Causing the need for his social. The need for social protection of the population

Melenchuk Savely Gennadievich

3rd year student, department of social work of the Law Institute of Siberian Federal University, RF, Krasnoyarsk

AT modern world there are many social problems. These problems hinder the development and normal functioning of society. Their solution is possible only through the coordinated activities of the state and society. This activity is carried out in any state, but it is not always effective, according to different reasons such as lack of funding, lack of knowledge about the causes of social inequality and ways to overcome it, and, sometimes, from the unpreparedness of society itself for change.

Thus, one of the most important social problems in Russia at the moment is the problem of childhood disability. Disabled persons constitute a special category of the population. Disability is associated with a persistent health disorder that leads to limited life activity and necessitates social protection. The state policy towards persons with disabilities is aimed at solving problems of this nature. handicapped. Disability should be considered in the same way as one of the forms of social inequality. This means that society does not perceive disabled people as full-fledged members of society. This fact suggests that the existing social conditions limit the activity of this population group. This, in turn, hinders the integration of children with disabilities into society.

Therefore, despite the fact that Russia is a social state, which guarantees the equality of rights and freedoms of every person and citizen, regardless of any differences, people with disabilities cannot always exercise their constitutional rights. This characterizes childhood disability as one of the most important social problems.

Problem: Can we say that the rights of children with disabilities, guaranteed by the state, are fully implemented?

Hypothesis: The rights of children with disabilities guaranteed by the Constitution of the Russian Federation and other laws are not fully implemented in practice.

The object of the study is children with disabilities.

The subject of the study is the situation of children with disabilities and the problems they face in modern Russia.

The goal is to determine to what extent the rights of children with disabilities guaranteed by the state are realized.

Tasks: - describe the concepts of "disabled" and "disabled child";

· consider the list of guaranteed rights of children with disabilities;

· draw up a questionnaire and conduct a survey of children with disabilities;

Determine to what extent the guaranteed rights of children with disabilities are realized.

Research methods: theoretical - analysis, systematization, generalization: empirical - questioning.

In accordance with the Federal Law "On the social protection of persons with disabilities in Russian Federation»: disabled person - a person who has a health disorder with a persistent disorder body functions caused by diseases, consequences of injuries or defects, leading to limitation of life and necessitating his social security. Therefore, the concept of a disabled person is enshrined in law. And it denotes a category of people with disabilities who need help and social protection.

Depending on the degree of disorder of body functions and limitation of life activity, persons recognized as disabled are assigned a disability group, and persons under the age of 18 are assigned the category of “disabled child”. Disabled child - an individual under the age of 18 inclusive with deviations in physical or mental development having limitations in life due to congenital, hereditary or acquired diseases, the consequences of injuries that necessitate his social protection. Accordingly, children's disability has a certain age range. Thus, children with disabilities constitute a separate group that requires a special approach in the implementation of assistance programs.

The Manual of Medical Occupational Examination defines "disability" in childhood, as "a state of persistent social maladjustment due to chronic diseases or pathological conditions, sharply limiting the possibility of including the child in age-appropriate educational and pedagogical processes, in connection with which there is a need for constant additional care for him, assistance or supervision. It follows from this that children with disabilities are not adapted to self-integration into public life and need social protection.

According to the Analytical Bulletin of the Federation Council, until 1979, the presence of disabled children eligible for social benefits was not recognized at all in the USSR, since disability was defined as “a permanent impairment (decrease or loss) of general or professional working capacity due to illness or injury” . The status of a "child with a disability" was first officially introduced in the USSR during the International Year of the Child, declared by the UN in 1979. Consequently, until 1979, disabled children were not recognized in the USSR, and they were not provided with assistance. Which, in turn, had a negative impact on the condition of children with disabilities, since the rehabilitation of disabled people is the more effective the earlier it begins.

At the moment, according to official data from the Federal State Statistics Service, the number of disabled children receiving social benefits aged 0 to 17 in the Russian Federation in 2012 is 568,000 people.

As I.V. Larikov, today in Russia there is progressive legislation that provides conditions for the integration of children with disabilities into society. It is based on international treaties signed by Russia and other international acts containing generally recognized principles and norms. international law, following the norms of the Constitution of the Russian Federation, which declares the primacy of international law. Thus, Russia adheres to the position of the world community on the issues of providing children with disabilities with acceptable living conditions.

According to article 7 of the Constitution of the Russian Federation, Russia is welfare state, "whose policy is aimed at creating conditions that ensure a decent life and free development of man" . Accordingly, the policy of the Russian Federation is aimed at improving the level and quality of life and providing opportunities for realizing the potential of people.

It is obvious that the opportunity to realize oneself as a full-fledged member of society is an important factor for a child with disabilities that influences his future life. In accordance with the law “On the Fundamentals of Social Services for the Population in the Russian Federation”, social services created in Russia “provide assistance in professional, social, psychological rehabilitation to disabled people, persons with disabilities, juvenile delinquents, other citizens who find themselves in a difficult life situation and need rehabilitation services". This indicates that children with disabilities in the Russian Federation should be assisted in various areas of life.

According to the Law of the Russian Federation "On State Pensions in the Russian Federation", children with disabilities are provided with a social pension and supplements to it. Also, in accordance with Art. 18 of the Law "On Social Protection of Disabled Persons in the Russian Federation" educational institutions, social protection authorities, communication and information institutions, physical education and sports ensure the continuity of upbringing and education, the social adaptation of disabled children. Moreover, if it is impossible to educate and educate children with disabilities in general or special preschool and general educational institutions, the state undertook to provide them with a full general education or individual program at home. It follows from this that the educational process is aimed both at the rehabilitation of disabled children and at socialization and education. And the state, in turn, must ensure open access for children with disabilities to the education process.

The Town Planning Code of the Russian Federation guarantees the provision of conditions for disabled people to have unhindered access to social and other facilities. In accordance with the Decree of the Government of the Russian Federation, children with disabilities under the age of 16 are provided with medicines by prescription of doctors free of charge, free dispensing of medicines by prescription of doctors and free dispensing of prosthetic and orthopedic products by enterprises and organizations of the Ministry of Labor and social development RF. Thus, the state guarantees a wide range of rights and services to children with disabilities.

However, I.V. Larikova believes that Russian state policy in this area is contrary to the law - both in the field of the family and in the field of education and rehabilitation.

In order to identify the degree of implementation of the guaranteed rights of children with disabilities in 9 localities of the Russian Federation, a survey was conducted through personal and Internet surveys that covered 67 children with disabilities. The gender and age composition of respondents is represented by 23 boys and 44 girls, of which 11 are aged 11-13, 31 are 14-16 and 25 are aged 17-18.

Analysis of answers to the question “Does the state provide you with assistance?” showed that 87% of disabled children receive state assistance, and 13% of respondents do not receive state assistance. This fact can be explained by the fact that, perhaps, some children with disabilities do not need help or by the fact that the child is not registered with the social protection authorities.

Based on the results of the question “What types of assistance does the state provide you with?” managed to find out that 89% of the surveyed children with disabilities receive material assistance, 30% - sanatorium treatment, 40% receive drug supply and only 18% of respondents receive all of the above as state aid. Accordingly, assistance among needy children with disabilities is unevenly distributed.

In this regard, 77% of respondents note that the assistance provided by the state is not enough for them, and only 23% of disabled children from among those receiving state assistance consider it sufficient. Thus, the problem of insufficient state assistance for children with disabilities is confirmed.

Education is received by 65 children out of 67, which is 93%, respectively, 2 children do not receive education - 3% of the number of respondents.

Analysis by answering the question “How is your training going?” gave the following results: 33 surveyed children with disabilities receive education in a general educational institution, 24 out of 67 surveyed children study in a special educational institution for children with disabilities, and 10 respondents study at home. According to the results this issue, we can say that almost all children with disabilities receive education, to a greater extent in special educational institutions and at home, rather than in general educational institutions, which indicates that inclusive education for children with disabilities in Russia is still inaccessible.

After analyzing the answers to the question regarding the barrier-free movement of children with disabilities through the streets and buildings, it was possible to find out that 39% of the respondents always encounter problems when moving, 18% of the respondents often face, not often 23%, and 20% of the children with disabilities never do not encounter problems when moving on the street and buildings. Judging by the results of the answers to the question, it can be said with a fair degree of certainty that in Russia there is still no complete “barrier-free environment” that would ensure that there are no problems with the movement of children with disabilities and people with disabilities, in general, along the street and buildings.

