- Order of the Ministry of Health of the Russian Federation (Ministry of Health of Russia) of April 29, 2015 N 216n Moscow "On approval of the list of medical contraindications, due to the presence of which a citizen or recipient of social services may be denied, including temporarily, in the provision of social services in a stationary form, as well as the form of conclusion of an authorized medical organization on the presence of such contraindications "
- Order of the Ministry of Health of the Russian Federation (Ministry of Health of Russia) dated April 11, 2013 N 216n Moscow “On approval of the Procedure for medical examination of orphans and children left without parental care, including adopted (adopted), taken under guardianship (guardianship) , in a foster or foster family"
Order of the Ministry of Health of the Russian Federation of April 29, 2015 N 216n “On approval of the list of medical contraindications, in connection with the presence of which a citizen or recipient of social services may be denied, including temporarily, the provision of social services in a stationary form, as well as a form of conclusion authorized medical organization on the presence of such contraindications "
Order of the Ministry of Health of the Russian Federation of April 29, 2015 N 216n
"On approval of the list of medical contraindications, in connection with the presence of which a citizen or recipient of social services may be denied, including temporarily, the provision of social services in a stationary form, as well as the form of conclusion of an authorized medical organization on the presence of such contraindications"
In accordance with Part 3 of Article 18 of Federal Law No. 442-FZ of December 28, 2013 “On the Fundamentals of Social Services for Citizens in the Russian Federation” (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 2013, No. 52, Art. 7007; 2014, No. 30, Art. 4257) and subparagraph 11 of part 2 of article 14 of the Federal Law of November 21, 2011 N 323-FZ "On the basics of protecting the health of citizens in the Russian Federation" (Sobranie zakonodatelstva Rossiyskoy Federatsii, 2011, N 48, art. 6724; 2012, N 26, items 3442, 3446; 2013, N 27, items 3459, 3477; N 30, item 4038; N 39, item 4883; N 48, item 6165; N 52, item 6951; 2014, N 23, item 2930; N 30, item 4106, 4244, 4247, 4257; N 43, item 5798; N 49, item 6927, 6928; 2015, N 1, item 72, 85; N 10, item 1403, 1425; N 14, item 2018) I order:
a list of medical contraindications, in connection with the presence of which a citizen or recipient of social services may be denied, including temporarily, in the provision of social services in a stationary form, in accordance with Appendix No. 1;
the form of the conclusion of an authorized medical organization on the presence of medical contraindications, in connection with the presence of which a citizen or recipient of social services may be denied, including temporarily, in the provision of social services in a stationary form, in accordance with Appendix No. 2.
A list of medical contraindications has been compiled, in the presence of which a citizen or recipient of social services may be denied, including temporarily, in the provision of social services in a stationary form.
We are talking, in particular, about such diseases as tuberculosis, epilepsy with frequent seizures, malformations of the face and skull with impaired breathing, chewing, swallowing, tracheostomy.
The form of the conclusion of the authorized medical organization on the presence of contraindications has been approved.
Order of the Ministry of Health of the Russian Federation of April 29, 2015 N 216n “On approval of the list of medical contraindications, in connection with the presence of which a citizen or recipient of social services may be denied, including temporarily, the provision of social services in a stationary form, as well as a form of conclusion authorized medical organization on the presence of such contraindications "
Order of the Ministry of Health and Social Development of the Russian Federation dated May 5, 2008 No. 216n "On approval of professional qualification groups for positions of education workers"
In accordance with Article 144 of the Labor Code of the Russian Federation (Collected Legislation of the Russian Federation, 2002, N 1 (part I), art. 3; N 30, art. 3014, 3033; 2003, N 27 (part I), art. 2700; 2004, N 18, item 1690; N 35, item 3607; 2005, N 1 (part I), item 27; N 19, item 1752; 2006, N 27, item 2878; N 52 (part I), item 5498; 2007, N 1 (part I), item 34; N 17, item 1930; N 30, item 3808; N 41, item 4844; N 43, item 5084; N 49, item 6070; 2008, N 9, item 812) I order:
Approve the attached professional qualification groups for the positions of educators.
Professional qualification groups of positions of employees
education*(1)
(approved by order of the Ministry of Health and Social Development of the Russian Federation
dated May 5, 2008 N 216n)
Professional qualification group of positions of employees of educational and auxiliary personnel of the first level
Professional qualification group of positions of employees of educational and auxiliary personnel of the second level
Professional qualification group of positions of pedagogical workers
Professional qualification group of positions of heads of structural divisions
*(1) With the exception of positions of employees of higher and additional professional education
*(2) Excluding teaching positions classified as faculty.
*(3) With the exception of tutors employed in the field of higher and additional professional education.
*(4) In addition to the positions of heads of structural units assigned to the 2nd qualification level.
*(5) In addition to the positions of heads of structural units assigned to the 3rd qualification level.
Order of the Ministry of Health and Social Development of the Russian Federation of May 5, 2008 N 216n "On approval of professional qualification groups for positions of educators"
Registration N 11731
This Order shall enter into force 10 days after the date of its official publication.
