Application of ICF/ICF-CY to Physical Therapy and the ICF Mobility Scale in Taiwan

The International Classification of Functioning, Disability and Health (ICF) and its children and youth version (ICF-CY) have changed the medical and social welfare service systems in Taiwan tremendously. According to the People with Disabilities Rights Protection Act promulgated in 2007, since July 2012, the disability evaluation has to be based on the ICF framework. In Taiwan, the disability eligibility system in Taiwan is a 3-step procedure (Medical Examination (ICF b/s), Functional Assessment (ICF d), and Needs Assessment (ICF e)). The health authority is responsible for conducting the process of disability certificate accreditation and the social welfare authority for providing the services needed to the persons with certificates. After assessment by health professionals, a medical evaluation report will be sent to the local health and social welfare departments. Then, the professionals in the social welfare system do brief Needs Assessments in order to issue disability identification with the information of disability category and severity level. Before the Act passed, the physical therapists in Taiwan started to embrace the ICF framework, and have participated in ICF/ICF-CY related activities for the preparation of the Act implementation. To implement that Act, a series of preparatory work inside the government system, non-government organizations, and academic societies began in 2008. The preparatory activities include: fighting for research funding, ICF documentation and measurement tool translation, development of measurement tools, evaluation establishment, staff training, and conferences of ICF. Another purpose of this article was to introduce assessments of Activities and Participation by using the ICF Mobility Scale as an example, to present the process of preparation (i.e. how to select codes and how to assign qualifiers) and its content. Issues regarding the implementation of ICF/ICF-CY and plans in the future are also discussed.