Disabled children themselves assess the implementation of state policy aimed at supporting children with disabilities in the following way: 19% of respondents believe that state policy is implemented rather in full, 62% of respondents say that the policy is implemented rather not in full, and 19% of respondents % find it difficult to assess. Accordingly, children with disabilities are convinced that the state does not fully realize its potential in protecting the rights, freedoms and interests of children with disabilities. Children with disabilities are either not satisfied with government assistance, or, for the most part, assess their satisfaction as average, which is a problem that needs to be addressed.

Children with disabilities themselves see possible ways The solution to the above problem is to organize an accessible environment, not in words, but in deeds, 42% of respondents think so. The inevitability of a change in public opinion for the greatest assistance and protection of children with disabilities say 28% of respondents. The fact that not only children, but also their parents need help is evidenced by 9% of responses. The need for free sanatorium-and-spa treatment is noted by 16% of respondents, and 61% of disabled children note an increase in the amount of material assistance. The option of building special schools and rehabilitation centers was voiced by 28% of the respondents, and 20% of the respondents spoke about the coverage of the problems of children with disabilities in the media.

Thus, children with disabilities see the prevailing importance in providing the greatest assistance and protection for themselves in increasing material assistance, as a universal means by which children with disabilities and their families themselves can purchase the necessary goods and services to improve the process of rehabilitation and life.

And the final question of the questionnaire showed that 8% of the respondents are quite satisfied with their lives, 17% of the respondents are mostly satisfied with their current situation, and 27% of the interviewed children with disabilities are somewhat satisfied with their lives. A large number of respondents, namely 37%, for the most part are not satisfied with their life, but 11% are not at all satisfied with the way they live. Accordingly, there are much more children with disabilities who are not satisfied with their living conditions at the moment than children with disabilities who are satisfied with their life situation. This is due to the combination of the above problems and factors.

Thus, after analyzing the answers to the questionnaire, we can say with a fair degree of certainty that childhood disability in modern Russia is one of the most important social problems. The situation of children with disabilities at the moment is not one of the best.

Through analysis, comparison of legislation and survey results, it was possible to find out that insufficient state assistance, expressed in minimal financial assistance, cannot compensate for the costs of families for the rehabilitation of children. Pervasive negative public opinion also complicates the processes of rehabilitation and socialization of children with disabilities. Underdevelopment of infrastructure, lack of inclusive education and inadequate legislative measures and standards - all this worsens living conditions, making a child with disabilities feel unwanted, segregated from society.

Thus, the hypothesis that the rights of children with disabilities guaranteed by the Constitution of the Russian Federation and other laws are not fully implemented in practice is confirmed.

Bibliography:

1. Analytical Bulletin of the Federation Council of the Federal Assembly of the Russian Federation. Protection of children's rights in the Russian Federation, 2007. [Electronic resource] - Access mode. - URL:: http://www.council.gov.ru/print/inf_sl/bulletin/item/285/
2. Urban Planning Code of the Russian Federation of December 29, 2004 No. 190-FZ. [Electronic resource] - Access mode. - URL:http://www.consultant.ru/popular/gskrf/15_1.html#p103
3. Law of the Russian Federation "On State Pensions in the Russian Federation" dated November 20, 1990 No. 340-1. [Electronic resource] - Access mode. - URL: http://www.consultant.ru/document/cons_doc_LAW_34222/ (date of access: 15.09.2014).
4. Constitution (1993). Constitution of the Russian Federation: official. text. Novosibirsk: Sib. univ. publishing house, 2008. - 48 p. - (Codes and laws of Russia)
5. Larikova I.V. Integration of children with disabilities in Russia legislation, real situation, ways of change. [Electronic resource] - Access mode. - URL: http://aupam.narod.ru/pages/deti/integraciya_deteyj_invalidov_rossii/oglavlenie.html (date of access: 09/03/2014).
6. Decree of the Government of the Russian Federation "On measures to ensure the social protection of citizens from special risk units" dated 11.12.1992 No. 958. [Electronic resource] - Access mode. - URL: http://www.consultant.ru/document/cons_doc_LAW_83422/ (date of access: 09/15/2014).
7. Guide to medical and labor expertise. T. 1. Pod. Ed. Yu.D. Arabatskaya. M.: Medicine, 1981. - 559 p.
8. Federal State Statistics Service. [Electronic resource] - Access mode. - URL: http://www.gks.ru (date of access: 13.09.2014).
9. Federal Law "On the Social Protection of Disabled Persons in the Russian Federation" dated November 24, 1995 No. 181-FZ. [Electronic resource] - Access mode. - URL: http://base.consultant.ru/cons/cgi/online.cgi?req=doc;base=LAW;n=142572 (date of access: 09/12/2014).
10. Federal Law No. 195-FZ dated December 10, 1995 "On the Fundamentals of Social Services for the Population in the Russian Federation". [Electronic resource] - Access mode. - URL: http://base.consultant.ru/cons/cgi/online.cgi?req=doc;base=PRJ;n=106171;dst=0 (date of access: 09/16/2014).

Size: px

Start impression from page:

transcript

2 General information 1. A disabled person is defined as a person who has a health disorder with a persistent disorder of body functions, caused by diseases, the consequences of injuries or defects, leading to a limitation of life and causing the need for his social protection. 2. Depending on the degree of impairment of body functions and limitation of life activity, persons recognized as disabled are assigned a disability group, and persons under the age of 18 are assigned the category of "disabled child". 3. The basis for the establishment of the first group of disability is such a violation of the functions of the body, in which the disabled person cannot serve himself and needs constant help, care or supervision. 4. The basis for determining the second group of disability are significantly expressed functional disorders, which lead to complete or long-term disability, or to such a state when certain types of labor can be available only in specially created conditions. 5. The basis for determining the third group of disability is a significant reduction in disability due to violations of body functions caused by chronic diseases or anatomical defects. 6. Recognition of a person as a disabled person is carried out by a federal institution of medical social expertise. 7. Re-examination of disabled people of group I is carried out once every 2 years, disabled people of II and III groups once a year. 8. Without specifying the re-examination period, disability is established for men over 60 years old and women over 55 years old, disabled people with irreversible anatomical defects, other disabled people in accordance with the criteria approved by the executive body authorized by the Government of the Russian Federation. 9. After a person is recognized as a disabled person by the specialists of the institution who conducted the medical and social examination, an individual rehabilitation program is developed within a month, approved by the head of this institution. 10. A person recognized as disabled is issued a certificate confirming the fact of the establishment of disability, as well as an individual rehabilitation program.

3 Rehabilitation of disabled people 1. Rehabilitation of disabled people is defined as a system and process of full or partial restoration of the abilities of disabled people for household, social and professional activities. 2. The main areas of rehabilitation of the disabled include: restorative medical measures, reconstructive surgery, prosthetics, orthotics, sanatorium treatment; vocational guidance, training and education, employment assistance, industrial adaptation; socio-environmental, socio-pedagogical, socio-psychological and socio-cultural rehabilitation, social adaptation; physical culture and recreation activities, sports. 3. The implementation of the main directions of the rehabilitation of the disabled provides for: the use of technical means of rehabilitation by the disabled; creation necessary conditions for unhindered access of disabled people to objects of engineering, transport, social infrastructure and use of means of transport, communications and information; providing disabled people and members of their families with information on the rehabilitation of disabled people. 4. The state guarantees disabled people to carry out rehabilitation measures, receive technical means and services provided for by the federal list at the expense of the federal budget.

4 Technical means for the rehabilitation of the disabled 1. Technical means for the rehabilitation of the disabled include devices containing technical solutions, including special ones, used to compensate or eliminate persistent limitations on the life of a disabled person. 2. The technical means of rehabilitation of the disabled are: special means for self-service; special care products; special means for orientation (including guide dogs with equipment complexes), communication and information exchange; special facilities for teaching, education (including literature for the blind) and employment; prosthetic products (including prosthetic and orthopedic products, orthopedic shoes and special clothing, eye prostheses and hearing aids); special training and sports equipment, sports equipment; special means of transportation (wheelchairs). 3. The technical means of rehabilitation provided for by individual programs for the rehabilitation of disabled people, provided to them at the expense of the federal budget and the social insurance fund of the Russian Federation, are transferred to disabled people for free use

5 Social protection of disabled people 1. Social protection of disabled people is defined as a system of state-guaranteed economic, social and legal measures that provide disabled people with conditions for overcoming, replacing (compensating) life restrictions and aimed at creating equal opportunities for them to participate in the life of society with other citizens. 2. Economic measures to ensure the life of the disabled include: pensions for the disabled; monthly cash payments (UDV), the size of which depends on the group of disability. A part of the UDV amount can be directed (at the request of the disabled person) to finance a set of social services (social package); additional monthly material support for disabled people (DEMO), whose disability is caused by a military injury; provision of a set of social services (NSO) (social package), which includes: - ensuring medicines; - Spa treatment; - free travel in suburban railway transport. Granting to the NSO is subject to the retention of the right to receive it. social services for disabled persons by institutions of the state system of social services (including home care), including the provision of services: .

