Key Benefits:
The Minister of Employment and Solidarity and the Minister of the Interior,
Given the Social Action and Family Code;
Due to Act No. 2001-647 of 20 July 2001 Relating to the care of the loss of independence of the elderly and the personalised self-employment allowance;
In view of the opinion of the National Pension Fund for Employed Workers as of 20 November 2001;
In view of the The Assembly of departments of France as of 4 December 2001;
In view of the opinion of the National Fund for Health Insurance of Employed Workers as of 27 November 2001;
In view of the opinion of the Central Agency of Security Agencies Social as of November 30, 2001,
Stop:
The terms of reference laid down in Article L. 232-13 of the Code of Social Action and of the families referred to above are Annex 1 to this Order.
List of information exchanged between departments and collection agencies Pursuant to Article L. 232-16 of the Code of Social Action and of the families in Annex 2 to this Order.
The The Director General of the Social Action of the Ministry of Employment and Solidarity and the Director General of the local authorities of the Ministry of the Interior shall each have responsibility for the execution of this Order, each of which shall be Published in the Official Journal of the French Republic.
A N N E X E 1
EXPENSES CONVENTIONS UNDER ARTICLE L. 232-13 OF THE CODE OF SOCIAL AND FAMILY ACTION
Preamble
Article L. 232-13 of the Code of Social Action and Families, in its legal drafting On 20 July 2001, a convention is concluded between the Department and the social security bodies for " Organise the arrangements for their cooperation in the implementation of the self-government allowance in the home "
Maintenance by the Act of 20 July 2001 referred to in Article L. 113-2 of the same Code, in its wording drawn up by the Act of 24 January 1997 establishing the specific dependency provision, implies that this specification includes both More general perspectives, in particular the coordination of benefits to elderly persons in loss of autonomy, which have been the subject of the coordination agreements laid down in Article L. 113-2, while organising and developing the partnership In the implementation of the Personalised Autonomy Allowance (APA), in accordance with the objective set out in Article L. 232-13.
It is thus necessary to depart from the advance represented by all the agreements negotiated and signed Since 1997 between the general councils and the social security bodies; it is, of course, appropriate to change these conventions, if necessary by way of amendment, in order to put their cooperation arrangements into the legislative framework New. These agreements have, for half of them, established a close partnership between the departments and the social security agencies (CRAM, CRAV, CGSS, MSA and other bodies), where appropriate, by establishing Joint procedures for training and evaluating the need for support from applicants by mixed medical-social teams.
This is certainly a model of effective partnership, allowing for a true mutualisation of skills and The conventions referred to in Article L. 232-13 new of the Code of Social Action and Families.
In this logic, this specification includes requirements and recommendations drawn up in Consultation with the representatives of the chairs of the General Councils and the social security agencies on the following points:
1. The articulation of areas of expertise and benefits for continuity of care;
2. Cooperation and the pooling of know-how in the instruction and monitoring of the individualised allocation of home autonomy.
It should be stressed that, in addition to this dual purpose, the conventions must meet the objective more Which consists in placing the new system in an overall policy for the elderly in loss of autonomy made consistent by the various institutional actors.
This consistency of the care taken and the Intervention modes are primarily based on the definition and implementation of a gerontological scheme. To this end, the Act of 20 July 2001 refers to Article L. 232-13 that the departments ensure the coordination of gerontological action within the framework of a scheme agreed jointly by the President of the General Council and the representative of the State In the department. The scheme defines the territories for the coordination of the local gerontological action and establishes arrangements for informing the public and coordinating providers, based in particular on the local information and coordination centres (CLIC).
The development or revision of this scheme may be an opportunity to organise a joint reflection with the social security bodies and consolidate a needs analysis that allows for the definition of local policies In
second place, it is important to build on the progress made in the agreements signed since 1997 between the General Councils and the Social Security Funds, one of the objectives of which was to promote the Coordination of all benefits that may be provided to older persons, whether they are valid or in loss of independence. This coordination of funders and policies will find a natural extension in the proximity actions implemented by the LINC as they develop.
In this perspective, it can be considered by the Partners in gerontological action, in order to pool their skills and resources, to articulate the departmental bodies of gerontological coordination set up in the framework of the 1997 conventions with the steering committees Departmental CLIC. The partners in the Convention could, where appropriate, consider the approximation of these two bodies, or even organise the departmental steering committee of the CLIC from the departmental coordinating body, or In
last place, bearing in mind that the object of the convention concerns the implementation of the self-government allocation and on the modalities of partnership between social security funds and departments, it is appropriate To insist on the need for it to be concluded in close time. The priority objective is, in fact, to allow the allocation of the new allowance to users as quickly as possible and to organise the transitional phase of the transition from existing benefits and aid to the new system in the Better conditions effective January 1, 2002.
