By Decree of the President of the Russian Federation 597

04.08.2020

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DECREE

PRESIDENT OF THE RUSSIAN FEDERATION

ABOUT EVENTS

ON THE IMPLEMENTATION OF STATE SOCIAL POLICY

In order to further improve state social policy, I decide:

1. To the Government of the Russian Federation:

a) provide:

an increase in real wages by 1.4 - 1.5 times by 2018;

bringing the average salary of teaching staff in educational institutions of general education to the average salary in the corresponding region in 2012;

bringing the average salary of teaching staff in preschool educational institutions to the average salary in the field of general education in the corresponding region by 2013;

bringing by 2018 the average wages of teachers and industrial training masters of educational institutions of primary and secondary vocational education, workers of cultural institutions to the average wage in the corresponding region;

increasing by 2018 the average salary of doctors, teachers of educational institutions of higher professional education and researchers to 200 percent of the average salary in the corresponding region;

increasing the number of highly qualified workers by 2020 so that it constitutes at least a third of the number of qualified workers;

creation annually from 2013 to 2015 up to 14.2 thousand special jobs for people with disabilities;

b) prepare and submit, before September 1, 2012, to the State Duma of the Federal Assembly of the Russian Federation a draft federal law on introducing changes into the legislation of the Russian Federation relating to the development, approval and application of professional standards;

d) develop and approve at least 800 professional standards by 2015;

e) in order to develop uniform principles for assessing the professional training of workers:

create, in accordance with the established procedure, before December 1, 2015, a basic center for professional training, retraining and advanced training of workers;

f) in order to preserve personnel potential, increase the prestige and attractiveness of professions in the public sector of the economy, by December 1, 2012, adopt a program for the gradual improvement of the system of remuneration for workers in the public sector of the economy, conditioning the increase in wages on the achievement of specific indicators of the quality and quantity of services provided and providing for:

establishing basic salaries for professional qualification groups;

increasing the wages of workers in the public sector of the economy with the possible attraction for these purposes of at least a third of the funds received through the reorganization of ineffective organizations;

g) create a transparent mechanism for remuneration of heads of organizations financed from budgetary allocations of the federal budget, establishing the ratio of the average wages of managers and employees of these organizations and providing for the presentation by the heads of these organizations of information on income, property and property-related obligations;

h) in order to expand the participation of employees in the management of organizations:

develop a set of measures for the development of self-government institutions and the adoption of codes of professional ethics;

i) submit, by March 1, 2013, proposals on the use of the regulatory per capita financing mechanism in certain sectors of the budgetary sector of the economy;

j) together with public organizations, before April 1, 2013, ensure the formation of an independent system for assessing the quality of work of organizations providing social services, including the determination of criteria for the effectiveness of the work of such organizations and the introduction of public ratings of their activities;

k) to introduce, starting from 2013, measures aimed at increasing support for socially oriented non-profit organizations;

l) develop, by October 1, 2012, a draft Strategy for the long-term development of the pension system, providing in it a mechanism for increasing the size of pensions for citizens who have expressed their intention to continue working upon reaching retirement age and have decided to delay the assignment of a pension, as well as defining measures to guarantee the safety of pension savings and providing profitability from their investment;

m) for the purpose of further preservation and development of Russian culture:

create at least five cultural development centers in small towns by 2015;

include annually in the National Electronic Library at least 10 percent of book titles published in the Russian Federation;

provide support for the creation of public electronic libraries, websites of museums and theaters on the information and telecommunications network Internet, as well as the placement of films and performances of outstanding film and theater directors on the Internet;

to ensure an increase until October 1, 2012 in federal budget allocations for the payment of scholarships for cultural and artistic workers, creative youth, as well as for the provision of grants to support creative projects of national importance in the field of culture and art;

ensure the creation, by March 1, 2013, of a mobile collection of leading Russian museums for exhibiting works of art in museums and galleries of small and medium-sized cities, and also create 27 virtual museums by 2018;

double the number of exhibition projects carried out in the constituent entities of the Russian Federation by 2018;

increase by 2015 to 4 thousand the number of state scholarships for outstanding cultural and artistic figures and young talented authors;

to increase by 2018, in order to identify and support young talents, the number of children involved in participation in creative activities to 8 percent of the total number of children.

2. To the Government of the Russian Federation together with the executive authorities of the constituent entities of the Russian Federation:

a) ensure, by August 1, 2012, the development of regulatory legal acts providing for the implementation of measures to gradually increase the wages of cultural workers;

b) develop, by November 1, 2012, a set of measures to expand the practice of exchanging exhibitions between museums of the Russian Federation, for the work of museums in the evening and at night, and ensure their implementation;

c) develop, by November 1, 2012, a set of measures aimed at increasing the effectiveness of the implementation of measures to promote the employment of people with disabilities, to ensure accessibility of vocational education, including improving methods of vocational guidance for children with disabilities and people with disabilities, to prepare specialized vocational training programs disabled people, taking into account the characteristics of their psychophysical development and individual capabilities, as well as individual rehabilitation programs for disabled people, to create conditions for increasing the level of employment of disabled people, including in workplaces equipped for them.