Order of the Ministry of Health of the Russian Federation (Ministry of Health of Russia) of April 29, 2015 N 216n Moscow "On approval of the list of medical contraindications, due to the presence of which a citizen or recipient of social services may be denied, including temporarily, in the provision of social services in a stationary form, as well as the form of conclusion of an authorized medical organization on the presence of such contraindications "
Registration N 37608
In accordance with Part 3 of Article 18 of Federal Law No. 442-FZ of December 28, 2013 “On the Fundamentals of Social Services for Citizens in the Russian Federation” (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 2013, No. 52, Art. 7007; 2014, No. 30, Art. 4257) and subparagraph 11 of part 2 of article 14 of the Federal Law of November 21, 2011 N 323-FZ "On the basics of protecting the health of citizens in the Russian Federation" (Sobranie zakonodatelstva Rossiyskoy Federatsii, 2011, N 48, art. 6724; 2012, N 26, items 3442, 3446; 2013, N 27, items 3459, 3477; N 30, item 4038; N 39, item 4883; N 48, item 6165; N 52, item 6951; 2014, N 23, item 2930; N 30, item 4106, 4244, 4247, 4257; N 43, item 5798; N 49, item 6927, 6928; 2015, N 1, item 72, 85; N 10, item 1403, 1425; N 14, item 2018) I order:
Order of the Ministry of Health of the Russian Federation (Ministry of Health of Russia) dated April 11, 2013 N 216n Moscow “On approval of the Procedure for medical examination of orphans and children left without parental care, including adopted (adopted), taken under guardianship (guardianship) , in a foster or foster family"
Registration N 28454
In accordance with the Decree of the Government of the Russian Federation of February 14, 2013 N 116 "On measures to improve the organization of medical care for orphans and children left without parental care" (Collected Legislation of the Russian Federation, 2013, N 7, Art. 660) I order:
Approve the Procedure for medical examination of orphans and children left without parental care, including adopted (adopted), taken under guardianship (guardianship), in a foster or foster family, according to the appendix.
Minister V. Skvortsova
The procedure for medical examination of orphans and children left without parental care, including those adopted (adopted), taken under guardianship (guardianship), in a foster or foster family
1. This Procedure establishes the rules for medical organizations participating in the implementation of territorial programs of state guarantees of free medical care to citizens (hereinafter referred to as medical organizations), medical examinations of orphans and children left without parental care, including adopted (adopted), adopted under guardianship (guardianship), in a foster or foster family, with the exception of orphans and children left without parental care, staying in stationary institutions (hereinafter referred to as medical examination).
2. Clinical examination is a set of measures, including a medical examination by doctors of several specialties and the application of the necessary examination methods 1, and is carried out in relation to orphans and children left without parental care specified in paragraph 1 of this Procedure (hereinafter referred to as minors).
A necessary preliminary condition for medical intervention is the giving of informed voluntary consent of a minor or his legal representative to medical intervention in compliance with the requirements established by Article 20 of the Federal Law.
3. Clinical examination is carried out in medical organizations determined by the heads of executive authorities of the constituent entities of the Russian Federation, empowered to establish the conditions for minors to undergo medical examination, and having a license to carry out medical activities, providing for the performance of work (provision of services) in "pediatrics" or "general medical practice (family medicine)”, “neurology”, “ophthalmology”, “traumatology and orthopedics”, “pediatric surgery”, “psychiatry”, “pediatric dentistry” or “stomatology” 2 , “pediatric urology-andrology” or “urology” 2 , “pediatric endocrinology” or “endocrinology” 2 , “otorhinolaryngology” 3 or “otorhinolaryngology (excluding cochlear implantation)”, “obstetrics and gynecology” 3 or “obstetrics and gynecology (excluding the use of assisted reproductive technologies)”, “laboratory diagnostics ”, “clinical laboratory diagnostics”, “functional diagnostics”, “ultrasound howling diagnostics” and “roentgenology”.
4. If a medical organization that has a license to carry out medical activities, providing for the performance of work (provision of services) in "pediatrics" or "general medical practice (family medicine)", does not have a license for medical activities in terms of performing other works (services) ) listed in paragraph 3 of this Procedure, the specified medical organization engages medical workers of other medical organizations licensed to carry out medical activities in terms of performing the required work (services) for medical examinations in accordance with agreements concluded between these medical organizations.
If the medical organization specified in paragraph 3 of this Procedure does not have:
1) a pediatric urologist-andrologist, then a urologist or a pediatric surgeon trained in additional professional education programs in terms of the characteristics of urological diseases in children is involved in the medical examination, while the medical organization must have a license to carry out medical activities, providing for the implementation works (provision of services) in "urology" or "children's surgery", respectively;
2) a pediatric dentist, then a dentist who has been trained under additional professional education programs in terms of the characteristics of dental diseases in children is involved in the medical examination, while the medical organization must have a license to carry out medical activities, providing for the performance of work (provision of services) for "stomatology";
3) a pediatric endocrinologist, then an endocrinologist who has been trained under additional professional education programs in terms of the characteristics of endocrinological diseases in children is involved in the medical examination, while the medical organization must have a license to carry out medical activities, providing for the performance of work (provision of services) for "endocrinology";
4) a pediatric psychiatrist (adolescent psychiatrist), then a psychiatrist who has been trained in additional professional education programs in terms of the characteristics of mental disorders and behavioral disorders in children is involved in the medical examination, while the medical organization must have a license to carry out medical activities involving the performance of work (provision of services) in "psychiatry".
5. Clinical examination is carried out annually for the purpose of early (timely) detection of pathological conditions, diseases and risk factors for their development, as well as in order to form health status groups and develop recommendations for minors.
