The government is planning to double subsidies paid to care facility residents with disability level 4 or above to NT$120,000 per year and remove an exclusion clause for wealthy individuals, Minister of Health and Welfare Hsueh Jui-yuan (薛瑞元) said on Wednesday. Hsieh announced the plan after the Ministry of Health and Welfare in January said it would expand the Long-term Care Plan 2.0 to include a subsidy for families to enable them to send a family member in need of care to a short-term facility or employ a short-term care assistant for up to 52 days.
The two policies are examples of how the ministry is trying to better meet the needs of families in need of care services. They come as care demand is expected to increase rapidly. The ministry forecasts that the number of people in need of long-term care would climb to 1 million in 2026 from 820,000 last year. The Long-term Care Plan 2.0 was launched in 2017 to create an affordable and accessible long-term care system, and ensure that elderly and disabled people receive better care. It includes subsidies for in-home or facility care services, shuttle bus services, assistive devices, transforming people’s homes into a barrier-free environment and respite care services.
However, Taiwan’s 100,000 care facility residents and 200,000 people being cared for by migrant caregivers were previously excluded. Social welfare groups and lawmakers have championed calls for better services for disabled people and their families, highlighting discrepancies between services covered by the long-term care plan and their actual needs. The main problem is that the health ministry’s plan does not integrate services offered by migrant caregivers under the purview of the Ministry of Labor.
Many affected families have said it is too difficult to find a suitable migrant in-home caregiver — an issue that is exacerbated by regulations that impose waiting periods before families can replace a worker who left their job without prior notice. Many families also distrust residential facilities, thinking that taking care of an elderly family member at home is a matter of filial piety. Despite cultural and language barriers and often insufficient training, hiring a migrant caregiver remains the option of choice for many families, as migrants offer one-on-one services around the clock for a minimum salary of NT$20,000 per month. Hiring a care service that employs Taiwanese professionals costs two to three times that amount, while service is limited to fewer hours. Migrant caregivers often find their duties overwhelming, and there is too little rest and emotional support available to them. The prospect of a job in a factory, for which their average salary is NT$30,000 per month, is tempting for many migrants, while others see their in-home care job in Taiwan as a stepping stone to better employment in a third country.
Meanwhile, many families say respite care services might not be suitable, as it would take a temporary caregiver too much time to learn how to address all the needs of the person they should care for, while other families are not aware that they are eligible for those services. Government data showed that only 5 percent of eligible families booked respite care services last year. While the overall number of migrant workers has returned to pre-COVID-19 pandemic levels, the number of social welfare workers, including in-home caregivers, has continued to decrease.
On Wednesday, Hsueh said: “Taiwanese prefer one-on-one 24/7 long-term care services, but if we continue to go in this direction, we will never have enough care workers.” Meanwhile, a Control Yuan report on the long-term care plan said that while the number of care facilities is rising, quality remains uneven, as there is no sufficient monitoring mechanism. The health ministry should address this issue, while continuing to expand the plan. It should also enhance cross-ministerial efforts to integrate services offered by migrant workers into Taiwan’s long-term care architecture.
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