3. The Government of the Russian Federation, executive authorities of the constituent entities of the Russian Federation, when forming, respectively, the federal budget and the budgets of the constituent entities of the Russian Federation for 2013 and for the planning period of 2014 and 2015, budget allocations for the implementation of the measures provided for by this Decree.

4. This Decree comes into force on the date of its official publication.

The president

Russian Federation

Moscow Kremlin

Real wages in the Russian Federation as a whole in 2016 amounted to 100.7% compared to 2015. The growth of real wages by 2011 was: in 2012 - 1.08 times, in 2013 - 1.14 times, in 2014 - 1.15 times, in 2015 - 1.05 times, in 2016 - 1 .05 times.

In 2016, decisions were made that allowed the minimum wage to be increased by 25.7%. “On amendments to Article 1 of the Federal Law “On the Minimum Wage””, from July 1, 2016, the minimum wage was increased by 21% and set at 7,500 rubles per month. “On Amendments to Article 1 of the Federal Law “On the Minimum Wage”” provides for an increase in the minimum wage from July 1, 2017 by 4%, to 7,800 rubles (about 70% of the cost of living for the working population in the Russian Federation).

In 2016, according to Rosstat, the average monthly nominal salary in the Russian Federation amounted to 36,746 rubles and increased by 7.8% compared to 2015, including in the field of education - by 4.3% (28,094 rubles, or 76.5% of the average salary in the Russian Federation), in the field of culture and art - by 5.7% (31,079 rubles, or 84.6% of the average salary in the Russian Federation), in the field of healthcare - by 6, 2% (30,992 rubles, or 84.3% of the average salary in the Russian Federation), in the field of providing social services - by 4.3% (23,955 rubles, or 65.2% of the average salary in the Russian Federation) , in the field of scientific research and development - by 9.6% (64,054 rubles, or 174.3% of the average salary in the Russian Federation).

The increase in nominal wages is facilitated by the implementation of measures to increase wages of certain categories of public sector workers in accordance with decrees of the President of the Russian Federation dated May 7, 2012 No. 597, dated June 1, 2012 No. 761, dated December 28, 2012 No. 1688, implementation (order Government of the Russian Federation dated November 26, 2012 No. 2190-r), as well as sectoral and regional action plans (“road maps”) for the development of sectors of the social sphere, providing for linking wages and achieving indicators of the quality and quantity of government (municipal) services provided.

According to federal statistical observation, in 2016, in the Russian Federation as a whole, the average monthly salary of teaching staff in educational institutions of general education amounted to 33,338 rubles and increased by 2.1% compared to 2015; in educational institutions of preschool education - 27,476 rubles (+ 3.5%), institutions of additional education for children - 27,989 rubles (+4.3%), educational, medical organizations or organizations providing social services to orphans and children without parental care - 30,034 rubles (+1 %), teachers and masters of industrial training of institutions of primary and secondary vocational education - 29,848 rubles (+4.1%), teachers of educational institutions of higher vocational education - 55,028 rubles (+8.5%), scientific employees - 53,836 rubles (+4%), doctors – 50,667 rubles (+5.8%), nursing staff – 28,174 rubles (+4.3%), junior medical staff – 18,436 rubles (+9.6%), workers cultural institutions - 27,080 rubles (+6.3%), social workers - 21,601 rubles (+9.3%).

In 2016 and 2017, the Ministry of Labor of Russia, together with interested federal executive authorities, all-Russian associations of employers, all-Russian associations of trade unions, leading professional associations and major companies, continued work on the development of professional standards. As of April 19, 2017, the Russian Ministry of Labor has approved 1004 professional standards.

An independent assessment of the quality of service provision by organizations in the field of culture, social services, health care and education (hereinafter referred to as social organizations) involves an assessment of the conditions for the provision of services by these organizations. The independence of such an assessment is ensured by the participation in it of public councils, which are formed from representatives of all-Russian and regional public organizations, public associations of consumers (their associations, unions), representing the interests of citizens and carrying out their activities in relevant areas regardless of government authorities, citizens themselves - consumers services, as well as ensuring publicity of the results of the independent assessment.

Public councils created under federal executive authorities in the social sphere consider at their meetings issues of conducting an independent quality assessment with the participation of executive authorities of the constituent entities of the Russian Federation at least once every six months.

The results of monitoring conducted by the Russian Ministry of Labor with the participation of interested federal executive authorities and constituent entities of the Russian Federation show that conditions have been created in the regions for an independent assessment of the quality of service provision by organizations in the field of culture, social services, health care and education:

in all subjects of the Federation the necessary regulations have been adopted, public councils have been created in the prescribed manner to conduct independent assessments, and regional leaders responsible for coordinating this work have been identified;
Social organizations create open and publicly accessible information resources containing information about their activities, including by posting it on their official website on the Internet. By the beginning of 2016, according to information from the constituent entities of the Federation, 86.3% of organizations had official websites (in 2013 - 71.6%), in culture - 46.9% of organizations in this field, in social services - 87.1%, in healthcare – 91.0%, in education – 99.3% of organizations;
on official websites on the Internet, government authorities have created sections “Independent quality assessment” (in social services - in 85 subjects of the Federation, in healthcare - in 84, in culture - in 83, in education - in 80 regions);
the technical ability is provided to express the opinions of service consumers on the quality of services, including on the official websites of executive authorities of the constituent entities of the Federation (in social services - in 67 constituent entities of the Federation, in healthcare - in 84, in culture - in 67, in education - in 45 regions );
in the constituent entities of the Federation, the practice of taking into account the results of independent quality assessments when developing measures to improve the activities of social service organizations is established.