6 3. Measures of social support for disabled people include: providing housing for disabled people and families with disabled children who need to improve their living conditions at the expense of the federal budget. Provided that the disabled person suffers from severe forms chronic diseases, provided for by the list established by the executive body authorized by the Government of the Russian Federation, he may be provided with residential premises under a social tenancy agreement with a total area exceeding the provision rate per person (but not more than twice); priority obtaining of land plots for individual housing construction, maintenance of subsidiary and summer cottages and gardening; ensuring that persons with disabilities receive public and free primary general, basic general, secondary general education and secondary vocational education and free higher education. ensuring the employment of disabled people by establishing a quota in organizations for hiring disabled people and creating working conditions for them in accordance with individual programs for the rehabilitation of disabled people; creating conditions for entrepreneurial activity; organizing training for disabled people in new professions. 4. In order to protect the rights and legitimate interests of disabled people, to provide them with equal opportunities with other citizens, disabled people have the right to create their own public associations.

7 The state provides assistance and assistance to public associations of the disabled, including material, technical and financial. Authorized representatives of public associations of the disabled are involved in the preparation and adoption of decisions affecting the interests of the disabled. Decisions made in violation of this rule may be declared invalid in court. State authorities and local self-government bodies may provide support to public associations of the disabled and organizations created by all-Russian public associations of the disabled by providing free use of property (including buildings, non-residential premises) used by them legally for at least five years. The state guarantees free legal assistance to disabled people.

8 STATE SERVICES THAT PROVIDE SOCIAL SUPPORT FOR DISABLED PEOPLE GU TO "Department of social protection of the population of the Aleksinsky district" Aleksin, st. Lenina, d.10 tel. 8 (48753) Monday-Thursday Friday Reception of citizens in the "single window" mode: - monthly cash payments and subsidies for payment of housing and communal services - consultations on legal issues in the social sphere SE TO "Center for Social Services for the Population of the Aleksinsky District", Aleksin , st. Pionerskaya, 2 tel. 8 (48753) tel. 8 (48753) tel. 8 (48753) Monday-Thursday Friday social and socio-medical care at home - social rehabilitation of the disabled, psychological assistance, socio-cultural adaptation - rental of technical rehabilitation equipment - consultations on legal issues in the social sphere

9 Bureau 15 - branch of the FKU "Main Bureau of Medical and Social Expertise in the Tula Region", Aleksin, st. Lenina, d.18 - passage medical and social expertise- medical examination - establishment of a disability group tel. 8 (48753) Monday, Wednesday Tuesday, Thursday Office of the Pension Fund of the Russian Federation in Aleksin and Aleksinsky District Aleksin, st. Oktyabrskaya, d. 1 tel. 8 (48753) tel. 8 (48753) Monday-Thursday Friday pensions and social cash payments

10 GU-Tula regional branch of the Social Insurance Fund Aleksin, st. Geroev-Aleksintsev, d. 8a - sanatorium-resort treatment - provision of technical means for the rehabilitation of bodies. 8 (48753) Monday-Thursday Friday SE TO "Employment Center of the Aleksinsky District" Aleksin, st. Mira, d. 10a - employment of disabled people - getting a new profession "hot line" - tel. 8 (48753) tel. 8 (48753) Monday-Thursday Friday

11 Department of Education of the Municipal Formation "Aleksinsky District", Aleksin, st. Pionerskaya d. 8 - implementation of the right to study in educational institutions for persons with disabilities tel. 8 (48753) Administration of the municipal formation "Aleksinsky district" Aleksin, st. Geroev-Aleksintsev, 10 Committee for Property and Land Relations Legal Counsel Office 210 tel. 8(48753) Office 211 tel. 8(48753) Room 117 tel. 8(48753) housing - allocation of land plots - free legal assistance (1 time per quarter)

13 The legislative framework Federal Law No. 181-FZ (as amended) “On the Social Protection of Disabled Persons in the Russian Federation” Federal Law No. 323-FZ “On the Fundamentals of Health Care in the Russian Federation” Federal Law No. 178-FZ “ On State Social Assistance Federal Law No. 122-FZ On Social Services for Elderly Citizens and the Disabled Federal Law No. 166-FZ On State Pensions Federal Law No. 173-FZ On Labor Pensions Federal Law No. 173-FZ On Labor Pensions Law No. 323-FZ “On Free Legal Aid in the Russian Federation” Federal Law No. 173-FZ “On Labor Pensions” Decree of the Government of the Russian Federation of No. 965 “On the Procedure for Recognizing Citizens as Disabled” Decree of the Government of the Russian Federation of 59 “Federal Comprehensive Program “Social Support for the Disabled” Decree of the Government of the Russian Federation dated d. “On the federal list of state-guaranteed social services provided to citizens of the elderly and disabled idam by state and municipal institutions of social services "

Federal benefits (guarantees) provided to children with disabilities Name of the benefit (guarantee) and its short description Social Security and Services, State Child Health Priority

INDIVIDUAL PROGRAM OF REHABILITATION OR HABILITATION OF A DISABLED PERSON (IPRA): development and implementation procedure Moscow, 2018 WHAT IS REHABILITATION AND HABILITATION OF DISABLED PEOPLE? Rehabilitation of the Disabled - System

LAW OF THE REPUBLIC OF TAJIKISTAN ON SOCIAL PROTECTION OF THE DISABLED (Akhbori Majlisi Oli of the Republic of Tajikistan, 2010, 12, part 1, art. 834) Adopted by the Resolution of the Majlisi Namoyandagon Majlisi Oli of the Republic of Tajikistan

LAW OF THE REPUBLIC OF TAJIKISTAN ON THE SOCIAL PROTECTION OF THE DISABLED This Law defines the legal, economic and organizational framework for ensuring the social protection of the disabled and creates equal opportunities for them

Disability as a medical and social problem St. Petersburg Polyclinic 88 Deputy Chief Physician for the Examination of Temporary Disability Fassakhova Galina Vasilievna 2 Disability is one of the important medical and social

Ministry of Social Development of the Saratov Region Department of Social Protection of the Population of the Volsky District Department of Information and Analytical Support RIGHTS AND GUARANTEES FOR DISABLED CHILDREN Volsk 2013

On the social protection of persons with disabilities in the Russian Federation RUSSIAN FEDERATION FEDERAL LAW On the social protection of persons with disabilities in the Russian Federation *O) (as amended on July 10, 2012) Amended document

RIGHT OF SOCIAL SECURITY 1. The concept and principles of social services (slides 1-5) 2. Forms of social services and types of social services (slides 6-9) 3. Rights of recipients of social services (slides

Department of social protection of the population of the Administration of the Volgograd region Information guide for the disabled 1 Table of contents p. 2 Introduction p. 3

To help a family raising a disabled child This informational guide has been developed to help families raising children with disabilities. We hope you find useful information in it that interests you.

GOVERNMENT OF THE NIZHNY NOVGOROD REGION DECISION dated January 24, 2007 N 24 ON THE REHABILITATION OF THE DISABLED IN THE NIZHNY NOVGOROD REGION (as amended by the Decrees of the Government of the Nizhny Novgorod Region dated 11.04.

Contents: Targeted one-time financial assistance for the purchase of a wheelchair for a disabled child ... 3 Monthly cash payment for the upbringing and education of disabled children at home ... 4 Monetary

Memo to a citizen undergoing an examination at the Federal State Institution "Main Bureau of Medical and Social Expertise in the Republic of Mari El" of the Ministry of Labor and Social Protection of the Russian Federation

Rights and benefits of children with disabilities and their families. In our state there is a whole system of social protection of disabled people, fixed by law. The following areas are included:

December 17, 2004 N 130-z REPUBLIC OF BASHKORTOSTAN LAW ON SOCIAL SUPPORT FOR DISABLED PEOPLE IN THE REPUBLIC OF BASHKORTOSTAN ,

Law of the Orenburg Region of November 18, 2006 N 684/124-IV-O3 "On social services for the population in the Orenburg Region (adopted by the Legislative Assembly of the Orenburg Region on October 18, 2006) Law

Benefits and social guarantees for families raising disabled children Conditions and procedure for recognizing a child as disabled. For a child to be recognized as disabled, a combination of several conditions must be present.

