Question 8307 — personal services

Summary

Ms. Sophie Errante draws the attention of the Minister of Health and Prevention to article 44 of the LFSS 2022, the objective of which is to restructure by “bringing together/merging” the existing services such as SAAD, SSIAD, SPACAD, to form a single category of “home autonomy services”. If the structures approve the spirit of this project, which should allow greater efficiency and coherence of interventions to home, for the benefit of dependent people, confusion is brought about by the note published by the DGCS on February 1, 2022. While it is desired “a single category of home autonomy services” (page 1), it is described on page 2 “two categories of home autonomy services: services providing help and care and services providing only help”. Thus, current SAAD assistance services would automatically be autonomy service, with the need for agreement if they want to provide “care” support. This name would therefore designate two entities that cannot provide the same service to the population, which goes against the clarity expected by each. The current landscape, in full swing with the creation of DRAD, DIVADOM, CRT, generates a certain confusion among citizens and professionals. A simplification of routes is essential and must rely on the expertise of existing services, providing them with the financial means to develop coordination. In certain territories, the SAAD and SSIAD have been working for several years in a spirit of positive and facilitating partnership. They communicate and coordinate naturally, focusing on the needs of the people they support. If the partners welcome the desire to strengthen this coordination, they believe that the proposed lever is unsuitable for them. The announcement of this reform raises concerns about the consequences of its implementation and in particular about the resulting obligation to merge and absorb other services. Indeed, the injunction to create new legal entities will necessarily: destructure existing partnerships and committed projects: competition between services, which will associate with whom and under what status? What governance? ; create confusion among users and their families who appreciate the ease of current procedures, the proximity of services and small establishments; generate concern among caregivers who work and thrive professionally in these small structures. Field workers know the needs of their territory. They are convinced of the value of partnerships and need the confidence of the Minister to pursue their projects to support dependent people. The creation of a single legal entity with an integrated offer of aid and care cannot be a response that can be transposed to the entire national territory: it is essential to take into account the specificities, strengths or levers of each person. This reform can bring real added value in supporting dependent people at home if it allows field actors to pursue a territorial project, with a coordination envelope managed by the central and neutral actor of this support, before questioning the relevance of a new legal model. The MP therefore calls on the Government on the following points: is this reform intended to propose citizens a harmonized offer in the territory? Can stakeholders count on the support of the Government to continue their partnership actions in favor of local and quality support, beyond an approach to creating a legal entity? What articulation and visibility can field workers and users have in the face of the multitude of systems created in recent months? What will be the terms of payment of the coordination grant? Can a CLIC, a central entity for the coordination of services and stakeholders, keep its central place and possibly be the bearer of this coordination grant? She would like to have details on these subjects.

Machine translation from French. The official text remains authoritative.

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