Question 15870 — health

Summary

Ms. Marianne Maximi questions the Minister of Health, Families, Autonomy and People with Disabilities on the future of participatory coordinated care structures and on the need to guarantee long-term funding for all existing structures engaged in this approach. Since the covid-19 health crisis, numerous health structures located in working-class neighborhoods and rural areas have developed innovative models of coordinated and participatory care, based on proximity, prevention, health mediation, social support and the involvement of users in the organization of care. These structures today play an essential role in the fight against inequalities in access to care, non-recourse and medical deserts. The so-called “SECPa” experiment, initiated within the framework of article 51 of the law of social security funding for 2018, enabled 26 structures to benefit from additional funding intended to support missions not covered by fee-for-service pricing: health mediation, interpreting, psychological support, prevention actions, coordination or even patient participation. However, beyond just the 26 structures integrated into this experiment, today there are nearly 60 participatory and coordinated care structures that exist on the national territory, several of which have been reorganized in recent years with a view to expanding or perpetuating the system. However, the Government's recent announcements are causing great concern among these stakeholders, who fear a gradual disappearance of the specific funding necessary for their operation. The Member wishes also emphasize that needs are not limited to maintaining existing structures. In many areas, particularly in the Puy-de-Dôme department, both in working-class neighborhoods and in rural areas facing increasing difficulties in accessing care, a real desire is emerging on the part of health professionals, communities and associative actors to develop new participatory coordinated care structures. These local initiatives demonstrate a strong expectation around models allowing more global, more preventive and more accessible patient care. The announced integration of certain structures within the framework of common law systems, in particular via the Maison France santé label, appears insufficient in view of the real financing needs of the missions carried out. THE The structures concerned warn in particular of the risk of a return to a logic centered exclusively on fee-for-service pricing, unsuitable for the prevention, coordination and social support missions that they carry out on a daily basis. She therefore wishes to know what measures the Government intends to take to guarantee sustainable funding not only for the 26 structures currently supported within the framework of the SECPa experiment, but also for all existing participatory and coordinated care structures in the region. She would also like to know if the Government plans to support the development of new structures of this type in areas that express the need, particularly in priority neighborhoods and rural areas that are under-resourced in healthcare provision. She finally wants to know the budgetary resources that could be mobilized within the framework of the social security financing bill for 2027 in order to ensure the continuity, sustainability and development of these models of care. Finally, she asks if she is considering the rapid opening of a national consultation bringing together the structures concerned, health professionals and users, in order to build a stable and sustainable framework of funding for these initiatives recognized for their health and social usefulness.

Machine translation from French. The official text remains authoritative.

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