Information on the results of an independent quality assessment is posted on the official websites of executive authorities, and since 2016, on a single portal - the official website for posting information about state and municipal institutions www.bus.gov.ru (hereinafter referred to as the website bus.gov.ru) . For this purpose, special functionality has been created on this site and the technical ability has been provided for duly registered users to post such information. The composition of information on the results of an independent quality assessment and the procedure for posting it on the website bus.gov.ru have been determined (Order of the Ministry of Finance of Russia dated July 22, 2015 No. 116n), and guidelines have been developed for authorized executive authorities on posting this information.

Currently, the website bus.gov.ru has created the opportunity to construct, based on the results of an independent assessment of the quality of an interactive regional rating of organizations (based on the sum of points received during the assessment) for each subject of the Federation in the relevant field, as well as an industry rating of organizations in general for the Russian Federation. Federations (ratings are formed based on the latest data on the organization automatically as information is posted by the authorized body): http://bus.gov.ru/pub/top-organizations.

In 2016 (as of February 1, 2017), 35.5 thousand organizations were covered by an independent quality assessment, which is 26.0% of the total number of organizations, including 2.2 thousand organizations in the field of social services, or 34 .6%, in the field of culture - 6.9 thousand organizations, or 33.2%, in the field of health care - 3.5 thousand organizations, or 33.8%, in the field of education - 22.8 thousand organizations, or 23.1% taken into account by Rosstat.

Based on the results of an independent quality assessment, action plans are adopted to improve the activities of social organizations and improve the quality of service delivery.

According to information from the constituent entities of the Federation, in a number of regions specific measures are being implemented to improve the work of social organizations, developed based on the results of an independent assessment of the quality of services provided to the population, which cover such areas as optimizing the work of organizations (changing the work schedule of institutions, doctors, registries, introducing new services ), improving the material and technical base of organizations (equipping with equipment and machinery, replacing or updating furniture), creating additional conditions for serving people with limited mobility, primarily the disabled, equipping special areas for the disabled and visitors with children, including the results of an independent assessment in the performance criteria activities of organizations, in the target performance indicators of their managers, incentive activities, organization of training for employees of institutions on improving the quality of service delivery.

For implementation purposes, a legislative framework has been formed aimed at optimizing the pension system.

On January 1, 2015, a new procedure was introduced for the formation of pension rights of citizens and the calculation of pensions in the compulsory pension insurance system, which involves a transition to the formation of pension rights in relative values (pension coefficients).

The main goal of introducing a new pension formula is to fulfill pension obligations while ensuring the financial balance of the pension system and giving the system an incentive character that creates incentives for productive work.

The new procedure for the formation of pension rights of citizens and the calculation of pensions makes it possible to increase the importance of the insurance period and white wages.

In order to maintain an acceptable level of pension provision for persons who have not made a sufficient contribution to the pension system, it is envisaged to separate the basic part of the insurance pension, the resource support of which is guaranteed (fixed payment).

Insurance contributions to the Pension Fund of the Russian Federation have been introduced, differentiated by hazard classes of workplaces, depending on the results of a special assessment of working conditions.

A two-level system has been created to guarantee the rights of insured persons in the funded component, including reserves for compulsory pension insurance (internal guarantee funds).

Measures are provided aimed at improving regulation, control and supervision of the activities of non-state pension funds.

Labor pensions of citizens who were assigned before January 1, 2015 have been recalculated using a new formula. If, when recalculated according to the new rules, the pension does not reach the amount received by the pensioner before the specified date, then such pensioner is paid a pension in the previous higher amount.

In 2015, the indexation of the insurance pension and the fixed payment to it, as well as the social pension, was carried out taking into account the new pension legislation.

From February 1, 2016, all types of insurance pensions for non-working pensioners were indexed by 4%. The size of the fixed payment after indexation amounted to 4558.93 rubles per month. As a result of indexation, the average old-age insurance pension, taking into account the fixed payment, amounted to 13,100 rubles. This indexation of insurance pensions applies to insurance pensions only for non-working pensioners.

For the purpose of material support for pensioners, in accordance with “On a one-time cash payment to citizens receiving a pension,” a one-time cash payment in the amount of 5 thousand rubles was made in January 2017. The payment affected both non-working and working pensioners, including military personnel.

In 2016, important decisions were made regarding the pension indexation mechanism. Since 2017, a return has been made to the indexation mechanism based on the actual inflation of the previous year. Insurance pensions of non-working pensioners from February 1, 2017 are indexed based on the consumer price growth index for 2016 by 5.4% in accordance with “On approval of the consumer price growth index for 2016 to establish the cost of one pension coefficient from February 1, 2017.” and “On approval of the indexation coefficient from February 1, 2017 of the fixed payment to the insurance pension.”

This increase in the size of insurance pensions made it possible to improve the material security of about 31.4 million non-working pensioners.

From April 1, 2017, in accordance with the Federal Law “On the budget of the Pension Fund of the Russian Federation for 2017 and for the planning period of 2018 and 2019,” insurance pensions were additionally increased by 0.38%, that is, based on the forecast inflation rate included in the budget Pension Fund of the Russian Federation for 2017 (5.8%).

