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On Thursday May 15, following a vote by the Executive Council, a territorial decree signed by President Xavier Lédée ratified the increase in the daily rate for residents of Gustavia's Etablissement d'hébergement pour personnes âgées dépendantes (Ehpad). This decision was expected, if not announced.
The report submitted to the vote of the local councillors to adopt the 2025 budget on March 27 (JSB 1610) did not contain a single budget line aimed at balancing the accounts of the Ehpad. However, every year, the daily rate paid by residents, their families or social assistance recipients who do not have the necessary means, must be readjusted in line with the expenses incurred by the establishment. For a number of years, the local authorities had opted to allocate a subsidy to balance the accounts, thus maintaining a relatively affordable daily rate. The hospital's director, Éric Djamakorzian, indicated several months ago that, in the absence of a subsidy, rates would have to be revised upwards. This has now been done.
"A concern for fairness
The daily accommodation rate for residents is now 105 euros, compared with 95 euros previously. It then varies according to the level of dependency, from 8 to 38.20 euros. "Since the hospital has adopted a transparent budgetary approach, the local authorities - and hence the public, through indirect indirect contributions - has made a significant contribution to the hospital's financial equilibrium," says the President of the Collectivité. In less than a year, two Executive Council decisions have enabled the payment of 856,000 euros in balancing subsidies for fiscal years 2021, 2022 and 2023. "It is specified that the increase in the daily rate "was proposed by the territorial management of social cohesion and validated by the CAS (social affairs commission, editor's note) in the interests of fairness". The aim is "to support all those on the island who are having difficulty paying for the Ehpad via CAS assistance schemes, while leaving it up to those with the necessary resources to contribute their fair share". The presidency of the Collectivité asserts that "this position is intended to avoid an air draught", as "having the cheapestEhpad the cheapest in France, in a setting as attractive as Saint-Barthélemy, could generate outside pressure contrary to the interests of local residents".
"A political fault line
In an online publication, the leader of the Saint-Barth d'Abord group, Alexandra Questel, expressed her strong disapproval of this presidential decision. The elected representative stated that she was "firmly opposed" to this increase in the daily rate. "I am told that this increase is reasonable," she writes. That it is "sustainable". But in reality, it represents more than 3,000 euros a year for each resident. For elderly people, often dependent, sometimes without family support, this is an immense burden. It's not just an accounting adjustment. It's a political fault line. "She adds: "Our Ehpad was never conceived as a business. If it were intended to make a profit, we would have included the cost of depreciating the building in our daily rates from the outset. This is not the case (...) If the local authority is able to pay out over two million euros in subsidies to associations each year, it is capable of maintaining a sustainable accommodation rate for our seniors. And if the cost of living rises, it's up to the Collectivité to adjust its contribution. "
In future, it will be the residents who will have to adjust their contribution.
For Marie-Hélène Bernier, first vice-president and leader of the Action-Équilibre group, given that Gustavia's Ehpad has been one of the least expensive for several years, a ten-euro increase in the daily fee does not "shock" her. However, she adds: "On the other hand, we need to monitor the situation rigorously. "In particular, we need to ensure that those admitted, or their families, have the financial means to pay for their accommodation. And so avoid getting into debt.
