Key Benefits:
The National Assembly and the Senate adopted,
The President of the Republic enacts the following legislation:
The adaptation of society to aging is a national imperative and a priority for all public policies of the Nation.
The report defining the objectives of society's policy of adaptation to population ageing, annexed to this Act, is approved.
Title III of Book II of the Code of Social Action and Families is supplemented by a chapter III, as follows:
“Chapter III
"Prevention of loss of autonomy
"Art. L. 233-1.-In each department, a funders conference on prevention of the loss of autonomy of older persons establishes a diagnosis of the needs of persons aged sixty and over residing in the departmental territory, identifies local initiatives and defines a coordinated programme for financing individual and collective preventive actions. Funding is allocated in addition to legal or regulatory benefits. The diagnosis is based on the needs identified, in particular, by the departmental scheme for persons with loss of autonomy referred to in Article L. 312-5 of this Code and by the regional health project mentioned in theArticle L. 1434-2 of the Public Health Code.
"The programme defined by the conference is:
« 1° Improvement of access to individual equipment and technical aids that promote home support, including through the promotion of innovative procurement and provisioning modes and the inclusion of the evaluation provided for in Article L. 14-10-1, 5° of this Code;
« 2° The allocation of the autonomy package referred to in Article III L. 313-12 of this Code;
« 3° The coordination and support of prevention activities implemented by home support and assistance services working with older persons;
« 4° The coordination and support of preventive actions implemented by the multi-purpose home care and assistance services referred to in Article 49 of Act No. 2015-1776 of 28 December 2015 on the adaptation of society to ageing, which is involved with older persons;
« 5° Support for the support actions of the caregivers of the elderly in loss of autonomy;
« 6° The development of other collective preventive actions.
"Art. L. 233-2.-The competitions mentioned in the V of Article L. 14-10-5 contribute to the financing of the expenses referred to in 1° and 6° of Article L. 233-1. These expenses benefit, for at least 40% of their amount, persons who do not meet the conditions of loss of autonomy referred to in Article L. 232-2. They are managed by the department. By agreement, the department may delegate their management to one of the members of the finance conference referred to in Article L. 233-1. A decree sets out the modalities of that delegation.
"The individual aids granted as part of the actions mentioned in the 1st of Article L. 233-1 that the department finances by the contest mentioned in the 2nd of Article L. 14-10-10 shall benefit persons who meet the conditions of resources varying according to the geographic area of residence and defined by decree.
"The rule referred to in the second paragraph of this section also applies to supplementary funding allocated by other members of the finance conference referred to in section L. 233-1.
"Art. L. 233-3.-The finance conference referred to in Article L. 233-1 is chaired by the chair of the departmental council. The Director General of the Regional Health Agency or his representative is the Vice-Chair. It brings together natural or legal persons who contribute to the financing of shares within its jurisdiction. It includes representatives:
« 1° From the department and, by decision of their deliberative assembly, territorial authorities other than the department and public institutions of intercommunal cooperation;
« 2° National Habitat Agency in the department and regional health agency;
« 3° Basic old-age insurance and health insurance plans and federations of complementary pension institutions referred to in theArticle L. 922-4 of the Social Security Code ;
« 4° Organizations governed by the code of mutuality.
"Any other natural or legal person concerned by the policies for the prevention of loss of autonomy may participate, subject to the agreement of the majority of members of law.
"In case of equal sharing of votes, the president has a dominant voice.
"Art. L. 233-4.-The President of the Departmental Council shall transmit to the National Solidarity Fund for Self-Government and to the Public Health Policy Coordination Commissions, no later than 30 June of each year, an activity report and the data necessary for the follow-up of the activity of the finance conference referred to in Article L. 233-1. These data, which include sex indicators, are related to:
« 1° Number and types of requests;
« 2° The number and types of shares financed by the members of the finance conference mentioned in the same article L. 233-1 and the distribution of expenses by type of shares;
« 3° The number and characteristics of the beneficiaries of the shares.
"The lack of transmission of this information by the National Solidarity Fund for Self-Government is an obstacle to any new payment to the department as such.
"Art. L. 233-5.-The departmental funders conference for the prevention of the loss of autonomy of older persons is competent in the territory of the metropolis, if any, established in the departmental jurisdiction, where the latter exercises competence in respect of older persons under the conditions laid down in this chapter, subject to this section. It is called “Departmental-Metropolitan conference of the prevention of self-reliance”.
"It has representatives of the metropolis and is chaired by the president of the city council for all matters concerning the metropolis.
"Art. L. 233-6.-The modalities for the application of this chapter are determined by decree in the Council of State. »
Article L. 14-10-5 of the same code is amended as follows:
1° In the first paragraph, the word "seven" is deleted;
2° The V is thus modified:
(a) In the first paragraph, after the word "prevention", the words are inserted: "including those provided for in 1°, 2°, 4° and 6° of article L. 233-1 of this code", and after the word "studies" are inserted the words "and expertise";
(b) The text is as follows:
“(a) For the elderly, these charges, which include competitions to the departments for the preventive actions planned, respectively, at the same 1°, 2°, 4° and 6°, for amounts fixed annually by decree of the ministers responsible for social action, social security and budget, are traced in a specific sub-section abounded by a fraction at least equal to 28% of the product of the contribution mentioned at 1°-10. »
(c) The b is thus modified:
-the word: ", fixed" is replaced by the words: "the resources provided for in paragraph III of this article and a fraction of the proceeds of the contribution referred to in paragraph 1 bis of Article L. 14-10-4, fixed";
- at the end, the words: ", resources provided for in a of III" are deleted;
3° The V bis is repealed;
4° In the second sentence of the first paragraph of the VI, the words "with the exception of section V bis" are deleted.
I.-Chapter X of Book I title IV of the same code is supplemented by an article L. 14-10 as follows:
"Art. L. 14-10-10.-The competitions to the departments mentioned in the V of Article L. 14-10-5 are as follows:
« 1° The competition corresponding to the autonomy package referred to in the III of Article L. 313-12 is distributed annually between the departments according to the number of places in the eligible establishments;
« 2° The competition corresponding to the other preventive actions mentioned in 1°, 4° and 6° of Article L. 233-1 is distributed annually among the departments according to the number of persons aged sixty and over. »
II.-Any metropolis exercising jurisdiction over the elderly shall be eligible for the competitions of the National Solidarity Fund for Self-Government under Article L. 14-10-10 of the Code of Social Action and Families.
Chapter V of title I of Book I of the Social Security Code is thus amended:
1° After Article L. 115-2, an article L. 115-2-1 is inserted as follows:
"Art. L. 115-2-1.-Organizations responsible for the management of a mandatory social security regime exchange information, other than medical, that they hold and that are necessary to assess the situation of their nationals for access to social benefits and benefits they serve as well as to the actions they implement to prevent the loss of autonomy of the elderly.
"A decree in the Council of State, taken after the advice of the National Commission on Informatics and Freedoms, specifies the nature of the information that can be transmitted, the conditions of this transmission and the organizations that may be consigned to it. » ;
2° An article L. 115-9 is added as follows:
"Art. L. 115-9.-The National Pension Insurance Fund for Employees, the Central Fund for Agricultural Social Mutuality, the National Fund for the Social Plan of Independents and the National Pension Fund for Local Government Officials conclude with the State a multi-year agreement setting out the principles and objectives of a coordinated policy of social action for the preservation of the autonomy of the elderly, led by the regimes that these bodies manage. It is concluded in accordance with the objectives and management conventions that these bodies sign with the State.
"This multi-year agreement may also, upon request, be signed by other national organizations responsible for the management of a basic mandatory pension plan and by national organizations responsible for the management of legally mandatory supplementary pension insurance plans. »
After Article L. 113-2 of the Code of Social Action and Families, an article L. 113-2-1 is inserted as follows:
"Art. L. 113-2-1.-The department and social security organizations define the terms and conditions for mutual recognition of the loss of autonomy of older persons according to the national evaluation grid referred to in Article L. 232-2. »
I.-Le IV de l. L. 14-10-5 du code de l'action sociale et des familles est ainsi modifié :
1° The first is thus written:
« 1° Resources:
“(a) A fraction of the product referred to in the 3rd of Article L. 14-10-4, fixed by joint decree of ministers responsible for social action, social security and budget, which cannot be less than 5%, nor more than 12% of that product;
“(b) Part of the fraction of the proceeds of the contributions referred to in 1 and 2 of the same Article L. 14-10-4 assigned to 1 of the I of this Article, set by joint decree of ministers responsible for social action, social security and budget, within 12 per cent of this fraction;
"(c) A part of the fraction of the proceeds of the contribution referred to in 1° bis of the said Article L. 14-10-4 assigned to the V of this Article, fixed by joint decree of ministers responsible for social action, social security and budget, within 4% of this fraction; »
2° 2° is thus written:
« 2° In charge, the financing of the modernization of the services that provide to the home of the elderly in loss of autonomy and persons with disabilities assistance in the daily acts of life, of the professionalization of their personnel and of those directly employed to do so by the elderly in loss of autonomy and persons with disabilities, of the accompanying expenses of the creation and consolidation of multi-purpose services of assistance and home care, of accompanying expenses »
II.-At the beginning of the first sentence of Article L. 14-10-9 of the same code, the words: "In the two subsections mentioned" are replaced by the words: "In the section mentioned".
In the second paragraph of Article L. 120-17 of the National Service Code, the words "superior civic service can be" are replaced by the words "stutorate is".
I.-Article L. 313-12 of the Code of Social Action and Families is thus amended:
1° I is thus written:
"I.-The establishments referred to in 6th of I of Article L. 312-1 that accommodate a number of dependent elderly people in proportions above the thresholds enjoyed under conditions established by decree are residential institutions for dependent elderly people. » ;
2° I bis and I ter are repealed;
3° The second is thus written:
"II.-The establishments mentioned in I whose capacity is less than a threshold fixed by decree are small units of life.
"These institutions may derogate, under conditions established by decree, from the terms and conditions for the payment of reimbursable benefits to social insured persons set out in 1° of Article L. 314-2. » ;
4° The III is thus written:
"III.-Sont known as residences autonomy establishments that are in a combined manner within 6° of I of Article L. 312-1 of this code andArticle L. 633-1 of the Construction and Housing Code and who receive dependent elderly persons in proportions below the thresholds mentioned in this article.
"Residences autonomy offer their residents minimum, individual or collective benefits, which contribute to the prevention of loss of autonomy, defined by decree. These benefits, which can be shared and outsourced, can also be offered to non-residents.
"The exercise of their preventive mission shall take place, subject to the conclusion of a multi-year contract referred to in Article L. 313-11 of this Code or, if applicable, to the IV ter of this article and within the limits of the corresponding appropriations allocated under Article L. 14-10, to a so-called "autonomy package" aid, allocated by the department. A decree determines the expenses incurred in this regard, as well as the conditions in which the department determines the amount of the package.
"Residences are self-sufficient in the access of their residents to help and home care services. They may only receive a new resident who meets the conditions of loss of autonomy referred to in Article L. 232-2 if the proposed establishment provides for it and that partnership agreements, whose minimum content is provided by decree, have been concluded with, on the one hand, an institution of accommodation for dependent elderly persons referred to in I of this article and, on the other hand, at least one of the following categories of health care nurses:
"As part of an intergenerational-purpose settlement project, self-reliance residences can accommodate persons with disabilities, students or young workers, in proportions below a threshold set by decree.
"The places of the establishment occupied by these persons shall not be taken into account either to determine the thresholds mentioned in the same I or to determine the number of places of the establishment eligible for the self-service plan referred to in this III. » ;
5° The IV is thus restored:
"IV.-The institutions referred to in the first paragraph of the III which, on the one hand, did not benefit from an authorization to provide care to social insured persons on the one hand and, on the other, accommodate a number of elderly persons in a proportion less than the thresholds mentioned in the I retain, subject to the conclusion of a multi-year contract of objectives and means referred to in Article L. 313-11 or, These packages are revalued annually within the limits of the rate of renewal of the means retained under the national objective of health insurance expenses applicable to the establishments mentioned in the 3rd of Article L. 314-3-1.
"These expenses are the subject of an employment account, under conditions provided by decree.
"The III of this section applies to these establishments. »
II.-Article L. 313-3 of the same code is supplemented by a paragraph as follows:
"The President of the Departmental Council shall transmit to the Director General of the Regional Health Agency any act of authorization for the establishments referred to in Article L. 313-12 III and IV. The contents and modalities of this transmission are defined by decree. »
III.-The Government shall submit to Parliament, within two years of the promulgation of this Act, a report on the possibilities of developing a temporary accommodation offer dedicated to persons in situations of loss of autonomy and on the possible integration of this offer within the same self-reliance residences.
Article L. 633-3 of the Construction and Housing Code is as follows:
"Art. L. 633-3.-A titre dérogatoire, dans les établissements sociaux et médico-sociaux relevant des 6°, 7° and 12° of I of Article L. 312-1 of the Code of Social Action and Families, the duration of the contract under section L. 633-2 of this code is that of the residence contract between the resident and the manager pursuant to the articles L. 311-4 or L. 342-1 the code of social action and families. The mandatory clauses and mentions in this chapter may be included in the residence contract.
"For establishments referred to in the first paragraph of this section, the operating regulations referred to in theArticle L. 311-7 of the Code of Social Action and Families is the place of rules of procedure. »
The 3rd of Article L. 342-1 of the Code of Social Action and Families is thus written:
« 3° Institutions granted under personalized housing assistance and not entitled to receive beneficiaries of social assistance, with respect to benefits that are not taken into account in calculating the share of the royalty equal to rent and recoverable rental charges in accordance with the conventions mentioned in theArticle L. 353-2 of the Construction and Housing Code ;".
Section L. 411-10 of the Construction and Housing Code is amended as follows:
1° At the beginning of the 3rd, the words: "The public real estate management establishment of Nord-Pas-de-Calais and" are deleted;
2° At the end of the penultimate paragraph, the words: "with the exception of the dwellings or beds mentioned in the 4th of Article L. 302-5" are deleted.
I.-Les Articles 41-1 to 41-5 of Act No. 65-557 of 10 July 1965 establishing the status of co-ownership of built buildings are replaced by articles 41-1 to 41-7 as follows:
"Art. 41-1.-The co-ownership regulation may extend the purpose of a co-ownership union to the provision to residents of the specific service building whose categories are specified by decree and which, because they benefit by nature to all its residents, cannot be individualized.
"Non-individual services are provided in accordance with agreements with third parties. Expenses relating to these services are apportioned under the first paragraph of Article 10. Operating expenses are common expenses, as defined in section 14-1.
"Decisions on the creation or suppression of non-individualizable services shall be made by a majority referred to in the first paragraph of Article 26. The decision to delete a non-individual service can only intervene provided that the General Assembly had first learned of a report on the utility of this service for all residents and the consequences of the deletion of this service on the financial balance of the condominium.
"If the financial balance of one or more of the services referred to in this section is seriously compromised or if the financial imbalance of one or more services compromises the financial balance of the condominium, and after the general assembly has pronounced itself, the judge ruling as in the matter of reference, seized by co-owners representing at least 15% of the union's voices, may decide either the suspension or the removal of these services.
"The status of co-ownership of built buildings is incompatible with the provision of care or assistance and support services exclusively related to the person, which can only be provided by establishments and services under the umbrella of I of Article L. 312-1 of the Code of Social Action and Families institutions, services or health professionals in the fourth and sixth parts of the Public Health Code.
"Art. 41-2.-The co-ownership regulations may provide for the assignment of certain common parts to the provision of individualized services to the occupants of the building. It specifies the cost of maintenance and operating expenses related to these common areas and its distribution.
"Art. 41-3.-The terms and conditions of use by third parties of the common parts for individual specific services are set out in a free-of-charge agreement pursuant to Chapter I of Title X of Book III of the Civil Code. This agreement is concluded for a period not exceeding five years. It's renewable.
"Art. 41-4.-The general assembly, on the proposal of the trade union council, elects, by a majority of section 25 or, where applicable, of section 25-1, the service providers called to provide the individualised services. The Commission approves, by a separate vote and on the same terms, the terms of the proposed agreement with the chosen providers for the purpose of the free loan of the common parties assigned to these services, established under the conditions set out in section 41-3.
"The duration of the benefit contracts concluded by each occupant with the contractors cannot exceed that of the loan they receive.
"Art. 41-5.- Amendments to the co-ownership by decommissioning common parties assigned to the services referred to in section 41-3 shall be made by a majority of the provisions of section 26. They are notified by the trustee to the relevant providers. They result in the full termination of the loan agreements and the provision of services with providers.
"Art. 41-6.-The union of co-owners of a co-ownership with services cannot derogate from the obligation to establish a union council.
"The general assembly may delegate to the union council, by a majority of the decisions set out in section 25, concerning the day-to-day management of specific services.
"When no delegation is given to this effect, the union council shall give its opinion on the draft conventions referred to in the second paragraph of Article 41-1 and Article 41-4. He monitors the execution of the report and presents an annual report to the General Assembly.
"The provider of individualizable and non-individualistic services cannot be the trustee, his/her attendants, his/her spouse, the partner bound to him by a civil pact of solidarity, his/her concubin, his/her parents or allies up to the third degree included, or the companies in which the above mentioned natural persons hold an participation or in which they exercise leadership or control functions, or of which they are subordinated. When the trustee is a legal entity, the prohibition of being a provider of individualizable and non-individualizable services is extended to companies in which the trustee holds an interest and to companies that hold an interest in the trustee's capital.
"Art. 41-7.-People remaining as principal in the residence constitute the council of the residents.
"This advisory body addresses the requests and proposals of residents to co-owners.
"The resident council is convened by the trustee before the general meeting of the co-owners. The agenda of this assembly is communicated to him. The resident council may also meet on its own initiative, in a premises made available to it by the trustee.
"The trustee shall communicate to the Residents' Council the records of the General Assembly and all information relating to the services provided in the residence, so that the board may issue a notice, in particular, on the need to create or delete a service.
"At the Resident Council meeting, a meeting secretary is appointed. The secretary prepares the record of the session, which is co-signed by the trustee and addressed to all residents and co-owners at the same time and in the same manner as the agenda of the next general meeting. The record of the resident council meetings of the previous three years is given to any interested person prior to the signing of a housing lease contract or the assignment of a lot in the residence. »
II.-At the 4th of Article L. 7232-1-2 of the Labour Code, the words: "service residences under Chapter IV bis" are replaced by the words: "providers who are called to provide individualised services in condominiums with services, referred to in Article 41-4".
I.-Chapter I of Title III of Book VI of the Construction and Housing Code is supplemented by a section 5 of the book:
“Section 5
"Service residences
"Art. L. 631-13.-Residence-services is a set of self-contained housing units that allow occupants to benefit from specific non-individualistic services. Non-individualistic specific services are those that benefit by nature to all occupants. The categories of these services are defined by decree, taken after the advice of the National Commission for Consultation.
"Specific individualizable services can be subscribed by occupants to service providers. The notice period prior to termination of this contract cannot exceed one month.
"Art. L. 631-14.-People remaining as principal in the residence constitute the advice of the residents. The purpose of this advisory body is to implement a discussion space between the residents and the manager of the service residence. She refers to the residents' requests and proposals.
"The resident council is convened at least once a year, at the initiative of the manager or the resident council.
"The manager shall provide the board with information on the number and accounting situation of specific non-individualizable services provided in the residence, so that the board may issue a notice, in particular, on the need to create or delete a service.
"At the resident council meeting, a meeting secretary is appointed to his office. The secretary prepares the record of the meeting, which is co-signed by the manager of the residence and addressed to all residents. The records of the resident council meetings of the previous three years shall be submitted to any interested person prior to the signing of the rental contract.
"Art. L. 631-15.-Without prejudice to Act No. 89-462 of 6 July 1989 to improve rental reports and to amend Act No. 86-1290 of 23 December 1986, when a dwelling in the service residence is rented:
« 1° The lease agreement specifies the specific non-individualizable services referred to in Article L. 631-13, provided to the tenant;
« 2° The lessor and the lessee are obliged, respectively, to provide and pay non-individual services under the agreed terms. The monthly payment is entitled when the tenant applies;
« 3° The lease agreement may contain a clause providing for the termination of the contract's full right in the event of non-payment of such services. This clause may be effective under the conditions provided for inArticle 24 of Act No. 89-462 of 6 July 1989 referred to above ;
« 4° For the purposes of Article 17 of the same Law, the specific non-individualizable services and the specific individualizable services giving rise to payment by the tenant may not constitute a characteristic of the housing justifying an additional rent;
« 5° The leave referred to in section 21 of the Act provides details of the sums paid by the tenant, including rent, expenses and non-individual services.
"Art. L. 631-16.-Sections L. 631-14 and L. 631-15 apply where specific non-individualable services are provided by a manager, natural or legal person, who is also a lessor in the context of lease agreements with occupants. Section 41-7 of Act No. 65-557 of 10 July 1965 establishing the status of co-ownership of built buildings, relating to the council of residents, is not applicable in this case. »
II.-Section L. 631-15 of the Construction and Housing Code applies to lease agreements entered into as of the coming into force of this Act.
III.-Article L. 7232-1-2 of the Labour Code is supplemented by a 5° as follows:
« 5° For their home help services rendered to the persons referred to in section L. 7231-1 who reside in them, the managers of service residences under section L. 631-13 of the Construction and Housing Code. »
IV.-Article L. 7232-4 of the same code is thus restored:
"Art. L. 7232-4.-By derogation fromArticle L. 313-1-1 of the Code of Social Action and Families, the service residences referred to in the 5th of Article L. 7232-1-2 of this Code that manage home assistance services rendered to the persons referred to in Article L. 7231-1 who reside therein are authorized under the terms of theArticle L. 313-1-2 of the Code of Social Action and Familiessubject to compliance with the national specifications set out in Article L. 313-1-3 of the same code. »
V.-The III of section 47 of this Act applies to residential services referred to in section L. 631-13 of the Construction and Housing Code in operation prior to the date of promulgation of this Act, in respect of the licence they have for the provision of home assistance services rendered to persons mentioned in the Act.Article L. 7231-1 of the Labour Code resident, subject to compliance with the national specifications provided for in theArticle L. 313-1-3 of the Code of Social Action and Families and provided that the manager of the service residence and services presumed is the same.
The f of Article 7 of Act No. 89-462 of 6 July 1989 to improve rental reports and amend Act No. 86-1290 of 23 December 1986 is supplemented by five sentences as follows:
"However, work to adapt housing to persons with disabilities or loss of autonomy can be done at the tenant's expense. This work is subject to a written request by registered letter with a request for a notice of receipt from the lessor. The failure to respond within four months of the date of receipt of the application is a decision to accept the lessor. At the departure of the tenant, the lessee may not require the relocation of the premises. The list of works and the modalities of implementation are set by decree in the Council of State. »
The Government shall submit to Parliament, within 12 months of the promulgation of this Act, a report on intergenerational housing in order to secure and promote existing practices.
The report examines the opportunity to adapt the legal regime of the precarious occupation convention to the characteristics of intergenerational cohabitation, whether or not it is subject to the payment of a royalty.
It examines the appropriateness of derogations from the rules relating to the housing tax and the payment of social allowances in order not to penalize the host or hebergé.
Particular attention is drawn to the distinction between services rendered by the person housed in the context of intergenerational cohabitation and what could be considered concealed work.
After the eighth preambular paragraph of Article L. 302-1 of the Construction and Housing Code, it is inserted a paragraph as follows:
"the answers to the special needs of people in situations of loss of autonomy related to age or disability, the development of a new offer and the adaptation of existing housing. »
In the first paragraph of article L. 122-1-2 of the urban planning code, after the word "demographic" are inserted the words: ", especially with regard to the ageing of the population."
I.-The construction and housing code is amended as follows:
1° Section L. 301-5-1 is amended as follows:
(a) The 1st of the IV is supplemented by the words: "and the granting of the specific authorization provided for in Article L. 441-2";
(b) The first sentence of the second paragraph of the VI is supplemented by the words: ", as well as the conditions for granting the specific authorization provided for in Article L. 441-2";
2° After the first sentence of the third paragraph of Article L. 301-5-2, a sentence is inserted as follows:
"It sets out the conditions for the granting of the specific authorization provided for in Article L. 441-2. » ;
3° After the third paragraph of Article L. 441-2, two paragraphs are inserted:
"By derogation from the third paragraph of this article and for the only dwellings not subject to a reservation by the representative of the State in the department pursuant to the fourteenth paragraph of Article L. 441-1, the allocation board may assign, as a priority, all or part of the dwellings built or fitted specifically for this use to persons with a loss of autonomy related to age or disability, in the framework of programmes granted by a specific authorization granted by the State. The modalities for granting this specific authorization are defined by decree.
"For dwellings that are subject to a reservation by the representative of the State in the department, the department may undertake, according to its appreciation of the local housing needs adapted to this type of population, to propose, first and foremost, the dwellings built or fitted specifically for this purpose, to persons with a loss of autonomy related to age or disability. »
II.-At 1° of the I of Article L. 3641-5, at 1° of the II of Articles L. 5217-2 and L. 5218-2 and at 1° of the VI of Article L. 5219-1 of the General Code of Territorial Communities, after the word "beneficiaries" are inserted the words: ", the granting of the specific authorization provided for in theArticle L. 441-2 of the Construction and Housing Code "
III.-Conventions concluded under articles L. 301-5-1 and L. 301-5-2 of the Construction and Housing Code or of Article L. 3641-5, II and III of Article L. 5217-2, II and III of Article L. 5218-2 or VI and VII of Article L. 5219-1 of the General Code of Territorial Communities, in their writing before this Act, may be the subject of an amendment to take into account this section.
Section L. 2143-3 of the General Code of Territorial Communities is amended as follows:
1° The sixth and ninth preambular paragraphs are supplemented by the words "and the elderly";
2° In the seventh paragraph, the words "consultation of persons with disabilities, to the departmental committee of retirees and seniors" are replaced by the words "citizenship and autonomy".
Book II of the first part of the transport code is amended as follows:
1° The 2nd of Article L. 1214-2 is supplemented by the words: ", as well as the elderly";
2° The last paragraph of Article L. 1231-8 is supplemented by the words: ", as well as for specific audiences, including persons with disabilities and the elderly."
In the first paragraph of section 1 of Act No. 2008-496 of 27 May 2008 on various provisions for adapting to community law in the field of the fight against discrimination, after the word "age", are inserted the words: "his loss of autonomy".
Chapter III of title I of Book I of the Code of Social Action and Families is thus amended:
1° In the first paragraph of Article L. 113-1, the word "investment" is replaced by the word "reception";
2° After the same article L. 113-1, articles L. 113-1-1 and L. 113-1-2 are inserted as follows:
"Art. L. 113-1-1.-In the conditions set out in chapter II of Book II title III, the elderly person with a loss of autonomy is entitled to assistance tailored to his or her needs and resources, in accordance with his or her life plan, to meet the consequences of his or her loss of autonomy, regardless of the nature of his or her disability and way of life.
"Art. L. 113-1-2.- Older persons and their families have the right to information on the forms of support and care adapted to the needs and wishes of the elderly in self-reliance, which is implemented in particular by the National Fund of Solidarity for Self-Government, by the departments and by local information and coordination centres, within the framework of the competencies defined in Articles L. 14-10-1 and L. 113-2. »
At the end of the title of chapter I of title III of book II of the same code, the word "placement" is replaced by the word "reception".
I.-Article L. 231-4 of the same code is amended as follows:
1° In the first paragraph, the word "placed" is replaced by the word "received" and the words "or, if not" are replaced by the word "or";
2° In the first sentence of the second paragraph, the words: "induction" are replaced by the words: "intake" and the words: "input" are replaced by the words: "intake".
II.-In the second paragraph of Article L. 231-5 of the same code, the words: " placement" are replaced by the words: "admission".
Section 2 of Chapter I of Book III title I of the same code is amended as follows:
1° The first part of article L. 311-3 is as follows:
« 1° Respect for his dignity, integrity, privacy, privacy, security and right to go and come freely; »
2° Article L. 311-4 is amended as follows:
(a) The a is supplemented by the words: "; the charter is displayed in the establishment or service »;
(b) After the fourth preambular paragraph, two sub-items are inserted:
"At the conclusion of the residence contract, in an interview outside of the presence of any other person, unless the recipient chooses to be accompanied by the trusted person designated under section L. 311-5-1 of this code, the director of the institution or any other person formally designated by him or her research, whenever necessary with the participation of the medical coordinator of the institution, the consent of the person to be received, subject to the last-2 of the contract He informs him of his rights and ensures their understanding by the person being welcomed. Prerequisitely for maintenance, under conditions defined by decree, he informs him of the possibility of appointing a trusted person, as defined in Article L. 311-5-1 of this Code.
"The health care facility, establishment or social or medico-social service that has taken care of the person previously accommodated in the facility referred to in the fifth paragraph of this section shall transmit to the institution the name and contact information of the person of trust if the person has designated one. » ;
(c) After the word: "received", the end of the first sentence of the fourth paragraph is replaced by a sentence as follows:
"In the event of a legal protection measure, the rights of the person received are exercised under the conditions set out in Title XI of Book I of the Civil Code. » ;
(d) At the beginning of the second sentence of the same fourth paragraph, the words: "This contract or document" are replaced by the words: "The contract of stay or the individual document of care";
3° After Article L. 311-4, an article L. 311-4-1 is inserted as follows:
"Art. L. 311-4-1.-I.-When it is concluded in one of the accommodation facilities under 6th of I of Article L. 312-1, including those listed in Article L. 342-1, the residence contract may include an annex, the contents and the terms of development are provided by decree, which defines the specific measures to be taken, other than those defined in the operating regulations, to ensure the physical integrity and These measures are intended only in the interest of the persons welcomed, if they are strictly necessary, and should not be disproportionate to the risks involved. They are defined after examination of the resident and after a collegial procedure implemented on the initiative of the doctor coordinator of the institution or, in the event of a failure of the doctor coordinator, of the attending physician. This procedure combines all representatives of the medical-social team of the institution to conduct a multidisciplinary assessment of the benefits and risks of the measures envisaged. The contents of the schedule may be revised at any time, in accordance with the same procedure, at the initiative of the resident, the director of the institution or the co-ordinating physician or, in the absence of a co-ordinating physician, the attending physician, or on the proposal of the trusted person designated under section L. 311-5-1.
"II.-A person who is welcomed or, where applicable, his legal representative may exercise in writing a right of withdrawal within fifteen days after the signature of the contract, or the admission if the contract is later, without any notice period may be against him or her and without any other consideration other than the payment of the price of the effective stay. In the case of a legal protection measure, the rights of the person received are exercised under the conditions set out in Title XI of Book I of the Civil Code.