For minors who have reached the age of 3 years and are subject to medical examination, preventive medical examinations in accordance with the order of the Ministry of Health of the Russian Federation dated December 21
2012 N 1346n "On the Procedure for the passage of medical examinations by minors, including upon admission to educational institutions and during the period of study in them" (registered by the Ministry of Justice of the Russian Federation on April 2, 2013, registration N 27961) are not carried out.
6. Medical examination is carried out within the framework of the program of state guarantees of free provision of medical care to citizens and territorial programs of state guarantees of free provision of medical care to citizens.
7. Clinical examination is carried out by medical organizations in the amount provided for by the list of examinations and studies during the medical examination of orphans and children in difficult life situations staying in stationary institutions (appendix to the Procedure for conducting medical examination of orphans and children in difficult life situation 4) (hereinafter - the List of studies).
8. In order to organize medical examinations by pediatricians, district pediatricians, general practitioners (family doctors) (hereinafter referred to as the doctor responsible for conducting medical examinations) of a medical organization in which a minor receives primary health care, lists of names of minors are compiled from among those on medical care, which indicate the following information:
1) last name, first name, patronymic, age (date, month, year of birth);
2) a student or not a student at an educational institution (for students, the full name and legal address of the educational institution are indicated);
3) a list of examinations by medical specialists, laboratory, instrumental and other studies based on the List of studies;
4) the planned date and place of medical examination.
9. An authorized official of a medical organization, on the basis of the name lists of minors, draws up a calendar plan for the medical examination, indicating the dates and places of its conduct, the required number of examinations by specialist doctors (indicating the position, surname and initials), laboratory, instrumental and other studies (hereinafter - calendar plan).
The calendar plan is approved by the head (authorized official) of the medical organization no later than 1 month before the beginning of the calendar year, and is brought to the attention of the medical workers involved in the medical examination, including the doctors responsible for the medical examination.
In the event of a change in the number of minors subject to medical examination, the doctor responsible for the medical examination shall submit, by the 20th day of the current month, an updated list of names to an authorized official of the medical organization.
10. The doctor responsible for the medical examination, not later than 5 working days before the start of its conduct, is obliged to hand (send) the minor (his legal representative) a referral for medical examination indicating the list of examinations by specialist doctors and studies, as well as the date, time and their venues.
11. On the day of the medical examination, the minor arrives at a medical organization and presents a referral for medical examination and a compulsory medical insurance policy. A minor who has not reached the age established by Part 2 of Article 54 of the Federal Law arrives at a medical organization accompanied by a legal representative.
12. When conducting medical examinations, the results of examinations by medical specialists and studies included in the medical documentation of a minor (child development history) are taken into account, the prescription of which does not exceed 3 months from the date of the examination and (or) examination, and in children under the age of 2 years , the results of examinations and studies are taken into account, the prescription of which does not exceed 1 month from the date of examination and (or) examination.
13. If a minor is suspected of having a disease (condition), the diagnosis of which cannot be established during examinations by specialist doctors and studies included in the List of studies, the doctor responsible for conducting the medical examination, the medical specialists participating in the medical examination, send the minor for additional consultation and (or) examination, indicating the date and place of their conduct.
14. Clinical examination is completed in the event of examinations by specialist doctors and laboratory, instrumental and other studies provided for by the List of studies, in the absence of suspicions that the minor has an undiagnosed disease (condition) and (or) the need to obtain information about the state of health of the minor from other medical organizations 5 (I stage).
In case of suspicion that a minor has a disease (condition), the diagnosis of which cannot be established during examinations by specialist doctors and studies included in the List of studies, and (or) the need to obtain information about the state of health of a minor from other medical organizations, medical examination is completed in the event of additional consultations, studies scheduled in accordance with paragraph 13 of this Procedure, and (or) obtaining information about the state of health of a minor from other medical organizations (stage II).
15. The total duration of the I stage of medical examination should be no more than 10 working days, and when additional consultations, studies and (or) the need to obtain information about the state of health of a minor from other medical organizations, the total duration of the medical examination - no more than 45 working days (I and II stages).
16. Data on the passage of medical examinations are entered into the medical documentation of the minor (the history of the development of the child).
The medical documentation of the minor (history of the development of the child) must contain the following information:
1) history data:
about previous diseases (conditions), the presence of functional disorders, chronic diseases, disability;
on the results of the dispensary observation (if established) indicating the diagnosis of the disease (condition), including the code according to the International Statistical Classification of Diseases and Related Health Problems (hereinafter referred to as the ICD), the medical organization and the specialist doctor performing the dispensary observation;
2) data obtained during the medical examination:
objective data and results of examinations by medical specialists;
results of laboratory, instrumental and other studies;
the results of additional consultations and studies not included in the List of studies and appointed during the clinical examination;
diagnosis of a disease (condition) detected (established) during medical examination, indicating the ICD code, whether it was detected for the first time or not;
3) assessment of physical development;
4) group of the state of health of the minor;
on the formation of a healthy lifestyle, daily routine, nutrition, physical development, immunoprophylaxis, physical education;
on the need to establish or continue dispensary observation indicating the diagnosis of the disease (condition), including the ICD code, the type of medical organization and the specialty (position) of the doctor;
on treatment, medical rehabilitation and sanatorium treatment, indicating the type of medical organization (sanatorium and resort organization) and the specialty (position) of the doctor.