ALGORITHM OF WORK FOR THE IMPLEMENTATION OF THE IPR IN THE CONDITIONS OF AN EDUCATIONAL ORGANIZATION REGULATORY AND LEGAL SUPPORT Federal Law No. 181-FZ of November 24, 1995 “On the Social Protection of Disabled Persons in the Russian Federation”;

On the social protection of persons with disabilities in the Russian Federation (as amended on December 29, 2015) Federal Law of November 24, 1995 N 181 FZ RUSSIAN FEDERATION

The concept of "disabled person" is enshrined in Article 1 of the Federal Law "On the social protection of persons with disabilities in the Russian Federation". A disabled person is a person who has a health disorder with a persistent disorder of body functions,

State Budgetary Institution of the Republic of Kazakhstan "Center for Vocational Rehabilitation of the Disabled" LEGISLATION ON REHABILITATION AND HABILITATION OF DISABLED PEOPLE Lecturer Solomatin E.S. Evpatoria - 2017 BRIEF LIST OF FEDERAL AND REGIONAL RLAs

STATE SOCIAL ASSISTANCE. SOCIAL SERVICE The right to social security 2. State social assistance: natural types of security 3. Legislative framework 1) Federal Law of 17.07.1999

THE RIGHT OF SOCIAL SECURITY 1. The concept and principles of social services 2. Forms of social services and types of social services 3. The rights of recipients of social services 4. Social services for the elderly

Decree of the Government of the Russian Federation of February 20, 2006 N 95 Moscow On the procedure and conditions for recognizing a person as disabled 4 2 In accordance with the Federal Law "On the Social Protection of Disabled Persons"

Law of the Tambov Region of December 13, 2005 N 410-Z "On State Social Services for the Population of the Tambov Region" (adopted by the Tambov Regional Duma on December 13, 2005) This Law governs

Department of social protection of the population of the Volsky district of the Ministry of social development of the Saratov region Department of information and analytical support Measures of social support for families raising

GOVERNMENT OF THE RUSSIAN FEDERATION DECISION N 965 of August 13, 1996 ON THE PROCEDURE FOR RECOGNIZING CITIZENS AS DISABLED (as amended by Decrees of the Government of the Russian Federation of 09/21/2000 N 707, of 10/26/2000 N 820, of 12/16/2004

October 26, 2005 N 55 LAW OF THE CITY OF MOSCOW ON ADDITIONAL MEASURES OF SOCIAL SUPPORT FOR THE DISABLED AND OTHER PERSONS WITH LIFE LIMITATIONS IN THE CITY OF MOSCOW (as amended by the Law of Moscow dated 06/23/2010

Appendix N 2 to the order of the Ministry of Labor and Social Protection of the Russian Federation of July 31, 2015 N 528n Form (name of the federal state institution of medical and social expertise)

Legal regulation of social protection of children with disabilities in the Russian Federation In the Russian Federation, issues of social protection of children with disabilities are regulated, along with general rules social law,

GUARANTEED SERVICES Type Content 1 social services aimed at maintaining the life of social services in everyday life 2 aimed at maintaining and maintaining health socio-medical

Order of the Ministry of Labor of Russia 528n dated July 31, 2015 On approval of the Procedure for the development and implementation of an individual rehabilitation or habilitation program for a disabled person, an individual rehabilitation or habilitation program

Law of the City of Moscow dated October 26, 2005 N 55 "On additional measures social support for the disabled and other persons with disabilities in the city of Moscow" This Law on the basis of the Constitution

The strategy of the Sebryakovskiy branch of VolgGASU for the formation of an accessible educational environment for students with disabilities and the disabled is a tolerant model of communication based on

Page 1 RUSSIAN FEDERATION FEDERAL LAW On the social protection of persons with disabilities in the Russian Federation (as amended on March 7, 2018 (as amended from March 18, 2018) Amended by:

ADMINISTRATION COUNCIL OF THE KRASNOYARSK REGION AGENCY OF SOCIAL PROTECTION OF THE POPULATION OF THE ADMINISTRATION OF THE KRASNOYARSK REGION COLLECTION OF REGULATORY LEGAL ACTS ON SOCIAL SUPPORT FOR DISABLED PEOPLE KRASNOYARSK 2008 UDC 362.45

Prepared using the ConsultantPlus system Registered with the Ministry of Justice of the Russian Federation on December 22, 2004 N 6226 MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT OF THE RUSSIAN FEDERATION ORDER dated November 29

Appendix 4 (name of the federal state institution of medical and social expertise) Individual program for a disabled person * issued by federal government agencies medical and social

On the social protection of persons with disabilities in the Russian Federation (as amended as of June 1, 2017) RUSSIAN FEDERATION FEDERAL LAW On the social protection of persons with disabilities in the Russian Federation (as amended by 1

On the organization of work on the development and implementation of a list of activities for an individual rehabilitation or habilitation program for disabled children issued by federal state institutions of medical and social

The standard for the provision of social services in a stationary form of social services. 1. Stationary service for disabled and elderly citizens: 1.1. Mobile recipients of social N p / p Name

TECHNICAL REHABILITATION FACILITIES (TSR) AND SERVICES PROVIDED TO THE DISABLED IN ACCORDANCE WITH THE IPR: order of appointment and receipt Moscow, 2018 WHAT IS TECHNICAL REHABILITATION FACILITIES (TSR)? To technical

Social services for people with disabilities. Technology. REMINDER on social services for people with disabilities living in the territory of Khanty-Mansiysk

International Day of Persons with Disabilities In 1992, at the end of the United Nations Decade of Persons with Disabilities (1983-1992), the UN General Assembly, by its resolution 47/3, proclaimed 3 December

March 12, 1999 N 45-OZ NOVOSIBIRSK REGION LAW ON THE SOCIAL PROTECTION OF THE DISABLED IN THE NOVOSIBIRSK REGION

PAYMENTS FROM THE FEDERAL BUDGET VI. Cash payments to disabled people as a result of a military injury Types of payments Amount of payment (rubles) Where to apply Order of appointment List of documents Accounting

FEDERAL STATE BUDGETARY INSTITUTION "FEDERAL BUREAU OF MEDICAL AND SOCIAL EXPERTISE" OF THE MINISTRY OF LABOR AND SOCIAL PROTECTION OF THE RUSSIAN FEDERATION

Decree of the Government of the Russian Federation of November 25, 1995 N 1151 (as amended on April 17, 2002) "On the Federal List of State-Guaranteed Social Services Provided to Elderly Citizens and Disabled Persons by State

Annex 2 to Decree of the Government of Moscow of December 26, 2014 N 829-PP COMPOSITION OF SOCIAL SERVICES AND REQUIREMENTS FOR STANDARDS OF SOCIAL SERVICES 1. Social services provided to citizens in the form

P A M Y T K A In cases of identifying children and adolescents who find themselves in a difficult life situation, the facts of ill-treatment with them must be reported: to the law enforcement agencies of the city of Belogorsk, st. Kirov

GOVERNMENT OF THE NOVGOROD REGION DATE 28.04.2016 160 Veliky Novgorod On tariffs for social services In accordance with the regional law of October 29, 2014 650-OZ "On measures to implement

Rules for recognizing a person as disabled (as amended by Decree of the Government of the Russian Federation dated 07.04.2008 247, dated 30.12. 2009 1121)

MINISTRY OF LABOR AND SOCIAL PROTECTION OF THE RUSSIAN FEDERATION ORDER dated July 31, 2015 N 528n On approval of the Procedure for the development and implementation of an individual rehabilitation or habilitation program for a disabled person,

November 24, 1995 N 181-FZ RUSSIAN FEDERATION FEDERAL LAW ON THE SOCIAL PROTECTION OF THE DISABLED IN THE RUSSIAN FEDERATION Adopted by the State Duma on July 20, 1995 Approved by the Federation Council on November 15

1 Appendix 1 to the order of the Ministry of Labor and Social Protection of the Russian Federation of 2015. The procedure for the development and implementation of an individual program for the rehabilitation or habilitation of a disabled person, individual

State budgetary institution of the Saratov region "Regional rehabilitation center for children and adolescents with disabilities” INDIVIDUAL PROGRAM OF REHABILITATION AND HABILITATION FOR A CHILD WITH A DISABLED:

IF YOUR FAMILY IS A CHILD WITH A DISABLED BENEFITS FOR DISABLED CHILDREN AND THE FAMILIES WHERE THEY ARE BROUGHT A disabled person whose opportunities for his personal life in society are limited due to his physical,

1 2 3 Mandatory requirement, compliance with which is subject to verification during implementation state control(supervision) Type of state control (supervision) Within the framework of the state function of supervision

Document provided by ConsultantPlus Registered with the Ministry of Justice of Russia on August 21, 2015 N 38624 MINISTRY OF LABOR AND SOCIAL PROTECTION OF THE RUSSIAN FEDERATION ORDER dated July 31, 2015 N 528n ON APPROVAL

NROOOI "Invatur" within the framework of the project "Law and Mercy" "Rights of disabled people in places of deprivation of liberty" Reference and information publication Nizhny Novgorod 2014 Rights of people with disabilities in places of deprivation of liberty LBC 65.272.