"After the withdrawal period, the person who is welcomed or, if any, his legal representative, in accordance with the same title XI of Book I of the Civil Code, may terminate the residence contract in writing at any time. As of notification of its termination decision to the establishment manager, it has a 48-hour period of reflection during which it may withdraw this decision without having to justify a reason. This period of reflection is imputed on the notice period that may be opposed to it. The notice period must be provided for in the contract. It cannot exceed a period provided for by decree.
"III.-The termination of the contract by the manager of the establishment can only intervene in the following cases:
« 1° In the event of an incompetent person's failure to perform an obligation in respect of his or her contract or a serious or repeated breach of the settlement's operating regulations, except where a medical notice finds that this incompetent or breach is the result of the alteration of the mental or physical faculties of the receiving person;
« 2° In the event of a complete cessation of activity of the establishment;
« 3° In the event that the recipient ceases to meet the conditions of admission to the facility, where the condition of the facility is permanently requiring equipment or care not available in the facility, after the manager has ascertained that the person has an appropriate reception solution.
"IV.-The duration of the notice period applicable to the termination of the contract by the manager of the establishment shall be provided by the decree referred to in the second paragraph of II. It shall not be less than the maximum period of notice applicable to the termination of the contract at the request of the person or his legal representative pursuant to that same second paragraph. » ;
4° After Article L. 311-5, an article L. 311-5-1andsi is inserted:
"Art. L. 311-5-1.-When taking care of an institution or social or medico-social service, it is proposed that the person in question be given the opportunity to designate, if it has not already done so, a person of trust in the conditions defined in the first paragraph of Article L. 1111-6 of the Public Health Code. This designation is valid without limitation of time, unless the person otherwise has. In the course of this designation, the person admitted may expressly indicate, in accordance with the conditions set out in the same article L. 1111-6, that the person in question also exercises the duties of the trusted person referred to in article L. 1111-6, as specified in the same code.
"The person of trust is consulted in the event that the person concerned encounters difficulties in the knowledge and understanding of his or her rights.
"If the person wishes, the trusted person shall accompany him in his or her steps and assist in the medical interviews to assist him in his or her decisions.
"When a judicial protection measure is ordered and the judge or family council, if it has been established, authorizes the person responsible for the protection to represent or assist the person in the acts relating to the person under the supervision of the person second paragraph of Article 459 of the Civil Code, the designation of the trusted person shall be subject to the authorization of the family council, if it is constituted, or failing the guardianship judge. Where the trustee is previously designated as a judicial protection measure, the family council, if any, or the judge may either confirm his or her mission or revoke it. »
I.-Chapter VI of Book I of the Code of Social Action and Families is supplemented by an article L. 116-4 as follows:
"Art. L. 116-4.-Personnel owners, managers, administrators or employees of an establishment or service subject to authorization or reporting under this code or service subject to approval or declaration referred to in 2° of Article L. 7231-1 of the Labour Code, as well as volunteers or volunteers who act in or exercise responsibility, may not take advantage of free arrangements between live or willary made in their favour by persons taken over by the institution or service for the duration of such care, subject to the exceptions provided for in the 1° and 2° of Article 909 of the Civil Code. Section 911 of the same code is applicable to the liberalities involved.
"The prohibition in the first paragraph of this article shall apply to the couple or foster family subject to an approval pursuant to Article L. 441-1 of this Code and to the spouse, to the person with whom he has entered into a civil pact of solidarity or his concubine, to his or her ascendants or descendants in direct line, and to the employees mentioned in theArticle L. 7221-1 of the Labour Code performing services to the person defined in 2° of Article L. 7231-1 of the same code, with respect to the provisions free of charge between live or willary made for them by the persons they receive or accompany during the period of such reception or accompaniment. »
II.-Sections L. 331-4 and L. 443-6 of the same code are repealed.
In the first paragraph of Article 911 of the Civil Code, after the words "physical person" are inserted the words "or a legal person".
After Article L. 331-8 of the Code of Social Action and Families, an article L. 331-8-1 is inserted as follows:
"Art. L. 331-8-1.-The establishments and services and places of life and reception shall inform, without delay, under conditions established by decree in the Council of State, the competent administrative authorities to grant them the authorization provided for in article L. 313-1 or to receive their declaration under articles L. 321-1 and L. 322-1 of any serious malfunction in their management or organization likely to affect their health care »
The first paragraph of Article 2-8 of the Code of Criminal Procedure is amended as follows:
1° In the first sentence, the words: "or disabled" are replaced by the words: ", disabled or elderly";
2° In the first two sentences, the words "or disability" are replaced by the words ", disability or age".
I.-Chapter I of Title VII of Book IV of the Code of Social Action and Families is thus amended:
1° Article L. 471-6 is as follows:
"Art. L. 471-6.-In order to ensure the effective exercise of the rights and freedoms of the protected person, including the prevention of any risk of abuse, the judicial agent for the protection of the majors shall personally surrender to the protected person or, where the status of the protected person does not allow him to measure the extent of the abuse, to a member of the family council if he or she has been constituted or, if not, to a parent, an ally or a person of his or his or his or his or his or his or his or his or his or his or his or his or his or his or his or her person.
« 1° A notice of information to which a charter of rights of the protected person is annexed;
« 2° An individual document for the protection of majors, if any, is an individual document for the application of the fourth paragraph of Article L. 311-4.
"This document sets out the objectives and nature of the protection measure, in accordance with ethical and ethical principles, recommendations of good professional practices and, where appropriate, the proposed service. It details the list and nature of the benefits offered as well as the forecast amount of the levies from the protected person's resources. The minimum content of this document is set by decree.
"A copy of the documents mentioned in 1° and 2° of this article shall, in all cases, be sent to the person by any means proper to establish the date of receipt. » ;
2° Section L. 471-8 is amended as follows:
(a) At 1°, the reference: "to Article L. 471-6" is replaced by the reference: "to 1° of Article L. 471-6";
(b) The 3rd is thus written:
« 3° The individual document for the protection of majors provided for in 2° of Article L. 471-6 is also given to the person; "
II.-The 6th of articles L. 554-3, L. 564-3 and L. 574-3 of the same code is amended as follows:
1° In the third paragraph, the reference: "to Article L. 471-6" is replaced by the reference: "to the 1st of Article L. 471-6";
2° The penultimate paragraph is thus written:
« 2° The individual document for the protection of majors provided for in 2° of Article L. 471-6 is also given to the person; "
After article L. 471-2 of the same code, an article L. 471-2-1 is inserted as follows:
"Art. L. 471-2-1.-A decree in the Council of State defines the cases in which any judicial agent or natural person who has been delegated from a proxy may exercise the activity of a judicial agent to protect the majors according to a method of exercise different from that for which he was initially authorized or authorized, under conditions to guarantee the professional independence of the person exercising the activity of a judicial agent in the protection of major freedoms, »
I.-Section 1 of Chapter II of Title VII of Book IV of the same Code is amended as follows:
1° The last three paragraphs of Article L. 472-1 are deleted;
2° After the same article L. 472-1, an article L. 472-1-1 is inserted as follows:
"Art. L. 472-1-1.-Agreement is granted after a call for applications issued by the representative of the State in the department, which sets the date on which applications must be filed. The conditions for the application of this paragraph, including the information to be provided by the candidates, are set by decree.
"The representative of the State in the department stops the list of candidates whose file is admissible under the conditions laid down in articles L. 471-4 and L. 472-2.
"He classifies the candidates on the list referred to in the second paragraph of this article and selects some of them, according to the objectives and needs set by the regional scheme of social and medico-social organization provided for in the b of the 2nd of Article L. 312-5 and criteria guaranteeing the quality, proximity and continuity of the care defined by decree in the Council of State.
"The representative of the State in the department shall issue the approval to the candidates selected, after the opinion of the prosecutor of the Republic.
"Any change in the activity, installation or organization of an agent or in the civil liability guarantees provided for in Article L. 472-2 shall be made known to the competent authority. Any change affecting compliance with the criteria referred to in the second and third paragraphs of this article and the nature of the measures that the agent exercises requires the issuance of a new approval under the conditions provided for in this article. »
II.-The same code is amended as follows:
1° Article L. 544-6 is repealed;
2° In 1° of articles L. 554-7, L. 564-7 and L. 574-7, the reference: "In Article L. 472-1, in the second paragraph" is replaced by the reference: "In Article L. 472-1-1, in the first, second and fourth paragraphs" and the words: "the third paragraph is deleted" are replaced by the words ", in the third paragraph, the words: "
After Article 477 of the Civil Code, an article 477-1 is inserted as follows:
"Art. 477-1.-The future protection mandate is published by a registration on a special register whose terms and access are regulated by decree in the Council of State. »
The last paragraph of Article 311-12 of the Criminal Code is replaced by three paragraphs:
"This section is not applicable:
“(a) When the flight relates to objects or documents essential to the daily life of the victim, such as identity documents, relating to the residence or residence of a foreigner, or means of payment;
“(b) When the perpetrator is the guardian, the curator, the special agent designated in the context of a safeguard of justice, the person authorized in the context of a family authorization or the agent carrying out a victim's future protection mandate. »
In the first sentence of the second paragraph of Article L. 3211-6 of the Public Health Code, after the word "health" are inserted the words "or hosted in a social or medico-social institution".
The Civil Code is thus amended:
1° After Article 21-13, an article 21-13-1 is inserted as follows:
"Art. 21-13-1.-Peuvent to claim French nationality, by declaration subscribed pursuant to articles 26 to 26-5, persons who, at least sixty-five years of age, have been residing regularly and usually in France for at least twenty-five years and are the direct ascendants of a French national.
"The conditions set out in the first paragraph of this article shall be appraised at the date of the subscription of the declaration referred to in the same first paragraph.
"The Government may object, under the conditions set out in Article 21-4, to the acquisition of French nationality by the declarant who takes precedence over the provisions of this Article. » ;
2° In the first paragraph of Article 21-28, after the reference: "21-12," the reference is inserted: "21-13-1,"
3° The first sentence of Article 26 is as follows:
"The declarations of nationality subscribed by reason of marriage with a French spouse, pursuant to Article 21-2, either of the ascendant quality of French, pursuant to Article 21-13-1, are received by the administrative authority."
4° In article 26-1, after the word: "French", the words are inserted: "on the one hand, and those subscribed under article 21-13-1 because of the ascent quality of French, on the other hand";
5° The last paragraph of section 26-3 is amended as follows:
(a) At the end of the first sentence, the reference: "of section 21-2" is replaced by the references: "articles 21-2 and 21-13-1";
(b) In the second sentence, the reference: "Article 21-4" is replaced by the references: "Articles 21-4 or 21-13-1".
The 1st of Article L. 816-1 of the Social Security Code is supplemented by a sentence as follows:
"The compliance of this condition may be attested by the insurance periods referred to in Article L. 351-2; "
Article L. 863-3 of the same code is supplemented by a paragraph as follows:
"The right to this deduction is automatically renewed for persons who benefit from the allowance referred to in Article L. 815-1 or from any of the allowances referred to inArticle 2 of Order No. 2004-605 of 24 June 2004 simplifying the minimum age. »
I.-Chapter II of Title III of Book II of the Code of Social Action and Families is thus amended:
1° Section L. 232-3 is amended as follows:
(a) The first paragraph is supplemented by the words: "on the basis of the multidimensional assessment referred to in Article L. 232-6";
(b) The second paragraph is deleted;
2° After the article L. 232-3, an article L. 232-3-1 is inserted as follows:
"Art. L. 232-3-1.-The amount of the aid plan cannot exceed a ceiling defined by decree according to the degree of loss of autonomy determined by the national grid referred to in Article L. 232-2 of this code and revalued each year on January 1 in accordance with the evolution of the increase for constant assistance of a third person mentioned in theArticle L. 355-1 of the Social Security Code.
3° The first paragraph of Article L. 232-4 is replaced by three paragraphs as follows:
"The personalized self-sufficiency allowance is equal to the amount of the fraction of the aid plan that the recipient uses, reduced by a charge-sharing.
"This participation is calculated and updated as of 1 January of each year, based on its resources determined under the conditions set out in Articles L. 132-1 and L. 132-2 and the amount of the aid plan, according to a national scale revalued annually as of 1 January pursuant to Article L. 232-3-1.
"When the recipient uses a globally funded home support and support service as part of a multi-year contract of objectives and means provided for in Article L. 313-11-1, his or her allowance and participation may, under conditions defined by decree, be calculated on a lump-sum basis under the aid plan that he or she has accepted. » ;
4° In section L. 232-5, the reference: "L. 443-10" is replaced by the reference: "L. 444-9" and the reference: "in II of Article L. 313-12" is replaced by the references: "in the second paragraph of II and III and IV of Article L. 313-12";
5° Article L. 232-6 is amended as follows:
(a) The first paragraph is replaced by five subparagraphs:
"The medical-social team:
« 1° Recognizes the degree of loss of autonomy of the applicant, which determines eligibility for the benefit, based on the national grid referred to in Article L. 232-2;
« 2° Assess the situation and needs of the applicant and his or her caregivers. This assessment is carried out under conditions and on the basis of references defined by decree of the Minister for Older Persons;
« 3° Proposes the assistance plan referred to in Article L. 232-3, informs all of the existing procedures and recommends those that appear to it to be the most appropriate given the need for assistance and loss of autonomy of the recipient and the needs of the caregivers, as well as the terms and conditions for the care of the recipient in the event of hospitalization of the recipient. The information provided on the various terms and conditions of intervention is a guarantor of the free choice of the recipient and provides a comprehensive overview of all assistance and home retention devices in the territory concerned;
« 4° Identifies other useful aids, including those already in place, the recipient's home support, including in a prevention goal, or the support of his or her caregivers, not supported by the allowance that may be allocated to him or her. » ;
(b) At the end of the second paragraph, the words: "accredited under the conditions set out in theArticle L. 129-1 of the Labour Code » are deleted;
6° The second paragraph of Article L. 232-7 is deleted;
7° Article L. 232-12 is amended as follows:
(a) After the word "proposal", the end of the first paragraph is thus written: "of the medical-social team referred to in article L. 232-6. » ;
(b) The second paragraph is deleted;
(c) In the third paragraph, the reference: "third paragraph" is replaced by the reference: "fourth paragraph";
8° At the end of the first sentence of the second paragraph of Article L. 232-13, the words: "accredited under the conditions specified in theArticle L. 129-1 of the Labour Code » are deleted;
9° The first and last paragraphs of Article L. 232-14 are deleted;
10° Article L. 232-15 is amended as follows:
(a) The first paragraph is replaced by six subparagraphs as follows:
"The personalized self-reliance allowance is paid to its beneficiary, subject to the fifth and sixth paragraphs.
"The payment of the portion of the allowance used to pay regular aids is monthly.
"The portion of the allowance for the regulation of expenses relating to technical assistance, accommodation adaptation and temporary reception or home respite benefits may be paid on a one-time basis to the beneficiary under conditions defined by decree.
"The portion of the allowance intended to pay an employee, a family host or an authorized home help service under the conditions set out in Article L. 313-1 of this Code may be paid to the beneficiary of the allowance in the form of a universal employment-service cheque referred to in Article L. 1271-1 of the Labour Code, subject to Article L. 1271-2 of the same Code.
"The department may pay the portion of the allowance to pay a home help service directly to the service chosen by the recipient. The recipient remains free to choose another service.
"The department may pay the portion of the allowance concerned directly to the natural or legal person or to the organization that provides technical assistance, performs housing development or provides temporary reception or home respite. » ;
(b) The last paragraph is deleted;
11° Section L. 232-18 is repealed.
II.-In the second paragraph of Article L. 3142-26 of the Labour Code, the reference: "third paragraph" is replaced by the reference: "second paragraph".
III.-Sections 15,17,19-1 and 19-2 of Act No. 2001-647 of 20 July 2001 relating to the care for the loss of autonomy of older persons and the personalized allowance of autonomy are repealed.
Article L. 1611-6 of the General Code of Territorial Communities is supplemented by three sub-items as follows:
"The territorial authorities and their public institutions referred to in the first paragraph may entrust to a public or private agent, under conditions defined by a convention, the payment, on their behalf and on their behalf, of personalized support cheques to the beneficiaries they have previously determined.
"The convention provides, under penalty of nullity, the contents of the principal obligations of the principal agent and the agent, as well as the general terms and conditions of execution and termination of the convention.
"The terms of reference agreement is concluded on an expensive basis after a consultation that complies with the public procurement code. »
After Article L. 153 of the Tax Procedures Book, an article L. 153 A is inserted as follows:
"Art. L. 153 A.-The tax administrations transmit annually to the departments, under conditions provided for by decree in the Council of State taken after the advice of the National Commission of Computer Science and Freedoms, the information necessary to the assessment of the resources of the beneficiaries of the personalized allowance of autonomy. »
The code of social action and families is thus modified:
1° Article L. 146-4 is supplemented by a paragraph as follows:
"The Director of the Departmental House of Persons with Disabilities shall issue the card referred to in Article L. 241-3 to applicants who are beneficiaries of the allowance provided for in Article L. 232-1 and classified in groups 1 or 2 of the national grid referred to in Article L. 232-2, in accordance with the notification of the award decision. » ;
2° After the first paragraph of Article L. 241-3, it is inserted a paragraph as follows:
"When the applicant is a beneficiary of the allocation referred to in section L. 232-1 and classified in groups 1 or 2 of the national grid provided for in section L. 232-2, the card is issued on a final basis under the conditions specified in the last paragraph of section L. 146-4. » ;
3° Section L. 241-3-2 is amended as follows:
(a) In the second sentence of the first paragraph, the word "prefect" is replaced by the words "representative of the state in the department";
(b) After the same first preambular paragraph, a sub-item reads as follows:
"When the applicant is a beneficiary of the allocation referred to in Article L. 232-1 and classified in groups 1 or 2 of the national grid provided for in Article L. 232-2, the card shall be issued definitively by the representative of the State in the department in accordance with the notification of the award decision within the time limits mentioned in the first paragraph of this article. » ;
4° At the 3rd of the I of Article L. 241-6, after the second occurrence of the word "disability", the words are inserted: ", with the exception of that requested by the beneficiary of the allowance referred to in Article L. 232-1 and classified in groups 1 or 2 of the national grid provided for in Article L. 232-2."
Within six months of the promulgation of this Act, the Government shall report to Parliament on the impact of the seventy-five-year thresholds for the provision of disability compensation in the consideration of disability for ageing persons with disabilities.
After Article L. 313-11 of the Code of Social Action and Families, an article L. 313-11-1 is inserted as follows:
"Art. L. 313-11-1.-The authorized home support and support services under 1°, 6° and 7° of I of Article L. 312-1 may conclude with the president of the departmental council, under the conditions provided for in Article L. 313-11, a multi-year contract of objectives and means to promote the territorial structuring of the offer of home aid and the implementation of the public service. The contract includes:
« 1° The number and categories of recipients covered under one year;
« 2° The territory served and the time-frames for care;
« 3° The objectives pursued and the means implemented;
« 4° The terms and conditions for calculating the allocation and participation, referred to in the third paragraph of Article L. 232-4, of persons using and receiving the allowance referred to in Article L. 232-3;
« 5° The parameters for the calculation, control, revision and recovery of funding allocated by the department;
« 6° The modalities of participation in actions to prevent the loss of autonomy set out in the departmental plans for persons with disabilities or loss of autonomy referred to in the last two paragraphs of Article L. 312-5 of this Code and by the regional health scheme mentioned in theArticle L. 1434-3 of the Public Health Code, as well as the optimization of the care paths of the elderly;
« 7° Professional qualification and promotion objectives for accompanied audiences and the organization of services;
« 8° The modalities for the implementation of measures for the prevention of abuse and the promotion of good-treatment;
« 9° The nature and modalities of coordination with other social, medico-social or health organizations;
« 10° The nature and form of administrative, financial and accounting documents as well as statistical information to be provided to the department;
« 11° The criteria and timing of evaluation of actions taken.
"For services falling within 1° of I of Article L. 312-1 of this Code, the references provided for in 4° and 6° of this Article shall not apply. »
I.-The same code is amended as follows:
1° Section L. 245-12 is amended as follows:
(a) In the first paragraph, the words: "accredited under the conditions specified in theArticle L. 129-1 of the Labour Code » are deleted;
(b) In the first sentence of the last paragraph, the reference: "L. 129-1" is replaced by the reference: "L. 7232-1";
2° At 7° of Article L. 312-1, the word "adults" is deleted;
3° Section L. 312-7 is amended as follows:
(a) In the b of the 3rd, the words "or approved under Article L. 7232-1 of the Labour Code" and the words "or approval under Article L. 7232-1 above" are deleted;
(b) In the fifteenth paragraph, the words: "and, under the conditions provided for in this article, the bodies authorized under theArticle L. 7232-1 of the Labour Code » are deleted;
4° Article L. 313-1-2 is as follows:
"Art. L. 313-1-2.-To intervene with the beneficiaries of the personalized self-reliance allowance referred to in Article L. 232-1 and the disability compensation benefit referred to in Article L. 245-1, a home support and support service under 6° or 7° of Article I L. 312-1 must be specifically authorized if it is not holder of the 6-hour social security. This authorization may be refused or withdrawn under the conditions provided for, respectively, in articles L. 313-8 and L. 313-9.
"A service authorized under the conditions set out in the first paragraph of this section shall be required to accept, within the limits of its specialty and authorized area of intervention, any person who is eligible for the benefits referred to in the same first paragraph that is addressed to it under specified conditions, if any, by a multi-year contract of objectives and means entered into under the conditions set out in Article L. 313-11-1. » ;
5° Article L. 313-1-3 is as follows:
"Art. L. 313-1-3.-The assistance and home support services under 6° or 7° of the I of Article L. 312-1 comply with a national specifications defined by decree. » ;
6° Article L. 313-8-1 is supplemented by a paragraph as follows:
"For home support and support services under 6° or 7° of Article I of Article L. 312-1, the capacity to receive is expressed only in the area of intervention. » ;
7° At the end of the 1st of Article L. 313-22, the words: "or the approval provided for in the third paragraph of Article L. 313-1-2" are deleted;
8° At the end of the title IV of Chapter VII of Book III, the words: "submitted to authorization" are replaced by the words: "qualified to social assistance";
9° Article L. 347-1 is amended as follows:
(a) In the first paragraph, the words: "as mentioned in the 2nd of Article L. 313-1-2" are replaced by the words: "help and home support within the 6th or 7th of Article L. 312-1 which are not entitled to receive beneficiaries of social assistance";
(b) The same first paragraph is supplemented by a sentence as follows:
"The contract is indefinitely; it specifies the terms and conditions of its termination. » ;
(c) In the second paragraph, the words: "from the Minister for Economy and Finance" are replaced by the words: " Ministers for Economics and Finance, Older Persons and Self-Government";
(d) In the last paragraph, the words: "State representative in the department" are replaced by the words: "President of the departmental council";
II.-Sections L. 7232-2 and L. 7232-5 of the Labour Code are repealed.
III.-Home assistance and support services that, on the date of publication of this Act, fall under both the 2nd of section L. 313-1-2 and 6° or 7° of Article L. 312-1 of the Code of Social Action and Families are deemed to have, under section L. 313-1 of the same code, an authorization that does not permit to receive beneficiaries of social assistance from the effective date of their last approval.
They are also deemed to be authorized under section L. 313-1-2 of the said Code, in its drafting under section I of this section.
On the date on which their approval is terminated, they shall conduct the external assessment, as provided for in Article L. 312-8 of the same code, their activities and the quality of the benefits they deliver. However, the expiry of this obligation may not take place within two years of the date of promulgation of this Act.
IV.-When the authorized capacity of a home support and support service is within the scope of 6° or 7° of Article L. 312-1 of the Code of Social Action and Families has been set within the limits of a number of hours or persons allowed, this limit is no longer enforceable from the date of publication of this Act.
V.-Until 31 December 2022, the authorization for the creation or extension of a home support and support service under 6° or 7° of I of the same article L. 312-1 together with the authorization to receive beneficiaries of the social assistance or the authorization provided for in Article L. 313-1-2 of the same code, as well as such authorization or authorization for the purpose of the project
The chair of the departmental council has a period of three months from the receipt of the request from the help and home support service to make a decision. The application may be rejected on the grounds set out in section L. 313-8 of the same code. The lack of response within the three-month period is rejected. The decision to reject, explicit or implicit, is based on the conditions set out in the articles, respectively. 1 and 5 Act No. 79-587 of 11 July 1979 on the motivation of administrative acts and the improvement of relations between the administration and the public.
The Chair of the Departmental Council shall communicate annually to the department's deliberative assembly and to the departmental council of citizenship and autonomy a document relating to the assessment, depending on the legal nature of the manager, of applications submitted pursuant to this V as well as to the follow-ups given to them.
I.-The title I of Book III of the Code of Social Action and Families is thus modified:
1° After the 15th of the I of the article L. 312-1, it is inserted a 16th grade as follows:
« 16° Services that provide personal home assistance or mobility assistance in the community environment for the benefit of fragile families and whose list is set by decree. » ;
2° After the f of Article L. 313-3, a g is inserted as follows:
“(g) By the president of the departmental council for the services mentioned in the 16th I of Article L. 312-1. » ;
3° In the first sentence of the first paragraph of Article L. 313-14-1, after the reference: "10°", the reference is inserted: "and 16°".
II.-This article is applicable on the date of entry into force of the decree provided for in 16° of Article L. 312-1 of the Code of Social Action and Families.
III.-The services which, on the date of entry into force of the decree provided for in 16° of I of the same article L. 312-1, enter the scope of application of the same 16° and have an approval granted under theArticle L. 7232-1 of the Labour Code are deemed to have, from the date of effect of this approval, an authorization that is not eligible to receive beneficiaries of social assistance.
Experiments of an integrated model of organization, operation and funding of multi-purpose home care and assistance services can be implemented with the joint agreement of the President of the departmental council and the Director General of the regional health agency, as of the promulgation of this Act and for a period not exceeding two years, by:
(a) Multi-purpose home care and assistance services 6° and 7° of Article L. 312-1 of the Code of Social Action and Families ;
(b) Home nursing services and home support and assistance services under Article L. 313-1-2 of the same code, within the framework of a social or medical-social cooperation group or a cooperation agreement under Article L. 312-7 of that Code.
The prevention actions they provide are eligible for funding under the finance conference referred to in Article L. 233-1 of the same code.
The implementation of this model, the terms of which are defined by the terms of reference of the Ministers responsible for the elderly, persons with disabilities, the budget and the local authorities, is subject to the signing of a multi-year contract of objectives and means defined in Article L. 313-11 of the same Code.
This contract includes:
1° Coordination of care, assistance and support in an objective of integrating and preventing the loss of autonomy of accompanied persons, under the responsibility of a coordinator nurse;
2° For home aid activities, hourly rates or the overall package determined by the chair of the departmental council;
3° For home care activities, the overall nursing staffing determined by the Director General of the Regional Health Agency;
4° For prevention activities, the definition of actions that are included in the departmental plan for persons with loss of autonomy referred to in theArticle L. 312-5 of the Code of Social Action and Families and the regional health projectArticle L. 1434-2 of the Public Health Codetheir modalities of implementation and monitoring according to the objectives pursued and the distribution of their funding between the department and the regional health agency.
Health centres under section L. 6323-1 of the same code may develop with the multi-purpose home care and assistance services referred to in the first paragraph of this section, as well as with the home support and support services referred to in the above-mentioned home care services 6° and 7° of Article L. 312-1 of the Code of Social Action and Families the coordination and prevention actions provided for in 1° and 4° of this article.
The Government shall submit to Parliament, by 31 December 2017, a report on the evaluation of experiments conducted under this section. This evaluation focuses on improving the quality of support for recipients and potential economies of scale that are feasible in terms of pooling means.
The Government shall submit to Parliament, within twelve months of the promulgation of this Act, a report on the issuance of one or more complementary currencies for self-government.
The report reviews the various sectoral currencies that have been put in place in other countries of the world.
It examines the characteristics that should present the securities of a complementary currency for autonomy, including their convertibility with the euro, their territorial anchorage, their possible depreciation in time, their materialization and their thesaurization.
It examines the possibilities of issuing such a currency by the actors of the social and solidarity economy in connection with the departmental services responsible for social action.
After Article L. 113-1 of the Code of Social Action and Families, an article L. 113-1-3 is inserted as follows:
"Art. L. 113-1-3.-Is considered to be close to helping an elderly person his or her spouse, the partner with whom she has entered into a civil pact of solidarity or his or her concubine, a parent or ally, defined as family caregivers, or a person residing with or maintaining close and stable ties with her, who assists him, on a regular and frequent basis, in a non-professional basis, to perform all or part of the acts or activities of daily life. »
After Article L. 232-3 of the same code, articles L. 232-3-2 and L. 232-3-3 are inserted as follows:
"Art. L. 232-3-2.-The caregiver who provides an indispensable presence or assistance for home support of a beneficiary of the personalized self-reliance allowance and who cannot be replaced may open upright, within the framework of the personalized self-reliance allowance and without prejudice to the ceiling mentioned in section L. 232-3-1, to devices that meet respite needs. These devices, which must be adapted to the assisted person, are defined in the help plan, depending on the need for respite assessed by the medical-social team at the time of the application for allocation, or as part of a request for review, within the limits of a ceiling and according to the terms fixed by decree.
"Art. L. 232-3-3.-In the event of need, the amount of the assistance plan may be occasionally increased beyond the ceiling mentioned in Article L. 232-3-1, up to an amount fixed by decree, to face the hospitalization of a close aide.
"A decree specifies the terms and conditions for the application of this article, including situations that may be the subject of the increase provided for in the first paragraph, as well as the conditions under which the request for assistance is made and the expenditure incurred by the department, in particular in emergency. »
I.-Subsection 2 of chapter II, section 2 of title IV of Book I of the third part of the Labour Code is amended as follows:
1° In the title, the words: "family support" are replaced by the words: "nearly helping";
2° In the first paragraph of Article L. 3142-22, in Article L. 3142-23, in the first paragraph of Article L. 3142-24, in the first paragraph and in the fifth paragraph of Article L. 3142-25, in the first paragraph of Article L. 3142-28, in Article L. 3142-29 and in Article L. 3142-31, the words "family support" are replaced by the words "family support"
3° Article L. 3142-22 is supplemented by a 9° as follows:
« 9° The elderly person or the disabled person with whom he resides or maintains close and stable ties, to whom he regularly and frequently assists in a non-professional manner to perform all or part of the acts or activities of daily life. » ;
4° At the end of Article L. 3142-23, the words: "and shall not be placed in a place of business or in a third party other than the employee" are deleted;
5° Article L. 3142-24 is supplemented by two paragraphs as follows:
"The worker's close leave may, with the employer's agreement, be transformed into a part-time activity period.