17. Based on the results of the medical examination, the doctor responsible for conducting the medical examination determines:
1) a group of the state of health of a minor in accordance with the Rules for a comprehensive assessment of the state of health of minors (Appendix N 2 to the Procedure for passing medical examinations by minors, including upon admission to educational institutions and during the period of study in them);
2) a medical group for physical culture in accordance with the Rules for determining medical groups for physical culture for minors (Appendix N 3 to the Procedure for minors to undergo medical examinations, including when entering educational institutions and during the period of study in them 6) with a medical conclusion on the minor's belonging to a medical group for physical education (in relation to minors engaged in physical culture), the form of which is provided for in Appendix No. 4 to the Procedure for minors to undergo medical examinations, including upon admission to educational institutions and during the period of study in them 6 .
18. Information about the state of health of a minor, obtained as a result of medical examination, is provided to the minor personally by a doctor or other medical workers who are directly involved in the medical examination. In relation to a minor who has not reached the age established by Part 2 of Article 54 of the Federal Law, information about the state of health is provided to his legal representative.
19. If, during the medical examination, signs of harm to the health of a minor are revealed, in respect of which there is reason to believe that they arose as a result of illegal actions, the medical worker is obliged to ensure that the internal affairs bodies are informed about this in accordance with the Procedure for informing the internal affairs bodies by medical organizations on the admission of patients in respect of which there are sufficient grounds to believe that harm to their health was caused as a result of illegal actions, approved by order of the Ministry of Health and Social Development of the Russian Federation dated May 17, 2012 N 565n 7.
20. The medical organization specified in paragraph 3 of this Procedure, if a minor has (established) a disease that requires the provision of specialized, including high-tech, medical care, medical rehabilitation, sanatorium-and-spa treatment, sends his medical documentation to the authority as a matter of priority. executive power of the constituent entity of the Russian Federation in the field of protecting the health of citizens to resolve the issue of providing him with medical care.
The executive authority of the constituent entity of the Russian Federation in the field of protecting the health of citizens, as a matter of priority, ensures the organization of all types of medical care for minors, including specialized, including high-tech, medical care, medical rehabilitation, and sanatorium treatment.
21. The medical organization specified in paragraph 3 of this Procedure, on the basis of the results of the medical examination entered into the medical documentation of the minor (the history of the development of the child), draws up, including in electronic form, an accounting form N 030-D / s / y-13 " Card of medical examination of a minor” 8 (hereinafter referred to as the examination card) for each minor who has undergone medical examination.
22. The examination card is drawn up in two copies, one of which, upon completion of the medical examination, is issued by the doctor responsible for conducting the medical examination to the minor (his legal representative), the second copy is stored in the medical organization for 5 years.
The medical organization, on the basis of examination cards, maintains an electronic monitoring system for medical examinations, in which information is entered on the passage of medical examinations by minors on a monthly basis, until the 30th day of the month following the reporting one, and at the end of the year - until January 20 of the year following the reporting one.
23. Based on the results of the medical examination, the medical organization, no later than 15 working days after the end of the calendar year, fills out the reporting form N 030-D / s / o-13 “Information on the medical examination of minors” 8] (hereinafter referred to as the report).
24. The report is drawn up in duplicate, approved by the head of the medical organization and certified by the seal of the medical organization.
One copy of the report no later than January 20 of the year following the reporting one is sent by the medical organization to the executive authority of the constituent entity of the Russian Federation in the field of protecting the health of citizens, the second copy of the report is stored in the medical organization that conducted the medical examination for 10 years.
25. The executive authority of the constituent entity of the Russian Federation in the field of protecting the health of citizens:
1) ensures the monitoring of the clinical examination in electronic form;
2) generalizes and analyzes the results of clinical examination in the subject of the Russian Federation;
3) sends a report on the subject of the Russian Federation to the Ministry of Health of the Russian Federation no later than February 15 of the year following the reporting year.
1 Part 4 of Article 46 of the Federal Law of November 21, 2011 N 323-FZ “On the Fundamentals of Protecting the Health of Citizens in the Russian Federation” (hereinafter referred to as the Federal Law).
2 Subject to compliance with the requirements established by paragraph 4 of this Procedure.
3 For licenses to carry out medical activities issued before the entry into force of Decree of the Government of the Russian Federation of April 16, 2012 N 291 “On Licensing Medical Activities (with the exception of the specified activities carried out by medical organizations and other organizations that are part of the private healthcare system, for territory of the Skolkovo Innovation Center)” (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 2012, No. 17, Art. 1965; No. 37, Art. 5002; 2013, No. 3, Art. 207).
4 For reference: approved by order of the Ministry of Health of the Russian Federation dated February 15, 2013 N 72n “On conducting medical examinations of orphans and children in difficult life situations staying in stationary institutions” (registered by the Ministry of Justice of the Russian Federation on April 2, 2013, registration N 27964).
5 In accordance with Clause 8 of Part 4 of Article 13 of the Federal Law, the provision of information constituting a medical secret without the consent of a citizen or his legal representative is allowed when exchanging information by medical organizations, including those placed in medical information systems, in order to provide medical care, taking into account the requirements legislation of the Russian Federation on personal data.
6 For reference: approved by order of the Ministry of Health of the Russian Federation dated December 21, 2012 N 1346n “On the Procedure for Underage Medical Examinations, including when entering educational institutions and during the period of study in them” (registered by the Ministry of Justice of the Russian Federation on April 2, 2013 ., registration N 27961).
7 For reference: registered by the Ministry of Justice of the Russian Federation on July 25, 2012, registration N 25004.
8 For reference: approved by order of the Ministry of Health of the Russian Federation dated February 15, 2013 N 72n "On conducting medical examinations of orphans and children in difficult life situations staying in stationary institutions" (registered by the Ministry of Justice of the Russian Federation on April 2, 2013, registration N 27964).
