The pricing of home help services: a tool for departmental policies?

Summary Local situations in terms of dependency care differ from one territory to another, for example in terms of the organization of the offer or the level of public expenditure. This variety may reflect both the diversity of the territory's characteristics and the diversity of departmental policies. Indeed, social action for the elderly is largely decentralized to the general councils. The Code de l'action sociale et des familles (CASF) entrusts them in particular with the regulation of home help and support services (SAAD): it is the general council that issues the administrative authorization to operate and sets the rates charged by "authorized" SAADs (which are distinguished from "approved" services). How do the general councils exercise this role of regulating the home help sector? Are authorization and pricing practices an opportunity to define specific departmental policies for the care of dependency at home? This study aims to describe the practices of authorisation and pricing of ADAS by the general councils. It is based on the results of the Territoire survey, carried out in 2012 by a multidisciplinary team to which some of the MODAPA members belong. This survey analyzes the policies for the care of dependent elderly people at the departmental level.