Special Report 1
Blissful Taipei, Friendly City
Have a Care-free Pregnancy, Immigrant Friendliness
A nation's population is one of its basic elements. Its composition, quality, distribution, development and migration are all related to a nation's development and society's wellbeing. In recent years, Taiwan's fertility rate has been decreasing year by year, resulting in a low birth rate which is leading to population ageing. According to the National Development Council's population estimates, Taiwan is expected to show negative population growth after 2019. Population issues have become an issue of national security, and the main way to boost a nation's population is to increase its fertility rate and to build an immigrant-friendly environment. In order to increase the fertility rate of Taipei residents and to relieve the financial pressure of many young couples who want to have children but are not financially capable of doing so, the Taipei City Government implemented a “Have a Care-free Pregnancy” in 2010, including a reward of NT$20,000 for giving birth, a monthly NT$2,500 childcare grant for children under the age of 5, a tuition subsidy for children of age 5, expanded childcare after school, post-nuptial and prenatal physical check-ups and maternal serum screening, child-raising friendly parks, and efforts to encourage corporations to implement daycare facilities or measures. Presently, a daycare environment of one infant daycare center and one parent-child center in each district has been established to strengthen support for parents and to help share the pressures of taking care of children. Since the launch of the “Have a Care-free Pregnancy” in Taipei City, over NT$12,073,670,000 has been provided as of the end of 2014, benefiting more than 1.65 million people. Overall, the number of births and the birth rate in Taipei City have shown trends of continuing increase since the policy's implementation with the birth rate of Taipei City being the highest among Taiwan's five major metropolitan regions for the past three years. Moreover, Taipei City was also recognized as the most childcare-friendly city in Taiwan by the Child Welfare League Foundation in its 2014 Survey Report on Childcarefriendly Cities, which shows that the program has yielded significant results.
To construct an immigrant-friendly environment, the Taipei City Government has planned a complete set of assistance and guidance measures, issuing the Taipei City Policy of Assistance for New Immigrants and Implementation Plan and setting up the Advisory Committee on Measures of Assistance for New Immigrants. In addition, growth camps and workshops for new immigrants were conducted, multicultural events were held, and the Taipei City New Immigrants' Hall, multicultural centers, and a specific website for new immigrants were established. Borough wardens or neighborhood secretaries also visited the homes of new immigrants directly to hand out lucky bags (the “happiness & lucky bag home delivery” project). According to statistics for the end of November 2013, there were 46,563 new immigrants in Taipei City. In order to help new immigrants adapt to their married lives as soon as possible, the Taipei City Government's Department of Civil Affairs, began to conduct growth camps and workshops for new immigrants in 2000. As of the end of December 2014, 334 classes – attended by 10,733 individuals – had been held. Moreover, by December 2014, 160,111 individuals had visited or used the Taipei City New Immigrants' Hall after it opened, 2,126,637 people had visited the website for new immigrants since its launch, and borough wardens or neighborhood secretaries had visited and distributed lucky bags to a total of 10,905 new immigrant families, turning Taipei into an immigrant-friendly city rich in multiculturalism. Through the “Have a Care-free Pregnancy” and measures providing “Assistance for New Immigrants”, the Taipei City Government has built Taipei into a friendly city full of happiness.