Order of the Ministry of Health and Social Development of the Russian Federation 216n
MINISTRY OF HEALTH OF THE RUSSIAN FEDERATION
On approval of the list of medical contraindications, in connection with the presence of which a citizen or recipient of social services may be denied, including temporarily, the provision of social services in a stationary form, as well as the form of conclusion of an authorized medical organization on the presence of such contraindications
In accordance with Part 3 of Article 18 of the Federal Law of December 28, 2013 N 442-FZ “On the Fundamentals of Social Services for Citizens in the Russian Federation” (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 2013, N 52, Art. 7007; 2014, N 30, Art. 4257) and subparagraph 11 of part 2 of article 14 of the Federal Law of November 21, 2011 N 323-FZ "On the fundamentals of protecting the health of citizens in the Russian Federation" (Sobraniye zakonodatelstva Rossiyskoy Federatsii, 2011, N 48, art. 6724; 2012, N 26, 3442, 3446; 2013, No. 27, st.3459, 3477; No. 30, st.4038; No. 39, st.4883; No. 48, st. 2930; N 30, art. 4106, 4244, 4247, 4257; N 43, art. 5798; N 49, art. 6927, 6928; 2015, N 1, art. 72, 85; N 10, art. , 1425; N 14, article 2018)
Registered
at the Ministry of Justice
Russian Federation
June 9, 2015
registration N 37608
Appendix N 1. List of medical contraindications, in connection with the presence of which a citizen or recipient of social services may be denied, including temporarily, in the provision of social services in a stationary form
It seems quite reasonable, and the list of patients given in it, who from now on will not be taken to a social hospital, is justified.
So, for example, from now on, a person with any form of tuberculosis, leprosy, a rash of unclear etiology, gangrene or neoplasms with copious secretions will not be taken to a nursing home or a veterans' home. From the point of view of hygiene and epidemiological safety, the measure seems to be understandable.
Then the questions begin. If a person is not taken to a social hospital, where should he go? To a medical hospital? Or will he be given home care? What if he's lonely? How will his stay in the hospital be ensured? None of this is included in the new order.
Questions also arise in connection with the list of diagnoses given here. For example, a person with “a chronic mental disorder and often exacerbated painful manifestations” or “frequent epileptic seizures” will not be admitted to a hospital.
Is an attack of dementia a “disease,” a symptom, or an annoying inconvenience? And where, in this case, should a grandmother with dementia go, if such old men and women are the main contingent of the current PNI; Do they even line up to get in?
And what will happen to the inhabitants of the PNI with other diagnoses, because sometimes people even with schizophrenia lie there? Are they sorted out? Will they be admitted to hospitals? Will they be there permanently? How is this technically feasible with the current number of inhabitants of the PNI - and there are many of them?
And “frequent epileptic seizures” is how many times a month? Or per year? And on the basis of what document is their frequency estimated? But what if the return of epileptic seizures is, in principle, a risk for patients with certain diagnoses, for example, when changing therapy? Well, the person could not get the right drug, started taking an analogue, got out of remission - the seizures returned. Does his status change immediately? And who will decide it? The new document is silent about all this.
Elena Klochko, Expert of the Civic Chamber of Russia, co-chair of the Coordinating Council for Children with Disabilities:
Moreover, sometimes the paragraphs of the Order contain impossible conditions at all. For example, according to him, people with urinary incontinence and various types of stomas will not be allowed into social hospitals. However, urinary incontinence is a common consequence faced by people with spinal cord injuries and cerebral palsy. It cannot be corrected surgically - such people will always use absorbent underwear.
Until recently, spinal children were, in principle, considered unteachable, but there are intellectually safe ones among them. That is, a person with a normal development of the psyche was thrown out of life only because he was “hygienically uncomfortable”!
Recently, a social hospital with 25 beds was opened in Moscow specifically for the rehabilitation of spinal cords - according to a new order, it will be inaccessible to them!
Undoubtedly, the best care for children with such diagnoses is in the family, but caring for such a child, often accompanied by the placement of catheters every few hours, is hard work. Now parents have lost the opportunity for small respite with the placement of the baby for a short time in the hospital.
It is believed that inclusive education can be a way out. But it turns out that it is possible for a child in absorbent underwear to go to a regular school class, but not to a specialized social hospital.
Lawyer of the Rusfond Pravo project Natalya Kudryavtseva:
That is, the new order does not differ in logic and, obviously taking care of the redistribution of funding, does not care too much about people. By the way, the transfer of all items of expenditure for the maintenance of these categories of patients from the Ministry of Labor and Social Development to the Ministry of Health will amount to a considerable cash flow. Where is the guarantee that it will not be cut in the spirit of the latest trends?
And, finally, one more consequence from the area of assumptions. At the beginning of summer, there was a loud story in the press about how. Formally, this situation is not subject to Order No. 216n, since the camps are under the jurisdiction of the Ministry of Education.
Order No. 216n, which passed through the Ministry of Health in April, was in the approval phase at the time of memorable history (it was registered by the Ministry of Justice on June 9). Of course, the camp authorities could not obey this document and did not see the text at that time. But it acted quite in his spirit, trying to "send all psychiatric patients to hospitals." And how much noise!
<*>In addition to the positions of teachers assigned to the teaching staff.
