Departmental disparities in the implementation of APA at home, a reflection of local policy choices?

Summary The Personalized Autonomy Allowance (APA), which came into effect in 2002, is a public assistance program for dependent elderly people (Articles 232 and following of the Social and Family Action Code). For people who live at home, this allowance finances part of the professional assistance devoted to the activities of daily living. Within the framework of the decentralization of social policies, the general councils are responsible for the implementation of the APA on their territory and ensure a large part of the financing of the allowance. The national legal framework defines a priori the modalities for calculating the APA: for each hour of assistance, the APA beneficiary assumes a financial participation that depends on his/her resources. But this legal framework leaves a grey area as to how to estimate the cost of the hour of assistance on which the beneficiary's contribution is calculated. How then do the general councils organize the calculation of the amount of the APA for the beneficiaries in their territory? Is the choice of a calculation method only technical or is it a public policy choice with consequences for the general council's expenditure, for the care of beneficiaries and for the regulation of assistance services? This study proposes to analyze the practices of the general councils in the implementation of the APA in their territory. It is based on the results of the Territory survey conducted in 2012, which describes, at the departmental level, the policies for the care of dependent elderly people living at home. The MODAPA team would like to thank the Territoire collective for making it possible to use the results for this note. Publisher.