Taking into account the increase in insurance pensions and fixed payments to them in February, as well as the increase in insurance pensions in April, the average annual old-age insurance pension in 2017 will be 13,655 rubles (159.8% of the pensioner’s subsistence level).

The mobile collection of leading Russian museums, starting from March 1, 2013, is updated through the organization and holding of traveling thematic exhibitions, which display objects that are part of the Museum Fund of the Russian Federation from the collection of Russian museums.

In total, during the reporting period from 2013 to 2016, 732 exhibitions were held, including:

in 2013 – 58 exhibitions;

in 2014 – 128 exhibitions;

in 2015 – 180 exhibitions;

in 2016 – 366 exhibitions.

Financial support for exhibition projects in 2016 was carried out within the framework of the federal target program “Culture of Russia (2012–2018)”, as well as through subsidies provided to interested museums for the implementation of government tasks.

In 2016, exhibition projects were carried out in such medium and small cities as Suzdal (Vladimir region), Anadyr, Pevek (Chukotka Autonomous Okrug), Vyksa (Nizhny Novgorod region), Borovsk (Kaluga region ), Vyazma (Smolensk region), Nevelsk (Sakhalin region), Yegoryevsk, Elektrostal, village. Bakovka, Golitsyno, Istra, Sergiev Posad (Moscow region), Prokopyevsk (Kemerovo region), Gorno-Altaisk (Altai Republic), Nizhny Tagil (Sverdlovsk region), Bakhchisaray ( Republic of Crimea), Maikop (Republic of Adygea), Dankov (Lipetsk Region), Livny (Oryol Region), Kimovsk (Tula Region).

Currently, 235 virtual museums are represented on the Internet information and telecommunications network on the basis of a single portal for popularizing the cultural heritage of Russia “Kultura.rf”, 87 of which were created with the assistance of federal budget funds.

Along with the creation of new virtual museums, modernization of existing ones was carried out in 2016, for example, the Virtual Museum of Architecture was updated with the participation of specialists from the State Museum of Architecture named after A.V. Shchusev and received the prize of the international competition Heritage in Motion in the “Application for Mobile Devices” category.

Every year, the Russian Ministry of Culture forms exhibition plans based on proposals from leading museums and applications from constituent entities of the Russian Federation. The volume of financing of exhibition projects from the federal budget is 60–70% of the total cost estimate for these purposes, from the budgets of the constituent entities of the Russian Federation and extra-budgetary sources – 30–40%.

In museums of the Russian Federation in 2012–2016, 314,057 exhibitions were held, including:

in 2012 – 52,840 exhibitions,

in 2013 – 57,593 exhibitions,

in 2014 – 63,038 exhibitions,

in 2015 – 69,628 exhibitions,

in 2016 – 70,958 exhibitions.

In 2016, 70,958 exhibitions were organized in museums of the Russian Federation, which is 34% more than in 2012. The number of museum objects exhibited at exhibitions amounted to 6,589,403 items, which is 41% more than in 2012. Of the total number of exhibitions, museums under federal jurisdiction in the constituent entities held 1,298 exhibitions, at which 615,398 museum objects were presented.

an increase in real wages by 1.4-1.5 times by 2018; bringing the average salary of teaching staff in educational institutions of general education to the average salary in the corresponding region in 2012; bringing the average salary of teaching staff in preschool educational institutions to the average salary in the field of general education in the corresponding region by 2013; bringing by 2018 the average wages of teachers and industrial training masters of educational institutions of primary and secondary vocational education, workers of cultural institutions to the average wage in the corresponding region; increasing by 2018 the average salary of doctors, teachers of educational institutions of higher professional education and researchers to 200 percent of the average salary in the corresponding region; increasing the number of highly qualified workers by 2020 so that it constitutes at least a third of the number of qualified workers; creation annually from 2013 to 2015 up to 14.2 thousand special jobs for people with disabilities;

d) develop and approve at least 800 professional standards by 2015;

e) in order to develop uniform principles for assessing the professional training of workers:

prepare and, before August 1, 2014, submit to the State Duma of the Federal Assembly of the Russian Federation a draft federal law on introducing changes to the legislation of the Russian Federation concerning the procedure for accreditation of organizations carrying out activities to improve the professional level of workers; create, in accordance with the established procedure, before December 1, 2015, a basic center for professional training, retraining and advanced training of workers;

increasing by 2018 the average salary of social workers, including social workers of medical organizations, junior medical personnel (personnel providing conditions for the provision of medical services), nursing (pharmaceutical) personnel (personnel providing conditions for the provision of medical services) - up to 100 percent from the average salary in the corresponding region, employees of medical organizations with higher medical (pharmaceutical) or other higher education, providing medical services (ensuring the provision of medical services) - up to 200 percent of the average salary in the corresponding region; establishing basic salaries for professional qualification groups; increasing the wages of workers in the public sector of the economy with the possible attraction for these purposes of at least a third of the funds received through the reorganization of ineffective organizations;

h) in order to expand the participation of employees in the management of organizations:

prepare, by December 1, 2012, proposals for introducing changes into the legislation of the Russian Federation regarding the creation of production councils in organizations, as well as the definition of their powers; develop a set of measures for the development of self-government institutions and the adoption of codes of professional ethics;

i) submit, by March 1, 2013, proposals on the use of the regulatory per capita financing mechanism in certain sectors of the budgetary sector of the economy;

k) to introduce, starting from 2013, measures aimed at increasing support for socially oriented non-profit organizations;

m) for the purpose of further preservation and development of Russian culture:

create at least five cultural development centers in small towns by 2015; include annually in the National Electronic Library at least 10 percent of book titles published in the Russian Federation; provide support for the creation of public electronic libraries, websites of museums and theaters on the information and telecommunications network Internet, as well as the placement of films and performances of outstanding film and theater directors on the Internet; to ensure an increase until October 1, 2012 in federal budget allocations for the payment of scholarships for cultural and artistic workers, creative youth, as well as for the provision of grants to support creative projects of national importance in the field of culture and art; ensure the creation, by March 1, 2013, of a mobile collection of leading Russian museums for exhibiting works of art in museums and galleries of small and medium-sized cities, and also create 27 virtual museums by 2018;

double the number of exhibition projects carried out in the constituent entities of the Russian Federation by 2018; increase by 2015 to 4 thousand the number of state scholarships for outstanding cultural and artistic figures and young talented authors; to increase by 2018, in order to identify and support young talents, the number of children involved in participation in creative activities to 8 percent of the total number of children.

2. To the Government of the Russian Federation together with the executive authorities of the constituent entities of the Russian Federation:

a) ensure, by August 1, 2012, the development of regulatory legal acts providing for the implementation of measures to gradually increase the wages of cultural workers;

4. This Decree comes into force on the date of its official publication.

President of the Russian Federation V. Putin

Report “On the implementation of Decrees of the President of the Russian Federation of May 7, 2012 No. 597, No. 598, No. 606 in the field of healthcare in the Kaliningrad region in 2013”

May 7, 2012. The President of the Russian Federation signed a number of decrees defining the main directions of the country's development for the near and medium term, 3 of which are aimed at solving social problems in healthcare.

Decree No. 597 of 05/07/2012 “On measures for the implementation of state social policy” affects the interests of medical healthcare workers in connection with an increase in their wages.
The main task set by the head of state is aimed at bringing the wages of doctors to twice the average wage in the region and 100% of the average and junior staff.
The salary increase affected over 11 thousand medical workers of state regional healthcare institutions, or 75% of their total number of employees, including 2,487 doctors, 5,540 nurses and paramedics, 2,748 junior medical personnel.

In accordance with the road map, the average monthly salary of medical workers by 2018 should be:
- doctors – 78,482 rubles;
- paramedical personnel – 41,986 rubles;
- junior medical personnel – 33,589 rubles.
At the end of 2013, the average salary of doctors was 43,215 rubles, which is 176% of the regional average and 55% of the 2018 target.
For nursing staff, the salary amounted to 25,600 rubles or 104.2% of the average for the regional economy and 61% of the 2018 target.
The average salary of junior medical personnel was 15,323 rubles, or 62.4% of the average for the regional economy and 45.6% of the 2018 target.

Decree of the President of the Russian Federation dated May 7, 2012 No. 598 “On improving state policy in the field of health care” determined the main directions for improving state policy in the field of health care to create the necessary conditions for maintaining health, reducing mortality and increasing life expectancy of the population.

In order to implement Decree No. 598, the Ministry of Health of the Kaliningrad Region has developed the most important system document - the State Program of the Kaliningrad Region “Health Development”, which defines the main goals, objectives and directions for the development of health care in the region until 2020 (hereinafter referred to as the Program).
The program was approved by Decree of the Government of the Kaliningrad Region on April 30, 2013 No. 273, agreed with the Ministry of Health of the Russian Federation, the Federal Compulsory Health Insurance Fund.
Changes are currently being made to the Program. The draft resolution of the Government of the Kaliningrad Region “On amendments to the state program of the Kaliningrad Region “Development of healthcare in the Kaliningrad Region for 2013-2020” will be considered at a meeting of the Government of the Kaliningrad Region on February 18 of this year.
The main goal, objectives and target indicators remained unchanged, the format for providing the target program and the source of funding changed.
The draft Decree was prepared in accordance with Decree of the Government of the Kaliningrad Region dated August 9, 2013 No. 565 “On approval of the procedure for the development, implementation and evaluation of the effectiveness of state programs of the Kaliningrad Region”, Order of the Ministry of Economy of the Kaliningrad Region dated August 29, 2013 No. 41 “On approval of methodological instructions on the development and implementation of state programs of the Kaliningrad region."

The main goals of the program are quite ambitious, by 2020:

we must increase the life expectancy of the region's residents to 76 years;

reduce mortality from all causes to 10.3 cases per 1000 population;

reduce infant mortality to 5.0 cases per 1000 live births;

Reduce mortality from diseases of the circulatory system to 625.0 cases per 100.0 thousand population;

reduce mortality from road traffic accidents to 9.0 cases per 100.0 thousand population;

reduce mortality from tuberculosis to 8.2 cases per 100.0 thousand population;

increase the supply of doctors to 32.5 people per 10.0 thousand population;

Increase the ratio of doctors and nursing staff to 1/3.