<**>With the exception of tutors employed in the field of higher and additional professional education.
Professional qualification group of positions of heads of structural divisions
| Qualification levels | Positions assigned to qualification levels |
| 1 qualification level | Head (head) of a structural subdivision: office, laboratory, department, department, sector, educational and consulting center, educational (training and production) workshop and other structural subdivisions implementing the general education program and the educational program of additional education for children<*> |
| 2 qualification level | Head (head) of a separate structural unit implementing the general educational program and the educational program of additional education for children; head (manager, director, head, manager): office, laboratory, department, department, sector, educational and consulting center, educational (training and production) workshop, educational facilities and other structural units of an educational institution (unit) of primary and secondary vocational education<**>; senior master of an educational institution (department) of primary and/or secondary vocational education |
| 3 qualification level | Head (manager, director, head, manager) of a separate structural unit of an educational institution (unit) of primary and secondary vocational education |
<*>In addition to the positions of heads of structural divisions assigned to the 2nd qualification level.
<**>In addition to the positions of heads of structural divisions assigned to the 3rd qualification level.
Registration N 28454
In accordance with the Decree of the Government of the Russian Federation of February 14, 2013 N 116 "On measures to improve the organization of medical care for orphans and children left without parental care" (Collected Legislation of the Russian Federation, 2013, N 7, Art. 660) I order:
Approve the Procedure for medical examination of orphans and children left without parental care, including adopted (adopted), taken under guardianship (guardianship), in a foster or foster family, according to the appendix.
Minister V. Skvortsova
Application
The procedure for medical examination of orphans and children left without parental care, including those adopted (adopted), taken under guardianship (guardianship), in a foster or foster family
1. This Procedure establishes the rules for medical organizations participating in the implementation of territorial programs of state guarantees of free provision of medical care to citizens (hereinafter referred to as medical organizations), medical examinations of orphans and children left without parental care, including adopted (adopted), adopted under guardianship (guardianship), in a foster or foster family, with the exception of orphans and children left without parental care, staying in stationary institutions (hereinafter referred to as medical examination).
2. Clinical examination is a set of measures, including a medical examination by doctors of several specialties and the application of the necessary examination methods 1, and is carried out in relation to orphans and children left without parental care specified in paragraph 1 of this Procedure (hereinafter referred to as minors).
A necessary preliminary condition for medical intervention is the giving of informed voluntary consent of a minor or his legal representative to medical intervention in compliance with the requirements established by Article 20 of the Federal Law.
3. Clinical examination is carried out in medical organizations determined by the heads of executive authorities of the constituent entities of the Russian Federation, endowed with the authority to establish the conditions for minors to undergo medical examination, and having a license to carry out medical activities, providing for the performance of work (provision of services) in "pediatrics" or "general medical practice (family medicine)", "neurology", "ophthalmology", "traumatology and orthopedics", "pediatric surgery", "psychiatry", "pediatric dentistry" or "stomatology" 2 , "pediatric urology-andrology" or "urology" 2 , "pediatric endocrinology" or "endocrinology" 2 , "otorhinolaryngology" 3 or "otorhinolaryngology (excluding cochlear implantation)", "obstetrics and gynecology" 3 or "obstetrics and gynecology (excluding the use of assisted reproductive technologies)", "laboratory diagnostics ", "clinical laboratory diagnostics", "functional diagnostics", "ultrasound howling diagnostics" and "roentgenology".
4. If a medical organization that has a license to carry out medical activities, providing for the performance of work (rendering services) in "pediatrics" or "general medical practice (family medicine)", does not have a license for medical activities in terms of performing other work (services) ) listed in paragraph 3 of this Procedure, the specified medical organization engages medical workers of other medical organizations licensed to carry out medical activities in terms of performing the required work (services) for medical examinations in accordance with agreements concluded between these medical organizations.
If the medical organization specified in paragraph 3 of this Procedure does not have:
1) a pediatric urologist-andrologist, then a urologist or a pediatric surgeon trained in additional professional education programs in terms of the characteristics of urological diseases in children is involved in the medical examination, while the medical organization must have a license to carry out medical activities, providing for the implementation works (provision of services) in "urology" or "children's surgery" respectively;
2) a pediatric dentist, then a dentist who has been trained under additional professional education programs in terms of the characteristics of dental diseases in children is involved in the medical examination, while the medical organization must have a license to carry out medical activities, providing for the performance of work (provision of services) for "stomatology";
3) a pediatric endocrinologist, then an endocrinologist who has been trained under additional professional education programs in terms of the characteristics of endocrinological diseases in children is involved in the medical examination, while the medical organization must have a license to carry out medical activities, providing for the performance of work (provision of services) for "endocrinology";
4) a pediatric psychiatrist (adolescent psychiatrist), then a psychiatrist who has been trained in additional professional education programs in terms of the characteristics of mental disorders and behavioral disorders in children is involved in the medical examination, while the medical organization must have a license to carry out medical activities involving the performance of work (rendering of services) in "psychiatry".
5. Clinical examination is carried out annually for the purpose of early (timely) detection of pathological conditions, diseases and risk factors for their development, as well as in order to form health status groups and develop recommendations for minors.
For minors who have reached the age of 3 years and are subject to medical examination, preventive medical examinations in accordance with the order of the Ministry of Health of the Russian Federation dated December 21
2012 N 1346n "On the procedure for underage medical examinations, including when entering educational institutions and during their studies" (registered by the Ministry of Justice of the Russian Federation on April 2, 2013, registration N 27961) are not carried out.
