Decree: early medical-social action centres (CAMSP) and psycho-educational centres (CMPP)

📜🔗LINK to the source

1. ANALYTICAL SUMMARY

A restructured regulatory framework after eighty years

The decree repeals the decrees of 1946, 1956 and 1976 that still governed the CAMSP and CMPP, and inserts two new specifications (annexes 5-1 and 5-2) into the code of social action and families. It concerns children aged 0 to 6 years at risk or in difficulty of development for the CAMSP, and children, adolescents and young adults aged 0 to 20 years presenting mental, behavioural, learning or neurodevelopmental disorders for the CMPP (p. 3-4, p. 7). The two structures remain directly accessible, without referral from the CDAPH or the MDPH (p. 4, p. 7). The text explicitly includes these centres in the early detection, diagnosis and intervention service provided for in article L. 2134-1 of the public health code (p. 5, p. 8).

Stronger obligations that are enforceable against practices

Beyond modernisation, the decree raises the level of requirement. It imposes the exercise of missions "in accordance with the recommendations of good professional practices" from the HAS, now enforceable and therefore mobilisable by the ARS during inspections (p. 3, p. 6). It sets out eight almost identical missions for the two types of centres, from detection to coordination of the pathway, with an obligation to ensure support during the three years following discharge (p. 4, p. 8). It formalises informed consent, the co-construction of the support project with the child and their family, prioritising maintenance in ordinary environments, mandatory evaluation every five years by an accredited body, and the interface with the information system of the autonomy branch and the digital health space (p. 5-6, p. 9-10).

2. KEY POINTS OF THE DOCUMENT

1. Repeal of a historical framework. The decree abolishes the decrees of 1946, 1956 and 1976 and annexes 32 and 32 bis, replaced by two specifications integrated into the CASF in the form of annexes 5-1 (CAMSP) and 5-2 (CMPP), via the new articles D. 312-123 and D. 312-124 (p. 2-3). It is a structural overhaul, not just a simple tidying up.
2. Enforceability of HAS recommendations. The two specifications state that the centres carry out their missions "in accordance with the recommendations of good professional practices" from HAS (p. 3, p. 6). This wording makes these recommendations enforceable and serves as a lever for control and evaluation for pricing and control authorities.
3. Direct access maintained, without MDPH. Support in CAMSP as in CMPP remains directly accessible to the individuals concerned, without the need for a referral from the CDAPH within the MDPH (p. 4, p. 7). A structuring point for early access and the fluidity of the pathway.
4. Eight missions and obligation of relay over three years. Each centre is assigned eight parallel missions: prevention, screening/diagnosis, family guidance, co-constructed and re-evaluated support project, multidisciplinary outpatient care and interventions, support in all living environments, pathway coordination, awareness/training of partners (p. 4, p. 7-8). The coordination mission requires ensuring that the relays are effective during the three years following discharge (p. 4, p. 8).
5. Quality, team and information system framed. Mandatory evaluation every five years by an accredited body based on the national HAS framework, continuous improvement plan in the annual activity report (p. 6, p. 9-10). Multidisciplinary team under the responsibility of a physician responsible for care; the CMPP can operate under dual administrative and medical direction and includes specialised teachers with a support component for schooling (p. 5, p. 8-9). Mandatory interface with the information system of the autonomy branch and the digital health space (p. 6, p. 10).

3. ACTION TRACKS FOR LOCAL ACTORS

1. Revise the establishment project and the operational regulations in light of the new specifications, ensuring that the eight missions and the articulation with the early detection service are explicitly included (p. 4-6, p. 7-9).
2. Map and formalise territorial cooperations through agreements specifying the roles of each with early childhood, ASE, national education, other ESMS, health professionals, and the MDPH, as required by part III of the two annexes (p. 5, p. 8).
3. Equip the exit and the relays. Establish a post-exit follow-up procedure ensuring, for three years, that the appropriate relays are effective for the child, the family, and the partners (p. 4, p. 8). This is a new obligation to be tracked.
4. Audit practices in light of HAS recommendations now enforceable, prioritising the discrepancies likely to be noted during the five-year evaluation conducted by an accredited body (p. 3, p. 6, p. 9-10).
5. Secure the collection of informed consent and co-construction of the support project with the child and their family, by formalising the times and means of collection prior to interventions (p. 4, p. 7-8).
6. Anticipate digital interoperability by verifying that the IT solutions allow the interface with the information system of the autonomy branch and the digital health space (p. 6, p. 10). Need not covered by the decree: the human and budgetary resources associated with these new requirements are not specified in the text, which will require local arbitration on resources and training.

4. ADDITIONAL REFERENCES (verified URLs, published after 2024)

1. Instruction No. DGCS/DGOS/DITND/2026/51 of 13 May 2026 regarding the implementation of pathways L. 2134-1, L. 2135-1, L. 2136-1 within the framework of the early detection, diagnosis and intervention service (SRP). Direct complement: specifies the operational role of CAMSP/CMPP in the deployment of the service, with models of agreements and timetable (first interventions no later than 1 January 2027).
   🔗 https://bulletins-officiels.social.gouv.fr/instruction-ndeg-dgcsdgosditnd202651-du-13-mai-2026-relative-la-mise-en-oeuvre-des-parcours-prevus-aux-articles-l-2134-1-l-2135-1-l-2136-1-du-code-de-la-sante-publique-inscrits-dans-le-cadre-du-service-de-reperage-de-diagnostic-et-dintervention
2. Order of 19 December 2025 setting the common principles for SRP pathways and the specifications for the designated structures (Légifrance). Methodological complement: details the standard pathway, detection, labelling and coordination with the MDPH in which CAMSP/CMPP are included.
   🔗 https://www.legifrance.gouv.fr/jorf/id/JORFTEXT000053143303
3. DREES, Studies and Results No. 1333 (March 2025) — The early medico-social action centres and the medico-psycho-pedagogical centres (ES-Handicap data 2022). Statistical complement: provides a numerical portrait of the public, staff and exits, useful for situating the decree in the reality of the offer.
   🔗 https://drees.solidarites-sante.gouv.fr/sites/default/files/2025-03/ER1333_MEL.pdf