Specific actions have been developed to achieve this. First of all, this is the formation of a healthy lifestyle and a unified preventive environment, this is a general medical examination of the population, annual for children and regular for adults (once every 3 years) depending on age and health status, this is a system of measures to improve the quality of medical care and its availability.
The implementation of activities in 2013 allowed us to achieve the following targets:
- reduce infant mortality by 3.2% of the target;
- reduce mortality from road accidents by 20.2% (the mortality rate from road accidents is already lower than in 2018);
- reduce mortality from tuberculosis by 2.3%.
Indicators not achieved:

mortality from circulatory diseases amounted to 727.1 cases per 100.0 thousand population, against the established 700.0 (the indicator was not achieved by 3.8%);

mortality from neoplasms amounted to 208.9 cases per 100.0 thousand population, against the established 200.8 (the indicator was not achieved by 4%).

In the Russian Federation, the mortality rate from diseases of the circulatory system was 700.4 per 100 thousand population (11 months of 2013), which is 3.7% lower than in the Kaliningrad region;
in the Northwestern Federal District - 776.8 per 100 thousand population (11 months of 2013), which is 6.8% more than in the Kaliningrad region.
Specific actions have been developed to achieve this. First of all, this is the formation of a healthy lifestyle and a unified preventive environment, this is the conduct of universal medical examination of the population, this is a system of measures to improve the quality of medical care and its accessibility.

The main reasons for the increase in mortality from diseases of the circulatory system include:

1. Increase in morbidity, late seeking of medical help, insufficient early diagnosis, failure of patients to comply with the recommended treatment regimen.

Analysis of morbidity rates among the population of the Kaliningrad region The dynamics of the area of circulatory system diseases over a three-year period indicates a significant increase. Compared to 2010, in 2012 the incidence of circulatory system diseases in the population increased by 5%.
According to the clinical examination of the adult population carried out in 2013, 13,795 residents of the region (8%) were diagnosed with diseases of the circulatory system, of which 2,671 (19%) had coronary heart disease, including angina pectoris - 363 (unstable angina 163). On the dispensary register consists of more than 25 thousand people, of which 8 thousand people with coronary heart disease (32%), about 5.0 thousand people with angina pectoris (20%), 13 thousand people with arterial hypertension (52%).
In 2013, the number of patients with congenital malformations of the heart and blood vessels increased by 22 people or 15% (from 148 to 170).
2. Growth over the past 5 years in the population over working ageon average by 2.3%.
The largest number of patients from cardiovascular pathology in the Kaliningrad region die at the age of 70 years and older, which is 84.6% (the age group from 80 years and older is 60%, the age group from 0 to 59 years inclusive - 6.1 %).
3. Cardiology bed capacity is insufficiently deployed
profile.
In the region, 246 cardiology beds have been deployed, while the estimated figure is 284 beds, due to the lack of space and personnel.

4. Understaffing.

Currently, the region lacks 12 cardiologists.

5. The increase in mortality from cardiovascular diseases occurred due to more accurate diagnosis of the causes of death (all patients with this pathology are delivered for treatment to hospitals of vascular centers) and the peculiarities of calculating the mortality rate (currently this indicator includes citizens who died in the Kaliningrad region, but are registered and permanently residing in other regions of Russia and abroad. This indicator adjusted by Rosstat (Federal State Statistics Service) only based on the results of the year.

Main measures taken:

As part of the implementation of the target program “Improving medical care for patients with cardiovascular diseases for 2012-2013,” cardiac care is organized in accordance with the procedure for providing medical care to patients with cardiovascular diseases. Three cardiology departments with intensive care units have been created in district and city hospitals for emergency cardiac care and care for patients with chronic diseases in the stage of decompensation, and a vascular center in the Regional Clinical Hospital. Treatment of cardiac patients who do not require round-the-clock monitoring is carried out in day care hospitals at the patients’ place of assignment.

In order to reduce mortality from diseases of the cardiovascular system in In 2013, 154.9 million rubles were allocated for the purchase of medical equipment for vascular centers.

The territorial program of state guarantees of free medical care includes 4 names of the most effective drugs of the new generation for thrombolysis (ticagrelor, bilivarudin, eptifibatide, tenectoplase).

