Audit highlights care system flaws

The regional audit chamber of La Réunion has identified vulnerabilities in the management of assistance for elderly individuals, which is the department's largest expenditure category. Its report dated November 2, 2026, highlights a mismatch between the scale of financial aid, the lack of accommodation capacity, and the inadequacies in administrative oversight.

Large budget for elderly care

The department allocated 220 million euros to autonomy in 2024, its largest budget item. Approximately 80% of these expenses concern individual assistance, mainly to enable elderly individuals to remain in their homes. This choice supports a strong demand for home care, but the financial jurisdiction believes it should be part of a more coherent strategy for managing dependency.

Limited care facilities

The department has only 20 establishments for dependent elderly individuals (Ehpad), representing 1,588 open places, according to the CRC audit. For comparison, data from the Direction of Research, Studies, Evaluation and Statistics (Drees) cited in an AFP dispatch from November 2, 2026, indicates that in 2023, there were 31.3 Ehpad places per 1,000 inhabitants aged 75 or older on the island, compared to 90.5 in Metropolitan France.

Risks of unregulated care

This insufficient medicalized accommodation leaves room for home assistance and other forms of care. It also makes it more difficult to support individuals whose loss of autonomy requires enhanced care. The CRC mentions the risks associated with unapproved care structures, sometimes referred to locally as "black pensions."

Outdated regulations and uneven treatment

Beyond accommodation capacity, financial judges criticize a departmental social aid regulation dating back to 2001, differences in treatment according to territories, and controls deemed insufficient. They request, in particular, clarification of the rules applicable to the personal autonomy allowance (APA) and better guidance for assessing needs.

Discrepancies in aid limits

The report also questions an internal note from January 2025 regarding the amounts of aid plans. According to the elements reported by AFP, the CRC considers that the indicative limits set in this document are on average 38.5% lower than the national ceilings. The president of the departmental council, Cyrille Melchior, disputes the existence of a local limitation of rights: he presents this note as a technical tool not subject to opposition and points out that a majority of aid plans exceeded these indicative amounts by the end of 2025.

Recommendations and improvements

The CRC formulates eight recommendations, including updating the regulatory framework, harmonizing aid, strengthening controls, and diversifying accommodation. The department, on the other hand, highlights a reduction in the processing time for APA, from 94 days in 2024 to 38 days by the end of 2025, according to the figures it provided in response to the audit.

Future demographic pressures

The demographic pressure should intensify. According to its population projections published in 2017, INSEE anticipated, under its reference scenario, 289,000 Reunionnais aged 60 or older in 2050. This is an old projection and not a current count. For the regional audit chamber, the immediate challenge is to make the rules for accessing aid more readable and better integrate home care with the accommodation capacity suitable for severe dependency situations.