Local self-government of the city of Taganrog, Rostov region Administration of the city of Taganrog DECISION 28.02. 2011 629 On amendments to the resolution of the Administration of the city of Taganrog dated 16.12.2009

Ability to self-service 3rd degree (inability to self-service, the need for constant outside help and complete dependence on other people);

Ability to move 3 degrees (inability to move independently and needing the constant help of other people);

Orientation abilities of the 3rd degree (disorientation and need for constant help and (or) supervision of other persons);

Ability to communicate 3 degrees (inability to communicate and the need for constant help from others);

The ability to control one's behavior of the 3rd degree (inability to control one's behavior, the impossibility of correcting it, the need for constant help (supervision) of other persons).

Criteria for determining Group II disability is a violation of the health of a person with a persistent disorder of body functions, caused by diseases, the consequences of injuries or defects, leading to the restriction of one of the following categories of life activity or their combination and causing the need for his social protection:

Ability to self-service 2nd degree (ability to self-service with regular partial assistance from other persons using, if necessary, auxiliary technical means);

Ability to move 2nd degree (ability to move independently with regular partial assistance of other persons using, if necessary, auxiliary technical means);

Orientation abilities of the 2nd degree (orientation ability with regular partial help of other persons, using auxiliary technical means, if necessary);

Ability to communicate 2nd degree (ability to communicate with regular partial assistance of other persons using, if necessary, auxiliary technical means);

Ability to control one's behavior of the 2nd degree (permanent reduction in criticism of one's behavior and the environment with the possibility of partial correction only with the regular help of other persons);

Ability to learn 3 and 2 degrees (inability to learn or ability to learn only in special (correctional) educational institutions for students, pupils with developmental disabilities or at home according to special programs using, if necessary, auxiliary technical means and technologies);

Ability to labor activity 3 and 2 degrees (inability to work or impossibility (contraindication) of work or the ability to perform work in specially created working conditions, using auxiliary technical means and (or) with the help of other persons).

Criteria for determining Group III disability is a violation of human health with a persistent moderate disorder of body functions, caused by diseases, consequences of injuries or defects, leading to a limitation of the ability to work I degree or limitation of the following categories of life in their various combinations and causing the need for social protection:

Ability to self-service of the 1st degree (ability to self-service with a longer expenditure of time, fragmentation of its implementation, reduction in volume, using, if necessary, auxiliary technical means);

Ability to move I degree (ability to move independently with a longer expenditure of time, fragmentation of performance and reduction of distance using, if necessary, auxiliary technical means);

Orientation abilities of the 1st degree (ability to orientate only in a familiar situation independently and (or) with the help of auxiliary technical means);

Ability to communicate I degree (ability to communicate with a decrease in the rate and volume of receiving and transmitting information; use, if necessary, auxiliary technical means of assistance);

Ability to control one's behavior of the 1st degree (periodically occurring limitation of the ability to control one's behavior in difficult life situations and (or) constant difficulty in performing role functions affecting certain areas of life, with the possibility of partial self-correction);

Ability to learn I degree (ability to learn, as well as to receive education of a certain level within the framework of state educational standards in general educational institutions using special teaching methods, a special training regime, using, if necessary, auxiliary technical means and technologies).

Category "disabled child" is determined in the presence of disability of any category and any of the three degrees of severity (which are assessed in accordance with the age norm), causing the need for social protection.

6. 36 Organization of obstetric and gynecological care in Kazakhstan. Measures to combat abortion.

Obstetric and gynecological care is provided in the following APOs:

1) organizations of primary health care (hereinafter referred to as PHC):

polyclinic (city, district, rural);

medical outpatient clinic, feldsher-obstetric station, medical center;

2) healthcare organizations providing consultative and diagnostic assistance (hereinafter referred to as CDP):

consultative and diagnostic centers / polyclinics.

In PHC healthcare organizations, pre-medical and qualified medical care without round-the-clock medical supervision for the protection of women's reproductive health is provided by doctors general practice, primary care physicians/pediatricians, feldshers, obstetricians and nurses.

In healthcare organizations of the KDP, specialized medical care without round-the-clock medical supervision for the protection of women's reproductive health is provided by obstetrician-gynecologists and other specialists.

The mode of operation of state and non-state APOs that provide a guaranteed amount of free medical care established in accordance with applicable law.

The obstetric and gynecological departments (offices) within the health care organizations of PHC and CDP organize obstetric and gynecological care for women outside and during pregnancy, in the postpartum period, provide family planning and reproductive health services, as well as prevention, diagnosis and treatment of gynecological diseases of the reproductive systems by:

1) dispensary observation of pregnant women in order to prevent and early detection complications of pregnancy, childbirth and the postpartum period with the allocation of women "by risk factors";

2) identification of pregnant women in need of timely hospitalization in day hospitals, pregnancy pathology departments of maternity hospitals, specialized medical institutions with extragenital pathology, in compliance with the principles of regionalization of perinatal care;

3) referral of pregnant women, women in childbirth, puerperas to receive specialized and highly specialized medical care in medical organizations of the republican level;

4) conducting prenatal training for pregnant women in preparation for childbirth, including for partner childbirth, providing an opportunity for pregnant women to visit a maternity facility where childbirth is planned, informing pregnant women about alarming signs, about effective perinatal technologies, the principles of safe motherhood, breastfeeding and perinatal care;

5) conducting patronage of pregnant women and puerperas;

6) counseling and provision of services on family planning and reproductive health;

7) examination of women of childbearing age with the appointment, if necessary, of an in-depth examination using additional methods and the involvement of narrow specialists for the timely detection of extragenital, gynecological pathology and taking them to the dispensary;

8) depending on the level of reproductive and somatic health, women are included in dynamic observation groups for timely preparation for a planned pregnancy in order to improve pregnancy outcomes for mother and child;

9) organization and conduct preventive examinations the female population for the purpose of early detection of extragenital diseases;

10) examination and treatment of gynecological patients using modern medical technologies, including in hospital-replacing conditions;

11) identifying and examining gynecological patients to prepare for hospitalization in specialized medical organizations;

12) clinical examination of gynecological patients, including rehabilitation and sanatorium treatment;

13) performing minor gynecological operations using modern medical technologies;

14) ensuring the continuity of interaction in the examination and treatment of pregnant women, puerperas, gynecological patients;

15) conducting an examination of temporary disability due to pregnancy, childbirth and gynecological diseases, determining the need for and terms of temporary or permanent transfer of an employee for health reasons to another job, referring women with signs of permanent disability to medical and social examination in the prescribed manner;

16) provision of medical and social, legal and psychological help;

17) advanced training of doctors and paramedical personnel in accordance with the current legislation of the Republic of Kazakhstan;

18) introduction into practice of modern safe diagnostic and therapeutic technologies, measures for the prevention and rehabilitation of patients, taking into account the principles of evidence-based medicine;

19) implementation of sanitary and anti-epidemic (preventive) measures to ensure the safety of personnel and patients, prevent the spread of infection;

20) carrying out activities in the field of informing and improving the sanitary culture of the population on various aspects healthy lifestyle life, preservation of women's reproductive health, preparation for motherhood, breastfeeding, family planning, prevention of abortion and sexually transmitted infections, including HIV infection and other socially significant diseases;

21) analysis of performance indicators of obstetric and gynecological units (office), statistical accounting, evaluation of the effectiveness and quality of medical care, development of proposals for improving obstetric and gynecological care;

22) conducting educational work with the population, doctors and midwives in the following forms: individual and group conversations, lectures, stained-glass windows, publications in print and electronic media (television, radio and the Internet). Educational work is carried out jointly with the centers for the formation of a healthy lifestyle. Accounting for the work done is kept in the register of information and educational work medical organization according to the form 038-1 / y, approved by the order of acting. Minister of Health of the Republic of Kazakhstan dated November 23, 2010 No. 907 "On approval of forms of primary medical records healthcare organizations, registered in the Register state registration normative legal acts No. 6697.

The first place should be given to sanitary and educational work among the population (male and female) using its various forms (lectures, conversations, films, radio, television, print, exhibitions, posters, brochures, leaflets, memos, evenings of questions and answers and etc.).

OK Nikonchik points out that for a number of years the percentage of primigravida and nulliparous among the total number of women resorting to abortion has remained the same (about 10%). In her opinion, this fact testifies to the insufficient effectiveness of the sanitary-educational work of women's clinics.