Abundant Childcare Resources, Friendly Childcare
One Parent-Child Center per District, Building a Taipei Wonderland
The aims of parent-child centers are to establish safe, high quality, community-based play environments and to make services available, enabling parents and main care providers to find the childcare resources they need in their home neighborhoods, so that childcare pressures can be lightened. Parent-child centers are open from Tuesday to Sunday from 9:30 a.m. to 17:00 p.m. (closed Mondays for disinfection) and offer services – including agespecific and themed parent-child playing spaces – for children under the age of 6 and their care providers. Furthermore, childcare and parent-child seminars, group promotion of childraising knowledge and consultation services, parent-child interaction or learning activities, volunteer training programs, and more are conducted as well. Outreach services are also provided to actively bring welfare services to communities which lack resources, as well as providing an on-site childcare consultation service to disadvantaged families. Following the inauguration of the first parent-child center in Zhongzheng District – 131 Fun Center – in September 2011, the second parent-child center opened in Songshan District in August 2012. Four parent-child centers opened in Zhongshan, Beitou, Datong and Wenshan Districts in 2013, and seven more began operation in Shilin, Neihu, Wanhua, Nangang, Daan, Xinyi and Zhongzheng Districts in 2014, fulfilling the objective of operating at least one parentchild center in every district as well as opening a second such center in Zhongzheng District – the 13th overall in Taipei City. Adopting the “publicly owned, privately operated” approach and incorporating private resources, each parent-child center was created with its own unique features. For instance, the mobile castle of 131 Fun has introduced multi-faceted teaching aids and toys into the community; the Songshan Center, with an activity space designed exclusively for children under the age of 3, conducts the ancient “Zhua Zhou” Ceremony to enable moms and dads to explore the inner world of their children; the Zhongshan center focuses on a parent-child theater for appreciating and experiencing life through drama; the Beitou center – possessing a large tree house, a painted water wall, and a parent-child kitchen – is committed to using community resources for the promotion of local culture; the Datong center seeks to build a multicultural global perspective, allowing children to explore customs from around the world; the Wenshan center is the first to offer DIY activities to inspire children's creativity and imagination; the Shilin center is the first in the nation with a “safe interaction” theme; the Neihu center promotes parent-child joint book reading to make parents and children fall in love with reading through games or activities; the Wanhua center emphasizes local features and has a large outdoor space for parents and children to experience old-time customs; the Nangang center offers diversified exploration spaces to boost children's potential; the Daan center is committed to the development of arts and sciences, providing parents and children with distinct experiences through natural light and shadow and water movement; the Xinyi center combines the culture of military dependents' villages with cultural and creative designs, constructing a Japanese Zen-style parent-child space; the Zhongzheng center integrates digital science and art to build a parent-child digital interactive park combining real and virtual worlds. In 2014, more than 1.26 million people visited these centers.
From its inauguration on July 22, 2013, to the end of 2014, a total of 31,930,000 people have visited the website for new immigrants (https://taipei.parent-child.org.tw/), and the “parent-child center” service of Apps I-Taipei was launched on August 30, 2013, to provide diverse channels for inquiries on information related to parent-child centers and for making reservations. Services provided by parent-child centers are both popular and acclaimed. The results of the service satisfaction survey on parent-child centers conducted by the Research, Development and Evaluation Commission, Taipei City Government, in 2014 (with 1,068 valid responses) showed that users gave average scores of 87.61 and 90.94 for overall physical facilities and service satisfaction respectively. As many as 99.1% of respondents were willing to visit the centers again with their children in the future, and as many as 90% of respondents were willing to make recommendations to their friends and relatives.
One Infant Day Care Center per District; a Model of High Quality, Affordable Day Care
In order to resolve the day-care needs of urban double-income families, the Taipei City Government has planned and established at least one publicly-owned, privately-operated infant day care center in every district to provide high quality, safe and affordable care services, allowing parents to rest assured by providing kind, professional care, hygienic conditions, and fire-safe environments. Taking the space available and the quality of day care service into consideration, each infant day care center accepts 40-45 children while reserving 10% of available slots for disadvantaged families (including low-income and mid-low income households, DOSW-verified families in crisis, and DOSW-verified families in special circumstances), families caring for more than 3 infants/toddlers, and indigenous infants/ toddlers, and charges a monthly fee of NT$11,000 per child – NT$5,500 after deduction of related subsidies. These centers open Monday to Friday from 8:30 a.m. to 5:30 p.m., as well as operating extended hours, to provide quality care and to lower parents' financial burdens regarding day-care costs.
By 2013, nine infant day centers had opened in Zhongshan, Beitou, Datong, Wanhua, Wenshan, Daan, Nangang, Zhongzheng and Xinyi Districts, and three more opened in Songshan, Shilin and Neihu Districts in February 2014, accomplishing the objective of “one infant day-care center per district”. In 2014, the Taipei City Government continued to establish such centers in administrative districts with a large number of newborns or few available daycare resources. The 13th infant daycare center began operation in Jingmei in July 2014. With these 13 publiclyowned, privately-operated infant day care centers, care for up to 540 children has been provided.