4. All patients undergo thrombolysis within the first hours of emergency medical care.
5. All ambulances are equipped with “Tredex” diagnostic systems for transmitting an electrocardiogram to the control center of the emergency medical service station in Kaliningrad and to the interterritorial center in the regions.
6. In 2013, the primary provision of high-tech medical care in the profile of “cardiovascular surgery” was carried out in the Federal State Budgetary Institution “Federal Center for Cardiovascular Surgery”, Kaliningrad - 2978 volumes. In total, 3,022 people received treatment for cardiovascular surgery in 2013 (an increase of 90% compared to 2010). For 2014, the planned volume of medical care for cardiovascular surgery will be 4,000 operations, which will mainly be performed at the Federal Center for Cardiovascular Surgery. Operating at full capacity of the institution (up to 5,000 operations per year) will reduce mortality from diseases of the cardiovascular system by 5%.
7. A department of follow-up care after cardiac surgery for adults has been organized. From 2014, children after heart surgery will be sent for follow-up treatment to the cardiology department of the Children's Regional Hospital of the Kaliningrad Region.
8. For three years, in accordance with the territorial program of state guarantees of free medical care, patients who have suffered an acute heart attack, acute stroke, as well as heart and vascular surgery have received rehabilitation in local sanatoriums (1,332 people in 2013).
In 2013, the mortality rate from neoplasms was not achieved; it exceeded the planned figure by 4% and amounted to 208.9 per 100 thousand population.
One of the reasons for the increase in mortality from neoplasms is the lack of a specialized oncological institution in the region. Currently, medical care is provided to patients at the Regional Clinical Hospital of the Kaliningrad Region, which is not equipped with modern radiological equipment for radiation therapy.
The government of the Kaliningrad region is currently considering the issue of building an oncology center on the terms of a public-private partnership with PET-Technology LLC.
A working draft of the medical and technical specifications for the construction and equipment of the radiological complex and the building of the oncology center of the Kaliningrad region for 280 hospital beds and 450 visits to the outpatient department has been developed.
Currently, patients are also sent to medical centers in Moscow and St. Petersburg to receive specialized oncological care. In 2013, 302 people were sent to federal centers for treatment; today there are 38 patients on the waiting list.

The fundamental block of the state program is drug provision and its improvement, since it is drug provision that often determines the quality of medical care.
The subprogram was prepared in accordance with the Drug Supply Strategy until 2025, approved by order of the Ministry of Health of the Russian Federation dated February 13, 2013 No. 66.
In order to improve the supply of medicines and the efficient use of financial resources, the Ministry of Health of the Kaliningrad Region is implementing a project to create a new model of interaction between participants in the pharmaceutical market.
To achieve this, the following activities were carried out:

a pharmaceutical organization was created in the form of the State Treasury Institution “Kaliningrad Regional Pharmaceutical Company”, whose functions include receipt, storage, distribution, control over the rational use (prescription) of medicines purchased from federal and regional budgets;

Within the structure of medical organizations, pharmacies and pharmacy points have been created that dispense medications.

Registers of patients in need of preferential medicines have been created, and personalized accounting has been organized in order to improve the quality of planning for the purchase of medicines.
Optimizing the system as a whole will allow us, without involving additional resources, to increase the capabilities of the system, according to our calculations, by approximately 20 percent with the same resources.

Achieving the planned health indicators is impossible without solving the most serious problem of Kaliningrad healthcare - the shortage of medical personnel.
As of January 1, 2014, there are 14,353 employees working in public health care institutions, the deficit is 821 people, of which 439 are medical personnel, 382 are paramedical personnel.
Staffing of outpatient clinics
is:
- doctors - 71.6 percent, the part-time ratio remains high - 1.3;
- paramedical personnel - 70 percent, part-time ratio - 1.3.
The number of emergency physicians is -52 percent, and the part-time ratio is 1.6.
Among working medical personnel, the share of specialists under the age of 36 is 16 percent, from 36 to 45 years - 16 percent, from 46 to 50 years - 15 percent, from 51 to 55 years - 18 percent, from 56 to 60 years 15 percent, over 61 years - 20 percent. 35 percent of working doctors are of retirement age.

In order to provide medical organizations of the state healthcare system with highly qualified personnel in the region, the target program “Staffing of the healthcare system of the Kaliningrad region for 2013-2017” is being implemented.
The specified program provides for measures to organize targeted contract training at the expense of federal and regional budgets (from 2014 in the amount of 3.3 million rubles), professional training (2.6 million rubles annually), retraining, advanced training (about 600 people annually .) and prestige of the profession (competitions, publications in the media), measures of social support:
- payment for housing and utilities to persons living and working in rural areas in the amount of 53,394.2 thousand rubles;
- one-time compensation payments to medical workers with higher medical education who arrived or moved to work in a rural locality of the Kaliningrad region, in the amount of 1 million rubles (in 2012 - 3 people received the payment, in 2013 - 2 people);
Providing, since 2014, a monthly scholarship to persons studying at state universities on the terms of targeted contract training (internship, residency) for the needs of the Kaliningrad region in the amount of 2,000 rubles;
- provision of a one-time cash payment to persons who completed training in an internship or residency under the terms of targeted contract training - 200 thousand rubles.
Funds from the reserve fund of the Government of the Kaliningrad Region and funds from the targeted programs of the Kaliningrad Region “Housing” and “Social Development of Rural Affairs” are allocated to medical workers for the purchase of housing. 60 service apartments are allocated to medical specialists of the Center for Cardiovascular Surgery in new buildings in the South-Eastern region of Kaliningrad.

In 2013, the Ministry of Health of the Kaliningrad Region issued 146 targeted referrals for admission to higher medical educational institutions (the selection of targeted referrals is carried out on a competitive basis). Enrolled for training - 51 people.
In 2013, 34 graduates of medical higher educational institutions were sent to target areas from the Kaliningrad region for internship training (30 people), residency (4 people).
In 2013, the second graduation from the Faculty of Medicine of IKBFU. I. Kant consisted of 42 people, of whom 9 graduates entered the internship and 3 into residency at the IKBFU. I. Kant. The remaining graduates continued their studies in clinical internship (residency) on a commercial basis and at the bases of federal higher educational institutions located outside the Kaliningrad region.
After the closure of the Kaliningrad Regional Medical College in 2008 on the basis of the Faculty of Medicine of the IKBFU. I. Kant is training specialists in secondary vocational education programs in the following specialties: “general medicine”, “nursing”, “obstetrics”, “dentistry”, “orthopedic dentistry”, “pharmacy”. There is no targeted enrollment in secondary medical education programs for the Kaliningrad region.
From September 2014, it is planned to train paramedical personnel after the 9th grade of secondary school.

