Guidelines of the Support Fund for the Transformation of Establishments and Services for People with Disabilities for the Year 2026

1️⃣ ANALYTICAL SUMMARY

From funding places to funding coordinated pathways

The instruction places the year 2026 in the trajectory opened by the National Conference on Disability 2023: moving from a logic of places to a coordinated service offer, adjusted to the needs, wishes and aspirations of individuals (p. 3). The recipients are the ARS, which pilot the territorial strategy in connection with the departmental councils, the MDPH and the National Education. The 2025 report shows a general progression in the formalisation of regional strategies and the commitment of the integrated system for children, but there are persistent territorial disparities and still strong needs for support of practices (p. 3-4). The priority groups remain young people under the Creton amendment, complex situations, children with dual vulnerability, individuals with neurodevelopmental disorders/autism and ageing disabled individuals (p. 4).

Two envelopes and a tightening of eligibility criteria

The document mobilises two levers: €7.1 million in engineering (intellectual services, across 3 axes) and €60 million in real estate investment (PAI) (p. 5-6). The engineering must serve the effective organisational transformation of the OG and ESMS for children, the strategic tooling of the ARS and the evolution of the adult offer. The major operational contribution lies in the tightening of the criteria : excluded are diagnostics without implementation, single-establishment actions without pooling, continuing education and, on the property side, only compliance upgrades (annex 2, p. 6-7). Property is redirected towards the integrated system, diversification of uses and ordinary housing (inclusive housing, transitional housing). A forthcoming instruction will operationally detail these axes.

2️⃣ KEY POINTS OF THE DOCUMENT

1️⃣ Contrasting 2025 assessment. Over 2024-2025, engineering has been almost entirely committed (6.4 M€ out of 6.5 M€ available), a sign of strong demand; conversely, property has only been consumed at 67 % (33.2 M€ out of 49.8 M€ of AE), with the ARS having voluntarily limited support to the most mature projects and postponed the rest (p. 3-4).

2️⃣ A property envelope for 2026 up by nearly 40 %. Thanks to unspent 2024-2025 carryovers (16,573,555.70 €) added to the projected 43.5 M€ of AE, the PAI property envelope reaches 60,073,555.70 € (p. 6, annex 1). Detailed regional distribution by ARS in annex 1.

3️⃣ Engineering structured into 3 exclusive axes. The 7.1 M€ (exactly 7,080,743.94 €) fund: Axis 1 — organisational transformation of OG/ESMS for children and generalisation of the integrated system; Axis 2 — strategic tools and mappings for ARS management; Axis 3 — territorial dynamics of the adult, including deinstitutionalisation (p. 5; annex 2, criteria p. 4-8).

4️⃣ What is no longer fundable. Are explicitly excluded: diagnostics/studies without operational outcomes, single-establishment actions without pooling, continuing professional training, observatories without decision-making use, and compliance alone in terms of real estate (annex 2, p. 6-7; body p. 7).

5️⃣ Specific real estate financial framework. Grant rate 60% (works) and 80% (intellectual services); maximum costs of €2,362/m² SDO excl. VAT for rehabilitation and €2,955/m² SDO excl. VAT for new works (Overseas and Corsica exempt from the ceiling); land acquisition and furniture excluded from the eligible expenditure (annex 2, p. 2-3).

A look at the HAS evaluation 

In practice, the shift to an integrated system or coordinated service offer now requires an evaluation that goes beyond the framework of an isolated establishment — hence the new HAS practical sheet on multi-ESSMS evaluation from July 2025. The guiding thread of this evaluation becomes the "accompanied tracer": the evaluator follows the person through the different modalities of their journey (home/establishment, childhood/adult transitions) and objectifies the continuity, fluidity of transitions and absence of breaks — which is exactly the target of the instruction. For this journey-based reading to be favourable, two prerequisites: formalise the typical pathways and their transition points, and above all, rewrite the establishment or service project in the logic of service offer before the visit. The five-year rhythm of the evaluation aligning with that of the establishment project, the risk to avoid is a gap between a project that remains on the old logic of places and practices that are already in transition — a gap that the evaluator would highlight as inconsistency.

