Paris, France
#00167
Case study of
#00181 Vulnerable-person registry with scripted phone check-ins during alerts, opt-out by default
Implementer
City of Paris (municipal social action services), triage script co-written with Necker Hospital doctors
Timeline
Since Jan 1, 2004
Location
Description
The CHALEX registry (since renamed REFLEX) was created in 2004 after the August 2003 heatwave that killed 14,802 people in France, roughly 82 percent of them aged 75 and over. Parisians who are elderly, disabled or isolated can register; when the heat alert reaches level 3, the city activates a call center of about 40 rotating agents who place up to 400 calls a day, reaching each registrant every 2 days. Agents follow a triage script written with doctors from Necker Hospital, and unanswered or worrying calls escalate to in-person checks. Only about 7,500 people are registered (average age 84), a small fraction of eligible Paris seniors; nationally only about 10 percent of eligible people appear on communal registers under opt-in rules. A July 2026 decree — following consultation with the CNIL data-protection authority — switches France to opt-out auto-enrollment through welfare data-matching, expected to cover about 2 million isolated elderly people nationally.
Metrics
5Funding
Lessons learned
- Opt-in enrollment is the binding constraint: two decades of promotion left about 90 percent of eligible people off the register, which is why France moved to opt-out auto-enrollment by decree in July 2026.
- A clinician-written triage script (co-developed with Necker Hospital doctors) lets non-medical call agents run health checks safely at scale.
- Data-protection consultation (CNIL in France) is part of the critical path for opt-out enrollment and must be initiated early, not treated as an afterthought.
- Mortality attribution belongs to the whole alert-and-response plan, not the registry alone; isolating the registry's specific contribution is not feasible with available data.
Documented Jul 24, 2026