Decree of the President of the Russian Federation dated May 7, 2012 No. 606 “On measures to implement the demographic policy of the Russian Federation” is aimed at solving one of the demographic problems - increasing the birth rate and increasing the life expectancy of the population.

The decree established two targets that the constituent entities of the Russian Federation must achieve by 2018: a total fertility rate of 1.753 and a life expectancy of 74 years.
At the end of 2012, in the Kaliningrad region the total fertility rate was 1.625 births, life expectancy was 70.12 years

Prenatal (antenatal) diagnostic programs and neonatal screening of newborns have a positive impact on increasing average life expectancy at birth.
Prenatal (prenatal) diagnostics is aimed at identifying disorders in fetal development, preventing the birth of children with developmental defects and hereditary diseases incompatible with life.
In 2013, the number of women undergoing examinations in the early stages of pregnancy (up to 14 weeks) was 9,875 people. (95.4% of subjects). The indicator for the Russian Federation is 88%.
Screening newborns for inborn errors of metabolism is aimed at identification of health problems while the child is in the maternity hospital in order to provide timely treatment for children. Newborn screening coverage is 99.6% (2013 target: 96.0%).

Financing of activities for prenatal diagnosis and examination of newborns is carried out within the framework of Agreements concluded between the Government of the Kaliningrad Region and the Ministry of Health of the Russian Federation on co-financing terms.

The volume of financial resources allocated for these purposes in 2013 amounted to 8,723.1 thousand rubles, including regional budget funds - 908.8 thousand rubles, federal budget funds - 7814.3 thousand rubles.
In 2013, 173 cases of congenital malformations of the fetus and chromosomal disorders were identified in the prenatal period, and in 62 cases the pregnancy was terminated.
9 cases of congenital metabolic disorders in newborns and 17 cases of children at risk for the development of deafness were identified.
The implementation of prenatal diagnostics and newborn screening programs will continue in 2014 and subsequent years.

Ministry of Health of the Kaliningrad Region as part of the implementation State Health Development Program The life expectancy indicator was determined in 2013 - 70.0 years.
To increase the life expectancy of the population, measures are aimed at improving the organization of medical care and increasing its accessibility, preventing socially significant diseases, and preventing mortality from road accidents and cancer.
The formation of a healthy lifestyle, measures to reduce the abuse of alcohol and tobacco products, the prevention of alcoholism, smoking, and drug addiction will also have a positive impact on life expectancy indicators.

One of the most significant measures to prevent cases of early mortality of the population and ensure timely treatment and rehabilitation is regular medical examination of the adult population and annual medical examinations of children.
In 2013, medical examinations were carried out on 157,835 people against the target of 152,796 people.
Based on the results of the medical examination, 33% of the examined citizens, 3,358 people, were found to be in need of health improvement and treatment. are directed to additional research. 87 people were sent to provide specialized (including high-tech) medical care, and 1038 people were sent to sanatorium-resort treatment.

In the first half of 2013, medical examinations were carried out for orphans and children in difficult life situations staying in inpatient healthcare, education and social protection institutions. A total of 1384 people were examined. (100.8% of the plan). - During the period September-December 2013, medical examination of orphans transferred to foster families was organized and carried out. In-depth examinations were carried out only with the informed voluntary consent of the child’s legal representatives. 1037 children were examined.
In 2013, a new scheme for conducting in-depth medical examinations of minors, including in educational institutions, was introduced. In-depth medical examinations are carried out at certain age periods of life, in the volumes approved by the Ministry of Health of the Russian Federation No. 1346n. (came into force in May of this year).
The inspection schedule was approved - 41,493 people. (preventive, preliminary, periodic examinations), of which preventive - 18,324 people.
All children were covered by medical examinations, registers were submitted to medical insurance organizations for 37,151 people.
According to the results of the examinations, 40.7% of children were classified as practically healthy, 51.5% had minor functional deviations in their health status, 7.4% needed rehabilitation and health improvement (these are children classified as health group III).

Work on conducting medical examinations of the adult population, orphans and children in difficult life situations, and in-depth medical examinations of minors will continue in 2014.

Achieving target indicators will allow:
1) Improve the availability of medical care by solving the personnel problem, improving the organization of work in primary health care institutions
2) Improve the quality of medical care through the acquisition of new diagnostic equipment and surgical instruments, professional training of medical personnel
3) Improve the population’s awareness of risk factors for developing diseases, preventive measures and motivate them to lead a healthy lifestyle
4) Reduce mortality and increase life expectancy of the population
5) Increase the efficiency of medical services, the volumes, types and quality of which must correspond to the level of morbidity and the needs of the population of the Kaliningrad region

PRESIDENT OF THE RUSSIAN FEDERATION

ABOUT EVENTS
ON THE IMPLEMENTATION OF STATE SOCIAL POLICY