Providing the population with effective contraceptives is of great importance in reducing the number of abortions. In fact, they are available, but either they are not used in sufficient volume, or they are ineptly used. This is indicated by the above data by O. E. Cherpetsky, according to which 52% of women going for an abortion did not use them, and 40% used them ineptly or resorted to ineffective, even harmful methods (coitus interruptus). Based on the materials of O.K. Nikonchik, 30-35% of women who have a regular sexual life do not protect themselves from pregnancy. In this regard, the organization in antenatal clinics is useful special tricks on this issue and the sale of contraceptives.

An important role should be played by well-placed social and legal assistance in women's consultations, especially in combination with patronage of pregnant women at home, which makes it possible to clarify the conditions of their life and family relations. Improving the living conditions of pregnant women is also one of the tasks of antenatal clinics.

Particular attention should be paid to primigravidas and women who often resort to abortions, as well as to persons who have resorted to criminal interventions for the purpose of abortion.

Practice has shown that the best results in reducing the number of abortions were achieved where the public was involved in this work and where the fight against abortion was supported by the implementation of the outlined plans for the construction of children's institutions, maternity hospitals, gynecological departments, etc.

Komsomol and trade union organizations of institutions, industrial enterprises and educational institutions should be involved in the fight against abortion. Vigorous work is needed to identify and bring to justice those involved in criminal abortions.

OK Nikonchik gives interesting data concerning new proposals introduced into practice in some regions of the country and aimed at reducing the number of abortions. These include the organization of people's universities for newlyweds (Syzran), dispensary observation women who often resort to abortions (Kuibyshev region), the establishment of a marriage hygiene consultation at the registry office (Voronezh region), a lecture hall for men (Sevastopol), the organization of a university of health for women (Tula region).

Of great importance in the fight against abortion will be the further rise in the well-being of the population, the implementation of state measures to encourage motherhood, the further growth of housing construction, children's institutions and the raising of the cultural level of the Soviet people.

1. 37Main types of institutions for the protection of motherhood and childhood. Their functions.

Women's consultations - dispensary-type medical and preventive institutions that provide all types of preventive and curative care to pregnant women and gynecological patients, as well as taking the necessary measures to protect and improve women's health. They can exist both as independent institutions and as part of maternity hospitals, polyclinics, medical and sanitary units of industrial enterprises or other medical institutions.

Consultations provide medical obstetric and gynecological care to women of the assigned territory, are engaged in the implementation of modern methods diagnostics and treatment, advanced forms and methods of outpatient obstetric and gynecological care, carry out sanitary and educational work among the population, provide assistance to women in matters of legal protection in accordance with the legislation on the protection of motherhood and childhood, conduct preventive actions aimed at preventing complications of pregnancy, childbirth, the postpartum period, gynecological diseases; provide continuity and communication in the examination and treatment of pregnant and sick women with other medical institutions (maternity hospitals, ambulance stations, children's clinics).

As part of each independent antenatal clinic, there are: obstetric and gynecological medical rooms, specialist doctors (therapist, dentist), procedural rooms, for psychoprophylactic preparation of pregnant women for childbirth, for mothers' school, for the prevention of pregnancy, a social and legal worker, an operating room with a rest room for patients, etc. If the consultation is part of another medical institution, then some of his offices are used to serve women.

The work of the antenatal clinic is based on the territorial-district principle, according to which the entire territory served by the consultation is divided into medical sections. The site is served by an obstetrician-gynecologist and a midwife. Reception in consultations is held daily at a convenient time for the population (optimal hours are from 8 to 20). Usually, each district doctor conducts alternating morning and evening appointments, which makes it possible for a woman to contact “her” doctor at a convenient time for her. Preliminary appointments for all days of the week, a doctor's house call are made by phone or directly through the consultation registry.

The patronage work of antenatal clinics consists in visiting pregnant women (mainly by a midwife or a doctor), puerperas and gynecological patients in order to familiarize themselves with their living conditions, monitor the patient's compliance with the doctor's prescriptions and adherence to the recommended regimen, and establish the health status of women who did not appear at the appointment. a doctor or not hospitalized in a hospital, teaching women the rules of personal hygiene, etc.

You can always get advice from the legal adviser of the antenatal clinic on issues of maternal and child health, work, leisure, etc.

Medical and sanitary units (MSCh) serve workers directly at industrial enterprises and belong to medical and preventive institutions of the outpatient-polyclinic type. They include polyclinics, hospitals, workshop health centers, as well as dispensaries, nurseries, diet tables. Many medical units have a antenatal clinic and an obstetric-gynecological department in a hospital and thus provide the entire volume of obstetric and gynecological care to workers. In addition to serving the workers of their enterprise, many medical units also provide assistance to the population living in the area of ​​their location.

Women's consultations as part of the medical unit are created and work on the shop principle. The duties of obstetrician-gynecologists working in the medical unit include: studying the working conditions of women; selection of pregnant women to be rehabilitated in sanatoriums; recommendations on dietary nutrition of pregnant women in the canteen of the enterprise; examination of temporary disability; development of health-improving measures for the prevention and reduction of temporary disability of women; employment of workers who have undergone gynecological diseases or operations, who are often and for a long time ill; participation in medical examinations of female employees (mandatory preliminary upon admission to work and periodic); organization of a sanitary asset on its site; participation in the development and implementation of activities carried out by the administration of an industrial enterprise and public organizations on labor protection and women's health. To prevent gynecological morbidity, each industrial enterprise creates personal hygiene rooms with separate cabins with a rising shower (bidet), shower units and a room for a short rest for workers after hygiene procedures. Personal hygiene rooms are located, as a rule, not far from the place of work of women, and in large enterprises - in each workshop. Where it is impossible to equip stationary personal hygiene rooms, mobile cabins with shower units and warm water tanks are organized.

"Marriage and Family" consultations are a relatively new form of medical care for the population and are designed to provide them with specialized treatment, preventive and advisory assistance on medical aspects family and marriage relations. They are organized in the capitals of the Union republics, republican, regional (territorial) centers, other cities with a population of over 500 thousand people and are subdivisions of women's consultations. They provide medical assistance to the population for infertility (male and female), conduct in-depth outpatient examinations and treatment of women and men suffering from reproductive dysfunction, provide consultations on the medical aspects of family planning (individual selection of modern contraceptives to prevent unwanted pregnancy for newlyweds, families with increased risk of giving birth to a sick child), on psychological issues of intra-family communication, on sexual disorders (outpatient examination and treatment of married couples suffering from sexual disorders), a medical genetic examination of families with hereditary pathology is being carried out, sanitary and educational work is being carried out on issues of marriage hygiene.

Medico-genetic consultations. There are two types of medical genetic institutions in the Soviet public health system: regional medical genetic offices and republican (interregional) medical genetic consultations.

Medical genetic rooms are usually deployed at the base regional hospitals. The tasks of the regional offices, in addition to the actual medical genetic counseling (assessing the risk of having a child with a particular pathology), include promoting medical genetic knowledge among doctors and the public, as well as helping doctors and families in diagnosing a number of hereditary diseases. Some genetic studies are also carried out in them (determination of the set of chromosomes, simple biochemical analyzes etc.). In necessary cases, families are sent to the republican (interregional) medical genetic consultations.

The tasks of the republican medical genetic consultations are an in-depth examination of patients with a hereditary pathology (or suspicion of it) and the determination of the genetic risk in the most difficult cases, prenatal diagnostics hereditary pathology, organizing and conducting mass examinations of all newborns for phenylketonuria and hypothyroidism.

Medical genetic counseling. A relatively new type of medical care for spouses (or one of them), aimed at preventing the birth of a child with hereditary diseases or congenital malformations.

There are 2 types of medical genetic counseling: prospective, which is carried out before the birth of a child, and retrospective, carried out after the birth of a sick child and is associated with an assessment of the risk of recurrence of the disease.

In what cases is it advisable to contact a medical genetic consultation for prospective counseling? Firstly, it is necessary in the presence of hereditary diseases or congenital defects in one of the spouses or their close relatives. In these cases, it is more expedient to consult a consultation before the onset of pregnancy, in order to plan a pregnancy or refuse it, taking into account the conclusion of a geneticist.

Second, prospective counseling includes counseling for pregnant women. Sometimes a woman in the period immediately preceding pregnancy, or at the beginning of it, without knowing it, takes medication, undergoes X-ray or radioisotope examination, suffers from certain diseases. In such cases, it is also advisable to contact a medical genetic consultation to find out if such effects will affect the condition of the fetus.

The third reason for treatment can and should be repeated spontaneous abortions (miscarriages) in the early stages of pregnancy, as well as infertility of spouses. It is known that in more than 50% of cases, miscarriages in the first 3 months of pregnancy are associated precisely with chromosomal pathology, which can be detected in a latent form in one or both spouses. Therefore, for couples where the wife had 2 or more spontaneous miscarriages in early dates, the study of chromosomes should be one of the elements of their medical examination.