Suitable Youth Employment
Taiwan's youth unemployment rate has been increasing since the 2008 financial crisis. Although it showed a trend of slight decline at the end of last year, the gap between education and employment was still substantial. Looking at the reasons for it, it was found that the difficulties faced by unemployed youth during the jobseeking process primarily stemmed from “unfamiliarity with the job market”, “insufficient employment preparation and unmatched skills”. To help young people plan their future careers so that they can find suitable jobs, the Taipei City Government established the Taipei Youth Salon under the Taipei City Department of Labor's Employment Services Office on March 24, 2014. The Youth Salon has adopted the core values of “professionalism”, “creativity”, “support” and “companionship” to provide free “career development assessment”, “career growth assistance” and an “entrepreneurs working space”, as well as “internship” and “employment services”. In 2014, the Taipei Youth Salon served 25,951 individuals, and the status of its various services were as follows:
In addition, the Taipei City Employment Services Office helped youth find employment through the “multiple matchmaking employment” and the “employment service” channels. In 2014, 10,297 young job-seekers under the age of 29 registered at the employment service stations for the first time, 4,039 young job-seekers found employment following referral, and 1,294 young people underwent occupational psychological tests. Moreover, youth summer work opportunities were offered to post-secondary students in Taipei City to effectively provide relief for children whose educational rights have been affected as a result of their parents' unemployment; in all, 340 individuals participated. Furthermore, the Taipei City Employment Services Office also conducted employment promotion (youth employment experts) workshops to help young people understand current trends in the job market and improve their job-seeking skills, enabling job-seeking youth to successfully enter the workplace upon graduation; a total of 413 individuals took advantage of this particular service.
Friendly Neighborhoods for the Elderly – Ten-Minute Living Perimeters
Moving towards an Ageing Society, Building an Active-Ageing New City
Ageing is an ongoing global issue. The number of senior citizens in Taipei City exceeded 380,000 in 2014, accounting for 14.08% of the overall population. With the number of older citizens increasing, the Taipei City Government has provided subsidies for private groups to establish elderly activity centers to prolong the health of senior citizens, to shorten periods of disability and to encourage elderly persons to leave their homes and integrate into society. These centers offer leisure and recreational activities, health promotion events for elderly persons and community-based age-friendly environments, in the hope of allowing elderly persons to enjoy healthy and joyful later years. Since 2000, the Taipei City Government has joined forces with the private sector to widely establish elderly activity centers in communities and provide multi-faceted age-friendly services. Through these elderly activity centers established by partnership between the public and private sectors, healthy elders have been encouraged to conduct regular out-ofhome and social activities and to participate in activities that suit them, including newspaper reading, chess club, recreational classes (e.g. Japanese classes), karaoke classes, and health promotion activities (e.g. health exercise and meridian classes), to create 10-minute living perimeters for the elderly.
Food Tastes Better when Eaten with Others! Eating- Together Programs to Meet the Various Needs of the Elderly
Besides promoting various types of elderly activity centers in communities and encouraging the elderly to leave home and socialize with others more often, the Taipei City Government has also conducted an eating-together program for the elderly at these centers, having them stay behind after participating in community activities to enjoy meals together. In Chinese society, the dining table is not just a place for eating but also a place for emotional exchange. By dining together, elderly persons can draw closer to each other, enjoying a greater appetite in a vibrant atmosphere.
Collaboration between the Public and Private Sectors, Building an Age-Friendly City
To put “ten-minute living perimeters” into practice, the Taipei City Government has established a two-track model involving crossdepartmental cooperation and collaboration with private groups. With respect to lateral communication, cross-departmental meetings are being held to integrate the resources of various departments, including the Department of Social Welfare, the Department of Health, the Department of Education, and the Department of Sports, to establish cross-departmental partnerships, as well as to inventory and organize the available venues in Taipei City. In regard to vertical communication, a tiered guidance mechanism has been adopted, supplemented by irregular visits, explanation sessions, and meetings, to establish a resource exchange platform, as well as improving the quality and quantity of services provided through education and training to set up a model of elderly-friendly centers.
Increased Innovation, Raising the Quality and Quantity of Services
After years of effort, the Taipei City Government has successfully incorporated the private sector into community elderly services and has fully developed a variety of innovative activities. However, there is only so much that the government can do, and with the endless creativity in the private sector in mind, the Taipei City Government has also injected funds to encourage these centers to present “innovation proposals”. These centers can make plans for creative activities, such as training elderly volunteers to serve disabled seniors in the community and conducting life reviews. In addition, through the integration of available resources and school spaces in the city, grandparents and their grandchildren have been encouraged to learn together in the hope that children's energy can influence their grandparents, putting the concept of life-long learning into effect as well as enabling elderly persons to share their valuable wisdom and life experience with young students, so that elderly persons may feel a sense of usefulness.