"With the employer's agreement, the leave may be split, without being able to exceed the maximum period provided for in the first paragraph. In this case, an employee who wishes to receive leave must notify his employer at least 48 hours before the date on which he intends to take each leave period. In the event of sudden deterioration of the health condition of the assisted person or a crisis situation requiring urgent action by the caregiver, the caregiver may be granted leave immediately. The terms of this split, including the minimum duration of each leave period, are set by decree. » ;
6° After the word: "of", the end of the first paragraph of Article L. 3142-26 is thus written: "close helper may not engage in any professional activity, except for the part-time activity referred to in Article L. 3142-24 of this Code. » ;
7° In section L. 3142-27, the words: "family support" are replaced by the words: "close caregiver or part-time activity period referred to in section L. 3142-24".
II.-The Social Security Code is amended as follows:
1° In the first sentence of Article L. 241-3-2, the words: "facilitated family support" are replaced by the words: "close care worker mentioned";
2° In Article L. 378-1and at the end of the first sentence of the fourth paragraph of Article L. 381-1, the words: "family support provided for in Article L. 225-20" are replaced by the words: "nearly helping mentioned in Article L. 3142-22".
As part of respite requirements, facilities and services referred to in 2°, 6° and 7° of the I of Article L. 312-1 of the Code of Social Action and Families can include one or more accommodations for a night of people requiring permanent supervision.
I.-Chapter X of title IV of Book I of the Code of Social Action and Families is thus amended:
1° Article L. 14-10-5 is amended as follows:
(a) The a is replaced by a 1° as follows:
« 1° Resources:
"(a) 20% of the proceeds of the contributions referred to in 1° and 2° of Article L. 14-10-4, the product referred to in 4° of the same article and the proceeds of the social levies referred to in 3° of that Article L. 14-10-4, diminished of the amount referred to in IV of this article;
“(b) A fraction of the product of the contribution mentioned in 1° bis of Article L. 14-10-4. For the 2016 fiscal year, this fraction is set at 55.9% of the proceeds of this contribution. Under the following exercises, it is set at 70.5 per cent of this product; »
(b) The b is thus modified:
- at the beginning, the mention: "b)" is replaced by the mention: "2°";
-in the first sentence, the reference: "a" is replaced by the reference: "1°".
2° Section L. 14-10-6 is amended as follows:
(a) The first paragraph is replaced by two subparagraphs:
"I.-The contest mentioned in the II of Article L. 14-10-5 is divided into two parts:
« 1° The amount of the first part shall be apportioned annually among the departments according to the terms set by decree in the Council of State within the limits of the resources mentioned in the 1st of the same II, after the collection of the sums necessary for a share to the communities of Saint-Barthélemy, Saint-Martin and Saint-Pierre-et-Miquelon, calculated and distributed according to the terms set out in the II of this article, according to the following criteria: » ;
(b) In the first sentence of the sixth preambular paragraph, the words: "of the amount so distributed" are replaced by the words: "of the amounts distributed according to this 1° and 2°";
(c) The seventh preambular paragraph reads as follows:
"The allocation of the first part is increased for departments whose report defined in the sixth paragraph of this 1° is higher than the fixed rate. For the other departments, it is reduced by the sum of the amounts thus calculated, on the basis of the apportionment carried out under the same sixth preambular paragraph between those departments. » ;
(d) The penultimate paragraph is supplemented by the reference: "of present 1°";
(e) At the beginning of the last paragraph, the word "Le" is replaced by the words: "The first part of" and the words: "of the section referred to in" are replaced by the reference: "as mentioned in the first part of";
(f) Two subparagraphs are added:
« 2° The amount of the second part is apportioned annually among the departments according to the estimate of their new expenses resulting from articles L. 232-3-1, L. 232-3-2, L. 232-3 and L. 232-4, in their drafting resulting from Act No. 2015-1776 of 28 December 2015 on the adaptation of society to ageing, and within the limits of the resources mentioned in b of 1° of the II of article 14-10. This distribution is carried out in accordance with the terms established by decree in the Council of State.
"II.-The assessment referred to in 1° of the I of this article shall be calculated by applying to the total amount of the first part of the contest mentioned in the same 1° the double of the ratio between the number of beneficiaries of the allowance referred to in Article L. 232-2 in the overseas communities mentioned in the 1° and the total number of beneficiaries of the allowance as of December 31 of the year preceding the competition. It is distributed among the three communities according to the criteria referred to in a, b and d of 1° of the same I."
II.-At the beginning of the 4th of the III of Article 59 of Law No. 2015-994 of 17 August 2015 on social dialogue and employment, after the reference: "d", is inserted the reference: "of the 1st of the I".
III.-Au 1° of Article 10 of Order No. 2014-463 of 7 May 2014 extending and adapting to Mayotte the provisions of code of social action and families relating to adoption, personalized self-reliance allowance and the provision of compensation for disability, after the reference: "in the first paragraph", is inserted the reference: "from 1° of the I".
IV.-The III of Article 18 of Act No. 2014-1655 of 29 December 2014 of Corrigendum Finance for 2014 is amended as follows:
1° In the first paragraph, after the word "application", the reference is inserted: "of the 1st of the I";
2° In the last paragraph, after the reference: "sixth paragraph", the reference is inserted: "1° of the I".
I.-The title IV of Book IV of the Code of Social Action and Families is thus amended:
1° Section L. 441-1 is amended as follows:
(a) The third and fourth preambular paragraphs are replaced by four sub-items:
"Accreditation can only be granted if the conditions of reception guarantee continuity of the reception, the protection of the health, the safety and the physical and moral well-being of the welcomed people, if the hosts have committed themselves to undergo initial and ongoing training and an initiation to the relief gestures organized by the president of the departmental council and if social and medico-social follow-up of the welcomed people can be assured. A decree in the Council of State sets the criteria for accreditation.
"The Accreditation Decision sets the number of persons who can be accommodated, within the limit of three persons simultaneously and eight hospitality contracts in total. The chair of the departmental council may, if the conditions permit and as a derogatory, authorize the simultaneous reception of up to four persons when, among these four persons, a couple is welcomed. The decision specifies the terms and conditions of reception provided for: full-time or part-time, in particular day reception or night reception, permanent, temporary or sequential. The approval decision may specify the characteristics, in terms of disability and loss of autonomy, of persons who may be welcomed.
"A decision to refuse approval shall be reasoned and, in response to a licence renewal application, made after notice of the advisory board referred to in section L. 441-2.
"The chair of the departmental council may, if necessary within the framework of the decision to approve, provide for the reception of persons whose characteristics in terms of loss of autonomy or disability require it to specific modalities of training, monitoring and accompaniment of the family receptionist and, where applicable, of the person being welcomed. » ;
(b) At the penultimate paragraph, the word "fourth" is replaced by the word "third";
2° In the first sentence of the second paragraph of Article L. 441-2, the word "fourth" is replaced by the word "third";
3° In article L. 441-3, after the word "permanent", the word "sequential" is inserted;
4° Section L. 442-1 is amended as follows:
(a) After the second preambular paragraph, a sub-item reads as follows:
"This contract provides for a personalized welcome project to meet the needs of the welcomed person. » ;
(b) The last sentence of the penultimate paragraph is replaced by two sentences as follows:
"The allowance referred to in the same 2° is revalued in accordance with the evolution of the minimum wage referred to in theArticle L. 3231-2 of the Labour Code. The compensation mentioned in the same 3° is revalued in accordance with the evolution of the national consumer price index. » ;
(c) Before the last preambular paragraph, a subparagraph shall read:
"The remuneration and compensation provided for in 1 to 4° may be declared and, if applicable, paid by the universal employment-service cheque defined in theArticle L. 1271-1 of the Labour Code, subject to Article L. 1271-2 of the same code. » ;
(d) Two subparagraphs are added:
"It ensures that the person who receives the exercise of the individual rights and freedoms set out in Article L. 311-3. For this purpose, the Charter of the Rights and Freedoms of the Accepted Person referred to in Article L. 311-4 is annexed to it.
"The contract also provides for the possibility for the person in question to use the devices provided for in articles L. 311-5 and L. 311-5-1. » ;
5° Article L. 443-11 is thus restored:
"Art. L. 443-11.-The objectives, content, duration and modalities for the implementation of the initial and continuing training provided for in Article L. 441-1 are defined by decree. This decree specifies the duration of the training that must be necessarily followed before the first reception as well as the training dispensations that can be granted if the family host justifies an equivalent previous training.
"Initiation to the relief gestures provided for in the same article L. 441-1 is before the first reception.
"The department, when it is not insured, supports the reception of persons with disabilities or loss of autonomy, during the mandatory training times of the hosts. » ;
6° Article L. 444-2 is as follows:
"Art. L. 444-2.-Sont applicable to persons under this chapter Labour code related:
« 1° Discrimination, as provided for in chapters II to IV of Title III of Book I of the same Part I;
« 2° To professional equality between women and men, provided for in chapter II of title IV of the same book I;
« 3° To harassment, as provided for in chapters II to IV of title V of the said book I;
« 4° To the formation and execution of the contract of work, provided for in chapter IV, sections 1 to 3 and 6 of section 1 and sections 2 to 6 of chapter V and subsection 1 of section 2, with the exception of sections L. 1226-4-2 and L. 1226-4-3, and section 3 of chapter VI of title II of Book II of Part I;
« 5° A termination of the indefinite work contract, as provided for in chapters I and II, subsection 1 of section 2, subsections 2 and 3 of section 3, and subsections 1 and 2 of section 3 of section 4 of chapter III, subsections 1 to 4 and 6 of section 1 and sub-sections 1 and 2 of chapter IV, section 1 and
« 6° In the fixed-term contract, provided for in chapters I to VII of title IV of Book II;
« 7° The resolution of disputes and the Council of Prud'hommes, set out in titles I to V of Book IV of Part I;
« 8° To the professional trade unions, under title I, chapter I and chapter II, section 1, chapter II, chapter II and chapters I and II, sections 1 to 4, chapter III and chapter IV, title IV, of part II;
« 9° To collective bargaining and collective labour agreements and agreements, as set out in Book II of Part II, except Chapter III of Title VIII;
« 10° To the representative staff institutions, provided for under title I with the exception of chapter VI, chapters I and II of heading II, in title III with the exception of chapter V, under title IV with the exception of chapter VI and title V with the exception of chapter V of Book III of Part II and articles L. 2323-1 to L. 2327-19;
« 11° To protected employees, provided for in chapter I, sections 2 to 6, and chapter I, sections 2 to 4, chapter I, section 3, chapter I, and chapter II, sections 1 and 2, chapter II, and chapter VII, title III, of Part II and articles L. 2421-3 and L. 2421-8;
« 12° To collective conflicts, set out in Book V titles I and II of Part II;
« 13° For the duration of work, rest and leave, as provided for in chapter III, section 2, chapter III, and chapter I, sections 2 and 3, subsections 1 and 2 of section 1 and subsections 1 to 3 and 5 to 7 and subsections 1 to 4 of chapter II, section 2, section II, section II, section II, section IV, of Book I of Part III;
« 14° To the various wages and benefits, provided for under Part I, chapters I to V of Part IV and chapters II and III of Title V of Part III;
« 15° Interestedly, as set out in chapter V, section 1, title IV of Book III of Part III;
« 16° To occupational health and safety, provided for in chapter IV, section 1, title V, of Book I and chapters I to IV, title II, of Part IV, except articles L. 4624-2 to L. 4624-4;
« 17° The provisions for employment, as set out in chapter II, sections 1 to 4, title II, of Part IV, and articles L. 5422-20 and L. 5422-21;
« 18° A la formation professionnelle toute au travers la vie, prévues à la section 1 du chapitre Ier du titre Ier et aux chapters Ier et II du titre Ier, aux chapitres Ier à V du titre I, aux chapitres I à V du titre II, aux chapitres Ier et II du titre III et aux titres IV à VI du livre III, au chapitre Ier et aux chapitres I et IV-2 du titre » ;
7° At 2° of Article L. 544-4, the reference: "8th preambular paragraph" is replaced by the reference: "9th preambular paragraph".
II.- Chapter I of Book II, title VII of Part I of the Labour Code is amended to read:
1° Section L. 1271-1 is amended as follows:
(a) The A is completed by a 3° as follows:
« 3° Declare the family friendlys mentioned to theArticle L. 441-1 of the Code of Social Action and Families.
(b) The B is completed by a 9° as follows:
« 9° Financial counterparties defined atArticle L. 442-1 of the Code of Social Action and Families.
2° In article L. 1271-2, after the word "employee" are inserted the words: "a family home";
3° In article L. 1271-7, the references: "1° or 2°" are replaced by the reference: "B";
4° In the second paragraph of Article L. 1271-15-1, the references: "c, d and e of 2°" are replaced by the references: "4°, 5° and 6° of B";
5° In the first paragraph of article L. 1271-16, after the reference: "1°", the reference is inserted: "and the 3° of the A".
III.- Chapter III bis of title III of Book I of the Social Security Code is amended as follows:
1° After the 6th of the article L. 133-5-6, it is inserted a 7° as follows:
« 7° Individuals welcomed by the family friendlys mentioned at theArticle L. 441-1 of the Code of Social Action and Families.
2° Article L. 133-5-8, in its drafting as a result of Order No. 2015-682 of 18 June 2015 on the simplification of employer social declarations, is amended as follows:
(a) The first sentence of the second paragraph is supplemented by the words: "or, to the family homeowners mentioned in the 7th of Article L. 133-5-6 of this Code, the monthly statement of financial counterparties defined in theArticle L. 442-1 of the Code of Social Action and Families » ;
(b) In the last paragraph, after the reference: "L. 133-5-6", the words "and the individuals mentioned in the 7th of the same article L. 133-5-6".
Chapter II of title IV of Book III of the Code of Social Action and Families is thus amended:
1° Section L. 342-2 is amended as follows:
(a) In the second sentence of the first paragraph, the words "in accordance with the first paragraph" are replaced by the words "in application of the first two paragraphs";
(b) After the second preambular paragraph, a sub-item reads as follows:
"For establishments under the first paragraph of the I of Article L. 313-12, the contract provides in all cases a minimum package of accommodation benefits, the list of which is set by decree, which is said to be "service base". » ;
(c) In the first sentence of the third paragraph, after the word "thes", the word "others" is inserted;
2° The first two paragraphs of Article L. 342-3 are replaced by four subparagraphs as follows:
"The benefit base provided for in the third paragraph of Article L. 342-2 is subject to a global price. Any clause providing a separate award for a benefit under the benefit base is deemed to be non-written.
"The price of the benefit base and the prices of other accommodation services are freely fixed when signing the contract. They then vary, under conditions fixed by decree, within a percentage fixed on 1 January of each year by order of ministers responsible for the elderly and the economy, taking into account the changes in the costs of construction and rent, food and services and the rate of evolution of the basic pensions provided for in Article L. 161-23-1 of the Social Security Code.
"The Council of Social Life is consulted at least once a year on the level of the price of the benefits base and on the price of other accommodation services as well as on each creation of a new benefit.
"For establishments within the 3rd of Article L. 342-1 of this Code, the price of the benefit base taken into account in the calculation of the share of royalty assimilable to rent and recoverable rental expenses evolves in accordance with the provisions of the agreement entered into for personalized housing assistance; only other benefits evolve according to the interdepartmental order referred to in the second paragraph of this section. » ;
3° Section L. 342-4 is amended as follows:
(a) In the first and second paragraphs, the words: "State representative in the department" are replaced by the words: "President of the departmental council";
(b) At the end of the second paragraph, the words "institutional council" are replaced by the words "social life council".
I.-The same code is amended as follows:
1° Section L. 14-10-9 is amended as follows:
(a) In the last paragraph of (a), the words: "the convention provided for in I" are replaced by the words: "the multi-year contract of objectives and means provided for in IV ter";
(b) After the words: "who did not conclude", the end of the first sentence of the first paragraph of the b is thus written: "the contract provided for in the IV ter of Article L. 313-12";
2° In the first sentence of the second paragraph of Article L. 232-8, the references: "to articles L. 314-2 and L. 314-9" are replaced by the reference: "to the second paragraph of Article L. 314-2";
3° Article L. 232-9 and the first paragraph of Article L. 232-10, after the reference: "3°", is inserted the reference: "I";
4° In the second sentence of Article L. 311-8, the words: "multi-year conventions referred to" are replaced by the words: "multi-year contracts of objectives and means mentioned";
5° After the word "decree", the end of the first paragraph of Article L. 313-6 is deleted;
6° Section L. 313-12 is amended as follows:
(a) After the IV, they are inserted from IV bis and IV ter as follows:
"IV bis.- Authorized health facilities, pursuant toArticle L. 6122-1 of the Public Health Codeto provide long-term care concludes a multi-year agreement with the chair of the departmental council and the director general of the regional health agency.
"The pricing of these establishments is stopped:
« 1° For repayable care benefits to social insured persons, by the Director General of the Regional Health Agency pursuant to theArticle L. 174-5 of the Social Security Code ;
« 2° For dependency benefits paid by the user or, if the user meets the conditions referred to in Article L. 232-2 of this code, supported by the personalized self-reliance allowance, by the chair of the departmental council;
« 3° For services related to accommodation, in institutions authorized to receive beneficiaries of social assistance, by the president of the departmental council.
"The rates for additional and freely accepted benefits and paid by the residents, provided that they do not fall within the rates cited in 1° to 3° of this IV bis, are supplements to the daily rates for accommodation. They must be established by the governing body of the managerial body for each homogeneous category of benefit being paid by the residents or their representatives within the establishment. Rates for supplements to daily rates must be communicated to the holders of a residence contract or to their representatives and brought to the attention of the president of the departmental council and the public, under conditions fixed by decree.
"In the health facilities referred to in the first paragraph of this IV bis and meeting the conditions mentioned in 1° to 3° of Article L. 342-1, the accommodation services are fixed and controlled under the conditions provided for in Articles L. 342-2 to L. 342-6.
"For residents who are not eligible for social assistance, in the health facilities referred to in the first paragraph of this IV bis and who meet the conditions referred to in Article L. 342-1, the services relating to supplements to the daily rates for accommodation are fixed and controlled under the conditions set out in sections L. 342-2 to L. 342-6.
"IV ter.-A.-The natural or legal person who manages an institution for dependent older persons referred to in I or II concludes a multi-year contract of objectives and means with the chair(s) of the departmental council and the Director General of the relevant regional health agency.
"When an organization manages several of these institutions located in the same department, a multi-year contract of objectives and means is concluded for all of these institutions between the natural or legal person who is the manager of the institution, the chair of the departmental council and the director general of the regional health agency. Subject to the agreement of the presidents of the relevant departmental councils and the director general of the agency, this multi-year contract of objectives and means may include the establishments located in other departments of the same region.
"This multi-year contract of objectives and means may include other categories of establishments or services referred to in I of section L. 312-1 and, for their authorization, fall within the purview of the President of the departmental council or the Director General of the regional health agency, where these facilities or services are managed by the same management agency and fall within the same territorial jurisdiction.
"When the manager refuses to sign or renew the multi-year contract, the package referred to in 1° of I of Article L. 314-2 is reduced to a maximum of 10% of the package per year under conditions set by decree.
"B.-The contract is concluded for a period of five years.
"The contract sets out the respective obligations of the signatory parties and provides for their follow-up modalities, including in the form of indicators. It defines objectives in terms of activity, quality of care, support and intervention of health facilities in the form of home hospitalization, including palliative care. Where applicable, it specifies the nature and amount of the additional funding referred to in Article L. 314-2, I.
"For institutions and services authorized to receive beneficiaries of social assistance, this contract is a social assistance agreement, within the meaning of Article L. 313-8-1 and Article L. 342-3-1.
"The multi-year contract of objectives and means complies with the terms of reference including a contract model, prepared by decree of ministers responsible for the elderly, local authorities and social security.
"By derogation from Article L. 314-7 II and III, this contract sets out the multi-year elements of the institution and service budget. It sets out the terms and conditions for assigning results in line with its objectives.
"C.-The manager shall transmit the statement of income and expenditure forecasts provided for in Article L. 314-7-1 for establishments and services under the contract, under conditions defined by decree in the Council of State. » ;
(b) At the first and last sentences of the V, after the reference: "I", is inserted the reference: "and IV bis";
7° At the end of the second paragraph of Article L. 313-14-1, the reference: "to section L. 313-11" is replaced by the references: "to articles L. 313-11 and L. 313-12";
8° After Article L. 313-14-1, an article L. 313-14-2 is inserted as follows:
"Art. L. 313-14-2.-For establishments and services under a multi-year contract of objectives and means, the Competent Pricing Authority may request the payment of certain amounts as soon as it finds:
« 1° Unrelated or manifestly out of proportion to the service rendered or with the costs of facilities or services providing comparable services in terms of the quality of care or support;
« 2° Unaccounted income. » ;
9° Section L. 313-23 is repealed;
10° Section L. 314-2 is amended as follows:
(a) At the beginning of the first paragraph, the mention is added: "I.-";
(b) In the same first paragraph, after the reference: "I", the reference is inserted: "and II";
(c) The first is thus written:
« 1° A comprehensive care package that takes into account, inter alia, the average dependency level and the required care needs of residents referred to in section L. 314-9, validated no later than June 30 of the previous year. Where applicable, this overall package includes additional funding relating, inter alia, to specific hosting arrangements, as defined in the IV ter contract of Article L. 313-12. This global package can take into account the activity carried out. The modalities for determining the overall package are set by decree in the Council of State.
"The amount of the overall care package is determined annually by the Director General of the Regional Health Agency. » ;
(d) At 2°, after the word "residents" are inserted the words: "in conditions specified by decree in the Council of State";
(e) In the first sentence of 3°, the first occurrence of the word: "to" is replaced by the words: "to a set of";
(f) After the 3rd it is inserted a paragraph as follows:
"A decree sets out the list of minimum accommodation benefits, which is said to be "service base". » ;
(g) In the first sentence of the penultimate paragraph, the words: "to complementary benefits" are replaced by the words: "to other accommodation services";
(h) In the last paragraph, the words: "and in long-term care facilities" are deleted;
(i) It is added a II as follows:
"II.-For newly created establishments, pending a validation of the assessment of the loss of autonomy as well as the assessment of the required care needs of the residents referred to in the first two paragraphs of Article L. 314-9, the overall care package referred to in 1° of I of this Article shall be determined taking into account the level of departmental dependency of the residents, set annually by decree of the President of the National Council This validation must take place within two years of the establishment's opening. » ;
11° At the end of the second sentence of the first paragraph of Article L. 314-6, the words: "specified in Article L. 313-11 or a multi-year convention referred to in Article L. 313-12" are replaced by the words: "or a multi-year convention referred to in Articles L. 313-11 or L. 313-12";
12° Article L. 314-8 is amended as follows:
(a) In the first sentence of the last two paragraphs, after the reference: "1°", is inserted the reference: "I";
(b) In the last sentence of the penultimate paragraph, the words: "Conventions mentioned in I" are replaced by the words: "contracts mentioned in the IV ter";
13° Article L. 314-9 is amended as follows:
(a) The first three paragraphs are deleted;
(b) After the fifth preambular paragraph, a sub-item reads as follows:
"The review of the level of self-reliance and the assessment of the needs for care of residents is defined by decree. » ;
(c) At the penultimate paragraph, the word "fourth" is replaced by the word "first";
14° At 1° of Article L. 315-12 and at the end of the last sentence of the first paragraph of Article L. 315-15, the reference: "to Article L. 313-11" is replaced by the references: "to Articles L. 313-11 and L. 313-12".
II.-The Public Health Code is amended as follows:
1° In Article L. 1111-16, the words: "institutions mentioned in I" are replaced by the words: "mentioned in the V";
2° At 6° of Article L. 5125-1-1 A, the words "the multi-year convention referred to in I" are replaced by the words "the contract referred to in IV ter".
III.-A the first sentence of the first paragraph of Article L. 133-4-4 of the Social Security Code, the reference: "to I" is replaced by the references: "to I, II and IV bis".
IV.-The II of section 56 of Act No. 2007-290 of 5 March 2007 establishing the right to enforceable housing and carrying various measures for social cohesion is repealed.
V.-The Director General of the Regional Health Agency and departmental council chairs schedule, by joint order, the signature of multi-year contracts of objectives and means provided for in the IV ter of Article L. 313-12 of the Code of Social Action and Families. This order is issued by 31 December 2016. This programming can be updated annually.
Effective 1 January 2017, these contracts replace the multi-year conventions referred to in I of the same article L. 313-12, in its writing prior to the coming into force of this Act, when it is expired, according to the schedule set out in the programming referred to in the first paragraph of this V.
VI.-A effective January 1, 2017, pending the signing of the contract referred to in IV ter of Article L. 313-12 of the Code of Social Action and Families, the amount of additional funding referred to in 1° of I of Article L. 314-2 of the same code is maintained at its level fixed for the previous year and revalued annually by application of a rate fixed by decree of ministers responsible for the elderly and social security.
VII.- For the years 2017 to 2023 and by derogation 1° of Article L. 314-2 of the Code of Social Action and Families, the establishments referred to in I and II of section L. 313-12 of the same code are funded, on the part of the reimbursable care benefits to social insured persons, by the sum of the following amounts:
1° The amount of the products of the re-conductable care tariff set out in the previous year, revalued with a rate set annually by decree of ministers responsible for the elderly and social security;
2° A fraction of the difference between the overall care package, excluding the additional funding mentioned in 1° of Article L. 314-2 of the said Code, and the amount referred to in 1° of this VII.
The 2° fraction is set at a seventh in 2017, a sixth in 2018, a fifth in 2019, a quarter in 2020, a third in 2021, a half in 2022 and one in 2023.
If applicable, this amount is reduced under the conditions set out in the last paragraph of A of IV ter of Article L. 313-12 of the same code.
VIII.-Funds under V VI and VI VII of this article are not subject to the annual budgetary procedure referred to in II and III of Article L. 314-7 of the Code of Social Action and Families.
IX.-As of 1 January 2017, the establishments mentioned in I and II of Article L. 313-12 of the Code of Social Action and Families use the statement of revenues and expenditures under section L. 314-7-1 of the same code.
X.- Competent pricing authorities shall, each with respect to the pricing of establishments under the control of the I of Article L. 313-12 of the Code of Social Action and Families that have not entered into a multi-year tripartite convention prior to the promulgation of this Act and shall, by order, set the objectives to be achieved until the effective date of the multi-year contract of objectives and means referred to in IV ter of the same article L. 313-12, pursuant to the programming order set out in V of this section.
These institutions shall, until the effective date of the multi-year contract referred to in the first paragraph of this X:
1° A comprehensive care package, corresponding to the amount of the care package awarded by the competent authority of the State for the 2007 fiscal year, when they were authorized to provide care to social insured persons;
2° A comprehensive care package, the maximum amount of which is determined on the basis of the weighted average resource group of the establishment, its capacity and a place-care rate set by ministerial order, where they are not allowed to provide care to social insured persons;
3° Daily dependency rates, the amounts of which are fixed by the chair of the departmental council pursuant to the 2° of Article L. 314-2 of the Code of Social Action and Families ;
4° Daily rates for accommodation, set by the chair of the departmental council in institutions authorized for social assistance, calculated taking into account the products mentioned in 1° and 2° of this X.
When the manager refuses to sign or renew the multi-year contract, the overall care package referred to in the 1° of Article L. 314-2 of the Code of Social Action and Families is reduced to a maximum of 10% of the package per year, in conditions set by decree.
I.-The code of social action and families is thus modified:
1° Article L. 314-14 is as follows:
"Art. L. 314-14.-Constitutes a breach punishable by an administrative fine whose amount cannot exceed 3,000 € for a natural person and 15,000 € for a legal person:
« 1° Hosting an elderly person without entering into a residence contract or an individual care document in accordance with Article L. 311-4;
« 2° To propose or conclude a residence contract or an individual care document, one of which is not in accordance with articles L. 311-4 and L. 311-4-1;
« 3° Invoicing costs in breach of Article L. II 311-4-1;
« 4° To charge fees in breach of Article L. 314-10-1;
« 5° Not to return within 30 days of the death of the resident, amounts collected in advance for undelivered benefits, in breach of Article L. 314-10-1;
« 6° To charge fees in breach of Article L. 314-10-2.
"These breaches are sought and found by competition, consumer and fraud law enforcement officers, under the conditions defined in the III of Article L. 141-1 of the Consumer Code. When these breaches are sanctioned and are no longer subject to appeal, the administrative authority responsible for competition and consumption informs the president of the departmental council of the nature of the penalties.
"The fine is pronounced under the conditions set out in section L. 141-1-2 of the same code. » ;
2° Article L. 314-15 is repealed;
3° Article L. 342-5 is as follows:
"Art. L. 342-5.-Constitutes a breach punishable by an administrative fine whose amount cannot exceed 3,000 € for a natural person and 15,000 € for a legal person:
« 1° Hosting an elderly person without having previously entered into the written contract in accordance with Article L. 342-1;
« 2° To propose or conclude a contract of which one of the stipulations is not in accordance with Article L. 342-2;
« 3° To practice prices higher than those resulting from the application of the percentage of variation set by the orders set out in sections L. 342-3 and L. 342-4.
"These breaches are sought and found by competition, consumer and fraud law enforcement officers, under the conditions defined in the III of Article L. 141-1 of the Consumer Code. When the breach is sanctioned and all avenues of appeal have been exhausted, the administrative authority responsible for competition and consumption informs the president of the departmental council of the nature of the penalties.
"The fine is pronounced under the conditions set out in section L. 141-1-2 of the same code. »
II.-The 9th of the III of Article L. 141-1 of the Consumer Code is thus written:
“ 9° Article L. 347-1 of the Code of Social Action and Families and articles L. 311-4, L. 311-4-1, L. 314-10-1, L. 314-10-2, L. 342-1, L. 342-2, L. 342-3 and L. 342-4 of the same code with respect to the breaches specifically listed in articles L. 314-14 and L. 342-5 of that Code; "
Article L. 312-9 of the Code of Social Action and Families is supplemented by a paragraph thus written:
"Under conditions established by decree, the establishments and services under 6° of the I of Article L. 312-1 shall periodically transmit to the National Solidarity Fund for the autonomy of information relating to their capacity for lodging, permanent and temporary, or accompaniment and to their rates, including the rates of accommodation for the fraction of their capacity under which they are entitled to receive beneficiaries of social assistance, the rates associated with their dependency 3 »
The last paragraph of Article L. 315-16 of the Code of Social Action and Families becomes Article L. 314-12-1 and, in the first sentence, the word "public" is deleted.
