France

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Health systems in transition
France
5.8.2 Long-term care for disabled
About 3.2 million people are registered as disabled in France, of whom
1.8 million are affected by a severe disability that limits their functional
autonomy. Disability is measured in terms of an incapacity level, which takes
into account the degree of difficulty with daily living. Specific committees for
children and for adults at the department level evaluate the degree of incapacity
and determine the right to certain benefits. They also have the authority to refer
the disabled person to a specialized institution.
Adults
Around 200 000 disabled adults are accommodated in 4800 dedicated facilities.
Various institutions provide services for disabled adults with different levels
of functional autonomy, 90% of which are private non-profit-making and 10%
public. Broadly, speaking, residential centres are linked to sheltered workshops
and support people with disabilities who are capable of working during the
day. Occupational centres take care of disabled adults who are not capable of
working, with various service levels depending on the severity of the disability
and the need for care. There are four sources of funding for dedicated facilities
for disabled adults (see section 3.3.4); the health care part is paid by the CNSA
on SHI funds while the costs of residential care are charged to the patient and/
or to the general councils of the department. Institutions for the most heavily
dependent people are financed entirely by the CNSA. Additionally, the state
finances sheltered workshops (Table 5.1).