A Sense of Usefulness for the Elderly, Further Developing Elderly Volunteering in the Community
The number of elderly activity sites in Taipei City has been growing year by year. In 2014, the number had expanded to 308 while serving an increasing number of people. Besides attracting the participation of elderly persons in the community, these sites have also drawn quite a number of elderly volunteers to be involved with their services. In the future, efforts will be directed towards the preservation and application of elderly volunteering, allowing more elderly persons to actively integrate into society, to not only “live long and healthily” but also “passionately and happily”.
The Establishment of a Holistic Long-Term Care Network
The Department of Health, Taipei City Government, carries out health promotion services for the elderly and provides opportunities for elderly persons to observe and learn from each other, holding activities, such as the Active Ageing Senior Show organized by the 12 district health centers, and health promotion-related classes, such as the Senior Health Vitality Station and the Community Active Ageing Station. Through professional guidance, elderly persons are able to learn new things, to walk out of their homes, to express themselves and to share and learn from each other, showing their creativity and worth, in short, to put “active ageing, healthy ageing” into practice.
To further build Taipei City into an age-friendly city, the Department of Health, Taipei City Government, constructed the first smart living center for senior health in the nation – the Active Ageing Pavilion – at the Taipei Expo Park in 2014, introducing universal designs and incorporating cloud-based technology, to provide services such as a multi-media interactive health experience, self-health management, assistive device exhibition and consultation, and healthcare information, becoming a model of healthy living services for Taipei's ageing society. Additionally, in order to improve the ability of the elderly to manage their own health, the Department of Health adopting the “Health Automated Teller Machine” concept, which integrated five health measurements – blood pressure, blood oxygen level, body temperature, height, and weight, launching 15 “health Automated Teller Machines” in the 12 administrative districts of Taipei in January 2014. Respectively, these health Automated Teller Machines can be found at the 12 district health centers, the Citizen Internet Area in the courtyard of the Taipei City Hall, the Information Resources Pavilion of the Taipei U Life Village inside the Taipei Expo Park, and the Department of Civil Servant Development. Several private institutions, including the Cathay Life Insurance Co., Ltd., the Fubon Life Insurance Co., Ltd., and the Taiwan Secom Co., Ltd., responded to the policy and joined the Department of Health to establish six additional health Automated Teller Machines in the city. Moreover, eight simplified health Automated Teller Machines have been set up by the Taipei City Hospital, giving the city a total of 29 health Automated Teller Machines. Exclusive cloud-based health management accounts are established for elderly persons through the use of their personal Taipei Card or EasyCard, encouraging them to develop the habit of taking health measurements regularly.
The Care Management Center of Taipei City has been set up within the Taipei U．Life Village, building a holistic care environment for Taipei's aging society with information and cloud technology applications, along with the Assistive Devices Center, the Information Resources Pavilion, and the Active Ageing Pavilion. Through close cooperation between social affairs and health authorities, medical, social welfare and community resources have been integrated to provide a “one-stop shop” for Taipei residents. New programs, including home care, institutional respite, home rehabilitation, home services, daytime care, long-term care institutions, meal delivery for the elderly, adult fostering, assistive device purchase, leasing and rental, barrier-free home improvement, transport/pick-up services, and a QC monitoring system have been implemented to improve Taipei's long-term care network, putting welfare policies for “ageing in place” into practice, to enable disabled persons to receive a diverse range of quality holistic care services.
The “Activeness 321, Wellness of the Mind” event was promoted for the prevention of dementia (diet – 3 balanced meals per day, exercise – two sets of brain exercises per day, and interpersonal interaction – social participation once a week), incorporating teaching plans and short films in the hope of introducing proper concept and attitudes towards dementia to Taipei residents, as well as raising people's understanding of dementia and ways to prevent it. In addition, a 24-hour dementia care hotline has also been promoted to provide multi-faceted dementia consultation services and to relieve the stress experienced by family members of dementia patients. Based on the needs of individual cases, interviews, seminars or courses for family members, and family member support groups may be arranged to improve dementia patients' quality of life and that of their caregivers, to increase the usage of the care hotline and to raise the quality of consultation services. A Post-acute Care Program has been implemented, carrying out disability assessment, rehabilitation and health education services for patients in the community who are potentially in need of long-term care, as well as recently-discharged patients with conditions such as hip fracture, joint replacement, stroke, spinal fracture and other related conditions, to enhance the mobility of disabled patients in Taipei City, improve their quality of life, help patients with chronic conditions return to the community and to provide a seamless transition from acute care to long-term care for individual patients.