In article L. 351-1 of the same code, after the word "department", the words ", the representative of the State in the region".
The 3rd of Article L. 312-7 of the Code of Social Action and Families is thus amended:
1° The seventh preambular paragraph is deleted;
2° The beginning of the first sentence of the eighth preambular paragraph reads as follows: "The grouping of social cooperation or medico-social cooperation may be made between professionals ... (the rest without change). » ;
3° The penultimate paragraph is thus amended:
(a) The first sentence is as follows:
"The legal nature of the grouping is determined by the members, subject to the following reservations: the grouping of social or social cooperation is a legal entity of public law when it is constituted exclusively by persons of public law, or by persons of public law and natural or legal persons exercising a health profession; it is a legal entity of private law when it is constituted exclusively by persons of private law; the social or medico-social cooperation group continues a non-profit purpose. » ;
(b) In the second sentence, the words "their revenues" are replaced by the words "the revenues of public law groups".
Article L. 313-13 of the same code is amended as follows:
1° In the second paragraph, after the words: "under that of the regional health agency", the words are inserted: "or made available to it by other State departments or by other regional health agencies";
2° In the third and fifth paragraphs, the words "regional agency personnel" are replaced by the words "regional agency personnel";
3° The second sentence of the sixth preambular paragraph is supplemented by the words "and other personnel referred to in the second paragraph of this article".
Title I of Book III of the same code is thus modified:
1° Article L. 312-1 is supplemented by a VI as follows:
"VI.-Restaurants of 6° or 7° of I can offer, in conjunction with the temporary accommodation of older persons, persons with disabilities or persons with chronic disability, a holiday for those who care for them.
"The 1st of Article L. 313-4 is not applicable to stays mentioned in the first paragraph of this VI."
2° Section L. 313-1-1 is amended as follows:
(a) I is thus modified:
-the first paragraph is as follows:
"Projects, including experimental projects, the creation, transformation and extension of social and medico-social facilities or services under section L. 312-1 of this Code, the proposed places of life and hospitality, as well as the projects for the transformation of health facilities referred to in the articles L. 6111-1 and L. 6111-2 the public health code in social and medico-social institutions or services under Article L. 312-1 of this Code are authorized by the competent authorities under Article L. 313-3. » ;
-the first two sentences of the second paragraph are as follows:
"When projects rely, in part or in full, on public funding, these authorities issue authorization after notice of a social or medico-social project call-up and call-up commission that involves user representatives. The opinion of the latter is not required, however, in case of an extension below a threshold fixed by decree. » ;
-the penultimate paragraph is thus written:
"The conditions for the application of this article are defined by decree in the Council of State, with the exception of the thresholds mentioned in this article, which are by decree. » ;
(b) The II and III are thus drafted:
"II.-Sont exonérés de la procédure d'appel à projet figurant au I :
« 1° Consolidation of facilities or social and medico-social services by managers with authorizations issued pursuant to section L. 313-1, if they do not result in capacity extensions above the threshold set out in second paragraph I of this section;
« 2° Projects for the transformation of establishments or services that do not include changes to the category of beneficiaries of the establishment or service, as defined in section L. 312-1;
« 3° The projects for the creation and extension of the places of life and reception mentioned in III of the same article L. 312-1;
« 4° Projects to extend the capacity of medical-social facilities and services not exceeding a capacity of ten places or beds, below a threshold set by decree;
« 5° The projects for the creation, transformation and extension of the reception centres for asylum seekers mentioned in Article L. 348-1.
"III.-Sont exonérés de la procédure d'appel à projet figurant au I, à la condition de donner lieu à la conclusion d'un contrat multi-year d'objects et de moyens :
« 1° Projects for the transformation of establishments and services with modification of the class of beneficiaries of the establishment or service, as defined in section L. 312-1, with the exception of home services that are not entitled to receive social assistance recipients or are authorized to provide care to social insured persons, provided that:
“(a) When the activity is subject to joint authorization, there is no disagreement between the competent authorities;
“(b) Transformation projects do not result in an extension of capacity above a threshold prescribed by decree;
« 2° Health institution transformation projects mentioned in the articles L. 6111-1 and L. 6111-2 the Code of Public Health in Social and Medical-Social Institutions or Services under Article L. 312-1 of this Code, except where the transformation projects result in an extension of capacity above a threshold prescribed by decree.
"The information and selection commission referred to in I of this article gives its opinion on the transformation projects. » ;
3° The beginning of the first paragraph of Article L. 313-2 is thus drafted: "Applications for authorization relating to social and psychosocial facilities and services that are not subject to the appeal proceedings are submitted... (the remainder without change). » ;
4° Article L. 313-3 is read as follows:
“(a) By the president of the departmental council, for the establishments and services mentioned in 1°, 6°, 7°, 8°, 11° and 12° of the I of the article L. 312-1 and for the places of life and reception mentioned in the III of the same article L. 312-1, when the benefits they provide are liable to be taken care by the departmental social assistance or when their interventions are subject to a devolute competence; »
5° C to f of the same article L. 313-3 are thus drafted:
"(c) By the competent authority of the State, for the establishments and services mentioned in 4°, 8°, 10°, 11°, 12° and 13° of the I of Article L. 312-1 and for the places of life and reception mentioned in the III of the same article L. 312-1, when the services they dispense are liable to be taken over by the State, as well as after the notice of the prosecutor of the Republic mentioned
"(d) Together with the President of the Departmental Council and the Director General of the Regional Health Agency, for establishments, services and places of life and reception, whose authorization is simultaneously under the a and b of this article, as well as for those authorized under the 3rd I of Article L. 312-1;
“e) Conjointly by the competent authority of the State and the president of the departmental council, for establishments, services and places of life and reception whose authorization is simultaneously under the a and c of this article, as well as for those whose authorization falls under the 4th I of Article L. 312-1;
“(f) Conjointly by the competent authority of the State and the Director General of the Regional Health Agency, for establishments, services and places of life and reception whose authorization is simultaneously in the b and c of this article; »
6° Article L. 313-5 is supplemented by three paragraphs as follows:
"For establishments and services under theArticle 80 of Act No. 2002-2 of 2 January 2002 Renovating social and medico-social action:
« 1° The one-year period provided for in the first paragraph of this Article shall be replaced by a nine-month period;
« 2° The six-month period provided for in the second paragraph of this article shall be replaced by a three-month period. » ;
7° Article L. 313-6 is amended as follows:
(a) At the beginning of the first paragraph, the words: "The authorization referred to in Article L. 313-1-1 or its renewal is valid" are replaced by the words: "The authorization granted for creation, transformation and extension projects greater than the threshold provided for in Article L. 313-1-1 of social and medical facilities and services is valid";
(b) After the first preambular paragraph, a sub-item reads as follows:
"The authorization granted for extension projects below the threshold provided for in Article L. 313-1-1 shall result in a compliance visit where they require work subordinate to the issuance of a building permit, an amendment to the proposed establishment referred to in Article L. 311-8 or a move on all or part of the premises. » ;
(c) At the beginning of the second paragraph, the word "They" is replaced by the words "Authorization or renewal";
8° In the first paragraph of Article L. 313-8, the word "second" is replaced by the word "third";
9° Article L. 315-2 is supplemented by a paragraph as follows:
"The call-up procedure provided for in Article L. 313-1-1 is not applicable to non-personalized institutions and services of departments and departmental public institutions when they fall within the exclusive competence of the chair of the departmental council. The information and selection commission referred to in I of the same article gives its opinion on the projects of these institutions or services. » ;
10° In Article L. 531-6 and 1° of Article L. 581-7, after the word "commission", the words "information and".
The Government shall submit to Parliament, by 31 December 2017, an assessment report on the renewal procedure for the institutions and services referred to in theArticle L. 312-1 of the Code of Social Action and Familiesauthorized and opened before the day on which the Act No. 2002-2 of 2 January 2002 renovating social and medico-social action.
I.-After theArticle 80 of Act No. 2002-2 of 2 January 2002 renovating social and medico-social action, it is inserted an article 80-1 as follows:
"Art. 80-1.-I.-The establishments, services and places of life and reception that do not have, on the date of publication of Law No on the Adaptation of Society to Ageing, an authorization under all or part of their activities under theArticle L. 312-1 of the Code of Social Action and Families, issued pursuant toArticle 9 of Act No. 75-535 of 30 June 1975 relating to social and medico-social institutions or pursuant to section L. 313-1 of the same code, are deemed to be entitled to the authorization referred to in section L. 313-1 from the date of their opening. Facilities, services and places of life and reception must meet the following two conditions:
« 1° Have these unauthorized activities carried out under section L. 312-1 of the said code prior to the application of the authorization regime provided for in theArticle 9 of Act No. 75-535 of 30 June 1975 referred to above or article L. 313-1 of the same code;
« 2° Having benefited under these activities, by virtue of a unilateral decision of the competent authorities or an agreement with them, an authorization to receive beneficiaries of social assistance or an authorization to provide repayable care to social insured persons.
"The categories of beneficiaries and the host capacities so deemed to have been authorized are those contained in the most recent decision or convention in force.
"II.- Settlements, services and places of life and hospitality 4° of Article L. 312-1 of the Code of Social Action and Families which do not have, on the date of publication of Law No on the Adaptation of Society to Ageing, an authorization issued under theArticle 9 of Act No. 75-535 of 30 June 1975 referred to above or section L. 313-l of the same code shall be deemed to benefit from the authorization referred to in the same section L. 313-1 from the date on which it is opened. This authorization is valid for a period of two years from the publication of Act No. Facilities, services and places of life and reception must meet the following two conditions:
« 1° Have these unauthorized activities carried out under section L. 312-1, 4°, of the said code prior to the application of the authorization regime provided for in theArticle 9 of Act No. 75-535 of 30 June 1975 referred to above or article L. 313-1 of the same code;
"2° Benefit or have been granted an authorization to receive minors usually entrusted by the judicial authority, issued under Article L. 313-10 of the said Code.
"Renewal of this authorization shall be carried out, under conditions specified by decree, in respect of:
“(a) Results of the external evaluation referred to in Article L. 312-8 of the same code;
“(b) Objectives and needs formalized in the diagrams provided for in the 4th of Article L. 312-5 of the same code;
"(c) Directions set by the representative of the State in the department, for what is exclusively within his authority.
"III.-The homes of young workers who do not have, on the date of publication of Law No on the Adaptation of Society to Ageing, for all or part of their activities under the 10° of Article L. 312-1 of the Code of Social Action and Familiesan authorization issued under theArticle 9 of Act No. 75-535 of 30 June 1975 referred to above or section L. 313-1 of the same code and which commenced activities under 10° of I of section L. 312-1 of the said code before the obligation arising from these sections is applicable to them, or between March 31, 2010 and March 27, 2014, are deemed to be eligible for the authorization referred to in section L. 313-1 of the same code as of their opening date. Also deemed to be authorized, from the signature of the agreement entered into by the household manager under the sections L. 351-2 and L. 353-2 the construction and housing code, the projects that have been the subject of a funding decision for public aids pursuant to the 1st of Article L. 301-2 of the same code before March 27, 2014.
"In a period of one year from the date of the promulgation of Act No. of the above-mentioned Act, the competent authority of the State shall determine the capacity to be so deemed authorized, taking into account the number of housing units intended for young workers and provided for in the agreement concluded by the manager of the household pursuant to the articles L. 351-2 and L. 353-2 the construction and housing code, or a convention entered into within the framework of theArticle L. 263-1 of the Social Security Code.
"IV.-The establishments and services referred to in I and III of this article which, on the date of publication of Act No. 2015-1776 of 28 December 2015 referred to above, did not disclose to the administrative authority the external evaluation provided for in fifth paragraph of Article L. 312-8 of the Code of Social Action and Families, and whose authorization expires within two years after the date of publication of the same Act, see the length of such authorization extended for a period of two years from that same date. »
II.-Section L. 315-5 of the Code of Social Action and Families is repealed.
III.-The XXIII of Article L. 543-1 of the same code is repealed.
IV.-Section 34 of Act No. 75-535 of 30 June 1975 on social and social institutions is repealed.
Article L. 14-10-5 of the Code of Social Action and Families is supplemented by a VII as follows:
" VII.-A section dedicated to investment assistance. She recounts:
“(a) In resources, for fiscal years 2016,2017 and 2018, an amount of 100 million euros annually;
“(b) In expense, the financing of the operations referred to in a of section L. 14-10-9. »
Chapter II of title IV of Book I of the Code of Social Action and Families is thus restored:
“Chapter II
"High Council of the Family, Children and Age
"Art. L. 142-1.-The High Council for the Family, Children and Age is placed with the Prime Minister. It is made up of equal numbers of men and women and has the task of animating public debate and providing public authorities with a forward-looking and cross-cutting expertise on issues related to family and childhood, age advancement, adaptation of society to aging and well-treatment, in an intergenerational approach.
"His functioning and composition are determined by a decree, which provides for plenary training and specialized training in their field of competence.
"As part of his missions, the High Council for the Family, Children and Age:
« 1° Formulating proposals and opinions and carrying out or carrying out evaluation and prospective work on the policies of its field of competence, in view of demographic, social, health and economic developments;
« 2° Draft recommendations on the priority objectives of family, child, elderly and retired people policies and the prevention and support of self-reliance, particularly with regard to the international commitments of France, including those of the International Convention on the Rights of the Child of 20 November 1989;
« 3° Formulate any proposal that ensures, at all ages of life, respect for the rights and well-treatment of vulnerable persons and the proper consideration of ethical issues;
« 4° Reflects on the financing of policies implemented in its field of competence;
« 5° Provides an opinion, within the framework of the relevant specialized training courses in the field of childhood, the advancement of older persons and retired persons, the adaptation of society to ageing and welfare, on any bill or order concerning them and can follow up on them;
« 6° Promotes the exchange of experience and information between the different territorial authorities on the policies that concern it.
"The training specialized in the field of competence of the age leads to a reflection on dependency insurance and foresight. It promotes exchanges of experience and information with the National Advisory Council for Persons with Disabilities referred to in Article L. 146-1 on the common aspects of policies for the autonomy of older persons and persons with disabilities.
"The High Council for the Family, Children and Age may be seized by the Prime Minister, the Minister for the Family, the Minister for Older Persons and other relevant ministers of any matter within the scope of his/her competence.
"It can take up any questions relating to the family and to childhood, the advance in age of older persons and retirees, and the adaptation of society to aging as well as to goodwill. »
Chapter X of title IV of Book I of the Code of Social Action and Families is thus amended:
1° Article L. 14-10-1 is amended as follows:
(a) The first is thus written:
« 1° To contribute to the financing of the prevention and support of the loss of autonomy of older persons and persons with disabilities, at home and in institutions, as well as to the financing of the support of caregivers, in accordance with the equal treatment of the persons concerned throughout the territory; »
(b) At the beginning of 2°, the words are added: "To contribute to the knowledge of the medico-social offer and to the analysis of needs,"
(c) The 3° is replaced by 3° and 3° bis as follows:
« 3° Ensure a role of technical expertise and proposal for national repositories that assess deficiencies and loss of autonomy, as well as the situation and needs of caregivers;
« 3° bis Ensure a role of technical expertise and proposal for methods and tools used to assess individual compensation needs; »
(d) The 5th is thus written:
« 5° To ensure the piloting of devices that contribute to innovation, information and advice on technical aids that aim to improve the autonomy of older persons and persons with disabilities, to establish an assessment of the adaptation of these aids to the needs of those who use them and to ensure the quality and fairness of the conditions of their distribution; »
(e) The 6° is thus modified:
- after the reference: "L. 146-3", the words are inserted: ", the departments responsible for the personalized allocation of autonomy and the lectures of the financialers mentioned in Article L. 233-1";
- after the word "needs" are inserted the words: "the development of aid plans and the management of benefits,"
-the words added: "disability and self-help";
(f) After the 6°, it is inserted a 6° bis as follows:
"6° bis Ensuring a role of accompaniment and support to the departmental homes of self-government referred to in Article L. 149-4 as well as an assessment of their contribution to the policy of the autonomy of persons with disabilities and the elderly; »
(g) The 7th is supplemented by the words: ", and the conditions in which it is answered on the territories";
(h) Added from 12° to 14° as follows:
« 12° To provide information on their rights and services to older persons, persons with disabilities and their families in connection with relevant local institutions;
« 13° To design and implement a system of information common to departmental houses of persons with disabilities, including accommodation of health data related to the public interest group provided for in theArticle L. 1111-24 of the Public Health Code. For the purposes of the implementation of this information system, the National Solidarity Fund for Self-Government can set standards to ensure the interoperability between its information systems, those of the departments and those of the departmental houses of persons with disabilities and, in connection with the above-mentioned grouping, to label information systems in accordance with these standards;
« 14° Define standards to ensure the exchange of information related to the implementation of the method of action for the integration of aid and care services in the field of autonomy referred to in Article L. 113-3 of this Code, in connection with the public interest group provided for in the public interest groupArticle L. 1111-24 of the Public Health Code.
2° The VI of Article L. 14-10-3 is supplemented by a sentence as follows:
"This report includes sex indicators. » ;
3° The last paragraph of Article L. 14-10-7 is as follows:
"The payment of the competition relating to the installation and operation of departmental houses is made under conditions specified in the agreement referred to in Article L. 14-10-7-2. » ;
4° After the article L. 14-10-7-1, articles L. 14-10-7-2 and L. 14-10-7-3 are inserted as follows:
"Art. L. 14-10-7-2.-A multi-year agreement signed between the National Solidarity Fund for Autonomy and the department sets out their mutual commitments in the field of the autonomy of older persons and persons with disabilities, in particular on:
« 1° The payment of the competition for the installation and operation of departmental houses, taking into account quality of service objectives and the performance of previous objectives;
« 2° Quality objectives;
« 3° The distribution of the credits between the preventive actions of 1°, 2°, 4° and 6° respectively of Article L. 233-1;
« 4° The terms and conditions for the payment of competitions to the departments under the personalized allowance of autonomy and the provision of compensation for the disability referred to in Article L. 14-10-5 and under the financing of the finance conference referred to in Article L. 233-2.
"In the absence of a convention, the department receives the contests defined in articles L. 14-10-6 and L. 14-10-7.
"Art. L. 14-10-7-3.-The National Fund for Solidarity for Self-Government signs with any metropolis exercising its competence with respect to the elderly a multi-year convention setting their mutual commitments on:
« 1° The terms and conditions of payment of the contests referred to in Article L. 14-10;
« 2° The distribution of the credits between the preventive actions of 1°, 2°, 4° and 6° respectively of Article L. 233-1. »
Article L. 14-10-3 of the Code of Social Action and Families is amended as follows:
1° After 5°, it is inserted a 5° bis as follows:
« 5° bis Representatives of basic health insurance and old-age insurance plans; »
2° After the eighth preambular paragraph, a sub-item reads as follows:
"The council elects three vice-presidents chosen respectively from the representatives of the departmental councils mentioned in 2°, the representatives of the associations of the elderly mentioned in 1° and the representatives of the associations of persons with disabilities also mentioned in the same 1°. »
Chapter IV bis of title I of Book I of the Social Security Code is thus amended:
1° In the first sentence of the first paragraph of Article L. 114-5, after the word "finance", the words ", as well as the National Solidarity Fund for Autonomy" are inserted;
2° In the first sentence of the first paragraph of Article L. 114-8, after the word "regimes" are inserted the words "and those of the National Solidarity Fund for Autonomy".
After Article L. 146-3 of the Code of Social Action and Families, an article L. 146-3-1 is inserted as follows:
"Art. L. 146-3-1.-I.-Each departmental house for persons with disabilities transmits to the National Solidarity Fund for Autonomy its annual activity report and the standard data on:
« 1° Its activities include multidisciplinary needs assessment, investigation of applications and implementation of decisions taken;
« 2° To the activity and decisions of the Committee on the Rights and Self-Government of Persons with Disabilities referred to in Article L. 241-5;
« 3° Follow-ups reserved for the guidance of the Committee on the Rights and Self-Government of Persons with Disabilities, collected in particular from institutions and services that may accommodate or accompany the persons concerned;
« 4° The characteristics of its users and the extent of their satisfaction;
« 5° To the resources and expenses of the departmental disability compensation fund referred to in Article L. 146-5;
« 6° To his staff;
« 7° The amount and distribution of the funding it received.
"The annual report and standardized data transmitted by the departmental houses of persons with disabilities to the National Solidarity Fund for Self-Government contain gender indicators.
"II.-For the purposes mentioned in I, the departmental houses of persons with disabilities use the registration number on the national user identification directory.
"III.-A decree in the Council of State, taken after the advice of the National Commission on Informatics and Freedoms, specifies the conditions for the application of this article, including the modalities according to which the standardized transmission of data is carried out. »
Section 3 of Chapter II of Title III of Book II of the Code of Social Action and Families is thus restored:
“Section 3
“Management and statistical monitoring
"Art. L. 232-21.-I.-Each department transmits to the National Solidarity Fund for Autonomy the data, specified by decree, relating to the net costs of personalized self-reliance.
"II.-The decree mentioned in I specifies the conditions under which the standardized transmission of these data is carried out.
"Art. L. 232-21-1.-I.-Each department shall transmit to the Minister for Older Persons the data, specified by decree, relating to the decisions on the allocation of the personalized self-reliance allowance, as well as the individual information relating to beneficiaries.
"II.-The decree mentioned in I specifies the conditions under which the standardized transmission of these data is carried out.
"Art. L. 232-21-2.- Individual information relating to persons affected by the decisions on the allocation of personalized self-reliance and social assistance to accommodation, the assessment of their needs and the instruction of requests shall be transmitted to the Minister responsible for the elderly, under conditions provided by decree, for the purpose of establishing statistically representative samples for the study of the situations and courses of persons included in these situations.
"Art. L. 232-21-3.-I.-For the attribution, management and control of the effectiveness of the personalized allowance of autonomy referred to in Article L. 232-12 and of the social assistance provided for in Article L. 231-4, as well as to statistical purposes, departments collect, maintain and maintain the individual relative data:
« 1° Personalized home and residential self-employment allowance payments, the nature of the expenses covered and the characteristics and resources of their beneficiaries;
« 2° The benefits provided in the establishment, the nature of the expenses covered and the characteristics and resources of the beneficiaries of social assistance provided for in the same article L. 231-4;
« 3° To the activity of the team referred to in Article L. 232-6, in particular with regard to needs assessment, application instruction and implementation of decisions taken.
"II.-For the purposes mentioned in I, the departments use the registration number to the national directory for the identification of natural persons beneficiaries, under conditions provided for by a decree in the Council of State, after the opinion of the National Commission of Computer Science and Freedoms.
"Art. L. 232-21-4.-The data and information referred to in articles L. 232-21 to L. 232-21-3 contain gender indicators. »
The code of social action and families is thus modified:
1° Article L. 247-2 is as follows:
"Art. L. 247-2.-The departmental houses of persons with disabilities must use a common information system, interoperable with the information systems of the departments, those of the National Family Allowance Fund and those of the National Solidarity Fund for Self-Government, under conditions specified by decree. » ;
2° In the last paragraph of Article L. 146-3, after the reference: "L. 247-2", the words are inserted: ", in its earlier drafting of Law No on the Adaptation of Society to Ageing".
Article L. 113-2 of the Code of Social Action and Families is thus written:
"Art. L. 113-2.-I.-The department defines and implements social action for the elderly and their caregivers referred to in Article L. 113-1-3. It coordinates, within the framework of the departmental scheme of social and medico-social organization referred to in Article L. 312-5, the actions carried out by the various stakeholders, including in favour of the caregivers. It defines geographic areas of intervention. It determines the terms and conditions of public information, advice and guidance on aids and services under its jurisdiction.
"The department coordinates, in accordance with their competence, the action of the actors responsible for the development and implementation of policies relevant to the living conditions of older persons, using, inter alia, the conference of the financeors of the prevention of the loss of autonomy of older persons referred to in Article L. 233-1 and the departmental council of citizenship and autonomy referred to in Article L. 149-1.
"The department ensures the territorial coverage and coherence of the respective actions of organizations and professionals that provide information, guidance, evaluation and coordination missions for older persons, including the local information and coordination centres referred to in 11° of I of Article L. 312-1 and the institutions and professionals implementing the method of action for the integration of assistance and care services referred to in Field 113-3.
"II.-The department can sign agreements with the regional health agency, social security agencies or any other stakeholders in favour of older persons to ensure the coordination of the Ghentological Action.
"These conventions are concluded in accordance with the scheme for persons with loss of autonomy referred to in Article L. 312-5 and the regional health project provided for in theArticle L. 1434-2 of the Public Health Code.
"They specify the terms and conditions under which missions referred to in the last paragraph I of this article are carried out throughout the department. They can also focus on the prevention and support of the loss of autonomy of older persons, as well as on the support and enhancement of their caregivers. In the latter case, they may specify the programming of the means devoted to it.
"The departmental council of citizenship and autonomy referred to in Article L. 149-1 is consulted on these conventions prior to their signature and is informed of their implementation. »
I.-Article L. 113-3 of the Code of Social Action and Families is amended as follows:
1° The first paragraph is amended to read:
(a) At the beginning, the mention is added: "I.-";
(b) The words: "affected by Alzheimer's disease or related disease or" are deleted;
(c) At the end, the words: "in homes for the autonomy and integration of Alzheimer's patients" are replaced by the words: "by following the method of action for the integration of aid and care services in the field of autonomy";
2° In the second paragraph, the words: "their operation" are replaced by the words: "the implementation of this method of action" and the words: "the methods implemented" are replaced by the words: "the means deployed";
3° It is added a II as follows:
"II.-Professionals dealing with an elderly person under the method referred to in I shall be held in professional secrecy, under the conditions provided for in sections 226-13 and 226-14 Criminal code.
"However, they may exchange information relating to the same person under the conditions provided for in theArticle L. 1110-4 of the Public Health Code. When they have at least one health professional, they are considered to be a care team within the meaning of Article L. 1110-12 of the same code.
"The legal representative or, if not, the trusted person referred to in Article L. 1111-6 of the said Code is competent to consent to the exchange of information or to oppose it when the data subject is out of order. »
II.-The I of Article L. 14-10-5 of the same code is amended as follows:
1° In the first paragraph, the words: "houses for the autonomy and integration of Alzheimer's patients mentioned" are replaced by the words: "the method of action for the integration of aid and care services in the field of self-reported autonomy";
2° In the first paragraph of 2, the words: "to homes for the autonomy and integration of Alzheimer's patients mentioned" are replaced by the words: "to the method of action for the integration of aid and care services in the field of self-reported autonomy";
3° In b of the same 2, the words: "houses for the autonomy and integration of people with Alzheimer's disease mentioned" are replaced by the words: "the method of action for the integration of aid and care services in the field of self-reported autonomy".
After the 5th of Article L. 312-4 of the Code of Social Action and Families, it is inserted a paragraph as follows:
"The regional centres for studies, actions and information for persons in vulnerable situations and the local information and coordination centres referred to in 11° of I of Article L. 312-1 contribute, in response to the request of the competent authorities for the development of the social and medico-social organisation schemes and regional health schemes, to the analysis of needs and the offer referred to in 1° and 2°, »
Article L. 312-5 of the Code of Social Action and Families is thus amended:
1° The last three sentences of the last paragraph are replaced by two sentences as follows:
"The Departmental Council of Citizenship and Self-Government referred to in Article L. 149-1 is consulted, for advice, on the content of these diagrams. The modalities of this consultation are defined by decree. » ;
2° It is added a paragraph to read:
"The objective of these schemes is to ensure the territorial organization and accessibility of the provision of community services for persons with disabilities or loss of autonomy and their caregivers. They include provisions on housing, including targets for the adaptation of existing housing and the provision of suitable new housing to preserve the autonomy of people. »
2° of Article L. 1431-2 of the Public Health Code is amended as follows:
1° The a is supplemented by a sentence as follows:
"They also contribute to the evaluation and promotion of support for caregivers, the training and support of volunteers who contribute to the maintenance of the social bond of older persons and persons with disabilities and the modernization of home aid; »
2° In b, the words: "houses for the autonomy and integration of Alzheimer's patients mentioned" are replaced by the words: "bearers of the method of action for the integration of aid and care services in the field of self-reported autonomy".
The code of social action and families is thus modified:
1° Chapter IX of title IV of Book I reads as follows:
“Chapter IX
“ Common institutions for older persons and persons with disabilities
“Section 1
"The departmental council of citizenship and autonomy
"Art. L. 149-1.-The departmental council of citizenship and autonomy ensures the participation of older persons and persons with disabilities in the development and implementation of the policies of autonomy in the department.
"It is competent in the prevention of loss of autonomy, medical-social support and access to human or technical care and assistance.
"It is also competent in terms of accessibility, housing, collective housing, urban planning, transport, schooling, social and professional integration and access to physical activity, leisure, associative life, culture and tourism.
"The departmental council of citizenship and autonomy is consulted for advice on:
« 1° The regional health pattern mentioned in theArticle L. 1434-3 of the Public Health Code and the regional and departmental diagrams mentioned in the 2nd and 4th of Article L. 312-5 of this Code;
« 2° The annual or multi-year programming of the means allocated by the regional health agency, the department and basic old-age insurance plans to the departmental policy of autonomy;
« 3° The coordinated programme referred to in Article L. 233-1;
« 4° The activity reports of the Departmental House of Persons with Disabilities provided for in Article L. 146-3, the finance conference referred to in Article L. 233-1 and the departments of the Department responsible for the elderly, prior to their transmission to the National Fund of Solidarity for Self-Government and to the Public Health Policy Coordination Commissions;
« 5° The agreements signed between the department and its partners to define their common objectives in favour of the departmental policy of autonomy and their implementation.
"He is informed of the content and application of the departmental habitat plan referred to in theArticle L. 302-10 of the Construction and Housing Code, the Departmental Programme for the Professional Inclusion of Disabled Workers and Plans of Equipment and Assistance of Persons with Disabilities in the Department.
"He gives an opinion on the constitution of a departmental home of autonomy referred to in article L. 149-4 of this code. He is informed of the activity and means of this departmental house of autonomy by the president of the departmental council.
"It makes recommendations for respect for the rights and well-treatment of older persons and persons with disabilities in the department, to ensure the support and enhancement of their caregivers and to enable the proper consideration of ethical issues.