1. Articulation of
skills and benefits fields for continuity of
1.1.A support. -Establishment of a transitional arrangement
The introduction of the self-government allowance presupposes, upstream, for those already covered by the household help of social security agencies, the Definition by the partners of a transitional arrangement organising, on the basis of a precise timetable, the arrangements for the transfer of the beneficiaries of home-based assistance classified in IRM 1 to 4 to the new allocation. This transitional arrangement will be phased in throughout the first half of 2002, or even in 2002; it can only be progressive.
In addition, the review and appraisal by the departments of the rights to the self-governing allocation of the Beneficiary of home-based household help presupposing a request from the person concerned, it is essential that social security agencies inform their beneficiaries under IRM 1 to 4 of the new In
, it is for the signatories of the Convention to give themselves the means, based on a thorough knowledge of the public concerned and within their respective fields of competence, to carry out effectively the The transition from the beneficiaries of home-based homemaker to social security agencies (AMD) to the self-government allowance (APA), with the ultimate objective of avoiding any interruption of care for the persons concerned.
Thus, It is desirable that the transitory device include:
-the transmission, with the permission of the beneficiaries, of the elements relevant to the investigation of the files;
-the principle of mutual recognition of evaluations;
-the exchange Information between the caisses and departments;
-how to determine the differential allocation;
-the timing of this progressive transfer: it is a matter of avoiding more than necessary delays in setting up The APA, while allowing departments to manage the transition in a realistic and concerted manner.
1.1.B. -
Support and Financial Compensation Continuity
Conventions must To organise the continuity of the care of the person concerned during the instruction of his application for AHS; it is essential to avoid any interruption of care for the beneficiaries of home-based assistance waiting for a decision of the Chairman of the General Council on their APA request. Thus, it is important that the filing of an APA request does not result in a de facto interruption of care for home-based housekeeping assistance.
The decision to award the APA, which comes at the end of the two months Have retroactive effect, the rights of the beneficiary being open on the date of the filing of the full application file (date of registration [mail stamp] of the complete file by the Department services). The result will be a period covered by the APA and already covered by home-based household help provided by social security agencies.
The corollary of the principle of continuity of care is that of compensation Financial. It is the responsibility of the partners to provide in the Convention the terms of recovery/refund/financial compensation. This is why, because it presents guarantees of simplicity and speed of implementation, the compensation scheme attached to this specification. It has the advantage of saving the user from cumbersome, complex and traumatic procedures for repaying too much money.
In addition, it is appropriate to note, for the period of care for home-based housekeeping assistance Covered by the APA, that the effectiveness check is deemed to be satisfied as a service provider is used.
1.2. Information and guidance for new applicants: application of the principle of mutual recognition of assessments
It is necessary for the Convention to provide for the establishment of a mechanism for mutual reporting between Departments and caisses in order to be able to direct applicants to the appropriate devices.
From the first questions of users, service providers such as local information and coordination centres, in the framework Their mission of welcoming and informing the elderly and their families, will be designed to inform the people, in connection with the signatory partners.
In addition, if during the course of the instruction of an application by such service Instructor, department or body, the assessment of its degree of loss of autonomy leads to a reorientation of the applicant to the arrangement managed by the partner party to the agreement, it is appropriate to provide for the arrangements for transferring the file and Useful supporting documents, in keeping with the medical confidentiality and confidentiality of individual data, in order to prevent the user from having to repeat the whole procedure. This transfer could be facilitated by the use of a single aid application package. The principle of mutual recognition of the evaluations carried out must be the basic principle of cooperation between the caisses and departments.
In addition, the Convention should provide that departments and caisses Shall keep each other informed of both the benefits granted and the profile of the beneficiaries and the details of the exchange of information: for example, it could be sent, on a monthly basis, by the General Councils, the Lists of APA applicants to the social security agencies of their jurisdiction, with feedback and reporting from AMD recipients.
Finally, pursuant to Article L. 232-16 of the Code of Social Action and the Families with respect to the verification of the declarations of APA applicants, it is important that the signatories to the Convention identify the list of data necessary for the instructors to assess the situation of the applicant with regard to the APA award criteria. The social security agencies, among other bodies covered by this article, will have to be able to communicate this data to the departments of the department.
1.3. Articulation of aid and benefits
the jurisdiction of the signatories to the Convention
It is a question of specifying the effects of the new mechanism on the policy of each of the partners to the Convention, their The respective fields of competence and the arrangements for the possible accumulation of certain aid or benefits, such as the possibility for social security bodies to supplement the care covered by the personalised self-government allowance, In relation to decisions that may be taken by the boards of directors of social security agencies in this matter.
The participation of representatives of social security agencies in the commission of the APA mentioned in Article L. 232-12 of the Code of Social Action and Families, a framework for a peer review and sharing of individual cases, will contribute to this objective.