3️⃣ ACTION TRACKS FOR LOCAL ACTORS

1️⃣ Check the eligibility of your project axis by axis before any submission. The prioritisation criteria and exclusions are detailed in annex 2 (Axis 1 p. 4-6, Axis 2 p. 6-7, Axis 3 p. 7-8): a single-establishment project or purely diagnostic will be excluded — reformulate it into a collective/mutual approach.

2️⃣ Anchor the project in the regional strategy and a multi-year trajectory. Funding requires explicit inclusion in the territorial trajectory formalised by the ARS and sharing in the dialogue bodies (CDCA, CTS) (p. 5). Consult the ARS in advance to verify this alignment.

3️⃣ Respect the reporting schedule in GALIS. Need for engineering AE to be reported before the 30 September 2026 ; validation of real estate PAI files by the ARS before the 15 November 2026 (application https://galis-subventions.cnsa.fr ; annex 2, p. 1 and 3-4). Beyond that, defer to 2027.

4️⃣ Mobilise real estate to transform, not just renovate. Target projects that enable the integrated system, the diversification of uses and the integration of ordinary housing (inclusive housing, bridge housing) ; rapprochement of the departmental council necessary for support in shared living (p. 7).

5️⃣ Integrate light monitoring through indicators. Plan for a limited number of steering indicators (progress + organisational changes) and a capitalisation of lessons learned at the regional level, designed as action tools and not as additional reporting (p. 5-6).

6️⃣ Articulate with other funding and the 37 advisors. Combine the Support Fund with the 50,000 solutions plan, the FIR and non-renewable credits, and rely on the offer transformation advisors recruited in ARS (37 positions from the AAP 2025 of €7.5 million) as well as on the service offerings of ANAP (p. 6). Identified unmet need: the CNSA guide for steering support is announced but not yet published — anticipate an upcoming operational breakdown.

4️⃣ ADDITIONAL REFERENCES 

1️⃣ ANAP — Guide "Reinventing the medico-social offer" + self-diagnosis + toolkit (8 December 2025). Operating procedure to build a coordinated service offer, with FALC and audio versions and 12 downloadable tools (maps, project sheets, function sheets). The direct operational complement of the instruction.

🔗 https://www.anap.fr/s/article/transformer-offre-services-coordonnes-guide-pratique-boite-outils (verified: active page, 12 documents online)

2️⃣ IGAS — Report No. 2024-017R, "Disability: how to transform the social and medico-social offer to better meet the expectations of individuals?" (March 2025). The independent diagnosis that underpins the reform (barriers, levers, low modularity rate of the adult offer).

🔗 https://igas.gouv.fr/sites/igas/files/2025-03/2024-017R%20rapport%20.pdf (verified: accessible PDF)

3️⃣ Platform for sharing inspiring practices ANAP-CNSA (launched March 2025). Collaborative space for peer capitalisation (MAS/IME outside the walls, ageing disability, participation of individuals in recruitment…), directly useful for the ‘regional capitalisation’ requested by the instruction.

🔗 https://www.cnsa.fr/presse/handicap-lanap-et-la-cnsa-lancent-une-plateforme-de-partage-pour-accelerer-la-transformation (verified: active page)

5️⃣ FREQUENTLY ASKED QUESTIONS (FAQ)

1️⃣ What is the total amount available in 2026 and how is it distributed?

≈ €67 million: €7.1 million for engineering (intellectual services) and €60.07 million for real estate investment (PAI). The distribution by ARS is detailed in annex 1 (pp. 5-6 of the body; annex 1 pp. 1-2).

2️⃣ My project only concerns a single establishment: is it fundable?

No, unless it is part of a logic of mutualisation, cooperation or territorial dissemination. Single-establishment actions without this perspective are explicitly excluded (annex 2, Axis 1 p. 6, Axis 3 p. 8).

3️⃣ Can the simple compliance of a building be funded by the PAI?

No. Compliance upgrades alone are not eligible; the PAI aims for transformation, diversification of uses and the integration of ordinary housing (p. 7).

4️⃣ What are the rates and ceilings for real estate funding?

60% for works, 80% for intellectual services, on the eligible expenditure excluding VAT, within the limit of €2,362/m² SDO for rehabilitation and €2,955/m² SDO for new builds (Overseas and Corsica outside the ceiling) (annex 2, pp. 2-3).

5️⃣ What are the deadlines not to be missed?