"He shall forward, no later than 30 June of the year concerned, to the High Council for the Family, Children and Age referred to in Article L. 142-1, to the National Advisory Council for Persons with Disabilities referred to in Article L. 146-1 and to the National Solidarity Fund for Self-Government a biennial report on the implementation of the policies of autonomy in the department, whose synthesis is the subject of a presentation in each case.
"He can discuss, on his own initiative, any questions concerning the policy of autonomy and formulate proposals on the policy directions. It may be seized by any institution wishing to consult it.
"Departmental councils of citizenship and autonomy of the same region can discuss, on their own initiative, any issues relating to the development and implementation of policies of autonomy in the region.
"Art. L. 149-2.-The departmental council of citizenship and autonomy is chaired by the president of the departmental council. It includes representatives:
« 1° Older persons, retired persons, including representative trade union organizations, persons with disabilities, their families and their caregivers;
« 2° Department;
« 3° Other territorial authorities and public institutions of intercommunal cooperation;
« 4° Regional Health Agency;
« 5° Departmental State services;
« 6° National Habitat Agency in the department;
« 7° Academy rector;
« 8° Regional management of companies, competition, consumption, work and employment;
« 9° Basic old-age insurance and health insurance plans;
« 10° Federations of complementary pension institutions mentioned in theArticle L. 922-4 of the Social Security Code ;
« 11° Organizations governed by the code of mutuality ;
« 12° Transport organizing authorities;
« 13° Social donors;
« 14° Urban architects;
« 15° Trade union organizations representing employers and employees of the establishments and services mentioned in the 6th and 7th I of Article L. 312-1 of this Code;
« 16° Voluntary actors that contribute to the maintenance of the social bond of older persons and persons with disabilities.
"Any other natural or legal person concerned by the policy of autonomy may participate, subject to the agreement of the majority of members of law.
"The departmental council of citizenship and autonomy sits in plenary or specialized training. It has at least two specialized training courses, respectively, for the elderly and for persons with disabilities. Within each specialized training, there are several colleges, including at least one college of user representatives and a college of institution representatives, which assists in the coordination of the latter in the territory. The college of representatives of the institutions competent for the elderly is composed of members of the finance conference provided for in Article L. 233-1.
"The composition, the modalities for the designation of members, their distribution in specialized training and colleges and the modalities of operation of the departmental council of citizenship and autonomy are set by decree.
"Art. L. 149-3.-The Departmental Council for Citizenship and Self-Government is also competent in the territory of the metropolis which exercises its competence with respect to older persons and persons with disabilities under the conditions set out in this section, subject to this section.
“It is called “Departmental-Metropolitan Council of Citizenship and Self-Government”.
"He has representatives of the metropolis.
"His presidency is ensured, alternately every year, by the president of the departmental council and the president of the city council. » ;
2° The second sentence of the first paragraph of Article L. 146-1 is deleted;
3° Articles L. 146-2 and L. 146-2-1 are repealed;
4° In the last paragraph of Article L. 114-3, the words "consultations of persons with disabilities referred to in Article L. 146-2" are replaced by the words "citizenship and autonomy referred to in Article L. 149-1";
5° At the end of the last paragraph of Article L. 114-3-1, the words: "consultation of persons with disabilities referred to in Article L. 146-2" are replaced by the words: "citizenship and autonomy referred to in Article L. 149-1";
6° In Article L. 531-7, the reference: "L. 146-2" is replaced by the reference: "L. 146-3";
7° Article L. 541-4 is repealed;
8° Section L. 581-1 is amended as follows:
(a) The b is thus written:
“(b) For the purposes of the article L. 149-1, the words: “departmental”, “department”, “department” and “department” are replaced, respectively, by the words “territorial”, “territorial”, “territorial” and “territorial”;”
(b) It is repealed.
Chapter IX of Title IV of Book I of the Code of Social Action and of Families, as the result of Article 81 of this Law, is supplemented by a section 2 of this Law:
“Section 2
« Departmental houses of autonomy
"Art. L. 149-4.-For the establishment of a departmental home of self-government, the chair of the departmental council may organize the sharing of hospitality, information, counselling, guidance and, where appropriate, the instruction of applications, needs assessment and the development of assistance plans for the benefit of older persons and persons with disabilities. The organization of the departmental home of autonomy ensures the quality of the assessment of needs and the development of assistance plans, on the one hand, of persons with disabilities in accordance with a reference provided by a decree of the Minister responsible for persons with disabilities and, on the other hand, of the elderly on the basis of the references mentioned in article L. 232-6.
"This organization, which does not give rise to the creation of a new legal entity, brings together the departmental house of persons with disabilities mentioned in the first paragraph of Article L. 146-3 and the staff and material resources of the department assigned to the policy for the elderly and persons with disabilities. However, its implementation does not affect the application of section 2 of chapter VI of this title and chapter I bis of title IV of Book II.
"The establishment of a departmental home of autonomy is subject to the consistent opinion of the executive board of the departmental house of persons with disabilities and to the advice of the departmental council of citizenship and autonomy referred to in Article L. 149-1.
"The President of the Departmental Council shall transmit annually to the National Solidarity Fund for Self-Government data on the activity and means of the organization for its evaluation. It also transmits these data to the departmental board of citizenship and autonomy.
"When this organization meets the requirements of a notebook of duties defined by decree, the Caisse nationale de solidarité pour l'autonomy issues the label of the departmental house of autonomy, in conditions specified by the same decree. »
I.-After the 3rd of Article L. 132-8 of the Code of Social Action and Families, it is inserted a 4th so written:
« 4° On a subsidiary basis, against the beneficiary of a life insurance contract subscribed by the beneficiary of social assistance, up to the fraction of the premiums paid after the age of seventy years. When the recovery concerns several beneficiaries, it is carried out on the pro rata of the amounts paid to each recipient. »
II.-At the end of Article L. 232-19 of the same code, the words "or on the donee" are replaced by the words ", on the donee or on the beneficiary of a life insurance contract". »
III.-At the end of the second paragraph of Article L. 245-7 of the same code, the words "or the donee" are replaced by the words ", the donee or the beneficiary of a life insurance contract".
IV.-The first sentence of 2° of Article L. 344-5 of the same code is supplemented by the words "or the beneficiary of a life insurance contract".
I.-A.-Articles 10, as it relates to self-reliance residences, to 13 are not applicable in Guadeloupe, Guyana, La Réunion and Martinique.
B.-Chapter I of title II of Book V of the Code of Social Action and Families is supplemented by articles L. 521-2 to L. 521-5 as follows:
"Art. L. 521-2.-Le 1° de l'article L. 14-10-10 is not applicable in Guadeloupe, Guyana, La Réunion and Martinique.
"Art. L. 521-3.-For the purposes of the fourth paragraph of Article L. 342-3 in Guadeloupe, Guyana, La Réunion and Martinique, the words: “in accordance with the provisions of the agreement concluded under personalized housing assistance” are replaced by the words: “in conditions provided by decree”.
"Art. L. 521-4.-For its application in Guadeloupe, chapter III of Book II title III of this Code applies under the conditions set out in Articles L. 1442-1 to L. 1442-6 of the Public Health Code.
"Art. L. 521-5.-For the application in Guyana of chapter III of title III of Book II of this Code, a decree in the Council of State sets out the special conditions for the adaptation of the applicable legislative provisions, including those relating to the conference of the financialers mentioned in article L. 233-1. »
II.-A.-Articles 10, as it relates to self-reliance residences, to 18 are not applicable to Saint-Pierre-et-Miquelon.
B.-The single chapter of title III of Book V of the Code of Social Action and Families is thus amended:
1° After the first paragraph of Article L. 531-1, it is inserted a 1° A thus drafted:
"1° A The 1st of Article L. 14-10; »
2° Articles L. 531-10 to L. 531-12 are added as follows:
"Art. L. 531-10.-Section L. 146-3-1 is applicable to Saint-Pierre-et-Miquelon, subject to the modifications provided for in Article L. 531-8.
"Art. L. 531-11.-Chapter III of Book II title III of this Code applies under the conditions set out in Public Health Codein particular in article L. 1441-3 of the same code.
"Decrees in the Council of State establish the special conditions for the adaptation of the legislative provisions applicable to the community of Saint-Pierre-et-Miquelon, in particular those relating to the conference of the financiers mentioned in Article L. 233-1 of this Code and to the departmental council of citizenship and autonomy referred to in Article L. 149-1.
"Art. L. 531-12.-For the application in Saint-Pierre-et-Miquelon of the fourth paragraph of Article L. 342-3, the words: “in accordance with the terms of the agreement concluded under the title of personalized housing assistance” are replaced by the words: “in conditions provided by decree”. »
III.-A.-Articles 10, as it relates to self-reliance residences, to 13 as well as to the c of 4th I and II and III of Article 56 are not applicable to Mayotte.
B.-For their application in Mayotte, sections 32,33 and 34 come into force as of January 1, 2016, pursuant to section 11 of Order No. 2012-785 of May 31, 2012 extending and adapting the code of social action and families to the Department of Mayotte.
Sections 73 and 82 of this Act come into force under the conditions set out in section 10, paragraph 3, of the Order and no later than January 1, 2016.
C.-Le titre IV du livre V du code de l'action sociale et des familles est ainsi modifié :
1° The IX of Article L. 541-1 is thus restored:
" IX.-Article L. 116-4 is amended as follows:
« 1° In the first sentence of the first paragraph, the reference: “at 2° of Article L. 7231-1 of the Labour Code” is replaced by the reference: “at theArticle L. 821-1 of the Labour Code applicable to Mayotte “ ;
« 2° In the second paragraph, the words: “ mentioned in theArticle L. 7221-1 of the Labour Code “are deleted. » ;
2° Section L. 541-4 is amended as follows:
(a) In the VII, the references: "a and the second paragraph of b of II" are replaced by the references: "1° and the second paragraph of 2° of II";
(b) In VIII, after the reference: "d", is inserted the reference: "from 1° of the I";
(c) The following are added:
"X.-The 1st of Article L. 14-10-10 is not applicable.
" XI.-Regulations in the Council of State establish the special conditions for the adaptation of the legislative provisions relating to the conference of the financialers provided for in Article L. 233-1 and the departmental council of citizenship and autonomy referred to in Article L. 149-1. » ;
3° Section L. 542-3 is amended as follows:
(a) II is thus amended:
- at the beginning of the first paragraph of 2°, the words: "The second" are replaced by the words: "The penultimate";
-the b of the same 2° is repealed;
-the 3rd is thus written:
« 3° The second paragraph of Article L. 232-7 of this Code is not applicable; »
-the 5th is repealed;
-the 6th is thus written:
« 6° The fourth paragraph of Article L. 232-15 of this Code is not applicable. » ;
(b) It is added a III as follows:
"III.-Chapter III of Book II title III of this Code applies under the conditions set out in Articles L. 1443-1 to L. 1443-7 of the Public Health Code.
"The 2° of Article L. 233-1 of this code is not applicable. » ;
4° The 1° E of the XIII of Article L. 542-4 is repealed;
5° V, VII, X, XIII and XVIII of Article L. 543-1 are repealed;
6° Article L. 543-3 is supplemented by a VI as follows:
"VI.-A l. L. 331-8-1, the words "or to receive their declaration under articles L. 321-1 and L. 322-1" are deleted. » ;
7° Section L. 543-4 of this code is amended as follows:
(a) I is thus restored:
"I.-A Article L. 342-3, at the end of the second paragraph, the words: "as provided inArticle L. 161-23-1 of the Social Security Code “are replaced by the words: “planned to thearticle 13 of Order No. 2002-411 of 27 March 2002 relating to health and social protection in Mayotte” and, in the fourth paragraph, the words: “in accordance with the agreement reached under the personalized housing assistance agreement” are replaced by the words: “in conditions provided by decree”. » ;
(b) The VIII reads as follows:
Chapters VI and VIII are not applicable. »
D.-Sections L. 821-6 and L. 821-7 of the Labour Code applicable to Mayotte are repealed.
IV.-A.-Articles 10, as it relates to self-reliance residences, 11,12,13,14,18 and 22 are not applicable to Saint-Barthélemy and Saint-Martin.
B.-The single chapter of title VIII of Book V of the Code of Social Action and Families is supplemented by articles L. 581-10 to L. 581-12 as follows:
"Art. L. 581-10.-Le 1° de l'article L. 14-10-10 is not applicable to Saint-Barthélemy and Saint-Martin.
"Art. L. 581-11.-For its application in Saint-Barthélemy and Saint-Martin, chapter III of Book II title III of this Code applies under the conditions set out in Articles L. 1442-1 to L. 1442-6 of the Public Health Code.
"Decrees in the Council of State set out the special conditions for the adaptation of the legislative provisions applicable to Saint-Barthélemy and Saint-Martin, in particular those relating to the conference of the financiers mentioned in Article L. 233-1 of this Code and to the departmental council of citizenship and autonomy referred to in Article L. 149-1.
"Art. L. 581-12.-For the application in Saint-Barthélemy and Saint-Martin of the fourth paragraph of Article L. 342-3, the words: “in accordance with the provisions of the agreement concluded under personalized housing assistance” are replaced by the words: “in conditions provided by decree”. »
I.-Article L. 14-10-7 of the Code of Social Action and Families is thus amended:
1° The first paragraph of I is replaced by four subparagraphs as follows:
"I.-The contests mentioned in the III of Article L. 14-10-5 are divided under the conditions specified in this article, according to the terms fixed by decrees in the Council of State taken after advice of the National Fund of Solidarity for Self-Government.
"II.-The contest referred to in the same III to cover a portion of the cost of the compensation benefit is distributed among the departments, after the collection of the sums required for a quota for the communities of Saint-Barthélemy, Saint-Martin and Saint-Pierre-et-Miquelon.
"This share is calculated by applying to the total amount of the contest intended to cover this expenditure the double of the ratio between, on the one hand, the number of beneficiaries of the compensation benefit referred to in Article L. 245-1 and the compensatory allowance for third person referred to in Article L. 245-1, in its drafting prior to the coming into force of Act No. 2005-102 of 11 February 2005 for equality
"III.-The balance of the contest referred to in II of this article and the contest referred to in III of Article L. 14-10-5 for the installation and operation of the departmental houses of persons with disabilities are divided according to all or part of the following criteria:"
2° After the f of I, a sub-item is inserted:
"In the absence of tax potential provided forArticle L. 3543-1 of the General Code of Territorial Communities, the competition for the installation and operation of departmental houses of persons with disabilities is determined by holding a zero value for the communities concerned. » ;
3° After I, it is inserted an IV as follows:
"IV.-The quota calculated under the conditions defined in II is distributed among the communities of Saint-Barthélemy, Saint-Martin and Saint-Pierre-et-Miquelon according to the criteria mentioned in the a toe of the III."
4° II is thus amended:
(a) At the beginning of the first paragraph, the reference: "II.-" is replaced by the reference: "V.-";
(b) In the first sentence of the first paragraph and the second paragraph, the reference: "I" is replaced by the reference: "III";
(c) At the end of the last paragraph, the reference "II" is replaced by the reference "V".
II.-Aux a and b of the IX of Article L. 541-4 of the same code, the reference "I" is replaced by the reference "III".
The Government shall submit to Parliament, no later than eighteen months after the promulgation of this Act, a report on the evaluation of its implementation. He shall submit a new report with the same purpose, no later than thirty-six months after the promulgation of this Act. These two reports are prepared following a joint analysis of the State and the departments and, where appropriate, propose changes to this Act and its enforcement measures.
The last paragraph of section L. 233-4 of the Code of Social Action and Families, in its drafting pursuant to section 3 of this Act, is not applicable to the competition awarded by the National Solidarity Fund for Self-Government for the year 2016.
I. - Articles 4, 5, 8 and 55 come into force on 1 January 2016.
II. - The 2° of Article L. 232-6 of the Code of Social Action and Families, in its drafting from this Act, comes into force on the date of publication of the decree revising the ceiling of the aid plan provided for in Article L. 232-3-1 of the same Code, in its drafting from the same Act, without waiting for the publication of the order provided for in that same 2°.
III. - The departmental committees of retirees and seniors and departmental advisory councils of persons with disabilities, as provided for in articles L. 149-1 and L. 146-2 of the said Code, in their earlier drafting of this Act, are maintained until the effective establishment, in their respective departments, of the departmental council of citizenship and autonomy provided for in section 1 of chapter IX of Title IV of Book I of the same Code, in its drafting.
I. - Self-reliance residences are in conformity with the provisions of the Order-in-Council second paragraph of Article L. 313-12 of the Code of Social Action and Families, in its writing resulting from section 10 of this Act, no later than January 1, 2021.
II. - Authorizations of self-reliance residences III of Article L. 313-12 of the Code of Social Action and Families which expires before the expiry date of the time limit set out in I of this Article shall be extended until two years after that date. These institutions shall conduct the external assessment referred to in the fifth paragraph of section L. 312-8 of the same code no later than one year after the expiry of this section. This assessment includes their ability to implement the minimum benefits provided for in the second paragraph of Article L. 313-12 of the Code. During the duration of this section, the establishment shall communicate the results of an internal assessment within the meaning of section L. 312-8 of the same code.
The 2nd of Article 13 comes into force on January 1, 2018 for the owners of more than 10,000 housing units for housing and shelters for asylum seekers on January 1, 2017, and on January 1, 2019 for other donors.
♪ Articles 41-1 to 41-6 of Act No. 65-557 of 10 July 1965 fixing the status of co-ownership of built buildings, in their drafting as a result of the I of section 15 14 of this Act, shall apply upon the expiration of a period of six months following the promulgation of this Act.
Service residences that have been issued prior to the expiry of the period referred to in the first paragraph of this section shall be governed by the rules of Articles 41-1 to 41-5 of Act No. 65-557 of 10 July 1965 referred to abovein their writing before this Act. The Article L. 7232-1-2 of the Labour Code, in its writing before section 15 of this Act, they remain applicable to them.
For these service residences, the trustee lists each year on the agenda of the General Assembly of co-owners the question of the compliance of the co-ownership settlement with the articles 41-1 and 41-2 of Act No. 65-557 of 10 July 1965 referred to above, in their drafting under this Act. The decision to amend the co-ownership regulation is made by a majority of the provisions ofArticle 26 of Act No. 65-557 of 10 July 1965 referred to above. Compliance with the co-ownership regulations results in the application of Articles 41-1 to 41-6 of Act No. 65-557 of 10 July 1965 referred to above, in their writing resulting from the I of Article 14.
The rules of operation and the booklet of the social and mediocial institutions and services, as well as the contracts of stay in execution that they have entered into, and the individual documents of care that they have issued, are brought into conformity with section 27 on the occasion of their earliest update and, at the latest, within eighteen months of the publication of this Act.
I. - No later than January 1, 2017, a review of the situation and rights of persons benefiting from the personalized allowance of autonomy on that same date and whose amount of the aid plan exceeds a threshold fixed by decree. Priority re-examined situations of persons with the highest degree of dependency.
At the end of this period, the persons referred to in the first paragraph whose situation has not been reconsidered shall, until the notification of the decision of the president of the departmental council, receive a proportional increase in the amount of their aid plan, in accordance with the terms fixed by decree.
II. - Prior to January 1, 2017, the situation of persons benefiting from the personalized allowance of self-reliance on the same date and who do not fall under section I of this section is subject to review under the law set out in section L. 232-3-2. Priority re-examined situations of persons with the highest degree of dependency.
For the 2015 fiscal year, the resources of the budget section of the National Solidarity Fund for Self-Government dedicated to the contest for the personalized self-sufficiency allowance, referred to in the a du II de l'article L. 14-10-5 du code de l'action sociale et des familles in its earlier drafting of this Act, a fraction of the proceeds of the contribution referred to in 1° bis of Article L. 14-10-4 of the same code, equal to 3.61 per cent.
By derogation fromArticle L. 313-1-2 of the Code of Social Action and Families, in its drafting pursuant to section 47 of this Act, for the examination of applications for the approval of assistance and home support services in the course of instruction on the date of entry into force of section 47, the 2nd of the same section L. 313-1-2 remains applicable in its writing before the same law.
The assistance and support services referred to in the first paragraph of this section to which an approval is granted shall be deemed to have, under section L. 313-1 of the same code, an authorization that does not allow the recipients of social assistance to be granted on the date of the approval.
The second and last paragraphs of Article 47 III of this Act are also applicable to them.
Application conditionsArticle L. 443-11 of the Code of Social Action and Families persons who have, on the date of publication of this Act, the approval provided for in section L. 441-1 of the same code shall be provided by order.
The II and III of section 39 56 of this Act come into force on January 1, 2016.
Provisions relating to the benefit base provided for in theArticle L. 342-2 of the Code of Social Action and Families, in its drafting resulting from section 57 of this Act, are not applicable to contracts entered into before the date of entry into force of the decree referred to in the same section L. 342-2.
The agreements signed between the National Solidarity Fund for Autonomy and the departments pursuant to thefirst paragraph of Article L. 14-10-7 of the Code of Social Action and Families, in its writing prior to the coming into force of this Act, are extended until the signature of the conventions provided for in Article L. 14-10-7-2 of the same Code, in its drafting resulting from Article 70 of this Act, and no later than 31 December 2016.
In 2016, the competitions a V of Article L. 14-10-5 of the Code of Social Action and Families, in its writing resulting from section 4 of this Act, shall be paid to the departments notwithstanding the absence of signature of the agreement provided for in article L. 14-10-7-2 of the same Code, in its drafting resulting from section 70 of this Act.
I.-The last paragraph of Article L. 146-3 of the Code of Social Action and Families is deleted on the date of the publication of the decree provided for in Article L. 146-3-1 of the same Code, in its drafting resulting from Article 73 of this Law.
II.-A the date of publication of the decrees necessary for the entry into force of articles L. 232-21 and L. 232-21-1 of the said Code, the same code is amended as follows:
1° Section L. 232-17 is repealed;
2° At the penultimate paragraph of Article L. 14-10-3, the reference: "L. 232-17" is replaced by the reference: "L. 232-21".
TheOrder No. 2014-463 of 7 May 2014 extending and adapting to Mayotte the provisions of code of social action and families relating to adoption, personalized self-reliance and disability compensation is ratified.
Within one year of the promulgation of this Act, the Government shall submit a report to Parliament on ways to facilitate the use of the provision of solidarity to older persons by persons who meet their eligibility criteria.
This law will be enforced as a law of the State.
Annex
ARTICLE 2 - ANEX REPORT
Introduction
France is engaged in a process of demographic transition, characterized by an increase in the longevity of the French and by a strong and continuous growth of the highest age classes. People aged 60 or over are now 15 million, they will be 18.9 million in 2025 and almost 24 million in 2060 (INSEE). The number of people over 85 is almost quadrupling by 2050, from 1.4 million today to 4.8 million. In 2060, one in three will be over 60 years old.
While our country has known for several years one of the highest birth rates in Europe, this "age revolution" is not the sign of a decline, but rather the sign of considerable progress for French society. The increase in life expectancy allows a large number of French to live longer and healthier. The French today live more than 80 years on average, compared to 47 years in 1900. Life expectancy in good health or without disability is growing rapidly: it was 63.5 years in 2010 for women, compared to 62.4 years 15 years earlier, and 61.9 years for men, compared to 60 years earlier. For the first time, two generations coexist in the field of age: age and age, each with its own challenges.
For the public power, it is now a question of meeting the needs of the ageing population, including for persons with disabilities, throughout the country. Three reports were submitted to the Prime Minister on March 11, 2013: that of the Age-Advanced Committee chaired by Dr Jean-Pierre Aquino, "Anticipate for a preserved autonomy: a stake in society", that of Martine Pinville, "Relevering the political challenge of the advance in age - International Perspectives", and that of the interdepartmental mission on the adaptation of French society to the ageing of its population, presided by They have drawn concrete and operational paths to adapt society to aging, which this law has inspired a lot.
The answer to the challenge of the "age revolution" must be universal: everyone is concerned with age. While the policies of age have been built in successive stages, the Government's ambition today is to bring them back into coherence, to drive a dynamic and to ensure the equality of all citizens in the face of the risk of loss of autonomy.
This "revolution" is also a carrier of growth, generating economic development for the needs and aspirations of the older. The longevity of the French population represents a strong potential for creating service jobs but also industrial jobs.
The age revolution is a major challenge: our society must now adapt to enable all to benefit in the best social, economic and health conditions, and as long as possible, from this tremendous progress made by the extension of life expectancy. It must adapt to give all their place to the elderly, a true spinal column for social and civic cohesion, given their essential contribution to family solidarity, social bond and citizen engagement. The question of the image also arises strongly, whereas age is too often associated with one or more diseases. The representations are strong and anchored in the minds, they must be overcome.
The Government intends to promote this positive vision of age for all generations. Susciting the commitment and improving the support of the elderly is to bring a more fraternal, more soothed and reconciled model of society with the most fragile, which is not based on the values of the strongest, the youngest or the fastest, but is part of a memory and is projected over time. In this way the adaptation of society to aging has a major ethical and societal dimension at the beginning of the 19th century.
Those for whom age means entering the loss of autonomy are waiting for us to meet their needs and to accompany them. This accompaniment must be part of a life project that fully integrates the expression of the wishes and expectations of the person until the end of his life.
The creation of the personalized self-sufficiency allowance (PAA) in 2001 represented a major step forward for the elderly and a profound change in the way to approach the support of people in loss of autonomy. The means for assistance and care in housing for older persons have also been strengthened since, in particular, through "medicalization". Ten years later, it is necessary to go further, by strengthening the APA at home, by taking better account of the environment and the entourage of the person in the definition of aid plans and developing preventive actions.
All the actors of the medico-social are, of course, called to mobilize; departmental councils, the state, regional health agencies (ARS), whose role is essential in the prevention, organization and de-regulation of health and medical-social supply in the territory, the construction of health routes and the reduction of infra-regional inequalities; but also pension funds, municipalities and intercommunalities, including through their social action centers, actors of home aid and institutions, health supplements, mutuals and welfare institutions. Because it is a law of adaptation to aging, not only a law on accompanying the loss of autonomy, new actors are invited to be strongly involved in public policies aimed at older people, especially in the housing, transportation, and culture sector... For the same reason, the elderly themselves, including through their representatives, must be associated with the construction, implementation and evaluation of the policies of autonomy.
The Government has made the choice of an orientation and programming law, listing the entire age policy in a multi-year and cross-cutting programme, embracing all the dimensions of the advance in age and comforting the choice of solidarity financing to support the loss of autonomy. The action that is committed will be global, perennial and will mobilize society as a whole.
The policy of adapting society to aging is based on three inseparable pillars:
1° The anticipation: to prevent the loss of autonomy, individually and collectively. Age is a factor in the acceleration of social and health inequalities that lead to an increased risk of loss of autonomy. Preventing and identifying risk factors is essential and will allow, on the one hand, to propose, whenever necessary, appropriate prevention programs and, on the other, to facilitate the use of technical aids to delay loss of autonomy. For our society, it is to anticipate, instead of suffering, the aging of our fellow citizens, whose effects on autonomy are not a fatality;
2° The adaptation of our society: age must not be a factor of discrimination or exclusion: we must change the look at ageing. This involves the creation of new social ties, bringing generations together, but also the reaffirmation of the rights of older people so that they are not ignored. All public policies, especially those of housing, urban planning and transport, must be rethought, but also the rights of the elderly, their civic engagement ... Cities and, more broadly, territories must be prompted to take into account the increase in the number of donkeys in their development. In France, technological innovation and the production of home automation equipment must be promoted to meet the needs of the elderly and to encourage the structuring of an industrial sector, as ageing represents a remarkable lever for society in terms of employment, industrial development and growth;
3° The accompanying of the loss of autonomy: the priority is to allow those who wish to live at home in good conditions: it is the preference of the elderly and families. An act II of the APA at home, more than ten years after its creation, is therefore necessary to strengthen aid opportunities and reduce the cost to families. In addition, caregivers, families or relatives, who are often the cornerstone of home support, must be better recognized and supported. Older people and their caregivers must be able to rely on clear and accessible information, a relevant orientation that respects their freedom of choice and a guaranteed assistance response and support throughout the territory. This Act also sets out the broad medium-term directions of the settlement offer.
These three components ensure the coherence of the Government's age policy. The elderly person and his family are at the heart of each of these components and of each of the provisions of this Act: their expectations, their projects, their needs, their participation also, with the crucial issue of better consideration of the voice and place of the elderly in the development of public policies.
This ambitious policy will be based on the additional contribution of solidarity for autonomy (CASA), an amount estimated at 726 million euros per year. The "accompaniment of the law" component aims, in particular, to make the right of older persons to live in their homes in good conditions. To achieve this commitment, 55.9 per cent of CASA's product will be devoted to home-based APA reform in 2016, and 70.9 per cent in the following fiscal years.
CASA will therefore respond well to its vocation and will be fully affected to the adaptation of society to aging in all its dimensions.
VOLET 1: ANTICIPATION AND PREVENTION
Prevention is the driving force of age policy. The advance in age is inexorable but is predictable, collectively as individually. For several decades, demographic curves have clearly drawn. Scientific, medical and technological advances today allow the optimism of the will: loss of autonomy is not inevitable.
The age revolution is parallel to the digital revolution and it will be thanks to its contribution. The wide-ranging access to the technical aids of autonomy will bring age policy into the 19th century. Funding will enable all to access it and help to reduce social inequalities caused by old age.
The anticipation is the first priority.
There is no fatality: there are situations on which we can and must act to preserve self-reliance, to reduce the loss of self-reliance known as "avoidable" by identifying and fighting earlier signs of fragility of the elderly and to better accompany those who need to be.
We are not equal to the loss of autonomy: some are more likely than others to encounter difficulties, because their lifestyle has exposed them to heavier risks, because they have not had the means to preserve their health. Social inequalities also mark their high age, and the risk of loss of autonomy is greater for those who are the least favoured. The desire to develop prevention joins the Government's ambition to make the fight against social inequalities a priority, through the multi-year plan to combat poverty and social inclusion but also the directions of the national health strategy.
The challenges of demographic transition and the management of the loss of autonomy in the medium term can be addressed with confidence if a true culture of prevention is required among the general public and all the actors directly concerned: seniors, families, caregivers, professionals, volunteers, etc.
In close connection with the national health strategy, which puts population ageing at the heart of its priorities, a graduated prevention policy will be implemented so that everyone can measure the impact of their behaviour on the conditions of their age development. It will include both health education and targeted programs.
This national policy of prevention, be it primary - throughout life -, secondary - in the face of the appearance of the first signs of fragility - or even tertiary - to prevent the worsening of the loss of autonomy - must be global. It is intended for all, and in particular for all older persons, regardless of their level of self-reliance, whether or not they are beneficiaries of the APA.
