Question 6294 — social and medico-social institutions

Summary

Mr. Mathieu Lefèvre draws the attention of the Minister to the Minister of Labor, Health, Solidarity and Families, responsible for health and access to care, to the growing budgetary difficulties encountered by several essential support and coordination mechanisms in the territories: coordination support mechanisms (DAC), regional expertise mechanisms (DER), specific regional mechanisms (DSR), local information and coordination centers (CLIC) as well as territorial food projects (PAT). Each year, these structures support more than 300,000 people faced with particularly complex medical-psycho-social situations: isolated elderly people, people with disabilities, chronically ill people, children and adults, often without any other recourse. Their missions of proximity, coordination and comprehensive support constitute an essential link in the health and social action system. These systems were integrated, on August 5, 2024, into the scope of structures having to apply the so-called “Ségur” bonus to their employees. This revaluation has enabled real recognition of professions in the sector. However, the financiers (ARS and departmental councils) face an additional financial burden of around 5,000 euros per employee, without any additional budget having been planned to cover this charge. This situation jeopardizes the continuity of the essential missions carried out by these systems and exposes users in complex situations, often without other recourse or support, to directly suffering the consequences of an inevitable reduction in support. Furthermore, this framework imposes increasing pressure on health establishments and liberal professionals who will have to absorb this care without appropriate coordination and endangers the continuity of health care pathways while some of these structures are threatened with disappearance. Thus, he asks whether the Government intends to guarantee the sustainability of these systems by including, in the social security financing bill for 2026, specific financing that meets needs. generated by the extension of the Ségur premium.

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