Question 16595 — health professions

Summary

Mr. Laurent Alexandre draws the attention of the Minister Delegate to the Minister of Labor, Health and Solidarity, responsible for health and prevention, to the future of the Asalée system (liberal team health action), created in 2004 and present today in all departments. In a rural area like Aveyron, subject to significant difficulties in accessing health care, this system of active cooperation between doctors general practitioners and nurses is an interesting lever to facilitate the care of patients, particularly those suffering from chronic pathologies. It is based on cooperation facilitated by the presence in the same premises (or nearby premises financed by the association) of doctors and nurses, which makes it possible to treat patients with chronic pathologies in a coordinated manner (education therapeutic, nutritional, smoking cessation, overweight in children and adolescents, screening for COPD, screening for cognitive disorders, etc.). These are time-consuming treatments that Asalée nurses provide with feedback to the attending physician, thus freeing up medical time. To date, there are 9,155 partner doctors and 2,080 salaried nurses (including 1,000 and 244 respectively distributed across 321 sites in Occitania) which make up a system with triple advantages: freeing up doctors' time, facilitating the patient's care journey in time and quality and allowing them to acquire and mobilize self-care skills thanks to the contributions of therapeutic patient education (TPE). Asalée is based on a financing agreement with the National Health Insurance Fund (CNAM). This allows in particular the taking into account charge of rent for premises inherent to the activity of Asalée professionals. However, professionals in the sector are concerned that the new agreement which came into force on January 1, 2024 has removed this earmarking of financing for rents. In addition, it does not seem to take into account the evolution of the number of installations, which would have an impact on the payment of salaries. The deputy recognizes the importance of the investment made by the CNAM and understands its concern to ensure compliance by the association with the proper use of the subsidies paid and the rules applying to any organization financed by public funds. However, he also wishes to recall the importance of conclusive discussions for a new agreement shared with the professionals concerned. Retraining as a nurse Asalée is often a professional project built over a long time and a strong personal investment that must be considered at its fair value. Thus, the MP wishes to know the objective motivations of the CNAM behind the new provisions of the agreement which binds it to Asalée. He would also like to know what measures are being considered to respond quickly to the legitimate concerns of professionals and health professionals involved and involved and to grant the Asalée association the means for its development.

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