1. Develop a culture of autonomy throughout life.
Everyone has to take his aging and consequences with his arm.
Advanced age can be anticipated very early, from working life, with the support of employers, who have a responsibility in preparing the aging of their employees.
The retirement is a key moment, an opportunity to remobilize on a more personal project or a commitment to the company. At this first stage will succeed others, representing each time a privileged moment to rethink his life project. Because old age is not homogeneous, but rather plural: there is the age when one is "old without being old", which refers to the age of retirement, but also to grandparentity, then the age of old age, where fragility appears, finally the great age.
A comprehensive policy of information and age education will be implemented for the entire population as part of a national and interdepartmental action plan, to which the High Council for the Family, Children and Newly Created Age will take all its part (see governance component). A special emphasis will be placed on the development of physical and sporting activity and the social bond.
1.1. Anticipate retirement and accompany the end of career.
Accompaniment of aging at work helps prevent the loss of autonomy at key moments of the end of career and retirement. This accompaniment must avoid the interference of breaks that may weaken already difficult life paths and instead promote a harmonious transition to a "third life".
A mobilization in the context of occupational health is necessary in order to improve the accompaniment of aging to work. This mobilization could be based on tools of common law of social dialogue and employment policy or on generation contracts, which could include, where appropriate, support actions for seniors engaged in work. This direction goes in the direction of the July 2012 social conference roadmap to strengthen the prevention of inability and the maintenance of senior employment.
When they are about to retire, insured persons who face social difficulties will be able to benefit from interviews that the pension funds will develop to the public in vulnerable situations, as part of their next objective and management agreements (COG).
In particular, ageing persons with disabilities (active or non-active, with special attention to unemployed persons at the time of retirement) could benefit from coordinated measures to prevent loss of autonomy and prevent periods of interruption of rights.
The National Old Age Insurance Fund (CNAV) is committed to experimenting, before the end of the COG (2017), with a "accompanied passage" for weakened audiences, with a proposal for a minimum age demand (an allowance for solidarity with the elderly, ASPA). In order to avoid interruptions of rights and periods without resources, automation solutions will also be explored.
1.2. Make prevention the case of all.
It is necessary to provide as many as possible all useful information to accompany the change to behaviours conducive to the preservation of autonomy: old, family or professional caregivers, volunteers, public services, etc. It is a well-aged education effort that needs to be undertaken, on all the national priorities defined, to allow all to "knowledge for power". In connection with the National Institute for Health Prevention and Education (INPES), the pension funds will put on-line a portal dedicated to the preservation of autonomy, articulated with the more general portal carried by the National Solidarity Fund for Autonomy (CNSA). This information should also be relayed to schools, administrations, businesses, public services, etc., so that mobilization is as broad as possible.
1.3. Bring together the actors of the world of research, the social world and the economic world around the "well-being" of the elderly.
The prevention of self-reliance and the accompanying of lifelonging are one of the major challenges facing our society. The mission of gérontopôles is to bring together and to dynamise around aging the actors of research, care (at the hospital, in the city, in the medical-social establishment), training and the company. They will facilitate the transfer of research, technological development ("silver economy") to care, medico-social and services provided to the elderly.
They will be part of the directions defined by the national health strategy and the strategic agenda of the research "France-Europe 2020". Already among the strong axes proposed by the National Alliance for Life and Health Sciences (Aviesan), research on normal and pathological aging has been highlighted, with longevity (genome and organism), neurosciences and cognitive functions, quality of life and loss of autonomy (to overcome isolation, risks and disability).
2. Identify and act on risk factors and fragility.
The identification of fragility and the best knowledge of aging from research must lead to innovating and imagining other ways to preserve autonomy and anticipate the negative effects of age. The priority actions of the prevention policy relate to the identification of fragility as far as possible and to targeted actions on the preservation of social bond, food and physical activity.
2.1. Improve the identification of risks of loss of autonomy and fragility.
Prevention of self-reliance requires the identification of risk factors at all stages of the elderly's journey, focusing on social and environmental determinants within a targeted and graduated prevention device.
Fragility corresponds to a set of signs of loss of autonomy still reversible. The identification of these signs and the setting up of actions aimed at the pallar allows to regain all or part of the autonomy and to avoid switching into the loss of non-reversible autonomy.
An awareness-raising programme for the identification of risks of loss of autonomy, taking into account the specific problems of disability, will be developed by the Ministry of Social Affairs and Health for the benefit of medical-social and health professionals, including on the basis of the recommendations of the High Health Authority (HAS), CNSA and INPES. The role of prevention in the training and support of aging trades will also be strengthened. Particular attention will be paid to caregivers, who are themselves at risk, and to persons with disabilities who are at age.
The track for a health examination in health care centres, targeted at precarious audiences, is examined, integrating, where appropriate, vulnerable caregivers.
For the most complex cases, geriatric day hospitals will in the future need to develop their functions of expertise and recourse of front-line actors for the evaluation and care of people with multiple risks.
2.2. Maintain the social bond and fight isolation: MONALISA.
Nearly one-quarter of people in relational isolation are people over the age of 75, or about 1.2 million people (Fondation de France, 2013). The share of elders in isolation increases sharply. Combating social isolation involves encouraging the participation of voluntary citizens and local actors to develop the creation of social ties with vulnerable people.
From this point of view, the National Mobilization against the Social Isolation of the Old (MONALISA) was born. The deployment of this national mobilization will be strongly supported and will be part of the major projects followed by the new High Council for the Family, Children and Age.
This national mobilization is for the many stakeholders (associations, local authorities, community social action centres [CCAS], primary and complementary pension funds, mutual ones, the CNSA, the Civic Service Agency, etc.) to carry out a program of emergence and deployment of volunteer citizens' teams, so as to better meet the needs, especially in places where there are no specific advances or particularly vulnerable people To enhance teams and their actions and facilitate the support of partners, a MONALISA charter allows "team operators" to recognize and register in this common cause. In the coming years, the Civic Service Agency will continue its efforts to mobilize young people in the field of the fight against isolation.
In addition, controlling the use of digital is a demonstrated factor in preventing loss of autonomy. It is necessary for all to have access to it and to avoid a new "branch" between those who have the means to access information and to equip themselves and others. MONALISA mobilization will not neglect this aspect.
2.3. Promote physical activity and good nutrition practices in older adults.
As a result of actions undertaken with the National Nutrition Health Programme (NSPN), the promotion of good nutrition practices, the fight against malnutrition of older adults and the promotion of physical activity are priorities for action on behaviours and improving the quality of life of older adults.
The national programme for the prevention of self-reliance, which will be developed by the Ministry for Older Persons in connection with the High Council for the Family, Children and Age, will decline the priorities of the public authorities around these essential components of prevention. It will provide for the strengthening of nutrition skills and hospital organizations for the elderly who are housed in institutions and will be ambitious on the development of physical activity.
The fight against sedentary helps to preserve the health of seniors, reduce the number of care and prevent the loss of autonomy or its worsening. Sports practice also breaks social isolation and strengthens intergenerational ties.
Measures relating to the promotion and development of targeted physical and sporting activities on the elderly, which are based in particular on the recommendations of the working group chaired by Professor Daniel Rivière, "A device for physical and sport activities towards the elderly" (2013), will be integrated into the national programme for the prevention of loss of autonomy. They focus on four objectives: the development at the territorial level of the offer of physical or sporty practice for older persons, regardless of their level of autonomy and place of accommodation, based on local authorities and "sport-health" networks; public awareness, with particular attention to disadvantaged persons; training of professionals; the suitable reception of the elderly in physical and sports facilities.
Among the various actions that will be taken, the creation of a network of professionals (educators athletic, social professionals, physiotherapists, nurses...) will be encouraged, especially around treating doctors. This network will provide coordinated care for the person, allowing him to adhere to a regular and suitable physical or sport practice, accessible even to the poorest (help with financial support for bike rental or entrance tickets in the pools for example). As part of the corporate social responsibility (CSR), companies, such as territorial administrations and authorities, will be encouraged to facilitate physical or sporting practice for their employees and agents and to accompany them during the end of their work to a physically active retirement.
Hosting institutions for the elderly (EHPA) and medical retirement homes will be encouraged to develop the practice of a suitable physical or sporting activity, supervised by a specifically trained sports professional.
2.4. Implement a national programme for the prevention of older suicide.
Persons over 65 years of age represent the most vulnerable population to suicide death. In France, of nearly 10,400 suicides in 2010, at least 28 per cent involved persons aged 65 and over (CepiDc-Inserm). In addition, the elderly person performing a suicidal gesture is usually driven by a strong determination, as evidenced by the radical means employed signs of great despair: precipitation of a high place, firearms, hanging. This is why the failure rate of older adults' attempts is much lower than for other age groups.
In the vast majority of cases, the suicide of the elderly is the culmination of the painful evolution of an unrecognized or mistreated depression. This is why a specific action must be carried out. Based in particular on the conclusions of the October 2013 report of the National Committee on Welfare and Rights (CNDB) on "Prevention of Suicide in Older Persons", the program of suicide prevention actions has been declined. It includes sixteen actions, articulated around three priorities:
1° Develop public and professional knowledge on issues related to the suicidal process of older persons, including the training of doctors on early recognition of depression and the establishment of adequate treatment, the training of professionals in the identification of the suicidal crisis or the training of telephone listeners on dedicated listening numbers;
2° To structure in the territories the collaboration between general medicine, geriatrics and psychiatry to improve care, for example, by proposing a notebook for improvement of care, identification of the patient and his surroundings;
3° Develop and implement a study and research programme on the suicide of older persons. These actions will be the decline for the elderly of the national action developed by the Observatory for Suicide.
2.5. Aging, a priority of the national health strategy.
The future health law from the National Health Strategy (NSS) will complement the provisions of this Act, in particular with respect to the prevention of loss of autonomy and the adaptation of the health system to aging. The SNS has three main priorities: to anticipate the two major challenges facing our health system: population ageing and care for patients with chronic disease, to combat social and territorial health inequalities, and to preserve solidarity with social protection. The use of care for older persons will thus be improved, both through common law measures and by provisions that specifically affect older persons.
Addressing social and territorial health inequalities.
Age increases social inequalities of health. In order to promote financial accessibility to quality care, the Government has made important commitments, including the supervision of medical fees overruns and access to complementary health care. La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La Act No. 2013-1203 of 23 December 2013 funding for social security for 2014 already provides an increase of € 50 in support of the acquisition of complementary health for its beneficiaries over the age of 60.
In terms of territorial health inequalities, and within the framework of the health territory pact, the strengthening of the provision of community care and the fight against medical deserts must guarantee an offer of care accessible to all, especially to people in situations of loss of autonomy or chronic disease. The various measures implemented in the framework of this compact, such as incentives for the installation of professionals in areas with a care shortage, the strengthening of cooperation among actors or the promotion of all telemedicine or tele-experts tools for the benefit of isolated patients, will contribute to the strengthening of the care arrangements for older persons who reside in areas where the provision of care is discontinuous, particularly in rural areas.
With regard to financial accessibility to quality care, the Government has made significant strides in addressing overexpenditures of fees, the commitment to generalize access to quality health supplements by 2017, the strengthening of the quality of eligible contracts with the help of complementary health and the increase of this assistance adopted within the framework of the Act No. 2013-1203 of 23 December 2013 referred to above. These measures will thus benefit the elderly with low resources.
Stay healthy to get old: a priority to prevention.
In order to preserve the best possible state of health with the advancement of age and to combat the factors of loss of autonomy, the SNS is based on three specific prevention priorities for the elderly: visual health, hearing health, nutritional and oral health. Indeed, the loss of autonomy often results from a deterioration in the visual or auditory health of people, mitigating their interactions with their environment to gradually place them in a social isolation situation.
Adapt our health system to aging.
The objective of the SNS is to implement a course medicine, in accordance with the guidance of the High Council's Opinion on the Future of Health Insurance of 22 March 2012. Pathway medicine ensures a better articulation between the different actors in the health, medical and social fields in the care of an elderly person. The aim is to combat both the renouncement of care and the disruption of care or therapeutic observance and to promote optimal and coordinated care around the needs of the person.
The launch of course experiments for elderly people at risk of loss of autonomy (PAERPA), planned by the Act No. 2012-1404 of 17 December 2012 Social Security Funding for 2013, illustrates the Government's commitment to improving the care of older persons. The continued deployment of MAIA devices, a method of action for the integration of aid and care services in the field of autonomy, whose title and content have been clarified in this Act, goes in the same direction. A specific plan will be developed for the care of patients with neuro-degenerative diseases, which will capitalize on the advances of previous Alzheimer's plans, including the transversal nature of social support research, was one of the conditions for success. This expansion to other diseases such as Parkinson's, for example, will be achieved in accordance with the needs of each individual. In fact, the answers cannot be standardized, but must be adapted to the specificity of the troubles that people experience. It is therefore a matter of reconciling a greater openness of our structures with the imperative to consider each situation in what it has of singular.
Act for the proper use of the medication.
According to HAS, 67% of people aged 65 and older acquired at least one drug product in one month, compared to 35% for people under 65. This proportion increases with age. Polymetrification is also responsible for 10 to 20 per cent of hospitalizations over the age of 65.
Inspired notably by the preconizations of Philippe Verger's report "The policy of the drug in EHPAD", a proactive action plan will be undertaken to promote the proper use of the drug in elderly patients in the city, hospital or nursing home. Four objectives are pursued and declined: limiting inappropriate use and promoting alternatives to drugs whenever possible; help the doctor to manage at best the risk of inappropriate drug use in the elderly; promote proper monitoring of the person's treatment and develop pharmaceutical support; improve the quality of drug care for residents in medicalized retirement homes.
This policy, refurbished and adapted to the needs of older persons, will include the re-engineering of the training of health professionals (initial and continuing) and the strengthening of public health goals in their remuneration. Research on appropriate forms of drugs on the elderly subject (compressed, pills, sachets, injectable...) will be encouraged to avoid a difficult treatment. This will, in particular, avoid that, in order to facilitate their taking, drugs are sometimes crushed or mixed, with many associated risks.
New tools will also be put in place to provide targeted support to physicians whose patients over 65 years of age have been prescribed a large number of molecules (more than 10), or to facilitate partenarial work between physicians and pharmacists around the pharmaceutical file. It will also be necessary to communicate more and more targetedly, through a national campaign, and to work on materials adapted to certain pathologies with associations of patients and families.
A follow-up committee will bring together all the partners involved.
3. Raising awareness and financing technical aids - developing collective preventive actions.
Technological advances make a great step through the help of autonomy and the possibility for older people to stay at home. The solvabilisation of the access of low-income people to self-reliance technologies, for example, to bundles of services focused on support devices and home automation, aims to reduce the social inequalities that worsen with age and to bring the policy of autonomy into the digital age.
In connection with the development of the silver-economy sector, this improvement in access to the technologies of autonomy must be accompanied by a comprehensive reflection allowing the definition of an ethical framework that guarantees the quality of the answers that will be made to the needs of people seeking technological solutions, in accordance with their dignity and free choice. The development of the assessment of the value of use of these aids will enable the distribution of products that adequately meet the needs of individuals. Structures already exist, such as the observatory of the prices of technical aids or national information centres, such as the National Centre of Expertise on Information and Communication Technologies for Autonomy and Health (CENTICH), on which it is necessary to rely, under the aegis of the National Fund of Solidarity for Autonomy (CNSA), comforted in its role as a common home of autonomy and in its mission It could thus be charged with creating tools, such as a guide to technical aids and "use labels".
Support for the home of older adults is today based almost exclusively on human assistance, especially for those who are less affected by loss of autonomy (GIR 4-6), i.e. those for which it is essential to develop a policy of secondary prevention. The APA ceilings, in particular, do not provide sufficient margins to have a significant impact on access to technical aids. In addition, the APA effectively excludes the most autonomous elderly, who still need equipment, in order to avoid falls. Many initiatives are being developed to organize collective actions for the elderly (prevention of falls, malnutrition, etc.), but they are still dispersed, unreadable and undeveloped.
In order to address these issues, this Act creates a new aid that can help to ensure access to technical aids and collective actions targeted at the most modest elderly. It will allow, under resource conditions, in a closed envelope, to provide an immediate and decisive response to facilitate the home life of the elderly. The scope of so-called so-called aids and actions is broad in order to be able, on a case-by-case basis, to act on all the determinants of home maintenance and the preservation of autonomy (technical aids, tele-assistance, small accommodation arrangements, home automation, collective preventive actions, etc.).
4. Develop coordinated prevention policies at the local level.
Many actors are engaged in actions to prevent loss of autonomy (departmental councils, ARS, CCAS, pension funds, associations, home aid services...), and the State can only encourage them to become more involved in this area. However, the aim of bringing prevention policies to power requires a better coordinated regional and local strategies, both in their target, in their content (cf. technical aids) and in their territorial deployment. The State will contribute to fostering this dynamic as the leader of the Gerontological Action. It will also strengthen the reconciliation, at the national level, of the social action of pension funds.
Promote local prevention strategies, ensuring better access to technical aids and the development of collective actions.
This Act provides for the establishment of a departmental conference of financeors for the prevention of loss of autonomy (see governance section). This conference brings together, under the chairmanship of the departmental council, all the actors involved in the financing of prevention. This organization will improve the visibility of the existing and the identification of non-covered or non-funded needs in the territory, in order to define a coordinated prevention strategy. The envelope that the State will allocate to the development of access to technical aids, collective actions and the "autonomous package" for self-reliance residences will be managed in this partenarial framework.
Coordinate the social action of pension plans.
Basic pension plans, as well as complementary schemes, have a very active role in social action and prevention. An important and indispensable step in this better coordination of preventive actions is to develop a common approach to basic pension plans for each retiree, regardless of the plan to which it is attached. This reconciliation has been initiated since 2011, between the National Old Age Insurance Fund (CNAV), the Agricultural Social Mutuality (MSA) and the Independent Social Plan (RSI). The three national bodies have initiated a new stage of inter-regime dynamics by signing a convention that defines the principles of a "common base". On this basis, it is necessary to go further. This Act provides for the signing by these three national bodies and the State of a multi-year convention setting out the principles and objectives of the coordinated policy of preserving autonomy, carried out within the framework of the social action of these regimes. This agreement may be extended to other basic or complementary pension funds.
5. Regulating the dependency insurance market.
The Government makes national solidarity the foundation of this Act and, in particular, of the reform of support. This choice of society allows to face the social risk of loss of autonomy.
However, from a perspective of individual anticipation, everyone can decide to also use private insurance. At the end of 2010, 5.5 million people were covered by a dependency insurance contract. However, it is sometimes difficult to find itself in the current, varied but very diverse and uneven insurance offer: the definitions of the entry state for loss of autonomy are often restrictive (since the loss of heavy autonomy is covered) and are not aligned with the grid used for the APA. Some insured persons can therefore benefit from this allowance while being denied annuity. Annuities may be modest in respect of the rest and lowly revalued. Finally, the deadlines for franchising or deficiency are often important and can hinder the triggering of guarantees.
In this context, the French Federation of Insurance Companies (FFSA) launched a label for dependency insurance contracts in May 2013. This approach allows to offer a minimum level of rent and guarantee a life annuity. To go further, the Government plans to promote, within the framework of the next financial laws and social security financing laws, the most protective contracts that will be required to comply with a specification (coverings, revalorization modalities, transfer opportunities, etc.), built in consultation with all the actors in the sector (insurers, mutuality, insurance institutions). This will encourage, in a conditionality logic, the development of a readable and safer offer for the benefit of insured persons.
VOLET 2: SOCIETY ADAPTATION
It is the very heart of the demographic challenge of designing and organizing the multiple effects of the elongation of life and ageing on society. The purpose of this Act is not to comprehensively examine all these effects, but only those that are most directly and concretely linked to the lives of older persons: housing, urban planning, displacement, economy and employment.
Designing the place and role of older people in society and asserting their rights is today a new field of investment whose public policies must take hold so that they know each other at the heart of the city, useful, essential, in connection with all generations.
Today it is necessary to design a society that, in one generation, will count one third of people over the age of 60. This development involves working on specific responses to age-related needs, but also, above all, integrating, in public policies of common law and in the supply of private goods and services, this reality of population ageing.
The way to see older people and think about solidarity must change and adapt to longevity, in particular by recognizing and promoting the commitment of older people, in the family as grandparents, or in civil society as citizens, strong in their experience and availability.
All public policies must take into account the age revolution and respect for the free choice of older people in their life project: housing is therefore emblematic. It is the first condition of autonomy. It is necessary to facilitate the adaptation of private and social housing, by conducting a proactive policy for the development and construction of suitable housing. Intermediate housing must also be developed that meets the expectations of those who do not wish or cannot live in traditional housing. Beyond housing, it is a matter of encouraging territorial communities to integrate into their urban policies the issue of age-old advancement and to develop their efforts to improve transport supply, adapt urban planning and accompany the ways of living and living together.
The economy of our country itself must be more focused than today on the needs of the elderly: creation and adaptation of jobs for the elderly, development of a new industrial sector, with the "silver economy", strengthening the research and innovation effort; so many opportunities for employment and growth for French society.
The Rights Defender stated in 2005 that age-related discrimination was increasing. Age is the third criterion of discrimination after origin and disability. All necessary measures to prevent them should be taken, in close consultation with the Ombudsman of Rights.
Finally, adapting society to aging is also to clarify and strengthen the rights and freedoms of older persons. Individuals in loss of autonomy, home or institution must be guaranteed that their fundamental freedoms will be respected.
1. Installing the age revolution in all public policies.
The housing and the place reserved for everyone in its city contribute to the citizenship of individuals. This is even more true for the elderly for whom housing must be a real "good autonomy", a place of life that must allow them to go and come without congestion and which must adapt, either by work or by equipment, to beginnings of fragility in order not to prevent their participation in social life.
The same applies to the territories. La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La Act No. 2005-102 of 11 February 2005 for equal rights and opportunities, participation and citizenship of persons with disabilities mobilizes all territories for universal accessibility. Thinking of urban planning in an intergenerational way, as well as reflection on the mobility of the elderly, invites us to consider elements that meet their specific needs with a single ambition: to develop territories that allow them to keep in mind with social life, to be integrated and to be fully involved.
1.1. Making housing a major lever of self-reliance and better-age policies.
90% of French people prefer to adapt their homes instead of having to leave them if their state of health is deteriorating (Recordway sound for the Observatory of the General Interest, 2012). Hence the importance of bringing together the necessary conditions for the exercise of a true "free choice".
Because housing, through its characteristics and location, conditiones both the ability of people to live independently and the maintenance of social relations. To make possible and effective the priority of the home, the adaptation of housing to autonomy is an absolute necessity. Today, only 6% of the dwellings are adapted to the daily lives of people with a loss of autonomy. This low rate of accommodation needs to be attributed to a portion of the too large number of domestic accidents involving older adults: 450,000 falls each year, of which 62% at home, resulting in 9,000 deaths per year. In addition to housing adaptation, it is necessary to develop a most diversified offer of housing to meet the expectations and needs of the elderly, depending on their degree of autonomy.
1.1.1. Develop coherent habitat adaptation strategies, anchored in programming tools.
The gerontological patterns and local habitat programs (HLPs) established at the community and intercommunal levels are to be used in the future as a basis for coordinated habitat adaptation policies to aging and loss of autonomy.
The law now ensures that HPLs take into account the subject of older housing. The PLH will have to take into account the needs associated with loss of autonomy. Territorial communities, with their own skills and fields of intervention, will align their directions, in connection with the relevant actors (National Habitat Agency [ANAH], social donors, pension funds, stewards, social services...).
Programming tools (including PLHs) must also be used to address the local issues of older habitat beyond dense urban areas. Particular attention must be paid, on the one hand, to the housing of the elderly in rural self-reliance, often remote from an easily accessible service offering, and on the other hand, to the aging of the peri-urban territories, which is one of the challenges of the next ten to twenty years.
1.1.2. Adapt housing: housing as a prevention tool.
In 2009, 85% of households aged 60 or older were housed in the private park, of which 85% owned their homes. But being the owner of his housing does not mean being rich: 10.5% of the owners have resources placing them under the poverty line. Some older owners therefore need to be strongly supported in their effort to adapt their homes. The President of the Republic has set a first objective: the State will have to adapt 80,000 housing to the constraints of age and disability by the end of its quinquennium. The social park, whose tenants age, must also adapt to this new gift.
Launch a national plan to adapt private housing.
Beyond the goal of 80,000 housing units by the end of 2017, it is necessary to provide answers that make the future easier for older people and more financially accessible the adaptation of their housing. Nowadays, the funding mechanism, broken up between many actors, is unreadable, complex procedures, poorly structured advice and trained professionals too few.
Based in particular on the joint NAAH and NAVC preconizations, the action plan will pursue the following objectives:
1° Simplify the applicants' path and make information more accessible;
2° Dedicate by two the time of instruction to NAAH and pension funds and better target urgent needs, such as an outflow of hospitalization;
3° To encourage local authorities to engage in housing adaptation operations: as such, a diagnosis of housing adaptation needs to self-reliance will now be required prior to the definition of each programmed habitat improvement operation. Agglomerations and departments will be encouraged to put in place programmes of general interest (GDP) in the area of housing adaptation (as is available for thermal renovation or insalubrity);
4° Develop the link between adaptation work and energy renovation work, to maintain a dynamic of training between the two policies and their respective tools;
5° Improve the skills of building craftsmen through the evolution of labels;
6° Change the list of work eligible for NAAH and NAV funding to take home automation into account.
Improve the tax credit for housing adaptation.
The improvement of the housing adaptation tax credit will also contribute. It will target the elderly and persons with disabilities. The list of eligible work, which has been in effect for almost ten years, will be reviewed to allow older persons to benefit from this tax credit for new technologies to support home autonomy. The Government will consider the opportunity to allow the descendants of the elderly to benefit from this tax credit when they pay the accommodation expenses eligible for this tax system.
Facilitate funding for adaptation work.
The NAAH assistance, in addition to other assistance provided by the pension funds or local authorities, allows people with modest incomes to finance work on adaptation to loss of autonomy or disability. The State ensures that a sufficient level of resources is maintained to the NAA so that it can continue to finance the adaptation of 15,000 housing units at least annually.
For those who have difficult access to bank credit and whose rest would remain excessive in view of the existing aids of NAAH or NAVC, a micro-credit scheme will be implemented to ensure that the remaining dependants not funded by these aids are not a barrier to the adaptation of their housing. A mechanism for the continuation of the social missions of anonymous cooperative companies of collective interest for the accession to the property (SACICAP) is thus under study.
The French have little use of the viager, while many donkeys could find a way to stay at home and finance the adaptation of their housing. Reluctance is due to the difficulty of getting an annuity considered suitable, but also to the fear of abuse of weakness or that of depriving its descendants of inheritance. Also the demand to buy in viager is low. The risk of longevity created by the payment of the life annuity is often deterrent, especially since the elderly who are likely to offer a viager are certainly those who are healthy and have a high life expectancy.
To remove these obstacles, the Caisse des dépôts et consignations has initiated, along with other institutional investors, the establishment of a fund for the acquisition of real estate in viager; At the same time, in partnership with the Social Union for Habitat, it is working to develop a system of viager or assimilation, involving a social lender and an elderly, in accordance with the general economic interest service for the social lender.
Devices such as "pair mortgages", which preserve the rights of heirs when people wish, must also be improved to become more attractive.
Mobilize social donors and disseminate good practices.
35% of the tenants in the social park will be over 65 in 2035. Social donors are already very busy at the service of the elderly, thanks to the introduction of innovative devices to provide original responses to isolation, the difficulties of everyday life, etc. The aim is to encourage the consideration of ageing in all registers of rental management and heritage management: to facilitate the adaptation of housing and to provide an appropriate offer, to identify accessible housing in order to enable them to be allocated to persons with disabilities or loss of autonomy, to facilitate the transfer of housing to enable the installation of older persons in a housing better adapted to their loss of autonomy or closer to their caregivers, to raise awareness and
A national convention between the State and the Social Union for Habitat (USH) will be developed to define a common strategy around these objectives, which will also affect persons with disabilities. In order to generalize good practices, a prize will also be created, in connection with the USH, the CNAV and the Caisse des dépôts et consignations, to reward the most innovative social donors in adapting their park to aging.
Encourage the establishment of scholarships for suitable housing.
In order to facilitate the reconciliation between the offer and the housing demand adapted to the loss of autonomy or disability, the establishment of scholarships for adapted housing with the assistance of private donors is encouraged at the departmental level.
Better prevent energy cuts.
The frame of energy cuts for unpaid has been strengthened by the Act No. 2013-312 of 15 April 2013 to prepare the transition to a sober energy system with various provisions on water pricing and wind turbines. However, some vulnerable elderly are still deprived of electricity or gas because they have not paid their bills.
In connection with the Ministry of Sustainable Development, energy suppliers and departmental councils, an information exchange device will be put in place to ensure that no older adults will remain isolated from a cut in electricity, gas or heat. Thus, departmental social services can accompany the person.
As part of the agreement signed in April 2013 between the National Health Insurance Fund for Employees (CNAMTS) and the National Union of Communal Social Action Centres (UNCCAS) to promote access to the rights and care of populations in precarious situations, targeted information campaigns for older persons will be conducted, in order to facilitate the access of low-resource pensioners to the social rates of gas and electricity.
1.1.3. Diversify housing supply.
Between the medicalized retirement home and the traditional home, other habitats can meet the needs of the elderly. This is the case of housing integrating services, which can become a relevant solution when the first signs of fragility arrive. In fact, it ensures safety, accessibility and guarantees of medical and social care.
Develop housing-foyers or "residences autonomy".
This Act gives new impetus to housing-foyers renamed "reward residences", in order to transform this form of alternative medical-social establishment to medical retirement homes when the age is more autonomous than dependent. Self-reliance residences represent an offer of 110,000 seating places, distributed in 2,200 housing units, which mostly accommodate older self-employed persons at the admission, the age advance of residents who often require support in order to preserve their autonomy. Initiated in the 1960s, they today need to be revisited to better fulfill their missions.
Housing houses date for most of the 1960s, 1970s and 1980s. Adjustment to new audiences (people with aging disability, people with social precariousness), regulatory compliance and continuous improvement of housing remain difficult to finance. In order to modernize this fragile offer, the CNSA's investment assistance plan will be exceptionally abundant for three years to help these structures engage in their work, in connection with the CNAV, the Caisse des dépôts et consignations and the local authorities.
