term care 2.0 plan now offers home assistance with a single phone call. The “1966 hotline,” launched November 24, 2017 by the Ministry of Health and Welfare, provides the public with yet another convenient, one-stop window for long-term care service.