6. Medical examination is carried out within the framework of the program of state guarantees of free provision of medical care to citizens and territorial programs of state guarantees of free provision of medical care to citizens.
7. Clinical examination is carried out by medical organizations in the amount provided for by the list of examinations and studies during the medical examination of orphans and children in difficult life situations staying in stationary institutions (appendix to the Procedure for conducting medical examination of orphans and children in difficult life situation 4) (hereinafter - the List of studies).
8. In order to organize medical examinations by pediatricians, district pediatricians, general practitioners (family doctors) (hereinafter referred to as the doctor responsible for conducting medical examinations) of a medical organization in which a minor receives primary health care, lists of names of minors are compiled from among those on medical care, which indicate the following information:
1) last name, first name, patronymic, age (date, month, year of birth);
2) a student or not a student at an educational institution (for students, the full name and legal address of the educational institution are indicated);
3) a list of examinations by medical specialists, laboratory, instrumental and other studies based on the List of studies;
4) the planned date and place of medical examination.
9. An authorized official of a medical organization, on the basis of the name lists of minors, draws up a calendar plan for the medical examination, indicating the dates and places of its conduct, the required number of examinations by specialist doctors (indicating the position, surname and initials), laboratory, instrumental and other studies (hereinafter - calendar plan).
The calendar plan is approved by the head (authorized official) of the medical organization no later than 1 month before the beginning of the calendar year, and is brought to the attention of the medical workers involved in the medical examination, including the doctors responsible for the medical examination.
In the event of a change in the number of minors subject to medical examination, the doctor responsible for the medical examination shall submit, by the 20th day of the current month, an updated list of names to an authorized official of the medical organization.
10. The doctor responsible for the medical examination, not later than 5 working days before the start of its conduct, is obliged to hand (send) the minor (his legal representative) a referral for medical examination indicating the list of examinations by specialist doctors and studies, as well as the date, time and their venues.
11. On the day of the medical examination, the minor arrives at a medical organization and presents a referral for medical examination and a compulsory medical insurance policy. A minor who has not reached the age established by Part 2 of Article 54 of the Federal Law arrives at a medical organization accompanied by a legal representative.
12. When conducting medical examinations, the results of examinations by medical specialists and studies included in the medical documentation of a minor (child development history) are taken into account, the prescription of which does not exceed 3 months from the date of the examination and (or) examination, and in children under the age of 2 years , the results of examinations and studies are taken into account, the prescription of which does not exceed 1 month from the date of examination and (or) examination.
13. If a minor is suspected of having a disease (condition), the diagnosis of which cannot be established during examinations by specialist doctors and studies included in the List of studies, the doctor responsible for conducting the medical examination, the medical specialists participating in the medical examination, send the minor for additional consultation and (or) examination, indicating the date and place of their conduct.
14. Clinical examination is completed in the event of examinations by specialist doctors and laboratory, instrumental and other studies provided for by the List of studies, in the absence of suspicions that the minor has an undiagnosed disease (condition) and (or) the need to obtain information about the state of health of the minor from other medical organizations 5 (I stage).
In case of suspicion that a minor has a disease (condition), the diagnosis of which cannot be established during examinations by specialist doctors and studies included in the List of studies, and (or) the need to obtain information about the state of health of a minor from other medical organizations, medical examination is completed in the event of additional consultations, studies scheduled in accordance with paragraph 13 of this Procedure, and (or) obtaining information about the state of health of a minor from other medical organizations (stage II).
15. The total duration of the I stage of medical examination should be no more than 10 working days, and when additional consultations, studies and (or) the need to obtain information about the state of health of a minor from other medical organizations, the total duration of the medical examination - no more than 45 working days (I and II stages).
16. Data on the passage of medical examinations are entered into the medical documentation of the minor (the history of the development of the child).
The medical documentation of the minor (history of the development of the child) must contain the following information:
1) history data:
about previous diseases (conditions), the presence of functional disorders, chronic diseases, disability;
on the results of the dispensary observation (if established) indicating the diagnosis of the disease (condition), including the code according to the International Statistical Classification of Diseases and Related Health Problems (hereinafter referred to as the ICD), the medical organization and the medical specialist performing the dispensary observation;
2) data obtained during the medical examination:
objective data and results of examinations by medical specialists;
results of laboratory, instrumental and other studies;
the results of additional consultations and studies not included in the List of studies and appointed during the clinical examination;
diagnosis of a disease (condition) detected (established) during medical examination, indicating the ICD code, whether it was detected for the first time or not;
3) assessment of physical development;
4) group of the state of health of the minor;
on the formation of a healthy lifestyle, daily routine, nutrition, physical development, immunoprophylaxis, physical education;
on the need to establish or continue dispensary observation indicating the diagnosis of the disease (condition), including the ICD code, the type of medical organization and the specialty (position) of the doctor;
on treatment, medical rehabilitation and sanatorium treatment, indicating the type of medical organization (sanatorium and resort organization) and the specialty (position) of the doctor.
17. Based on the results of the medical examination, the doctor responsible for conducting the medical examination determines:
1) a group of the state of health of a minor in accordance with the Rules for a comprehensive assessment of the state of health of minors (Appendix N 2 to the Procedure for passing medical examinations by minors, including upon admission to educational institutions and during the period of study in them);
2) a medical group for physical culture in accordance with the Rules for determining medical groups for physical culture for minors (Appendix N 3 to the Procedure for minors to undergo medical examinations, including when entering educational institutions and during the period of study in them 6) with a medical conclusion on the minor's belonging to a medical group for physical education (in relation to minors engaged in physical culture), the form of which is provided for in Appendix No. 4 to the Procedure for minors to undergo medical examinations, including upon admission to educational institutions and during the period of study in them 6 .