Self-reliance residences have a mission to prevent the loss of autonomy now recognized and reaffirmed by law. This mission will be supported, for those who do not benefit from the care package, by a "autonomy" plan to finance non-medical expenses to preserve the autonomy of the residents. The management of the autonomy package, delegated by CNSA, reports to departmental councils as part of the new finance conference. In addition, this Act now authorizes, under certain conditions, the derogatory admission to self-reliance of persons under IG 4, provided that an agreement with a home nursing service (SSIAD), a multi-purpose home care and care service (SPASAD) or a medicalized nursing home is signed. This will help to better respond to the diversity of local realities.
Small alternative accommodation structures such as "little living units" or rural homes for older persons (MARPA) will also be consolidated. They will again have the opportunity to join a medical retirement home, to benefit from a nursing package or to partner with a home nursing service.
Secure the development of the offer of residential services.
For some thirty years, the commercialization of buildings has been developed, either through the ownership of lots or through the rental of lots, offering unfurnished housing, as well as more or less diversified services. These service homes are aimed at elderly self-employed, valid and semi-valid, over 60 years old who wish to live in apartment or house, while enjoying the conviviality and security provided by the teams in place.
In a context of the development of these useful structures, the law provides for a number of provisions to better control and make the expenses for residents and co-owners more transparent. For future service residences, the "à la carte" residential model, which allows for better identification of the content and cost of services, greater individualization of expenses, and the General Assembly of co-owners to make decisions on the level of services more easily, becomes mandatory.
Encourage habitat grouped by the development of a charter of good intergenerational practices.
Many local authorities develop clustered habitats, in relation to the reality of their territories and populations, with the concern of intergenerational diversity. Beguinages, babayagas, octaves, intergenerational residences and other devices emerge, creating uneven practices. It is important to refer to these devices. An audit is launched to identify, analyse and identify the most interesting aspects. A charter of good practices, which will clearly recall the rights and duties of tenants and donors, will guarantee the rights of everyone.
This type of clustered habitat, also proposed in many territories by social donors, mutual funds or non-profit associations, must be encouraged so that a model of "social cost service homes" emerges. Less expensive than private service homes, while remaining outside the medical-social sphere, these initiatives correspond to the expectations of citizens, participate in the prevention of self-reliance and represent an offer of intermediate housing more accessible to older people with modest incomes.
1.1.4. Preparing tomorrow's architecture for seniors.
Medical retirement homes, such as facilities for persons with disabilities, are both places of care and life. These places must be designed to better integrate residents' privacy wishes, privacy and sexual life. It is important to raise awareness among the professionals concerned about the quality of use of these institutions (students in architecture, teachers in architectural schools, masters of work, masters of work and public finance). The actions undertaken will include the creation of a network of exchanges and skills among the actors in the design of self-reliance residences, on the basis of a convention between ministers responsible for the elderly, autonomy, persons with disabilities and culture.
1.2. Place at age in urban policies, in an intergenerational logic.
The city and the entire territory must adapt to the ageing of the population, so that urban space, services and habitat are accessible to all. Older people must be heard to change the ways of thinking about development and displacement, in a logic of intergenerational mixing. Urban programming tools - local habitat programs, urban displacement plans (HDPs), in particular - will have to take into account this reality of social needs.
Promote intergenerational urban planning.
Many local authorities have begun to develop urban policies that allow older people to find neighbourhoods where they can grow well: an offer of accessible and equipped housing, an environment that respects accessibility requirements that allows easy access to local shops and services, public transport and accessible roads, integration in social life that prevents isolation, and in a spirit of "living together" that is conducive to all generations.
In order to recognize and promote these initiatives, a protocol of actions "City Friend of Seniors" is based on the same name, defined by the World Health Organization and the French-speaking network of senior-friendly cities. This protocol of action, based on community volunteerism, aims to create favourable conditions for aging in order to accommodate, without exception, all ages. This memorandum of action is validated following a participatory audit conducted with the elderly, the modification of urban planning documents and the identification of areas that are conducive to high ageing (HQV). It allows for the inclusion of calls for projects from the Service, Craft and Trade (FISAC) Intervention Fund, the mobilization of sports associations and the cooperation of state services to carry out intergenerational clustered housing projects, in connection with the community.
Older people should also be better associated with the definition of land use policies. A first step will be the evolution of municipal accessibility commissions. TheOrder No. 2014-1090 of September 26, 2014 on the accessibility of institutions receiving public, public transport, housing and road services for persons with disabilities and aiming to promote access to civic service for young people with disabilities, ratified by Parliament in the summer of 2015, expands the composition of these communal commissions, which follow the accessibility of the built framework, transport and road, to the representative associations of the elderly. But it is also a matter of ensuring that, in all forums for consultation on development projects, the concern of adaptation to all ages can be raised.
Develop policies and a mobility offer that take into account the elderly.
It is necessary to ensure the accessibility and safety of elderly travel, whether on foot, in public transport or when they move using their personal vehicle; Hence the need to adapt the city to aging, but also to develop innovative ways of displacement.
It is important to affirm the right to mobility for the elderly.
The idea, unfortunately too widespread, that a medical visit should be imposed from 75 years old, or even a new examination of the driver's license for the elderly, is in complete contradiction with the facts. Older people are not more than the others involved in road accidents: one fifth of the dead on the wheel is over 65 years old when one in two is between 18 and 45 years old. However, mortality is higher with age in the event of an accident, due to the greatest fragility of people. Old pedestrians are also much more exposed. They account for more than 50% of pedestrians who were injured and killed.
A resolute action must be carried out to allow secure mobility through safer, motorized or non-motorized movements of innovative vehicles, whether individual or collective, but especially modes of transport and services that meet the needs of the elderly and reassure them. Complementing the action of the attending physician and pharmacist, who have been sensitized to the detection of possible fragility beginnings at the wheel, these alternatives will be developed, which is the best response to the discrimination that would be caused by the appreciation of the driving faculty only depending on age.
From now on, the public of the elderly will be, by law, specifically among the public taken into account in urban displacement plans (PDUs). Beyond accessibility, already taken into account, it will be necessary to integrate the quality of use (security, driving mode, access to information...) and to encourage the development of innovative modes of transport.
The law will also open access to the "mobility counselling services" set up by the transport organizing authorities (AOT) in the cities of more than 100,000 inhabitants, so that they are better informed about the possibilities of existing mobility.
A study on mobility platforms and facilities, launched by the Ministry of Ecology, Sustainable Development and Energy, will not only collect and disseminate good practices from the most innovative communities, but also review possible ways to encourage their creation, especially in rural areas.
In addition, industrialists are developing initiatives to produce vehicles or equipment for vehicles adapted to the elderly. In order to encourage the French industrial sector to innovate in this field, a network of transport actors to the elderly is structured around the "silver mobility", gathering large industrial, innovative companies and representatives of public transport, to work on the offer of the future. This offer will allow public carriers to develop public transport that respond to the problems of the elderly: stress, access to sensitive information, fear... All this must facilitate the use of public transport.
To allow the development of some of these new vehicles, the development of a specific status in the road code is necessary. This legal status will be addressed in the working group on "sharing public space and securing active modes" led by the delegation to road safety and traffic.
Walking is the mode of displacement preferred by the elderly, especially when they advance in age and restrict the perimeter of their movements. The future national action plan for active mobility will help, among other things, to enhance walking and to better secure public space for pedestrians. At the same time, the delegation to road safety and traffic will extend its awareness-raising efforts to secure older pedestrians in connection with all relevant actors.
2. Seize the potential of the demographic transition for growth and employment.
The field of the silver economy is very broad: it extends from the most advanced technologies of home automation and robotics to habitat, mobility, tourism for seniors..., to the simplest technical aids and the whole range of teleassistance services or service packages. As its perimeter is expanding continuously, since it aims to irrigate all markets, the objective is to structure an aging industry in a capacity to respond to a global market of almost a billion donkeys. The challenge is to create a national and regional ecosystem, with growth, employment and foreign investment in our clusters, or clusters of companies, within the silver regions.
The silver economy also concerns women and men who put their skills in the service of self-help. In order to better take into account the needs but also the expectations of the elderly, special attention is paid to the professions of autonomy in their great diversity, professional practices and conditions of employment. The "silver economy" is finally a rich and bearer of social utility. It participates in the Government's battle for quality, recognized and valued employment.
2.1. Make France a world leader in the "silver economy".
If the age revolution is primarily a significant social and societal issue, it is also a real opportunity for innovation, growth and employment. It will create a large demand for products, technologies and services for older people in addition to a likely increase in the savings rate that should promote the productive investment of our country. The demand for home design, products, technologies and services related to autonomy should double in the space of about 20 years and generate a new offer. The ambition is clear: to reach a market of over 900 million seniors worldwide, mainly in OECD countries. The elderly will be two billion in 2050. To meet this growing demand, an industrial sector is being structured, which meets these needs for products, equipment and technology for the elderly.
This Act, through measures that support the reduction of the remaining burdens of the elderly and their families, through the revalorization of the APA or a better solvabilisation of technical aids, will contribute to the emergence of a stronger demand for new products. By strengthening the deregulation of the various sectors involved in ageing (social, medical, urban, etc.) and by improving the coordination of the actors involved in the prevention of loss of autonomy, this Act also creates a more favorable environment for the development of the silver economy. Young seniors are, in particular, a population whose behaviours, desires, needs and social role will have more and more weight and represent an opportunity for the French economy and growth, in many areas of activity: clothing, cosmetics, equipment, housing, tourism, leisure, design, etc. These growth relays are also an important driver of competitiveness for French companies. If they take the lead in the "silver economy", they will gain market share and export more. Otherwise, they will lose their competitiveness.
Some of the French companies are already well positioned against their foreign competitors. France therefore has a priori a comparative advantage that it is necessary to consolidate and sustain. By creating a national, regional and even local ecosystem through the creation of several clusters of companies, France can consolidate its assets.
In April 2013, the French Government officially launched the "silver economy" industrial sector, which aims to structure a state-of-the-art aging industry in France. A strategic industrial sector committee has been formed and has been affirmed as the coordinating and piloting body for industrialists and economic actors of the silver economy. It brings together some forty professional federations and public actors, especially the regions, which develop this industrial sector in their territory. On December 12, 2013, a silver-economy sector contract was signed, comprising 49 actions articulated around six axes, which constitute a roadmap for the coming years:
- create conditions for the emergence of a large market of the silver economy;
- promote the development of a competitive offer;
- export the products and technologies of the silver economy;
- professionalize the actors of the silver economy;
- create innovations in the field of the silver economy;
- to communicate positively to the elderly and to the general public and distributors.
The industry contract thus brings together the commitments made by all actors in order to promote, for example, labelling, investments related to competitiveness poles and clusters of companies, export and the establishment of exhibition sites or experimenters in the territories.
In order to amplify this dynamic, the "silver regions" were launched: regional sector committees of the "silver economy" are set up, with the regional councils for leaders, and a forum for consultation will be set up in each region to coordinate the structure of this sector in different regions.
2.2. Develop quality service jobs to better meet the needs of older people and improve the quality of support.
Responding to the age revolution is also boosting and enriching the content of the services rendered to people, which will create in the coming years many non-localizable jobs. The strengthening of the APA and the rebuilding of the home aid sector will contribute.
This is why this Act is accompanied by a "business plan" to encourage job creation, attractiveness, professional loyalty and the qualification of trades in the elderly sector, but also in the disability sector, both the needs are common between these two sectors. It aims to address three key issues:
1° Changing the professions to serve the new goals of age and disability policies.
It is a matter of accompanying the evolution of professionals in logics of cooperation and integration of services better matching the needs of the person's life journey. This involves work on professional practices, interdisciplinaryness, teamwork or re-engineering of diplomas, which are currently factors of rigidity.
With audiences whose fragility is growing, the quality requirement must also be strengthened. An active policy of professionalization and qualification will be pursued and actions that strengthen the attractiveness and loyalty of professionals trained in employment will be undertaken. This is a priority for adapting society to aging, for the national health strategy and for the interdepartmental disability committee. At the same time, this requirement must be based on a complementary citizen and volunteer engagement of society as a whole in the service of the most fragile, in particular in the spirit of national mobilization to combat the isolation of the elderly (MONALISA);
2° Support the effort to create jobs in the area of support for the autonomy of older persons or persons with disabilities.
This sector represents a future investment both needs are growing. Faced with this challenge, it is important to mobilize all the levers of employment policy to stimulate this economy to the most fragile service. This has already resulted in the signing of a commitment to development of employment and skills (EDEC) between the state and social partners. This is a real intergenerational challenge where the needs of older people can create several thousand jobs, including jobs for the younger, in the spirit of the generation contract and future jobs carried by the whole government. The mixing of trades will also be an objective of this plan. The Government has established as a general objective that a third of employees, compared to 12% today, work in a mixed trade in 2025. A similar objective will be set taking into account the specificities of this sector;
3° Building on social dialogue to improve working conditions and combat precariousness.
Whether it is the future health plan at work III, the general states of social work or industry negotiations, all of these structuring projects will have as a priority the preservation of the quality of life at work and the support of the career paths, to fully reconcile the objectives of public policies and the legitimate needs and aspirations of professionals, especially in a sector that remains marked by precarious employment.
The priority given to the home resulted in the State's approval of an actor to the collective agreement of the home aid branch to revalue the index point. 220 000 employees are concerned. Work will also be undertaken on the qualification levels to be mobilized to meet the support needs of older persons in order to have shared repositories to support the development of multi-year contracts of objectives and means (CPOM) signed between departmental councils and home aid organizations.
In addition, the evolution of the mode of financing of authorized and empowered social services (see Part 3) will help to provide a response to the economic fragilization of the sector.
3. Consecrate the place of the elderly and recognize their fundamental role in society.
The increase in the number of elderly, mostly autonomous, in our country can be a real benefit if we know how to prepare and design it. Two major conditions for this collective benefit: recognition of their solidarity role in social cohesion and the need to give them the means to flourish and to understand and know the world around them.
Already, the social role of the elderly is considerable: civil society and, of course, families would not live without them. It is still necessary to enhance this role, facilitate it and renovate it so that these old "new" have the desire to engage in it. And in a rapidly changing world, guaranteeing their access to knowledge, culture and tourism allows them to stay in grip with him and interact with other generations.
3.1. Valorize and strengthen the family commitment of the elderly.
France has over 15.1 million grandparents. Women become grandmothers at an average age of 54, and male grandfathers at 56. The custody of grandchildren by their grandparents, the management by them of the organization of free time and possibly holidays represent a major intergenerational solidarity.
The extension of life to work results in the emergence of active grandparentality. Companies should be encouraged to take this social role into account in the development of the working time set out in human resources management plans. Similarly, business nurseries will be encouraged to open up to grandchildren, without prejudice to the reception of children of paid parents, who remain a priority.
Among the wide variety of parenting initiatives, the parenting nursery has a place of choice. Grandparents may be associated with this type of initiative.
Family conflicts concern parents, but also grandparents. If the child has the right to maintain relations with his or her ascendants, as provided for in the Civil code, this right depends on the relationship with the parents. Some are thus deprived of links with their grandchildren. Mediation is then convened to resolve this type of dispute. As part of the development of the territorial plans for services to families whose prefiguration was launched by the Minister of the Family in December 2013, intergenerational mediation will be the subject of a census of existing practices, public information in order to facilitate access and joint actions between the partners concerned in order to promote their development.
3.2. Valorize and strengthen the solidarity of the elderly.
Five to six million donkeys have a commitment to an association. They are an indispensable contribution to the associative life of our country. Comforting their commitment is recognizing their skills and experiences and strengthening social cohesion among generations; It is also a recognized way to prevent loss of autonomy.
Associative engagement of seniors must therefore be encouraged and valued.
Retirement is a break that can be difficult to live. Businesses, as part of their social responsibility (SSR), and pension funds have an essential role to play to help future retirees in the preparation of their new life project and to encourage them to put their skills and experience in the service of an association.
The valorization of seniors' engagement should not lead to a hierarchy of volunteers. A mechanism to demonstrate the recognition of the national community of the most committed volunteers, and to develop the most innovative projects could be put in place by the State, in collaboration with the associative world. This arrangement could provide for the materialization of this recognition as part of a ceremony on 5 December each year, on the occasion of the International Volunteer Day.
Guarantee quality and promote the development of intergenerational cohabitation.
The intergenerational cohabitation is being developed today thanks to the action of associations involving the elderly and youth. On the one hand, the elderly benefit from a reassuring and benevolent presence, on the other, the young enjoy a room at a lower cost. This is a costly solution that brings true comfort to the elderly, in a framework that is not medico-social but a citizen and a solidarity. This practice is at the crossroads of several legal provisions: it is not a rental contract, because there is no lease, it is not a contract of work either, but it is a mutual solidarity commitment without any other financial consideration than participation in expenses when the parties agree.
The creation of a specific label for associations implementing this type of device is a confidence factor for the elderly and potential financialers. The drafting of a charter of intergenerational cohabitation and a model convention, which can be concluded by the older person and the young person, will also improve the security of this practice. Self-reliance residences can also accommodate students or young workers in their homes, as well as elderly or disabled persons, in order to pursue the goal of intergenerational cohabitation.
Organize intergenerational transmission and solidarity.
La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La La Act No. 2013-595 of 8 July 2013 orientation and programming for the refoundation of the school of the Republic reaffirms the importance of the dialogue between the school and the parents, the local authorities and the community sector. The involvement of students in educational projects aimed at promoting educational success and learning can include projects with older people. Already, the reform of school rhythms has been able to allow retired people to participate in peri-school activities, according to their skills and projects developed by the municipalities. This dynamic will be encouraged.
Each year, a national day of intergenerational solidarity in the education system will make it possible to value the intergenerational projects developed throughout the year.
In the same spirit, 2014 was the year of commemoration of two world wars. It was an opportunity to mobilize the elderly around the sharing of their personal, civil or military archives, to help leave a trace of this time whose protagonists gradually turn out. A convention will be signed between the Ministers responsible for Veterans, Older Persons and Self-Government and the National Veterans' Office to encourage the collection of civil archives and their conservation by departmental archives.
Similarly, the contribution of older immigrants to our country's history will be better recognized. It is an essential component of national history, in particular the history of the reconstruction of the country and the development of its industrial tool. The recognition and transmission of this history is a guarantee of strengthening the intergenerational link and the foundation of any integration policy. In accordance with the preconizations contained in the report of the information mission on older immigrants, tabled on 2 July 2013 at the presidency of the National Assembly, the identification of "memory places" of immigration will be encouraged, the work on the memory of immigration will be supported, the places of exchange and transmission of immigration memory will be valued and the large companies heavily employed by immigrant workers will be invited
3.3. Giving the elderly the means to flourish by developing suitable service offers.
Encourage the development of free-time universities.
For forty years, they have been created, alongside universities and relying on their skills and know-how, structures with various appellations: "open" universities, "free time", "the third age", "for all", etc. These structures are carried out by public institutions of a scientific, cultural and professional character (EPCSCP), associations or local authorities, and are designed to provide lessons that are accessible to all, non-diplomants, to benefit from the influence of academic culture. By providing permanent education to the elderly, they contribute to the prevention of the adverse effects of aging.
These universities are forced to develop in the years to come. To this end, a convention was signed in the second quarter of 2015 with the conference of university presidents, the French Union of Universities of All Ages and the Association of Mayors of France (AMF) in order to bring back good practices and share them, and to encourage universities as well as local authorities to engage more in this approach, which responds to a growing expectation of the elderly. This agreement will allow, through the dialogue of the various actors it involves, a deployment but above all a better coordination of the collective educational activities.
Guarantee the right to holidays for all and access to culture.
Older people can leave on holiday without the constraints of the assets, which is important to promote. The National Agency for Holiday Cheques will be supported in the "Holiday Seniors" program, which allows 45,000 seniors to leave annually. It will be important to allow more dependent elderly people to go on vacation.
Within the "silver economy", the "silver tourism" will be developed, especially the part aimed at making France an attractive country in terms of tourism for seniors or well-being tourism. This "silver tourism" aims to attract seniors from Europe for short periods on French soil, especially in seaside, green or thermal resorts.
Similarly, in the field of culture, the holders of artistic and cultural education projects will be encouraged to develop an intergenerational dimension, whether it is projects designed in partnership with teachers and taking place in part or in whole during school time or projects taking place outside this time. As a result, in 2013, several artistic and cultural education courses were used to involve medical retirement homes. Particular attention will be given to digital access projects that allow for the creation of a social and intergenerational link, the learning of new uses, transmission and exchange.
4. Affirm the rights and freedoms of older persons.
4.1. Clarify and guarantee respect for the rights of older persons.
Human rights apply to all citizens. However, the vulnerabilities of some older adults, especially older adults, make it necessary to reaffirm and explain these rights. Conciliation between autonomy and protection of older persons must be sought.
The ethical approach can only guarantee the fair response to the confrontation between contradictory principles and yet individually legitimate (principle of freedom and security in institutions). It also concerns the field of persons with disabilities.
Provide appropriate information to allow you to choose your life plan.
The law first enshrines a fundamental right for the elderly in loss of autonomy: to benefit from accompaniment and care adapted to their needs in accordance with their plans of life.
It also enshrines the right of the elderly and their families to be informed in order to clarify their choice. The departments, through the network of local information and coordination centres (CLIC), the CNSA, through the establishment of an information portal, and other structures such as CCAS ensure the implementation of these rights.
Better respect for the rights of vulnerable older persons and combat discrimination.
As a result of the important work of the National Council for the Welfare and Rights of Older Persons and Persons with Disabilities (CNBD) and the referrals of the Ombudsman for Rights, the law specifies the rights of vulnerable elderly persons within the framework of the legal corpus of fundamental freedoms.
It is also a matter of combating age-related discrimination, which are increasing. Moral harassment and refusal to enter into a lease or loan contract due to age are regularly denounced by the Rights Defender. It conducts an investigation and makes recommendations in favour of awarding compensation. Justice can also be seized directly under age discrimination.
Old migrants, lesbians, gays, bisexuals and transgenders or HIV-positive people often accumulate the risks of discrimination during their age shift.
4.2. Enhancing the freedom to go and come from people who are housed in institutions.
It is first of all to reaffirm the freedom to go and come to the list of the fundamental rights of the hosted person. It does not oppose protection but becomes a component. The information and guidance of all adaptations to the freedom to go and come that would be necessary for community life are improved by law, which also sets the rule of proportionality and necessity in relation to the state of the person and the objectives of care.
New technologies can combine the fundamental rights and aspirations of autonomy and significantly improve the quality of life and freedom of vulnerable people in the best security conditions. CNBD has developed a charter, based on the principles of subsidiarity and proportionality, with a view to experimenting with institutions hosting older persons. The doctor's written notice and the consent of the person concerned condition the use of a geolocation device. The public authorities are committed to drawing all the lessons of this experiment, in the face of the foreseeable development of these technologies in the coming years.
4.3. Accompany the expression of consent of individuals.
The protection of resident persons is also due to the quality of the institution's approach to reception, to the attention given to consent, whose expression is sometimes delicate to collect, as well as to the quality of residence contracts. The law strengthens the procedure for accepting the contract of stay at the time of the contract's conclusion, allowing better assurance of the consent of the person being granted, the knowledge and understanding of his or her rights. The publicity of the Charter of Rights and Freedoms is strengthened.
In accordance with the recommendation of the Rights Advocate, a "trustworthy person" is also established to assist the elderly in his or her actions and assist him in his or her decisions at the medical-social institution, as is already the case for health-care users.
4.4. Protect vulnerable people.
Protect the elderly against the capture of inheritance, gifts and bequests.
The Inter-Ministerial Mission of Vigilance and Fight against sectarian drift and the work of the CNBD highlighted the vulnerability of the elderly, who are more than the entire population the target of attempts to capture heritage or inheritance, in particular by sects.
The Act aims to strengthen the provisions for the protection of older persons by prohibiting any person who is involved in the home under social or social care to be entitled to the benefit of gifts, bequests and financial benefits of any kind from the person visited. The balance of the person's will is, however, respected to the extent that the gifts of use remain possible.
Protecting the elderly against abusive clauses.
In order to avoid abusive clauses, some delays in breaking the contract are now regulated by law. The commission of abusive clauses and the general management of the consumption, competition and crackdown have denounced certain accommodation contracts for older persons that require the resident or his family to pay a sum of money for a benefit that will not be made. That is why the law provides for various measures to limit these clauses.
The obligation for social and social institutions to report situations of abuse or abuse is enshrined in the law.
Improving the detection, reporting and treatment of abuse is a major issue. The binding nature of the reporting obligation of social and social institutions is reinforced by a legislative affirmation and not only by means of a circular. It is necessary for any event that presents an immediate danger or a risk to the health, safety or well-being of residents or that results in disruption of the organization or operation of the facility. A departmental coordination unit of the actors involved in the collection, analysis and treatment of situations of abuse will be tested. The objective is based on a clarification of the information of concern and a structuring of local stakeholders around SRAs and departmental councils.
Extend the protection of persons under legal protection.
The law extends the safeguard of "medical" justice applicable in health facilities to people in medical and social facilities.
The situation of physical agents is improved: the individual document for the protection of majors is extended to them and the accreditation procedure is used to meet the needs defined in the regional scheme for the legal protection of majors.
The future protection mandate, which allows everyone to freely anticipate their protection, is an asset for dignity, freedom and respect for the will of people. Communication activities, such as film making, will be implemented by the School of High Studies in Public Health.
Surveys are carried out on a regular basis on violence and abuse against older persons and on gender-related issues.
VOLET 3: ACCOMPAGNER THE PERTE OF AUTONOMIE
The risk of loss of autonomy is constantly present in age policy. The anticipating, delaying, damaging, is also facing it. When it occurs, the Republic must be on the verge of reducing inequalities, supporting the public service and supporting all expressions of solidarity, within the family and beyond. National solidarity must, with the same requirement, be able to face the difficulties of staying at home and the choice or need to enter retirement homes.
The policy of accompanying the loss of autonomy continues two objectives: to enable the elderly to fully exercise their free choice, by giving the means to those who wish to stay at home in good conditions, and to guarantee to those who may enter the retirement home a welcome in good conditions. This double objective in the direction of both the home and the establishments is in keeping with the life and health paths that the French call for. This Act implements them without opposing them or stigmatizing any response to another. With regard to persons with disabilities, it is a matter of setting up the issue of age advancement in all reception and support projects, at home or in institutions.
In the short term, it is important to respond to the urgent needs of people in situations of self-reliance. Many of them do not find the financial, human and material means to cope with their situation today.
Accompaniment professionals, both at home and in institutions, are strongly committed to the service of the interests of the people and must be supported to ensure the mission entrusted to them. The financing and pricing models of the institutions and services concerned must be refurbished to accompany the profound transformation of the expected supply.
1. Home priority for all those who wish.
By relying on departmental councils, in their capacity as leaders of the policies of autonomy, the strategy is focused on all dimensions of home support: the strengthening of APA at home, with an increase in aid ceilings and a decrease in the rest at home; recognition and assistance to caregivers, including the financing of a right to respite; the improvement of the information of the elderly and their families, in addition to the revitalization of technical aids and prevention at home and the consolidation of home services.
It is also necessary to promote, through enhanced information on existing opportunities, access to day-care in appropriate structures to ensure the maintenance of a social life for those who have chosen to maintain their home.
Designed as places of proximity, professionalization and development of new form of organisation of home employment, life assistants are organized as part of a convention with departmental councils and the National Solidarity Fund for Self-Government. Enhanced participation of employees working in direct employment with people in high dependency situations (customized self-help, IG 1 and 2) must be sought.
1.1. Reform the custom home autonomy allocation.
The creation of the APA in 2001 marked a fundamental break in the way of accompanying the loss of autonomy of the elderly in France. While historically this public accompanying policy was a logic of assistance to the most needy, the APA has made it possible to overcome the logic of social assistance, conditioned at levels of resources and heritage, in favour of a universal benefit logic and a global aid plan. The creation of this service has thus constituted a decisive step in the recognition of a new social risk funded by national solidarity.
More than ten years later, this benefit has proved its usefulness and relevance, as evidenced by the increasing number of beneficiaries: at the end of 2011, nearly 1.2 million people benefited from the APA, including nearly 700,000 at home (60%). The APA allows to accompany the most dependent but also, and it is essential, to preserve the autonomy of those who are less dependent.
The principle of this universal service, in the broad field, based on community management, entrusted to the departmental councils, is today a consensus. However, in its implementation, the delivery is limited and the saturation of aid plans has become frequent. This was the case for a four-in-four help plan in 2011, particularly in cases of heavy self-reliance loss: 46% of IG 1 reached the ceiling of their aid plan. The level of financial participation leads modest beneficiaries to give up the help they need, at the cost of a subconsumption of aid plans. The moderator ticket, which depends solely on the resources, grows mechanically with the importance of the aid plan, which leads to high levels of effort for people with the highest loss of autonomy. The quality of the intervention can still progress, by a higher qualification of home professionals and better coordination of stakeholders.
Therefore, if people do not have the opportunity to mobilize family solidarity or their heritage, they will not resort to the help they need, the risk of a deterioration in their health and accelerating the loss of autonomy. This can also lead to the exhaustion of family caregivers or to the entry into undesired establishment. For the most modest ones, however, social assistance for housing can be mobilized.
Other APA limits are often highlighted by families and professionals, such as the diversity of practices in terms of assessing the needs of people and building aid plans, which is perceived as a source of inequity across national territory.
The time has therefore come from an act II of APA at home. This new step is highly expected by the French people whose families are or will be affected by the problem of home retention of an elderly parent. It is part of a more comprehensive reform aimed at modernizing this service by diversifying the content of aid plans, which need to better integrate access to technical aids and gérontechnologies as well as temporary reception, which also allows for a respite to caregivers. It is also a matter of strengthening equity in the territory, working with CNSA and departments to a greater degree of homogeneity in the evaluation and construction of aid plans.
The objective of the proposed reform on APA at home is to make it possible to exercise a true free choice by the elderly in loss of autonomy and thus to allow those who wish, and can, to stay at home.
The law relies on three complementary levers:
Improving the financial accessibility of assistance for all.
The reform will lighten the rest for the heaviest aid plans thanks to the reduction of the moderator ticket. For the part of the help plan between 350 and 550 €, the ticket moderator can drop up to 60%. For the share of over € 550, the decrease can reach 80%. This represents a significant decrease in the remaining burden for the most dependent, modest and middle classes. At the same time, the proposed new scale ensures that no recipient of the Elderly Solidarity Allowance (ASPA) receives a facilitator ticket. These two social justice measures are critical in access to rights and the use of aid and enable the fight against non-recourse, which can contribute to the worsening of the loss of autonomy, without sufficient support. Finally, improving accessibility is also simplifying the steps, including by promoting the use of the universal employment-service cheque for the APA and the third party paying for the services and by strengthening information on the rights and steps to access it, thanks to the Internet portal that will be hosted by the CNSA.
