Article 1 General Principles
Definition and population of persons with disabilities (in response to Paragraph 4 of the State Report)
The World Health Organization (WHO) estimates that 10% of the world’s population live with some form of disability, while in the UK and in the US, persons with disabilities (PWDs) make up between 19-20% of the total population. In Taiwan, as stated in Paragraph 4 of the State Report, there are approximately 1.15 million PWDs carrying disability certificates or a disability card, which account for 4.92% of the total population. It should be noted, however, that the Taiwanese statistics diverge hugely from those of the UK, the US and even of the world. In fact, PWD prevalence depends on the availability of government resources as well as on how the State allocates relevant resources and manpower, but the Taiwan Government have never carried out any survey on the number of PWDs among the total population while conducting a census.
We recommend that during the next census, the government should adopt the “6-question disability measure” published by the WHO to obtain preliminary proportion figures of PWDs in Taiwan, and they should also, based on the above census data, launch the second phase of the survey focusing on demands of PWDs. Current surveys in this regard select only the PWDs with a disability card or disability certificates as sample subjects, which makes it rather difficult to obtain an accurate estimate of the resources required (see Article 31).
Imbalance between classification procedures of PWDs, demands assessments and requested services
The main classification criteria should be the demands of PWDs instead of their impairment, whereas the latest version of the classification procedures in Taiwan is still dominated by a medical mindset. A new version of “Classification System of PWDs and Assessment on Welfare Services” was launched in 2012, and some major differences between the new version and the previous one are as follows: the number of disability categories has been reduced from 16 to 8; the size of team in charge of the classification has been enlarged, consisting now a group of professionals including medical professionals, social workers, special education teachers and career assessment specialists in contrast to one single physician formerly; and the “International Classification of Functioning, Disability and Health (ICF)” designed by the WHO has been introduced via the new version as an assessment tool. Although the ICF is generally considered an epitome of the social model given that the criteria of “Activities and Participation” (code D) and “Environmental Factors” (code E) are included, how Taiwan implements it shows a different reality: it is carried out predominantly by medical professionals along with classification procedures done mostly in assigned medical institutions. In addition, the Taiwan Government provide only a summary translation of the ICF and regards it merely as a set of codes without highlighting the underlying ideas and principles of this system. The 8 disability categories currently presented are all items taken from “body functions and structures” (code B/S) of the ICF, and seem less intuitive and realistic compared to the previous 16 categories. Under the new classification system, many people with physical disabilities, for instance, are put in the category 1 alongside those with intellectual disabilities according to the structure of their nervous system. As for the 8 categories of which body function impairments are the main classification criteria, they still fail to include all types of PWDs, such as certain rare diseases patients who cannot pass the required evaluations made by physicians or be certified with a disability card which guarantees them with resources to protect their own rights.1
The cost of assessing PWDs is huge; however, the government may not have in mind an aim to provide relevant services when allocating resources. The current “Assessment Form for PWDs” is designed in a way that benefits more the government than PWDs, thus failing to make comprehensive and dynamic assessments on the demands of PWDs. Upon obtaining an assessment form at a district office, PWDs have to check off items placed under “disability category” and “demands on welfare services” for which they would like to undergo an assessment. In the case of the forms distributed within Taipei City, there are three types of welfare items under “demands on welfare services,” the first being those entitled to all certified PWDs, while the second and the third being those that require the PWDs to file additional applications as well as pass demand assessments such as a disability evaluation, an evaluation or a career counseling interview.2 However, a frontline worker poorly aware of disability issues is oftentimes not able to guide the PWDs that s/he is helping to check off the items that correspond best to their own conditions. When services provided fail to meet actual demands of the applicant later on, the applicant will need to spend extra time, energy and money filing the same assessment application for a second time. Even if the applicant passes the required assessments and evaluations, the local governmental offices in charge may lack resources to provide the services requested, or even give out contradicting instructions or shirk responsibilities one after another.
To persons with invisible disabilities such as those with mental disorders, the cost of undergoing various types of assessments is too huge. They would have to go to assigned local hospitals or medical centers for assessments, pay fees for regular return visits, and request their supervisors in the workplace to approve their sick leave for each return visit, and so on. In addition, the disability card or certificates they succeed in obtaining not only fail to offer them sufficient protection of rights, but may also become an obvious target to be discriminated against by the society as well as the owner’s employers and colleagues. The fact that the safeguarding certificates eventually become a stigma-carrying label leads many persons with invisible disabilities to give up possessing these documents. In view of the above, we strongly encourage the government to review the current assessment procedures for PWDs, in order to work towards meeting certain dynamic demands of PWDs by putting forth measures that are more flexible. Examples of such measures include lowering the threshold for certain types of service to allow the PWDs who have difficulty obtaining a disability card or disability certificates to file an application of demand assessments with their health record, diagnostic reports or major illness/injury certificate.
- Yen et al. (2015), “Assessing the ability of PWDs to participate in activities: what it means and how it impacts the Taiwanese Classification System of PWDs,” Community Development Quarterly.
- “Application form of PWD certificates for the Taipei City, with explanations for demands on welfare services (in Chinese),” website of the Department of Social Welfare, Taipei City Government.