18. Information about the state of health of a minor, obtained as a result of medical examination, is provided to the minor personally by a doctor or other medical workers who are directly involved in the medical examination. In relation to a minor who has not reached the age established by Part 2 of Article 54 of the Federal Law, information about the state of health is provided to his legal representative.
19. If, during the medical examination, signs of harm to the health of a minor are revealed, in respect of which there is reason to believe that they arose as a result of illegal actions, the medical worker is obliged to ensure that the internal affairs bodies are informed about this in accordance with the Procedure for informing the internal affairs bodies by medical organizations on the admission of patients in respect of which there are sufficient grounds to believe that harm to their health was caused as a result of illegal actions, approved by order of the Ministry of Health and Social Development of the Russian Federation dated May 17, 2012 N 565n 7.
20. The medical organization specified in paragraph 3 of this Procedure, if a minor has (established) a disease that requires the provision of specialized, including high-tech, medical care, medical rehabilitation, sanatorium-and-spa treatment, sends his medical documentation to the authority as a matter of priority. executive power of the constituent entity of the Russian Federation in the field of protecting the health of citizens to resolve the issue of providing him with medical care.
The executive authority of the constituent entity of the Russian Federation in the field of protecting the health of citizens, as a matter of priority, ensures the organization of all types of medical care for minors, including specialized, including high-tech, medical care, medical rehabilitation, and sanatorium treatment.
21. The medical organization specified in paragraph 3 of this Procedure, on the basis of the results of the medical examination entered into the medical documentation of the minor (the history of the development of the child), draws up, including in electronic form, an accounting form N 030-D / s / y-13 " Card of medical examination of a minor" 8 (hereinafter referred to as the examination card) for each minor who has undergone a medical examination.
22. The examination card is drawn up in two copies, one of which, upon completion of the medical examination, is issued by the doctor responsible for conducting the medical examination to the minor (his legal representative), the second copy is stored in the medical organization for 5 years.
The medical organization, on the basis of examination cards, maintains an electronic monitoring system for medical examinations, in which information is entered on the passage of medical examinations by minors on a monthly basis, until the 30th day of the month following the reporting one, and at the end of the year - until January 20 of the year following the reporting one.
23. Based on the results of the medical examination, the medical organization, no later than 15 working days after the end of the calendar year, fills out the reporting form N 030-D / s / o-13 "Information on the medical examination of minors" 8] (hereinafter referred to as the report).
24. The report is drawn up in duplicate, approved by the head of the medical organization and certified by the seal of the medical organization.
One copy of the report no later than January 20 of the year following the reporting one is sent by the medical organization to the executive authority of the constituent entity of the Russian Federation in the field of protecting the health of citizens, the second copy of the report is stored in the medical organization that conducted the medical examination for 10 years.
25. The executive authority of the constituent entity of the Russian Federation in the field of protecting the health of citizens:
1) ensures the monitoring of the clinical examination in electronic form;
2) generalizes and analyzes the results of clinical examination in the subject of the Russian Federation;
3) sends a report on the subject of the Russian Federation to the Ministry of Health of the Russian Federation no later than February 15 of the year following the reporting year.
1 Part 4 of Article 46 of the Federal Law of November 21, 2011 N 323-FZ "On the Fundamentals of Protecting the Health of Citizens in the Russian Federation" (hereinafter referred to as the Federal Law).
2 Subject to compliance with the requirements established by paragraph 4 of this Procedure.
3 For licenses to carry out medical activities issued before the entry into force of Decree of the Government of the Russian Federation of April 16, 2012 N 291 "On licensing medical activities (with the exception of the specified activities carried out by medical organizations and other organizations that are part of the private healthcare system, for territory of the innovation center "Skolkovo")" (Sobraniye zakonodatelstva Rossiyskoy Federatsii, 2012, N 17, item 1965; N 37, item 5002; 2013, N 3, item 207).
4 For reference: approved by order of the Ministry of Health of the Russian Federation dated February 15, 2013 N 72n "On conducting medical examinations of orphans and children in difficult life situations staying in stationary institutions" (registered by the Ministry of Justice of the Russian Federation on April 2, 2013, registration N 27964).
5 In accordance with Clause 8 of Part 4 of Article 13 of the Federal Law, the provision of information constituting a medical secret without the consent of a citizen or his legal representative is allowed when exchanging information by medical organizations, including those placed in medical information systems, in order to provide medical care, taking into account the requirements legislation of the Russian Federation on personal data.
6 For reference: approved by order of the Ministry of Health of the Russian Federation of December 21, 2012 N 1346n "On the procedure for underage medical examinations, including when entering educational institutions and during the period of study in them" (registered by the Ministry of Justice of the Russian Federation on April 2, 2013 ., registration N 27961).
7 For reference: registered by the Ministry of Justice of the Russian Federation on July 25, 2012, registration N 25004.
8 For reference: approved by order of the Ministry of Health of the Russian Federation dated February 15, 2013 N 72n "On conducting medical examinations of orphans and children in difficult life situations staying in stationary institutions" (registered by the Ministry of Justice of the Russian Federation on April 2, 2013, registration N 27964).