2. Cooperation and sharing of
expertise in the training and monitoring of home-based ABS
2.A. -Definition of the terms of cooperation
in the implementation of the APA at home
Given the prospects for rapidly increasing the number of APA applicants, including potentially the public Concerned (persons under IRM 1 to 4) and information carried out, both at the national and local level, on the new system, it is to be expected that there will be a substantial workload for the departments in terms of the appraisal of applications, But also the implementation and monitoring of home care plans.
Thus, it seems essential that the Convention form the basis for genuine cooperation between the departments and the social action services of the caisses and their Social service, whose experience in assessing the needs of persons and actions to support the quality of interventions by service providers legitimise intervention, with the aim of achieving first payments of APA as soon as possible On 10 February 2002 and, in any event, as soon as possible from 1 January 2002.
In this context, it is appropriate for the conventions to provide, depending on the level of cooperation between the department and the funds held in the The training of the APA, the practical arrangements for the intervention of social welfare staff of the caisses and their social service, both with regard to the procedure for the instruction of the APA at home and the monitoring and measurement of The appropriateness of the benefit to the need for assistance.
It is also appropriate that the financial arrangements for the participation of social security agencies in the implementation of the APA be specified
Cooperation arrangements for signatories to:
1. Locations for withdrawal and filing of application files;
2. Procedures and deadlines for routing files to the instructor service (s);
3. The details of the parties to the Convention on the filing of an application;
4. Administrative instruction of applications (declaration of completeness of file, joint administrative secretariat);
5. Social and medico-social education: participation of social security agencies in medical and social teams (territorial competence, operation, means available, financial conditions), emergency management, etc.
6. How to organise the monitoring of the aid plan: adequacy of the needs and quality of the service rendered, control of effectiveness;
7. The arrangements for the exchange of information with social security and family allowance recovery agencies (URSSAF) as part of the effectiveness check.
2.B. -The role of the
commission The Personalized Benefit for Autonomy
The partnership between the signatories will also be expressed through the Committee on ABS, where, in addition to the department, social security agencies are represented. It will be appropriate for the partners to agree on the operating procedures of this committee (composition and representation of the funds, territorialisation, internal regulation, timetable).
The law stipulates in Article L. 232-12 of the Code of Social action and families that the committee has a proposal mission to inform the decisions of the President of the General Council. It could also be a forum for information exchange, harmonization of assessments, special examination of sensitive files, and concerted reorientation of some files.
Conventions Resolution
Partners will be required to provide for the effective date of the agreement, as well as the possibility of future evolution.
FISCAL COMPENSATION SCHEMES PROPOSAL FOR A CONTINUITY OF DEPENDENT BY-CATCH SELF-ALTY ALLOWANCE INSTRUCTION PERIOD
1. Description of the financial compensation scheme
The General Council shall pay a sum corresponding to a part of the Personalized Benefit (APA) to the credit union in respect of the reimbursement of the sums of the housekeeping aid to the Home (AMD) paid for the period covered by the APA and pays the corresponding part of the APA balance to the recipient.
Schema
You can view the table In OJ
No 32, 07/02/2002 page 2490 to 2493
2. A method for calculating
APA repayments to the lane and the
2.1 recipient. An example
Ms. Z classified in IRM 4 collects home help for her retirement fund.
She has an agreement for 40 hours per month.
Her monthly income is 914.69 EUR.
She Therefore pays a contribution of EUR 4.19 for the first 30 hours realised and EUR 2.10 for the following 10 hours.
It files a complete APA request file on 26 January, and the notification of the decision is sent to it by the President of the General Council on March 20 with a first APA payment scheduled for April 10 (i.e., a period of 54 days).
Throughout the APA instruction period-from January 26 to March 20-the fund always pays the AMD to avoid the
However, the right to the APA takes effect on the filing date of the application: the General Council (in accordance with the scheme of the previous page) must, therefore, remit to the credit union the amounts paid during the
On the other hand, the General Council may pay the APA only on the basis of costs actually incurred as it is an in-kind benefit.
The fact that the fund paid for the provision of housekeeping assistance to a Service provider is equivalent to actual expenditure incurred and makes it possible to consider that the principle of the effectiveness of the aid is verified.
In the absence of other identified expenditure corresponding to its APA assistance plan, the beneficiary Will receive an amount equivalent to the repayment of the differential of its financial participation, the APA schedule (no participation up to EUR 914.69 /month) being more favourable than the scale of participation of the funds (participation varying from 1.52 EUR at EUR 4.19 from the Social Assistance ceiling-570.62 EUR-to EUR 914.69).