5. FREQUENTLY ASKED QUESTIONS (FAQ)

1. Which audiences does each structure now welcome?
   The CAMSP welcomes children aged 0 to 6 years at risk or in difficulty of development; the CMPP welcomes children, adolescents, and young adults aged 0 to 20 years presenting psychological, behavioural, learning, or neurodevelopmental disorders (p. 3-4, p. 7).
2. Is a MDPH referral always required to receive support?
   No. Access remains direct, without a referral from the CDAPH or the MDPH, for both types of centres (p. 4, p. 7).
3. What does the enforceability of HAS recommendations concretely mean?
   Centres must carry out their missions in accordance with these recommendations, which become a mandatory reference during inspections and evaluations conducted by pricing and control authorities (p. 3, p. 6).
4. How many missions does the decree establish and which are new?
   Eight missions per centre, from detection to raising awareness among partners. The obligation to ensure support for three years following discharge is a particular point of attention (p. 4, p. 8).
5. How often is quality evaluation mandatory?
   Every five years, by an accredited evaluation body, based on the national quality evaluation reference of the HAS; regular self-evaluations are also recommended (p. 6, p. 9-10).
6. Who makes up the team and who leads it?
   A multidisciplinary team under the responsibility of a physician responsible for care. The director of the CAMSP can be a physician; the CMPP can operate under dual administrative and medical management and includes specialised teachers (p. 5, p. 8-9).
7. What digital obligations does the decree impose?
   The centres transmit their activity data and implement solutions ensuring the interface with the information system of the autonomy branch and the digital health space (p. 6, p. 10).

6. REWRITING IN EASY TO READ LANGUAGE

What the decree says

A new piece of legislation changes the rules for CAMSP and CMPP.

This text is called the decree of 26 June 2026.

It replaces very old rules.

CAMSP helps children from 0 to 6 years old.

CMPP helps children and young people from 0 to 20 years old.

These children have difficulties growing up, learning, or behaving.

Important points

• You can go to CAMSP or CMPP without going through the MDPH.
• The team works with you and your child.
• Your consent is requested before starting.
• The team follows a guide of good practices. This guide is called the recommendations of the HAS. Now, the team must really follow it.
• After the end of the support, the team checks for 3 years that your child has other support.
• Every 5 years, an external team checks the quality of the centre.

Who works in the centre

• Child doctors.
• Caregivers such as speech therapists or psychomotor therapists.
• Psychologists and social workers.
• At CMPP, there are also specialised teachers.
• A doctor is responsible for the care.

7. CROSS-ANALYSIS — VALUES OF HEALTH PRACTICES

Literacy : the decree imposes interoperability with the digital health space but does not provide specific tools for accessibility of information to families; accessibility relies on the HAS recommendations referred to, which are not detailed in the text.

Empowerment : informed consent and the co-construction of the support project explicitly involve the child and the family, with support for parental skills (p. 4, p. 7-8).

Participation : the support project is co-constructed and periodically re-evaluated with the child, the family, the surroundings, and the intervening professionals (p. 4, p. 8).

Community health : the collective dimension mainly appears through territorial registration and cooperation, but the text remains focused on the individual journey of the child.

Ethics : the family's agreement and respect for professional practice rules are established; cultural or social biases are not explicitly addressed in the regulatory text.

Human rights : direct access without MDPH, priority to the ordinary environment, and registration in a service open to all disorders serve equity of access (p. 4, p. 7).

Intersectorality : cooperation is recommended with early childhood, ASE, national education, independent professionals, other ESMS, and health (p. 5, p. 8).

Partnership : cooperation is formalised by agreements specifying the roles and articulations of each actor (p. 5, p. 8).

Fight against discrimination : the decree establishes support "whatever the disorders, alterations or disabilities" (p. 3, p. 7), but does not develop specific provisions on non-judgment or diversity.

8. EVALUATION OF THE RELIABILITY OF THE RESOURCE

Type of document: normative regulatory text (decree + two attached specifications), published in the Official Journal. Primary source of authority, with legal value — and not an analysis, evaluation or feedback document.

Scientific relevance: the text refers to international classifications and HAS recommendations but cites neither data nor studies; it does not demonstrate effectiveness, it prescribes a framework. Its scope is legal, not evidential.

Operational relevance: high. It sets obligations that can be directly mobilised for establishment projects, agreements, evaluations and controls.

Limits and points of caution to note:

• The decree does not specify the human and budgetary resources associated with raising the requirements (transition over 3 years, enforceability of HAS, interoperability). The gap between new obligations and resources is a blind spot in the text, regularly pointed out by sector organisations.
• The enforceability of HAS recommendations touches on a sensitive point, particularly for CMPPs that have historically been pluralistic in theory. The decree does not discuss this tension: it establishes it through the norm. This is a counter-argument that the text does not address.
• Several concrete modalities (diplomas, delegations, data transmission) are referred to other articles or regulations, which makes the reading incomplete without the associated texts.

10. STRATEGIC HASHTAGS

#EarlyIntervention #CAMSP #CMPP #TND #HealthSocialCare #EarlyYears #HASRecommendations #healthpractices