Increase in the need for engineering AE: 30 September 2026. Validation of real estate PAI files by the ARS: 15 November 2026. Unvalidated amounts will roll over to 2027 (annex 1; annex 2, p. 1 and 3-4).

6️⃣ How are the concerned individuals involved?

Through the consultation of regional strategies (CDCA, CTS) and, for the adult offer (Axis 3), a direct involvement of individuals in the design and implementation, even at the initiative of the projects (p. 5; annex 2, p. 7-8).

7️⃣ What changes concretely for the adult offer?

Axis 3 supports OG / departmental council cooperations, inclusive and shared housing, home support and processes of deinstitutionalisation reducing reliance on institutional responses in favour of solutions integrated into the community (annex 2, p. 7-8).

6️⃣ REWRITING IN EASY TO READ LANGUAGE

What is this document about?

• The State is providing money to change support for people with disabilities.
• Previously, we created places in institutions.
• Now, we want services that adapt to each person.
• The person chooses and participates in their journey.

How much money in 2026?

• There is about 67 million euros.
• 7 million is used to help think and organise (engineering).
• 60 million is used to build or renovate buildings.
• It is the Regional Health Agencies (ARS) that manage this money.

What the money finances… and no longer finances

• We fund projects made with several structures together.
• We fund supported ordinary housing, such as inclusive housing.
• We no longer fund a project in a single establishment alone.
• We no longer fund a simple compliance upgrade of a building.
• We no longer fund a study that leads to nothing.

What needs to be done

• Check if your project complies with the rules.
• Talk to the ARS before submitting your project.
• Submit your application on the GALIS website.
• Respect the deadlines: 30 September and 15 November 2026.

7️⃣ CROSS-ANALYSIS — VALUES OF HEALTH PRACTICES

• Literacy: low internally (technical text reserved for ARS), but the document aims for better readability of the offer for families and common law actors (p. 4).
• Empowerment: central — self-determination is established as a fundamental right, with the possibility for the person to modify their support mode (p. 3-4).
• Participation: co-construction via the CDCA and CTS, and direct involvement of the concerned individuals in the design of adult projects (p. 5; annex 2 p. 8).
• Community health: strong — territorial logic of coordinated services, coverage without white zones, anchoring in living places (p. 4).
• Ethics: cultural biases are not explicitly addressed; the focus is mainly on territorial equity and the refusal of a standardised offer (p. 3-4).
• Human rights: rights-based approach — deinstitutionalisation, access to common law, participation in social life, inclusion in the community (annex 2, p. 7-8).
• Intersectorality : very marked — departmental councils, MDPH, National Education, health sector, child protection, housing, local authorities (annex 2, p. 5 and 8).
• Partnership : formalised — ARS/lead partner agreements, territorial cooperations, governance and coordination frameworks (annex 2, p. 8).
• Fight against discrimination : no explicit mention of discrimination; the logic of inclusion and access to common law contributes indirectly, as does the reduction of white areas.

8️⃣ EVALUATION OF THE RELIABILITY OF THE RESOURCE

Scientific relevance : this is a official primary source (DGCS/CNSA), not a research output. The financial data is precise, calculated to the nearest euro and broken down by region (annex 1), and the timeliness is maximal (30 June 2026). Structural limit: the 2025 report is self-reported by the programme leaders, without external evaluation; for an independent view, refer to the IGAS report (ref. 2).

Operational relevance : very high for the ARS (framework, amounts, deadlines, eligibility criteria, GALIS procedure) and directly exploitable by the OG/ESMS to test the eligibility of a project, via the eligible/non-eligible action typologies in annex 2.

Inconsistencies / points of vigilance to report (not corrected) :

• The document is a transitional framework : he himself announces a " forthcoming instruction " operationally outlining the axes and a CNSA guide " currently being developed " not yet available. Therefore, stakeholders must anticipate forthcoming clarifications.
• Access : enforceable document published in the BO Santé but not filed with Légifrance — search for it via the official bulletins, not via Légifrance.
• No major quantified contradiction noted: the envelope " nearly 40 % " above the forecast (60.07 M€ vs 43.5 M€, i.e. +38 %) is consistent.

9️⃣ STRATEGIC HASHTAGS

#healthcarepractices #ServiceTransformation #Disability #MedicoSocial #SelfDetermination #Deinstitutionalisation #CoordinatedServices #ESMS