A Construction of Cost Model of Community Living for Adult with Intellectual Disability- An Activity-Based Costing System

[[abstract]]成年心智障礙者6人以下社區居住服務，在自我決定、生活品質、社區融合等面向，明顯優於機構型照顧，更符合聯合國身心障礙者權利公約的原則。然而，政府對於障礙者的居住政策主要是以設立長期收容的教養院模式處理，機構為維持生存或營運，選擇補助較充裕的全日型住宿作為主要服務，卻不利於社區居住服務的推展，2005起至2014年統計顯示教養機構服務增加的人數約是社區居住服務的10倍。此外，社區居住服務的發展亦遭遇服務推動與財務、家長及社會大眾的觀念等諸多阻礙。 成本管理是財務管理的基礎，傳統的成本會計制度無法正確反映居住單位的真實成本，也無法呈現住民需求與服務活動之間的關聯；本研究嘗試藉由建構與實施作業基礎成本制度所產生的成本資訊，將之與政府補助額度進行比較分析，期望其結果有助於政府就不同需求與支持密度的服務使用者，設定更合宜的專業人員服務補助標準。並達到以下目的： （一） 運用作業基礎成本制度，建構「成人心智障礙者社區居住與生活服務方案」之成本模組，並實施於研究個案單位。 （二） 澄清服務使用者需求與專業人員服務活動之間的對應關係或關聯。 （三） 提供其他機構一參考工具，能就不同支持密度的個別服務單位，編列作業基礎成本制預算。 依據本研究所架構之作業基礎成本制度的設計步驟，依序完成研究個案單位作業字典的形成和作業動因的擇定，進而執行成本模組，最後根據產出的成本資訊，包括財務及非財務資訊進行資料分析。研究發現與結論為： 一、作業基礎成本制的優點： （一） 令社區居住服務之內容更具體明確。 （二） 可計算出住民單位服務成本。 （三） 可提供專業服務費更合理、詳盡的成本資訊。 二、作業基礎成本制的應用 （一）可用於編列作業基礎成本制預算。 （二）可用於輔助作業之改善。 （三）有助於成本管理與收費決策。 對照衛福部評量工具申請基準表中級支持密度住民需求經費及本研究之單位作業項目成本，前者低於後者6,269元，以最高補助額6,400設算，自籌比例約52.3%，主要是部分服務項目補助金額偏低或未列入補助標準。本研究結果支持政府應提高社區居住專業人員服務補助額度，並調降申請及核銷作業的標準。[[abstract]]Adult mental disorders, which under six adults living in the community service, their outcomes obviously outperforms institution care in the dimensions of self-determination, quality of life, and community integration. It would be more fit for the principles of the United Nations Convention on the Rights of persons with disabilities. However, the government policy for disabled persons living mainly focused on the setting of reformatory mode of long-term storage treatment and maintained survival or operations. Selective grants were more abundant throughout the day as the main accommodation service, but it was not conducive to take forward community living services. Thus in statistics, institutions service increase in the number of community living is about 10 times. Besides, living in the community service also encountered service promotion, financial pressure, parents and public hinder. Cost management is the foundation of financial management. Traditional cost accounting system did not correctly reflect the true cost of a housing unit. It also hard to reflect the relationship between resident's needs and service activities. The research tries to construct and practice the activity- based costing, focusing on cost information, and comparing the government found. Expect that it would be helpful to government set more appropriate allowances for the density of the different needs of service users and, achieving the following goals: [1] using of activity-based costing, constructing a cost model of community living project for adult with intellectual disability , and implementing to the case care unit. [2] clarifying the relationship or correspondence of related service users' needs and professional service activities. [3] offering others institutes a reference structure; supporting different densities of individual service units, provision activity-based costing budgeting. It would follow the architecture design of this study, setting steps of activity based costing system. It would be sequential completion of the selected cases, forming unit job dictionary and activity driver; execution modules in cost issue. Finally, base on the outcomes of cost information, including of financial and non-financial information to do data analysis. The findings and conclusions were followings: I. Advantages of activity-based costing a. the contents of community would be made more specific and clear in residential service b. calculate the unit cost of service residents c. providing professional service, the fees would be more reasonable and detailed in cost information II. Activity based costing system applications a. It can be used for provision of activity-based costing budgeting b. It can be used for the improvement of the activities c. contributing the cost management and decision-making charges To compare the assessment tools from Ministry of Health and Welfare on Republic of China, the applicant of middle class of support density in resident needs funding; and the unit operational cost in this study; the former one lower than the latter NT 6,269. It means that NT 6,400 with a maximum grant of imputed, raised the proportion were about 52.3%, the mainly part of the services, which included lower amount of subsidy or not included in the subsidy standards. This research results implied that it should increase the amount of community living of subsidies and services professionals and lower down the standard of application and verification operations.[[note]]碩