More complicated is the issue of genetic testing for infertility. Those genetic diseases that can lead to infertility in women are usually manifested by delayed puberty and the absence of menstruation (amenorrhea), and in such cases, medical genetic counseling and examination are absolutely necessary. If sexual development proceeds normally and there are no violations menstrual cycle, we can firmly believe that the cause of infertility is not associated with chromosomal abnormalities and consultation with a specialist in infertility, and not a geneticist, is necessary.

In men, a manifestation of genetic disorders leading to infertility is aspermia (absence of spermatozoa in the ejaculate). Therefore, if a spouse has a similar anomaly, a genetic examination is highly advisable. In cases of infertility (male or female), a genetic study should be preceded by a consultation with the relevant specialists - a gynecologist or sexologist.

The second type of medical genetic counseling is retrospective, it is carried out when the family already has (or had) a sick child and the spouses are concerned about the probability of birth next child healthy. This type of counseling is more common. The fact is that in most families, young, healthy spouses, in whose relatives there were no similar diseases, usually there are no obvious reasons to turn to genetics and the birth of a sick child is unexpected for them.

Indications for retrospective counseling are: the birth of a child (fetus) with any congenital malformations; delay in his psychomotor or physical development and the presence of convulsions; intolerance to certain foods in a child, repeated vomiting, chronic diarrhea; progressive jaundice of newborns, enlargement of the liver or spleen; chronic bronchopulmonary diseases, death of a newborn child from intestinal obstruction; decreased hearing or vision in a child; change in color and smell of urine; violation of pigmentation of the skin and mucous membranes; paresis and paralysis of unknown origin. Consultation in these cases can be undertaken at the initiative of the family. There are many other indications for referring to a geneticist - for example, the presence of an unclear pathology of the blood system, intolerance to some drugs, etc., but the recommendation to consult a geneticist in these cases is usually given by the attending physician.

In any case, counseling begins with the establishment of an accurate diagnosis in a sick child or in a sick parent, relative, depending on what was the reason for the appeal. To do this, sometimes you have to resort to special genetic examination methods - chromosome analysis, biochemical studies, studying the nature of skin patterns on the palms and fingers, etc., and in some cases to additional methods clinical examination - X-ray, neurological, study of electrocardio- and electroencephalograms. This is due to the difficulty of identifying hereditary diseases, the number of which is very large (only diseases caused by single genes are known to be more than 3500). In addition, many hereditary diseases similar not only to each other, but also to diseases of a non-hereditary nature.

In each case, at the first visit of the family to the medical genetic consultation, detailed information is collected about the development of the disease, living conditions, past diseases, etc., a pedigree of at least 4 generations is compiled, and, if necessary, the tasks of additional research are determined. The consultation usually ends with the issuance of a medical genetic report.

It should be borne in mind that some hereditary diseases are clinically manifested already at the birth of a child, while others - only after a few months or even years. At the same time, the development of the disease can sometimes be prevented. timely treatment. That is why all newborns must be examined to identify some hereditary diseases, the list of which depends on the characteristics of the region.

Decision-making in retrospective counseling about the advisability of having the next child is influenced by both the magnitude of the risk (risk above 10% in genetics is assessed as high) and the nature of the disease. For example, even a 50% risk of having a baby with six fingers cannot be a reason for not planning a pregnancy, since this defect can be easily removed surgically. At the same time, even with a 5-6% risk of having a child with severe mental retardation or blindness, most spouses prefer to refrain from further childbearing. Of course, the nature of the recommendation is also influenced by the presence of healthy children in the family, the age of the spouses, their socio-cultural level, and other factors.

It is useful to know that if earlier a geneticist ended the consultation by determining the genetic risk and explaining to his family in an accessible form, giving the spouses the right to decide for themselves what to do, now, due to the success of medicine, it has become possible to directly study the intrauterine fetus. Such studies are united by the concept of prenatal (prenatal) diagnosis, the methods of which depend on the type of pathology, gestational age, and a number of other factors. What does prenatal diagnosis of malformations and hereditary diseases give?

Specialists of the Bureau of Medical and Social Expertise recognized 20-year-old Muscovite Ekaterina Prokudina, who has been suffering from childhood cerebral palsy and cannot move independently, a disabled person of the second group, effectively depriving her of the opportunity to undergo annual sanatorium treatment, the girl's mother Marina Prokudina told RIA Novosti.

In accordance with the rules for recognizing a person as a disabled person, approved by a decree of the Government of the Russian Federation of February 20, 2006, a citizen is recognized as disabled during a medical and social examination based on a comprehensive assessment of the state of the citizen's body based on an analysis of his clinical, functional, social, household, professional labor and psychological data using classifications and criteria approved by the Ministry of Health and Social Development of the Russian Federation.

Conditions for recognizing a citizen as disabled are:

Impairment of health with a persistent disorder of body functions due to diseases, consequences of injuries or defects;
- limitation of life activity (complete or partial loss by a citizen of the ability or ability to carry out self-service, move independently, navigate, communicate, control their behavior, study or engage in work activities);
- the need for social protection measures, including rehabilitation.

The presence of one of these conditions is not sufficient grounds for recognizing a citizen as disabled.

Depending on the degree of limitation of life activity due to a persistent disorder of body functions resulting from diseases, the consequences of injuries or defects, a citizen recognized as disabled is assigned I, II or III disability groups, and a citizen under the age of 18 is assigned the category "disabled child".

Disability of the I group is established for 2 years, II and III groups - for 1 year.

If a citizen is recognized as a disabled person, the cause of disability is a general illness, labor injury, occupational disease, disability from childhood, disability due to injury (concussion, mutilation) associated with military operations during the Great Patriotic War, military injury, illness received during military service, disability associated with the disaster at the Chernobyl nuclear power plant, the consequences of radiation exposure and direct participation in the activities of special risk units, as well as other reasons established by the legislation of the Russian Federation.

Re-examination of disabled people of group I is carried out once every 2 years, disabled people of groups II and III - once a year, and children with disabilities - once during the period for which the category "child with a disability" is established for the child.

A disability group is established for citizens without specifying the re-examination period, and for citizens under the age of 18, the category "disabled child" until the citizen reaches the age of 18:

Not later than 2 years after the initial recognition as a disabled person (establishing the category "disabled child") of a citizen who has diseases, defects, irreversible morphological changes, dysfunctions of organs and body systems according to the list according to the appendix;
- not later than 4 years after the initial recognition of a citizen as a disabled person (establishing the category "disabled child") in the event that it is impossible to eliminate or reduce the degree of limitation of the citizen's life activity caused by persistent irreversible morphological changes, defects and dysfunctions of the organs and systems of the body during the implementation of rehabilitation measures.

The list of diseases, defects, irreversible morphological changes, violations of the functions of organs and systems of the body, in which the disability group (category "disabled child" until the citizen reaches the age of 18) is established without specifying the re-examination period:
1. Malignant neoplasms (with metastases and relapses after radical treatment; metastases without an identified primary focus with treatment failure; severe general condition after palliative treatment, incurability (incurability) of the disease with severe symptoms of intoxication, cachexia and tumor decay).
2. Malignant neoplasms of lymphoid, hematopoietic and related tissues with severe symptoms of intoxication and severe general condition.
3. Inoperable benign neoplasms head and spinal cord with persistent pronounced disorders of motor, speech, visual functions and severe liquorodynamic disorders.
4. Absence of the larynx after its surgical removal.
5. Congenital and acquired dementia (severe dementia, mental retardation severe, profound mental retardation).
6. Diseases nervous system with a chronic progressive course, with persistent pronounced disorders of motor, speech, visual functions.
7. Hereditary progressive neuromuscular diseases, progressive neuromuscular diseases with impaired bulbar functions (swallowing functions), muscle atrophy, impaired motor functions and (or) impaired bulbar functions.
8. severe forms neurodegenerative diseases of the brain (parkinsonism plus).
9. Complete blindness in both eyes with the ineffectiveness of the treatment; decrease in visual acuity in both eyes and in the better seeing eye up to 0.03 with correction or concentric narrowing of the visual field in both eyes up to 10 degrees as a result of persistent and irreversible changes.
10. Complete deaf-blindness.
11. Congenital deafness with impossibility of hearing replacement (cochlear implantation).
12. Diseases characterized by increased blood pressure with severe complications from the central nervous system (with persistent pronounced disorders of motor, speech, visual functions), heart muscles (accompanied by circulatory failure IIB III degree and coronary insufficiency III IV functional class), kidneys (chronic renal failure stage IIB III).
13. Ischemic disease hearts with coronary insufficiency III IV functional class of angina pectoris and persistent circulatory disorders IIB III degree.
14. Diseases of the respiratory organs with a progressive course, accompanied by a persistent respiratory failure II III degree, in combination with circulatory failure IIB III degree.
15. Cirrhosis of the liver with hepatosplenomegaly and portal hypertension of the III degree.
16. Fatal fecal fistulas, stoma.
17. Pronounced contracture or ankylosis of large joints of the upper and lower extremities in a functionally disadvantageous position (if arthroplasty is impossible).
18. End-stage chronic kidney failure.
19. Fatal urinary fistulas, stoma.
20. Congenital anomalies in the development of the musculoskeletal system with severe persistent disorders of the function of support and movement when correction is impossible.
21. Consequences of traumatic injury to the brain (spinal) cord with persistent and pronounced disorders of motor, speech, visual functions and severe dysfunction of the pelvic organs.
22. Defects upper limb: amputation area shoulder joint, disarticulation of the shoulder, shoulder stump, forearm, absence of the hand, absence of all phalanges of the four fingers of the hand, excluding the first, absence of three fingers of the hand, including the first.
23. Defects and deformations lower limb: amputation area hip joint, disarticulation of the thigh, femoral stump, lower leg, absence of the foot.

