Question 17959 — health professions

Summary

Mrs. Annick Cousin alerts the Minister of Labor, Health and Solidarity about the situation of the Asalée association, which is now seriously threatened. This association, created in 2004, currently employs 2,080 nurses and 9,155 general practitioners, in 2,963 locations in France. It offers patients an innovative approach, using a pair collaboration between nurses and doctors, to put at the center of medical monitoring preventing the deterioration of patients' chronic pathologies. This increased emphasis on prevention aims to respond to the needs of patients and the challenges of the health system (insufficient care provision, increases in chronic diseases such as diabetes, cancers, addictions or other cardiovascular diseases). As an organization delegated to public health, the association is approved by the National Health Insurance Fund (CNAM). She now finds herself in great financial difficulty. On the one hand, because the CNAM has changed the date of payment of monthly installments, moving for example from February 27, 2024 to March 4, 2024 for the month of March 2024. This decision places psychological pressure and an additional burden on the association and its employees. On the other hand, because the CNAM refuses to resume negotiations with Asalée for the signing of a new agreement. In 2023, the CNAM proposed a new agreement to the Asalée association which refused it. It would in fact have led to an increase in management controls, as well as an administrative overload which would have had repercussions on the quality of patient care. At the same time, it provided for the payment of an underestimated number of full-time employees (1,200 compared to 1,500 currently). Negotiations have since stopped. These disagreements have led to tensions which risk having a strong impact on the reception of patients, but above all the sustainability of the Asalée model and its success in the territories for 20 years. The disappearance of this structure would have significant repercussions on access to healthcare in the country and more particularly in the departments affected by desertification. medical like Lot-et-Garonne. It would lead to a return of patients to traditional health services that are already saturated, a loss of quality in access to care and the prevention of pathologies, which in the long term will cause an increase in health costs for patients and the CNAM. She would like to know her position regarding this issue, as well as the solutions envisaged to enable the sustainability of the system of followed by the Asalée association, now threatened.

Machine translation from French. The official text remains authoritative.

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