Increase the ceilings of aid plans.
Monthly aid ceilings are valued from 400 € in GIR 1, 250 € in GIR 2, 150 € in GIR 3 and 100 € in GIR 4. This effort goes well beyond a simple catch-up of the increase in response costs since the creation of the APA. He testifies to a proactive choice for home support. It must allow both the increase in home support time, but also the expansion of the range of mobile services, in order to best adapt the intervention to the needs of the person. It deliberately covers all APA beneficiaries, regardless of the IRB, in order to act in prevention from the onset of the first signs of loss of autonomy. The revalorization effort is all the more important as autonomy decreases, which allows to stay at home as long as possible with the necessary help.
Improve the quality of home intervention.
This will require a strengthening of the qualification and coordination of stakeholders, which requires value and recognition of quality efforts in the cost of intervention. Thanks to the raising of aid ceilings and the complementary efforts of the State towards the branch of home aid, targeted measures to revalue the lowest wages and travel costs of stakeholders will be implemented, in order to combat precariousness and contribute to the stability of stakeholders and the professionalization of the sector, in line with the proposals of social partners in the context of social dialogue at the level of the sector
A national survey could be conducted on the nature of the sex assistance plans of the elderly person and their spouse. In addition, the development of awareness-raising and training actions in the direction of medical-social teams would help to change the representations.
Improvement of the quality of home intervention also involves taking into account a time of exchange between the elderly and the home aid professional beyond the technical intervention in the definition of needs.
1.2. Comfort the rebuilding of the home aid sector.
APA reform at home is accompanied by a redevelopment of the home aid sector. The aim is to get out of the crisis of the economic model, which suffered from a lack of regulation, and to respond to the issues of accompaniment and prevention related to aging. This refoundation is based on three pillars.
First, the regime of the mandate of the services authorized by the departments must be secured, within the meaning of European law, by clearly identifying the obligations of general interest that spell out home aid in the field of services to the person: universality, accessibility, fair treatment, continuity of care. CPOM will also provide funding to the global package, in return for forecasting activity and quality objectives. In this case, aid plans may be tailored to one-time needs: participations may be calculated in a lump-sum format, which will allow, where necessary, to reduce or intensify aid plans, without financial impact on the person.
The aim is to improve needs assessment tools and diversify the provision of services at home. If human assistance is to remain central, it is also essential to give greater emphasis to technical aids, new technologies of autonomy, temporary reception or family reception. The service rendered to the user must be modernized, especially around more diversified and better articulated service packages. Assistance plans must promote a continuity of personalized interventions according to the needs and expectations of the person, who require, on a case-by-case basis, to combine different forms of help, at home or outside the home: securing the bathroom, arranging weekly access to the day reception, linking home aid to the attending physician, installing the help desk, etc.
Finally, the law puts an end to the current double regime of registration and authorization with the right of option, open to services providing assistance and home support for the elderly and persons with disabilities. The law provides for a gradual and secure evolution towards a single system of authorization by the departments. Services currently approved will be deemed to be authorized. A national specifications will specify the operating conditions and organization of authorized services. An external evaluation of each service will be required on the date that it would have been due to its approval. This regime will position the department as the actor pulsating the territorial structuring of the offer of home aid, in coherence with the refocusing of its missions on its social skills. In order to control local spending, this unique licensing regime will not include automatic administered pricing. Within the National Steering Committee for the Refusal of Services and Home Support (SAAD) involving all federations of the sector and departments, work will be carried out to identify, from a better understanding of SAAD's cost structures, non-opposable national reference rates that take into account, inter alia, the specificity of their activities, their territorial coverage or the qualification of their personnel and provide greater transparency.
The requirements for transparency and equal treatment between structures, regardless of their legal status, are guaranteed: timeliness for the investigation of cases by departments are defined; the State shall accompany, where appropriate, the follow-up of such requests; Finally, the departmental councils of citizenship and autonomy (CDCA) will follow the evolution of the reform. Thus, access to the home support and support services provider market will be secure for all services, while allowing departments, through a modern management dialogue with managers through CPOM, to better cope with the issues of population ageing. Similarly, until December 31, 2022, the authorization to create or extend a home support and support service authorized or not for social assistance will be facilitated by the waiver of the project call.
This re-foundation approach is extended to IG 5 and 6 people, thanks to the involvement of pension funds in these experiments, and goes beyond the emergency response provided by the restructuring fund to the most in difficulty stakeholders by engaging in a real modernization of the home aid sector, which implements the necessary restructuring efforts to ensure the efficiency of management and to include the activity over time. At the same time, this sector aims to benefit from the additional activity related to the increase in the APA ceilings, and therefore the increase in the number of hours realized at the home of people. The Government thus responds to the crisis of home aid by operating three complementary levers: revitalization of activity, recognition of intervention costs and securing funding.
The re-founding of home aid must also lead to a rapprochement between aid and care, thanks to a better coordination of the intervention of professionals around the elderly in the health sector and the medical-social sector. This is why this Act consolidates and deepens the versatile services of home care and assistance (SPASAD), through an experiment to strengthen the integration of services and to facilitate the financing of preventive actions.
It is necessary to develop the bridges between the various professions in the home according to the public, but also with the professions employed in the establishment, to improve the qualification and certification scheme to increase the legibility of the building and the recognition of the skills and the construction of the career paths, as well as to develop the support for the validation of the acquired experience.
2. Support the caregivers.
Caregivers are non-professional people, supporting an elderly person on a daily basis, whether or not they belong to his family. The majority of older people with a loss of autonomy benefit from their entourage. Half of the caregivers are the children of the elderly and one third are their spouses. This assistance is essential from the perspective of home retention. With the extension of the life span in the years to come, this reality will only increase, with caregivers who continue to be professionally active or who must support both their children and grandchildren and their dependent parents.
In 2008, 4.3 million people regularly help at least one of their relatives aged 60 or over at home due to impairment or disability. Represents the population of APA recipients at home, the number of people assisted at the end of 2011 is about 600,000, for a total of approximately 800,000, of whom 62% are women. Caregivers who are still in work are in 88 per cent of the cases of women.
20% of caregivers are now considered to have to bear a significant burden, synonymous with moral or physical fatigue, with effects on their health: 40% of caregivers with the heaviest burden feel depressive, 29% say they consume psychotropic drugs. They frequently give up care, transferring the health of the elderly before their own health. Health care professionals are not always sufficiently sensitized to care for caregivers and help plans often ignore the situation of family caregivers. Depletion of caregivers may also, in some cases, lead to situations of passive or active abuse of the elderly in loss of autonomy.
When caregivers work, which is the case of 40% of them, the impact on professional activity is real: they give up opportunities, change their work schedules, etc. Finally, their positioning in relation to professionals, whether they intervene at home or in institutions, is sometimes difficult.
This is why it is today to give all their place to caregivers and volunteers in the support of the person's life project, under conditions guaranteeing the complementarity of their intervention with that of professionals. The law more strongly recognizes and enshrines the role of caregivers. The 2013 pension reform has already been a first step towards a better recognition of their role, with the removal of the condition of resources to benefit from the old age insurance of parents at home, guaranteeing continuity in retirement rights and the opening of a quarterly increase for the care of a disabled or dependent adult, up to a quarter for thirty months of full-time care.
Public action for caregivers is articulated around three axes.
2.1. Recognize a right of respite for caregivers as part of the personalized self-reliance allowance.
In the first place, it is necessary to better take care of caregivers, their interventions, if any their vulnerability and their support needs (repealing signs of fragility, counselling, support, respite), at the time of the evaluation of APA's requests to take them into account in the development of aid plans and to provide them, if necessary, relays or support actions.
Accompanying caregivers is also allowing them to take a "break". This Act creates in the APA at home a module specific to the "right to respite", which will allow the caretaker to take respite when the ceiling of the help plan is not sufficient. This new module is complementary to the revalorization of the ceilings of the aid plans, which will allow for the release of funding margins to allow, more easily than today, access to the respite structures.
These may be additional home help hours, even a continuous presence, but also a day or night reception, or a temporary accommodation.
This right is an envelope of assistance for the year and helped. An amount that can go up to 500 € annually, beyond the APA ceiling, it will, for example, finance seven days of stay in temporary accommodation. It is targeted to the caregivers of the most dependent people (GIR 1 and 2), depending on the load for the caregivers estimated by the medical-social evaluation team: isolation (one-time help), IRB, Alzheimer's disease, etc. In the end, to ensure a more homogeneous assessment of the territory, a simple evaluation tool can be developed for both medical and social teams and health professionals to identify caregivers in difficulty.
The right to respite is supplemented by the creation of an emergency device in the event of the caregiver's hospitalization, in order to temporarily take over the assisted person beyond the amounts and ceilings of the aid plans. This implies the establishment of a specific organization to respond to these situations, which are often vectors of acceleration of loss of autonomy, entry into unprepared institutions or unplanned hospitalization and not medically justified.
The module specific to the "right to respite" within the APA is a lever for developing support and respite devices. It will be in the future to work towards the improvement of the solvabilisation of temporary reception structures, whose current economic model releases a burden too often deterrent to families. The development and diversification of the respite offer also involves the deployment of support and respite platforms. A pre-study and consultation with all relevant social partners will be launched in order to appreciate the opportunity for experiments with home relay services provided by a single professional for several consecutive days, on the model of the "brushing" Quebec.
2.2. Comfort and expand training and support devices for caregivers.
While volunteers are not intended to substitute for professionals, caregivers need training and support.
The CNSA is entrusted by law with a methodological support role on the support of caregivers, and the scope of the actions it co-finances in this field is expanded to support actions (café des aides...). At the departmental level, departmental councils will ensure in the field of autonomy a coordinating role of all the actors involved in helping the caregivers. To improve the support of caregivers, support and respite platforms will be developed and better equipped. The health prevention policy for family caregivers will be intensified. This will also be addressed within the framework of the national health strategy. All forms of accompaniment, as long as they have shown their relevance, must be encouraged and developed: coffees of caregivers, speech and exchange groups...
2.3. Helping caregivers reconcile their role with a professional life.
Given the difficulties that caregivers encounter in their professional life and the beneficial effect that can have on continuing to work, it is essential to facilitate the reconciliation between professional and accommodating life and the maintenance of employment. This is even more important for women, who constitute the majority of caregivers; the longer the work interruption, the more difficult it is to reintegrate professionally.
Family support leave deserves reform. It is inadapted because too rigid and restrictive. The Inter-Professional National Agreement on Quality of Work signed by social partners in June 2013 provides for further negotiation on family leave. The Government, particularly attentive to the negotiation on this issue between social partners, will make proposals and propose the legislative translation of an agreement as appropriate.
Companies, administrations and social partners will be encouraged to take into account caregivers and, in particular, to facilitate the development of working time by identifying good practices.
3. Design the medical retirement home tomorrow.
Essential actors in the provision of care and support to the territories, the establishments are a response combining accommodation, help for autonomy and health and support for the richest possible social life.
Medical retirement homes need to better integrate the care project into the person's life project, for a more comprehensive support that preserves the uniqueness of the life journey while addressing the challenges of medicalization. The range path is not a linear path. There may be ruptures, but also, fortunately, reversibility when the state of the donkey improves. The possibility of these reversibility must be taken into account in the construction of the courses and in the establishment projects. Medical retirement homes need to be better integrated into their territory, as "resources" places that support and complementarity in the provision of home services, families and caregivers, as well as the provision for family reception.
In this context, this Act calls for reform, which aims first to ensure greater transparency in tariffs and, ultimately, to reform the pricing of institutions.
The law has already made it possible to better protect residents and their families by ensuring greater transparency and beginning to better regulate rates. For the sake of greater transparency and to make possible the comparison of the given benefit prices, this Act provides for the standardization of accommodation pricing and the definition of the basic services covered by the rates for non-social assistance institutions. A set of "seal" services and services will be defined by decree, separate from any other additional rates and billings. The internet portal that will be hosted by the CNSA will finally allow each person to access clear and accessible information about the establishments, the rates applied and the help that can be mobilized.
In order to better regulate the evolution of the rates for residential residents on non-socially empowered places (25 per cent of the total), the Ministry of Older Persons and Self-Government is now associated with setting the rate of change in accommodation rates alongside the Ministry of Finance. In addition, a new criterion is taken into account in relation to the current practice in setting this rate of evolution in order to take into account the purchasing power of the elderly: the evolution of the level of pension already liquidated.
The Government is also strongly committed to protecting the rights of residential residents through the provisions provided by the Act No. 2014-344 of 17 March 2014 relative to consumption. Thus, accommodation benefits that have not been issued, after the death or departure of a resident, cannot be charged. The same law also provides for the obligation to prepare a statement of conflicting places upon arrival and departure of a person housed in a retirement home and the prohibition of charging costs to the room state in the absence of such a state of the place.
In addition, in order to ensure their missions in the best possible conditions and to protect themselves against the unpaid, institutions must receive extensive judicial remedies. The law now provides an opportunity for all establishments to refer directly to the Family Justice to manage potentially conflicting situations regarding the settlement of residential accommodation bills in medical retirement homes, including among children or other food-related requirements.
Measures to simplify the organization and management of institutions hosting older persons will be further developed within the framework of a working group.
Several leverages exist to improve the efficient management of retirement homes and optimize public funds and financial contributions from users. A simpler and more legible operation of the medico-social sector will allow for less costly support, with a positive impact on the rest, and more adapted to the needs of the elderly and their families.
Part of the measures is included in this Act with the reform of calls for projects. The expansion and transformation projects will be facilitated. This will, for example, transform hospital beds into retirement homes.
In addition, in this context, it is necessary to promote the responsibility of managers, explore the paths of simplification, introduce more flexibility and objectivity in pricing and develop multi-year contractualization and associated resource allocation mechanisms.
The process of pricing reform will be opened, with a view to establishing a simpler and more objective allocation of the funding of the institutions, taking into account the needs of the residents and the quality of the care. A better understanding of the costs of the various components of the resident care, as well as a review of the support needs measurement tools, will support this approach.
Finally, the development of a coherent and diversified offer of accommodation and accompaniment, responding to the objectives of opening the institutions on their environment and integration in the projects of the establishments of a response in respect of the caregivers' respite, requires a review of the pricing system for daytime and temporary accommodation, in a logic of "service platform".
The project to reform the pricing of facilities and services for persons with disabilities, which opened in 2014, will need to take into account the conditions for the reception of persons with disabilities who are aging in institutions for older persons and persons with disabilities.
In a second phase, when the government's recovery of public finances has made it possible, the reform of institutional support must make the offer more accessible. Indeed, financial accessibility to this global response is a real difficulty for the less fortunate, but also for the middle classes, the Government has the ultimate goal of reducing the burden on users and their families.
4. Better accompany the end of life.
The average age of death is now higher than 80 years, both sexes combined, and it increases continuously. More than half of the French die in the hospital, under conditions often not conducive to serene death. According to the 2013 annual report of the National End of Life Observatory (ONFV) on older adults, in 2012, 13,000 elderly people died in the emergency shortly after their admission. The policy on the territorialization of health policies (PAPAs) aims, in particular, to reduce these delegate hospitalizations. In addition, nearly 90,000 people died in a medical retirement home in 2012.
Accompanying death in the great age in the most dignified way possible is a fundamental issue. Already, it is necessary to:
- to make systematic use of palliative care teams in institutions, with a special requirement for situations of great distress (social and family isolation, loss of heavy physical autonomy). The target of 100% medical retirement homes related to a mobile palliative care team must be quickly reached (75 per cent currently);
- develop training for professionals working in a medical or home-based retirement home. Coordinator doctors and caregivers should be better trained in communication and ethical thinking about the end of life. Given the critical role of treating physicians and coordinating physicians, team-based training must be implemented in conjunction with existing mobile teams or palliative care networks;
- take into account the issue of end-of-life during the development or updating of the medicalized retirement home project, encourage each person who is welcomed to designate a trusted person and to formulate his wishes and instructions in an early and accompanied manner;
- to make regular access to a night nurse, in particular by pooling positions if the number of places does not justify the presence of a dedicated professional. When an institution has a night nurse, the hospitalization rate drops by 37% (Report of the National End of Life Observatory);
- to strengthen the links between each regional or interregional ethical think-tank (ERI) and medical retirement homes, with a view to strengthening training and support for the implementation of an ethical think-tank within each institution in accordance with the recommendations of the National Agency for the Evaluation and Quality of Social and Medical Institutions and Services;
- develop the use of home hospitalization (HAD) in a nursing home when the nature and severity of the symptoms warrant it. Only 8% of these structures use the HAD to accompany the end of life, while it allows for significant strengthening of nursing care and easy access to medical and paramedical equipment.
5. Promote access to temporary reception and family reception.
Temporary reception and family reception meet the real needs of older persons such as persons with disabilities. Strengthening these forms of hospitality is an important project for the years to come.
5.1. Provide the answers to the brakes that the temporary reception is today.
The temporary reception is for both the elderly and persons with disabilities. It is understood as a host for a limited time, full time or part time, with or without temporary accommodation. It aims to organize a response tailored to a one-time or time-frame change in the needs of the elderly person, to a balance sheet, an emergency situation, or a transition between two caregivers. It also allows the surround to benefit from periods of respite.
In the future, these forms of temporary reception should correspond to a growing demand for flexibility of care modes. Today, the missions and territorial mesh of temporary reception structures are very heterogeneous and their place in the global supply of poorly defined care. Professionals also lack adequate training to meet the adaptability requirements of this device. Finally, the economic model of this type of reception is not attractive. Act II of the reform of the policy of autonomy must be able to respond to these different issues and allow the elderly to benefit more easily from a temporary reception of quality.
5.2. Encourage the deployment of the family home.
The family reception of older persons and adults with disabilities is an alternative formula between the home and the institution. It offers those who can no longer or do not want to stay at home a family living environment that allows them to benefit from a helping and stimulating presence and personalized support. It can meet a need for sustainable reception or a need for temporary reception. In order to meet the diverse and personalized expectations and needs, it is a service offer that the law will develop.
The family reception today represents only a very small part of the support service offer throughout the territory. This Act therefore provides for measures to develop an impulsive and controlled quality offer by the departments, as well as rights for welcomed persons and for welcoming persons.
Thus, a repository will specify the approval criteria by the departments. The rules will be better defined, allowing to specify the profile of persons who may be welcomed, to specialize or restrict the content and scope of the accreditation according to the characteristics of the welcoming candidates and to specify the duration and the pace of reception.
This Act now guarantees the same rights to persons in foster care as to residents of social and psychosocial institutions. It provides the same access to the mechanisms provided to facilitate the exercise of these rights in the event of difficulties, such as the use of a qualified person or a trusted person. Taking into account the specific needs and expectations of the recipient will be included in the hospitality contract.
In addition, the pay return will be simplified, thanks to the use of the universal job-service cheque.
For the welcoming, a mandatory training, quantified in the volume of hours, will ensure a quality reception and take into account in the framework of the "Trade Plan" a possibility of a career path. Finally, under the agreement of the social partners responsible for unemployment insurance, the affiliation of the hosts to the plan would be a major step forward. In fact, so far, in the absence of a labour contract, the family homeless voluntarily could not be. From now on, the remuneration of family-friendly persons will be derogatory to the same tax system and social contributions as wages. Their remuneration will be subject to contributions and they will therefore benefit, in times of unemployment, from the insurance plan, like any employee. By securing the periods of unemployment between two reception periods, this will make this offer of service more attractive to develop in the face of the expectations of the elderly.
6. Simplify supply management tools in the territory.
In the coming years, the competent authorities in terms of planning, authorization, financing and piloting, at the forefront of which departmental councils and SRAs, will increasingly have to work on the organization of the offer to improve it and to make it evolve according to needs, with a view to the proper allocation of public funding. Facilitating the reorganization of the offer includes the simplification of the rules relating to calls for projects. The law allows it, based on the assessment of the implementation of the regime established in 2009. The system in force has been reduced by combining the transparency of the information needed for the sector and the flexibility required for the evolution and adaptation of the existing offer.
The use of the project appeal procedure is mandatory only for establishments or services. The law exempts from the project appeal procedure minor extensions, defined by decree, and clarifies cases of exemption. Transformations affecting a changing social and medico-social institution of a beneficiary public class or a health institution that converts to a social and medico-social institution or service (ESSMS) can now be exempted from the use of the call for projects as long as their project results in the conclusion of a multi-year contract of objectives and means (CPOM).
In the future, the improvement of the organization of the offer on the territories will require enhanced cooperation between institutions and services. The law will encourage them by clarifying the authorisation rules for social and medical-social cooperation groups (GCSMS).
VOLET 4: GOVERNANCE
The governance of age policy meets two requirements: that of equality in the territory and that of proximity. It must also involve the elderly themselves according to the principle brought up and strong by persons with disabilities: "Nothing for us without us". Very concretely, its aim is to simplify the lives of the elderly and to accompany them as close as possible to their needs and aspirations.
Renewing the governance of the policy of autonomy is the condition of the success of the many projects opened for the years to come. The first requirement is democratic. The priority is therefore to give voice to older people. They must be listened to but also associated with the construction of this policy in all its aspects. The new governance must also make it possible to simplify the lives of the elderly and their families by providing them with more integrated and close reception, information, guidance and support throughout the territory. This includes bringing together actors and better coordination of actions.
The governance of autonomy policy must also be effective. The consecration of the role of CNSA as a "common home of autonomy" is part of this search for efficiency. In addition, it involves strengthening linkages between SRAs and departmental councils. It must help to de-dislocate policies, actors and audiences, to take into account the very broad scope of society's adaptation to ageing and to mobilize on common goals and projects. The dislocation of actors also involves a better legibility of funding allocated to this major nation policy. Knowing the national effort of spending on the autonomy of the elderly, by tracing all the funding involved by all the actors involved (state, departmental councils, pension funds...) will enable the French to measure and monitor the overall effort made for age policy.
Finally, the last condition of success, governance must be flexible and adaptable to local realities, build on the initiatives of local actors and, at the same time, ensure fairness throughout the territory.
1. At the national level: participation of older families strengthened in the service of a more cross-cutting ageing policy.
1.1. Create a High Council for the Family, Children and Age that contributes to developing this comprehensive policy.
This Act creates a High Council for the Family, Children and Age (HCFEA), to give more voice to the people concerned on all matters related to families and children, retirees, age-advanced and adapting society to aging, in an intergenerational approach.
This High Council is placed with the Prime Minister.
It will be a substitute for the National Council for Retirees and Older Persons (CNRPA), the Committee on Age Advancement, the National Council for the Welfare and Rights of Older Persons and Persons with Disabilities (CNBD), the High Council for the Family (HCF), the National Committee for Support for Parenthood (CNSP) and the Commission on "Children and Adolescents" of France strategy.
The High Council is also working with the National Advisory Council on Persons with Disabilities (CNCPH) on cross-cutting issues of rights and welfare for older persons and persons with disabilities. In order to promote the cross-cutting vision of the issues relating to the well-treatment and rights of older persons and persons with disabilities, the chairpersons of the two councils will jointly agree on the regular common working arrangements on these issues.
The functioning and composition of the High Council for the Family, Children and Age are determined by a decree which provides for plenary training and specialized training covering all the fields of competence of the High Council: elderly and retired persons, children and family.
It is responsible for making opinions and making recommendations on the priority objectives of family, child, elderly and retired people policies and the prevention and support of loss of autonomy.
It formulates any proposal to ensure respect for the rights and well-treatment of vulnerable persons at all ages of life and the proper consideration of ethical issues.
It provides an opinion on any draft legislation relating to childhood, the age advancement of older persons and retired persons, the adaptation of society to ageing and good-treatment, and can follow up on it.
It may be referred to by the Prime Minister, the ministers responsible for the family, the elderly, children and other ministers concerned, any questions relating to the family and children, the advance in age of older persons and retirees, and the adaptation of society to ageing as well as to good treatment. It can also be allowed on these same fields of competence.
1.2. Strengthen the National Solidarity Fund for Self-Government as a "common home" to better lead this global policy.
After almost ten years of existence, this Act enshrines the role of the "common house" of the CNSA's autonomy at the national level, the head of the network for the implementation of the policy of self-help. In the coming years, it will contribute to the operational piloting of the implementation of a comprehensive strategy, acting on all factors of loss of autonomy, as much as possible. It is explicitly recognized in its responsibility for the monitoring and efficiency of the medical-social expenditure covered by health insurance alongside CNAMTS. In keeping with the free administration of the territorial authorities, it must also contribute to a double objective in the medical-social field of expenditure control and territorial equity in response to needs.
This Act extends the skills of CNSA, in particular by entrusting it with a methodological support and harmonization of APA practices, like the missions it carries out with the departmental houses of persons with disabilities (MDPH), a public information mission on aids and services related to compensation for loss of autonomy, including through the animation of the Internet portal for the elderly, a mission to inform the general public about the aids and services associated with compensation for loss of autonomy. Finally, it will support the modernization and reorganization of the home aid sector.
In addition to strengthening its skills, its role as a "common house" is also reflected in a change in the governance of CNSA, with the admission to the Board of Directors of CNAMTS, CNAV, CCMSA and RSI. In addition, the Board will now include three Vice-Presidents elected from departmental councils, seniors and persons with disabilities respectively.
1.3. Better inform the elderly and their caregivers through a comprehensive information and guidance portal.
The services offered to elderly people with a loss of autonomy and their caregivers today suffer from a lack of transparency and legibility. Indeed, the multiplicity and complexity of social, health and social stakeholders do not facilitate the response to the multiple needs of people's life journeys. The accompanying of self-reliance loss, such as help to caregivers, is thus through an improvement in the information and guidance of the elderly and their caregivers.
This Act recognizes a right to information and creates a comprehensive information and guidance system, through a dedicated and articulated Internet portal with the provision of services from departments, pension funds and their local operators, starting with local information and coordination centres (CLIC). The portal will offer a unified entrance door to make public information and support services for the elderly and their caregivers more visible and legible. Managed by CNSA, it will rely on the data available at the national and local levels and will complement the existing support modes on the ground. It also agreed to experiment with a first-level national telephone response to the Internet portal. This system is, of course, more comprehensively part of the reform of the governance and prefiguration of the future public health information service.
2. At the local level: better coordination of actors for the elderly.
This Act reaffirms the role of the Departments in the care of older persons in the territories. For the first time, she also entrusts them with a driving role in the support, support and enhancement of caregivers.
She states that, in order to carry out her duties, the department relies on the finance conference of the loss of autonomy of the elderly and on the departmental council of citizenship and autonomy (CDCA).
This CDCA will ensure the participation of older persons and persons with disabilities in the development and implementation of autonomy policies in the department instead of the departmental committees of retired and elderly (CODERPA) and departmental advisory councils of persons with disabilities (CDCPH). It will be consulted on all the schemes and programs that concern older persons and persons with disabilities and will be widely open to all stakeholders involved in self-government policies.
Finally, this Act proposes a flexible legal framework for the creation, on the initiative of the president of the departmental council, of departmental self-government houses (MDA) that will not be provided with moral personality. The departmental houses of persons with disabilities (MDPH) will therefore remain public interest groups (IPGs) and it is only if their executive board gives a consistent opinion that the establishment of a home of self-government gathering the MDPH and the personnel and material resources of the department assigned to the policy for the elderly and persons with disabilities will be possible.
Seen to be annexed to the bill passed by the Senate in its sitting of December 14, 2015.
The president,
G. Larcher
Done in Paris, December 28, 2015.
François Hollande
By the President of the Republic:
The Prime Minister,
Manuel Valls
Minister of Ecology, Sustainable Development and Energy,
Royal
The Seal Guard, Minister of Justice,
Christiane Taubira
Minister of Finance and Public Accounts,
Michel Sapin
Minister of Social Affairs, Health and Women ' s Rights,
Marisol Touraine
The Minister of Labour, Employment, Vocational Training and Social Dialogue,
Myriam El Khomri
The Minister of the Interior,
Bernard Cazeneuve
Minister of Housing, Land Equality and Rurality,
Sylvia Pinel
Minister of the City, Youth and Sports,
Patrick Kanner
Minister of Overseas,
George Pau-Langevin
State Secretary for Transport, the Sea and Fisheries,
Alain Vidalies
The State Secretary for the Family, Children, Older Persons and Self-Government,
Laurence Rossignol
State Secretary for Persons with Disabilities and the Fight against Exclusion,
Ségolène Neuville
(1) Preparatory work: Law no 2015-1776.
National Assembly:
Draft Law No. 1994 ;
Report of Ms. Martine Pinville, on behalf of the Social Affairs Committee, No. 1994;
Opinion of Ms. Fanny Dombre Coste, on behalf of the Committee on Economic Affairs, No. 2119;
Information report of Mr. Jacques Moignard, on behalf of the delegation to the rights of women, No. 2111;
Discussion on 9, 10 and 11 September 2014 and adoption on 17 September 2014 (TA No. 403).
Senate:
Bill, passed by the National Assembly, No. 804 (2013-2014);
MM report. Georges Labazée and Gérard Roche, on behalf of the Social Affairs Committee, No. 322 (2014-2015);
Opinion of Mr. Daniel Gremillet, on behalf of the Committee on Economic Affairs, No. 305 (2014-2015);
Notice of Ms. Catherine Di Folco, on behalf of the Law Commission, No. 306 (2014-2015);
Commission text No. 323 (2014-2015);
Discussion on March 17, 18 and 19, 2015 and adoption on March 19, 2015 (TA No. 83, 2014-2015).
National Assembly:
Bill, amended by the Senate, No. 2674;
Report of Ms. Joëlle Huillier, on behalf of the Social Affairs Committee, No. 2988;
Discussion on 15 and 16 September 2015 and adoption on 16 September 2015 (TA No. 581).
Senate:
Bill, adopted with amendments by the National Assembly on second reading, No. 694 (2014-2015);
MM report. Georges Labazée and Gérard Roche, on behalf of the Social Affairs Committee, No. 101 (2015-2016);
Text of Commission No. 102 (2015-2016);
Discussion and adoption on October 28, 2015 (TA No. 27, 2015-16).
National Assembly:
Bill, amended by the Senate on second reading, No. 3186;
Report of Ms. Joëlle Huillier, on behalf of the joint parity commission, No. 3294;
Discussion and adoption on 10 December 2015 (TA No. 642).
Senate:
MM report. Georges Labazée and Gérard Roche, on behalf of the Joint Paritaire Commission, No. 210 (2015-2016);
Text of Commission No. 211 (2015-2016)
Discussion and adoption on December 14, 2015 (TA No. 53, 2015-16).
