湖南省解决农村贫困重度残疾人托养照护问题的实践与启示

Practice and Enlightenment of the Nursing Care for the Poor and Severely Disabled in Rural Areas of Hunan Province

解决农村贫困重度残疾人照护问题,既是党和政府的明确要求,也是残疾人和家属的热切期盼。湖南省农村贫困重度残疾人托养照护专项实践的主要启示:一是照护服务能有效改善农村重度残疾人生活质量和巩固脱贫攻坚成果;二是规划部署和经费配置是解决照顾问题的关键所在;三是“家庭自付+村社支持+政府补贴”的付费方式在实践中具有可行性和可持续性;四是农村地区需要优先发展保障急需的基本生活照护和寄宿照护服务,需要根据残疾人生活自理能力和家庭照护能力精准提供适合的照护服务。建议将“优先重点解决城乡低收入重度残疾人照护问题”纳入“十四五”规划及政府实事工程任务,加快建立以家庭照护为基础、社会化照护为支持、集中照护为补充的重度残疾人照护服务体系,完善以生活自理能力和家庭照护能力为核心指标的优先保障对象精准识别机制,通过“两补提标”、建立家庭照护和集中照护机构统一认定制度、评价制度和支持机制,完善残疾人帮扶机制。

Solving the problem of nursing care for the poor and severely disabled in rural areas is not only a sure requirement of the party committee and government,but also a long-term expectation of the disabled and their families.The practices of special care and care services for the poor and severely disabled in rural areas carried out by Hunan Province have brought about the following enlightenment:First,care services can effectively improve the quality of life of the poor and severely disabled in rural areas and help consolidate the results of poverty alleviation;second,planning deployment and funding allocation are the key to solving the problem of nursing care for the disabled;third,the payment method of“family self-finance+government subsidy”has good operability and sustainability in practice;fourth,speeding up nursing care for the disabled in the process of service development,it is necessary to give priority to the development of urgently needed basic life care and boarding care services,and it is necessary to accurately provide suitable care services according to the self-care ability and family care ability of the service receivers.In this paper the following are suggested:to include into the 14th Five-Year Plan and the government’s practical projects of the“phased priority to provide the nursing care for the poor and severely disabled in rural areas”;to fasten the establishment of the family care-based nursing care service system for the severely disabled,which should be supported by public care,and supplemented by collected care;to set up a joint work mechanism through the Workers’Committee for the Disabled to coordinate multi-sectoral efforts to meet the nursing care for the disabled;to establish a precise identification mechanism for priority service receivers with self-care and family care abilities as core indicators;by increasing subsidies and establishing a unified identification system,evaluation system and support mechanism for family care and centralized care institutions,innovate service-oriented assistance and mechanisms for the disabled.