Local health contracts are defined as public sector instruments promoting regional health agencies’ implementation of regional health projects in consultation with their partners. Deployed in the particular context of the French central government’s local reforms, these contractual mechanisms have significantly altered decentralised public services’ work organisation. The present article leverages Abbott’s studies to analyse how the restructuring of the French state’s territorial entities affects the activities of officers responsible for signing and operationalising local health contracts. Rooted in a field survey of officers working out of three regional health agencies’ central and local sites, the analysis reveals that changes in working arrangements (tasks, timing, power) differ depending on officers’ intervention levels and target audiences.