The Local Health Contract (CLS) is a health management tool designed to operate closely with territories, aiming to unite local actors around identified health needs and implement actions tailored to each area. The first CLS was signed in Valence, Drôme, in 2012, and the initiative progressively expanded to encompass 61 CLS by 2025. The ARS Auvergne-Rhône-Alpes commissioned an evaluation to better measure the contributions of these contracts.
Carried out by ORS Auvergne-Rhône-Alpes with financial support from ARS, this study combined perspectives from CLS coordinators and partners. It is based on two online surveys conducted in 2025 and finalized in 2026, covering the 53 active CLS in the region. The response rate from coordinators was 72% (38 responses), and from partners, 77.8% (391 responses).
Among the responding partners, the main groups include healthcare providers (21.7%), local authorities (19.4%), non-clinical health actors (18.4%), social and medico-social services (15.1%), and Departmental Councils (6.9%).
A key finding is the enhanced inter-awareness and cooperation among local stakeholders. 87% of partners discovered new local actors through the CLS, 75% reported better understanding of their missions, and 73.2% felt their communication with them had improved. These collaborations are often organized through working groups focusing on themes such as mental health and environmental health.
Beyond networking, CLS provide a framework for developing multi-partner projects. Nearly 50% of responding partners indicated that new multi-partner actions or projects were realized thanks to the CLS, particularly concerning mental health, access to care, nutrition, and adolescent health. Furthermore, 69% of partners believe their CLS participation facilitated or improved their work.
The evaluation also highlights the CLS's contribution to strengthening local primary healthcare services. In over 80% of CLS, actions were planned or carried out to encourage healthcare professionals to establish practices in the area, and in 68% of cases, efforts were made to facilitate the reception of medical interns or health students. 71% of coordinators stated that the CLS contributed to improving local healthcare provision, citing the installation of general practitioners and the creation of coordinated practice structures.
The benefits are particularly evident for territorial authorities: 91.8% discovered new local actors, 78.1% improved their knowledge on health topics, and 58.9% were able to implement new partnership actions or projects. Finally, 75% feel that their CLS participation has facilitated their missions.
ARS Auvergne-Rhône-Alpes supports local actors wishing to engage in this initiative, whether to learn more or to discover existing local dynamics.