Medical and social expertise a citizen is carried out at the bureau at the place of residence (at the place of stay, at the location of the pension file of a disabled person who has left for permanent residence outside the Russian Federation).

In the main bureau, a citizen's medical and social examination is carried out if he appeals against the decision of the bureau, as well as in the direction of the bureau in cases requiring special types of examination.

In the Federal Bureau of Medical and Social Expertise, a citizen is carried out in the event that he appeals against the decision of the main bureau, as well as in the direction of the main bureau in cases requiring particularly complex special types of examination.

A medical and social examination can be carried out at home if a citizen cannot come to the bureau (main bureau, Federal Bureau) for health reasons, which is confirmed by the conclusion of the organization providing medical and preventive care, or in the hospital where the citizen is being treated, or in absentia by decision of the relevant bureau.

The decision to recognize a citizen as a disabled person or to refuse to recognize him as a disabled person is made by a simple majority of votes of the specialists who conducted the medical and social examination, based on a discussion of the results of his medical and social examination.

A citizen (his legal representative) may appeal the decision of the bureau to the main bureau within a month on the basis of a written application submitted to the bureau that conducted the medical and social examination, or to the main bureau.

The bureau that conducted the medical and social examination of the citizen, within 3 days from the date of receipt of the application, sends it with all available documents to the main bureau.

The main bureau, no later than 1 month from the date of receipt of the citizen's application, conducts his medical and social examination and, based on the results, makes an appropriate decision.

In the event that a citizen appeals against the decision of the main bureau, the chief expert in medical and social expertise for the relevant subject of the Russian Federation, with the consent of the citizen, may entrust his medical and social expertise to another team of specialists from the main bureau.

The decision of the main bureau can be appealed within a month to the Federal Bureau on the basis of an application submitted by a citizen (his legal representative) to the main bureau that conducted the medical and social examination, or to the Federal Bureau.

The Federal Bureau, no later than 1 month from the date of receipt of the citizen's application, conducts his medical and social examination and, based on the results, makes an appropriate decision.

Decisions of the bureau, the main bureau, the Federal Bureau may be appealed to the court by a citizen (his legal representative) in the manner prescribed by the legislation of the Russian Federation.

Classifications and criteria, used in the implementation of medical and social examination of citizens by federal state institutions of medical and social examination, approved by order of the Ministry of Health and Social Development of December 23, 2009.

The classifications used in the implementation of the medical and social examination of citizens determine the main types of violations of the functions of the human body due to diseases, the consequences of injuries or defects, and the degree of their severity, as well as the main categories of human life and the severity of the restrictions of these categories.

The criteria used in the implementation of the medical and social examination of citizens determine the conditions for establishing disability groups (categories "disabled child").

To the main types of violations of the functions of the human body relate:

Violations of mental functions (perception, attention, memory, thinking, intellect, emotions, will, consciousness, behavior, psychomotor functions);
- violations of language and speech functions (disorders of oral and written, verbal and non-verbal speech, violations of voice formation, etc.);
- violations of sensory functions (vision, hearing, smell, touch, tactile, pain, temperature and other types of sensitivity);
- violations of static-dynamic functions (motor functions of the head, trunk, limbs, statics, coordination of movements);
- violations of the functions of blood circulation, respiration, digestion, excretion, hematopoiesis, metabolism and energy, internal secretion, immunity;
- violations caused by physical deformity (deformities of the face, head, trunk, limbs, leading to external deformity, abnormal openings of the digestive, urinary, respiratory tracts, violation of body size).

In a comprehensive assessment of various indicators characterizing persistent violations of the functions of the human body, four degrees of their severity are distinguished:

1 degree - minor violations,
Grade 2 - moderate violations,
Grade 3 - severe violations,
Grade 4 - significant violations.

The main categories of human life include: the ability to self-service; ability to move independently; ability to orientate; ability to communicate; the ability to control one's behavior; ability to learn; ability to work.

In a comprehensive assessment of various indicators characterizing the limitations of the main categories of human life, 3 degrees of their severity are distinguished:

Self-service ability- the ability of a person to independently fulfill basic physiological needs, perform daily household activities, including personal hygiene skills:

1 degree - the ability to self-service with a longer expenditure of time, the fragmentation of its implementation, reducing the volume using, if necessary, auxiliary technical means;
2 degree - the ability to self-service with regular partial assistance from other persons using, if necessary, auxiliary technical means;
Grade 3 - inability to self-service, the need for constant outside help and complete dependence on other people.

Ability to move independently- the ability to independently move in space, maintain body balance when moving, at rest and when changing body position, use public transport:

1 degree - the ability to move independently with a longer expenditure of time, fragmentation of performance and reduction of distance using, if necessary, auxiliary technical means;
Grade 2 - the ability to move independently with regular partial assistance from other persons using, if necessary, auxiliary technical means;
Grade 3 - inability to move independently and needing the constant help of other people.

Orientation ability- the ability to adequately perceive the environment, assess the situation, the ability to determine the time and location:

1 degree - the ability to orient only in a familiar situation independently and (or) with the help of auxiliary technical means;
2 degree - the ability to orientate with regular partial assistance of other persons using, if necessary, auxiliary technical means;
Grade 3 - inability to orient (disorientation) and the need for constant help and (or) supervision of other persons.

Ability to communicate- the ability to establish contacts between people through the perception, processing and transmission of information:

1 degree - the ability to communicate with a decrease in the pace and volume of receiving and transmitting information; use, if necessary, auxiliary technical means of assistance; with isolated damage to the hearing organ, the ability to communicate using non-verbal methods and sign language services;
2 degree - the ability to communicate with regular partial assistance of other persons using, if necessary, auxiliary technical means;
Grade 3 - inability to communicate and the need for constant help from others.

The ability to control your behavior- the ability to self-awareness and adequate behavior, taking into account social and legal and moral and ethical standards:

1 degree- periodically occurring limitation of the ability to control one's behavior in difficult life situations and (or) constant difficulty in performing role functions affecting certain areas of life, with the possibility of partial self-correction;
2 degree- a constant decrease in criticism of one's behavior and the environment with the possibility of partial correction only with the regular help of other people;
3 degree- inability to control one's behavior, the impossibility of its correction, the need for constant help (supervision) of other persons.

Ability to learn- the ability to perceive, memorize, assimilate and reproduce knowledge (general educational, professional, etc.), mastering skills and abilities (professional, social, cultural, everyday):

1 degree- the ability to learn, as well as to receive education of a certain level within the framework of state educational standards in general-purpose educational institutions using special teaching methods, a special training mode, using, if necessary, auxiliary technical means and technologies;
2 degree- the ability to study only in special (correctional) educational institutions for students, pupils, children with disabilities or at home according to special programs using, if necessary, auxiliary technical means and technologies;
3 degree- inability to learn.

Ability to work- the ability to carry out labor activities in accordance with the requirements for the content, volume, quality and conditions of work:

1 degree- the ability to perform labor activities in normal working conditions with a decrease in qualifications, severity, tension and (or) a decrease in the volume of work, the inability to continue working in the main profession while maintaining the ability to perform labor activities of a lower qualification under normal working conditions;
2 degree- the ability to perform labor activities in specially created working conditions using auxiliary technical means and (or) with the help of other persons;
3 degree- inability to any labor activity or impossibility (contraindication) of any labor activity.

The degree of restriction of the main categories of human life is determined based on the assessment of their deviation from the norm, corresponding to a certain period (age) of human biological development.