Taipei Card – Establishment of Cloud-Based Healthcare
The Origin of the Taipei Card
To put health promotion and the concept that an ounce of prevention is worth a pound of cure into practice, the Department of Health, Taipei City Government began to implement the “Wellness Card” in 2008. The Wellness Card enabled Taipei residents to accumulate health points that could be redeemed for discounts on health examination and outpatient registration fees charged by the Taipei City Hospital through participation in health screening or health promotion activities. Furthermore, to encourage use of preventive healthcare services and to incorporate the “health cloud”, the cards issued by the different departments of the Taipei City Government and various municipal services were integrated in 2012, along with the EasyCard, with the issuance of a multi-functional “Taipei Card” on April 30, 2014. Functioning as a tool for paying public transportation fares or as an electronic wallet for small payments, the “Taipei Card” utilizes the serial number of one's EasyCard as a means of substitute identification, protecting one's privacy and helping to establish a cloud-based health management account. When a Taipei resident participates in a health screening or a health promotion activity, it is automatically recorded in the cloud database, and he/she is able to inquire about his/her healthcare participation and, in the meantime, is rewarded with health points that can be redeemed as EasyCard credit. Personal health management and medical service histories are established to construct a model of holistic health care.
Establishing the Taipei Card Task Force
In 2012, Commissioner of the Department of Health Lin Chi-hung, who served as the task force's convener, led the team in its commitment to the concept of “consideration from the public's standpoint, participation by all, continuous improvement, and innovation and refinement”. Reward point activities were planned. Cancer was ranked first in a survey of the top 10 leading causes of death in Taiwan. In actively promoting free screenings for colon, breast, cervical, and oral cancers, the Department of Health connected to the database maintained by the Health Promotion Administration, Ministry of Health and Welfare, to obtain cancer screening records. Parents can have their newborns undergo child developmental screenings regularly beginning at birth, and preschool children are to receive oral cavity, eye, hearing and physical check-ups. Meanwhile, a web platform has been incorporated allowing individuals to undergo simple health screenings on their own and to have their blood pressure measurements uploaded automatically, as well as having the Active Ageing Pavilion provide cloud healthcare physiological records. Along with the Department of Transportation's “YouBike” records incorporated in 2013 and the Department of Sports' sports consumption records adopted in 2014, Taipei residents are provided with a diverse range of preventive healthcare and health promotion activities,allowing them to establish personal health information, as well as enhancing their health literacy.
Introducing Information and Communication Services
An open and transparent operational model was established for the online service system, setting up the “Taipei Card – Second Generation Wellness Card Management System” to offer functions such as online application and points inquiry to members of the public. Additionally, members of the public are provided with an “active, automatic, ubiquitous” care service mechanism that integrates the “substitute identification” function of the Taipei Card, mobile information and communication security technologies, and a personal health management database, establishing a personal health management platform involving both the community and the government. Besides the 12 district health centers and the various branches of the Taipei City Hospital. In 2014 locations for the redemption of EasyCard credits were expanded to include the 12 district sports centers and the EasyCard add-value machines at the various MRT stations in the Greater Taipei area.
Outcomes and Conclusions
Between April 30, 2013, and October 30, 2014, the number of applications for the “Taipei Card – Second Generation Wellness Card” reached 329,008, the number of health points rewarded added up to 23,877,470, and the number of participants in the program totaled 541,898. The program has received a number of awards and recognitions, including the “Outstanding” recognition of the Government Service Quality Award of the Taipei City Government in 2013, the “Innovation Achievement Award” of the 6th Healthy and Agefriendly Cities Award organized by the Alliance for Healthy Cities, Taiwan in 2014, and international healthy city poster presentations at the 6th Global Conference of the Alliance for Healthy Cities in 2014. In October 2014, the Department of Information Technology, Taipei City Government, integrated the functions of the Senior Card, Charity/Escort Card, student ID card and Second Generation Wellness Card to provide discounts at cultural venues and the Gongguan Commercial District for residents holding Taipei Cards. The issuance of the Taipei Card is a government service re-engineering project and is also one of the highlight programs for Taipei City's bid for World Design Capital 2016 designation. Designers, citizens, and the public sector have jointly participated in the process of public service design to improve the quality of living for Taipei's residents.