2.2. Method of calculation
For the calculation of the cash payment (X) and the payment of the balance to the beneficiary (Y), the following calculation method is proposed:
2.2.1. Principles
The amount of housekeeping assistance paid is known only at the end of the month following the realization of AMD hours. It will therefore not be known at the time of the first APA payment, which comes within 10 of the month following the notification. It is therefore proposed that reimbursements be made on the basis of a previously fixed monthly expenditure, which avoids waiting to know precisely the number of hours worked per month.
This fixed amount thus determined May be the one that will be communicated to the General Councils for the calculation of the differential APA. This corresponds, in the light of the texts, to the amount of expenditure for the month of the APA request. However, in order to facilitate the management of these folders, it is proposed that it actually matches:
-the expenses of the last known month (with an atypical month risk),
, or, which seems preferable:
-to a calculated monthly expense On the basis of the average consumption of the last six months.
The amount obtained is then prorated based on the number of days covered by both the APA and the AMD.
This method allows the general advice to be communicated early Amounts to be paid back. It remains flexible enough, since prorating in days allows for adjustments to the time limits for the instruction of the general counsel, but also to the time required between the notification and the date on which the body becomes aware of it.
2.2.2. Examples of calculation: application of the principles
Reimbursement at the lane:
The formula would be:
X = 30 x Fixed Monthly Cash Expense
Z
X =
x Monthly Cash Expense
30
where Z is the number of days covered by both the APA and the AMD.
For an average consumption of 36 hours per month and one 54 day support continuity, the refund will be calculated as follows:
X = 30 x 301.80 EUR = 543.25 EUR
54
X =
x 301.80 EUR = 543.25 EUR
30
where 301.80 EUR = [12.23 EUR (tx participp. Cnav) - 3.85 EUR (tx participp. User/h for 36 (h)] x 36 H.
Payment of balance to payee:
This payment will be calculated using the following formula:
X = 30 x Fixed monthly expenditure of payee
Z
X =
x Payee's Fixed Monthly Spend
30
For the same average AMD consumption of 36 hours per month, the General Council will have to pay back to the recipient the following amount :
Y = 30 x 138.35 EUR = 249.03 EUR
54
Y =
x 138.35 EUR = 249.03 EUR
30
where EUR 138.35 = amount of User involvement, i.e. 30 h x 4.19 EUR + 6 h x 2.10 EUR.
A N N E X E 2
The General Council will have a single point of contact for the collection branch in the department. It is the collecting body for social security contributions and family allowances of the headquarters of the General Council which will be retained.
By way of derogation from the rule of territoriality of the employee's activity, the collection body to which The home assistance shall be declared to be the one for which the home of the holder of the Personalized Benefit is to be located.
FLOW OF INFORMATION FROM THE GENERAL COUNCIL
A DESTINATION OF THE ORGANISATION OF RECOVERY
In order to allow collection agencies to identify the holders of the self-help allowance using home support or hosted in a foster family, the General Council will have to Address the following information to the centralized collection agency:
After granting the Personalized Independence Allowance and hiring home support or accommodation in the host family:
- Existence of the right;
-date of effect;
-type of help:
-employment of home support, specifying, where applicable, the use of an agent association (are excluded from employers' associations and registered businesses);
- Hosting family home;
-declarative mechanism used:
-quarterly nominal declaration;
-job-service cheque;
-employer identification:
-name;
-marital name;
-first name;
- Address;
-match address;
-date and place of birth;
-registration number for the National Personal Identification Directory;
-employee or host family identification:
-name ;
-marital name;
-first name;
-address;
-registration number for the National Personal Identification Directory or by default date and place of birth;
-date of hiring.
When changing Above for the self-help or loss entitlement holder:
-employer identification:
-name;
-marital name;
-first name;
-address;
-address of Correspondence;
-date and place of birth;
-National physical person identification number;
-reason for termination or modification (including change of residence for more than three months) ;
-effective date
The documents are transmitted systematically to the collection agency.
FLOW OF INFORMATION FROM THE RECOVERY ORGANIZATION
TO THE GENERAL COUNCIL
A of the The following information will be passed to it by the collection agency.
Nature of information:
-employer identification:
-name;
-name Marital;
-first name;
-address;
-address of correspondence;
-date and place of birth;
-registration number for the National Personal Identification Directory;
-quarterly overall salary cost :
-wages declared;
-number of hours worked;
-dues owing (accuracy of base plan or actual salary);
-reference period in year, real quarters (quarterly nominal returns) or presumed (employment-service cheque);
-additional elements in case of particularities or anomalies.
This information shall be communicated by the collection body to the General Council at the latest on the last day of the second month of the quarter In
case of particularity (non-payment of contributions), a specific transmission may be envisaged mentioning, where appropriate, the application of ex officio taxation.
Done at Paris, January 10, 2002.
The Minister of Employment and Solidarity,
For the Minister and delegation:
The Director General of Social Action,
S Léger
The Minister of the Interior,
For the Minister and by delegation:
The Director General of Local Communities,
D. Bur
