Implementation gaps or local public policies: the example of assistance to dependent elderly people at home.

Summary The departmental councils, which have been recognized as the leaders of social action since the law of August 13, 2004, are responsible for policies for the care of dependent elderly people in their territory. Their action is, however, constrained by the legal framework, particularly for the personalized autonomy allowance at home and the regulation of assistance services. At a time when both territorial reform and reform of the dependency care system are being considered, it is useful to take stock of this complex organization: what is the real room for maneuver that departmental councils have today in terms of dependency policy? After a brief presentation of the legal framework for solving the demand and regulating the supply of aid, we will focus on the practices of the departmental councils, which reveal the public policy instruments actually available to them and the priorities they pursue.