Review of the conference on "old age policies

On 26 January at the Espace Reuilly (Paris 12e), a conference on the difficulties of the old age policy sector was organised by the "Fédération Nationale des Associations de Directeurs d'Établissements et Services pour Personnes Agées". On the agenda of this meeting were the numerous societal, medico-social and economic challenges as well as the prevention of dependency.

The conference was opened by Marie-Anne Montchamp, Secretary of State for Solidarity, and Claudy Jarry, who gave the opening address and is President of Fnadepa. Jarry emphasised the extent of the "collective challenge" that dependency represents for French society and recalled the various measures taken by the public authorities in recent years, These include the 6% increase in the National Health Insurance Expenditure Target (ONDAM) for the elderly in the 2012 Social Security Financing Act, the increase in the minimum old-age pension (+250 euros per month compared to 2007) and the 3.3 billion euros raised through the national solidarity day.

Marie-Anne Monchamp stressed the need for a preventive approach to ageing and listed a number of avenues. These included prevention (balanced diet, physical and social care), the development of living environments and the social participation of older people so that they can play their role as full citizens until the end of their lives.

For his part, the President of Fnadepa, Claudy Jarry, emphasised the convergence of views with Marie-Anne Montchamp regarding the improvement of the services offered, recalling that Fnadepa's vocation was "to improve the quality of life of the elderly and of those who accompany them".

Conference on the 2012 LFSS

According to Marc Bourquin (director of the ARS Medical and Health Unit), EHPADs must be adapted to Alzheimer's disease and be a player in home care, particularly by providing services (meal delivery, etc.) but also thanks to new technologies that make it possible to improve the security offered to residents. The challenge is to improve the quality and efficiency of support for the elderly, not through a purely accounting approach, but with a global approach, avoiding unnecessary prolonged hospitalisations.

Indicators to measure quality

Sabine Fourcade, Director General of the DGCS (General Directorate for Social Cohesion), expressed the wish to define indicators for the implementation of a quality approach and to evaluate progress in EHPADs.

Dominique Gabeloux, President of Fnadepa Lozère, insisted on the urgency of freezing tariff convergence, the resumption and respect of tripartite agreements and the adjustment of the PATHOS tool.

New PATHOS governance

Yannick Eon set out to define the role of PATHOS, recalling that it was an "evaluation of the medico-technical care required (i.e. useful, feasible and acceptable) on the basis of clinical situations observed, for a given patient at a given time".

Harmonisation of standards for EHPAs in question

According to Françoise Toursière, Director of Fnadepa, the watchwords of the specifications for EHPAs (currently being validated) remain "quality and the desire to delay the loss of autonomy". There is one new feature: "the recommendation for the built environment, which provides for architectural changes to delay the loss of autonomy".

Towards a new pricing system for personal services?

Henri Naudet, Director General of the Fondation Maison des Champs, spoke of the difficulties and paradoxes of the home help sector: insufficient funding, a pile of schemes and pricing, the need to train employees in a financial context of economy, support for people who are in a fragile state with people who are in integration or in precarious situations...

Some progress has been made in the last two years as a result of the mobilisation of the sector's players, but it remains insufficient for Hugues Vidor, General Manager of ADESSA Domicile:

• Development of a restructuring fund of 50 million euros, over two years, whereas the actors had asked for the immediate creation of an emergency fund of 100 million euros
• Reactivation of the exemptions for personal services instituted by Jean-Louis Borloo
• Reform of the pricing system

All the stakeholders will meet at the next FNADEPA congress in La Grande-Motte on 12 and 13 June.