Among the technical means of rehabilitation there are various devices that facilitate the daily life of a sick person. These are crutches, prostheses, wheelchairs, hearing aids and much more.
Means of rehabilitation include mechanisms, products, electronic devices and other devices that facilitate the daily life of the patient, as well as close people caring for him. The main purpose of these products is rehabilitation after an operation or providing the most comfortable living conditions for people with poor health.
What are technical means of rehabilitation
For the disabled, as well as people with poor health, a number of technical means of rehabilitation (TSR) have been developed to ensure a normal lifestyle and fulfill basic needs - the ability to fulfill physiological needs, self-service skills, move normally, etc.
The list of technical means of rehabilitation is formed in accordance with federal law No. 181. At the same time, each patient can count on receiving these funds free of charge in the prescribed amount from the social security authorities, in accordance with the procedure established by the individual rehabilitation program - IPR.
Based on this program, a specific amount is allocated, within which it is possible to obtain a complete set of technical means at the expense of the budget. This list includes apparatus and devices for the recovery of the patient, for example, from complications of diseases of the musculoskeletal system, funds for bedridden patients. In this case, the patient can also purchase additional funds at his own expense, for example, in accordance with the doctor's recommendations.
The specified federal law provides for the provision of disabled people with technical means of rehabilitation of the following types:
- assistive devices for self-care, basic needs (e.g. toilet seat)
- care products;
- auxiliary mechanisms for learning, the ability to fully perform labor activities;
- tools to help navigate in space, including specially trained guide dogs;
- prosthetic products, including prosthetic eyes, hearing aids, etc.;
- sports equipment;
- movement mechanisms.
All these devices can only be issued by the social security authorities on the basis of relevant medical reports, orders and other regulations.
The right to use arises for a temporary period, for example, for a year before the next medical examination or indefinitely, for example, for disabled children who have received a group since childhood.
Classification of product types
A complete list of technical means for the rehabilitation of disabled people can be found in regulatory documents, for example, in the "Classification", which is approved by Order of the Ministry of Health and Social Development No. 214n. The document contains a list of names (nomenclature) of various medical products and devices. Their classification is based on different indicators, but mainly different types are grouped depending on the disability group and specific diseases - impaired hearing, vision, etc.
Self-service facilities
First of all, they allocate technical means of rehabilitation (tcp) for self-service of a person. They allow you to normally satisfy the natural physiological needs, and this can be done independently or with minimal help from outsiders.
Briefly, the list of these funds can be classified as follows:
- Pampers, which rely as a rehabilitation tool for bedridden patients, for example, after a stroke or diseases associated with cardiology.
Note! Along with diapers for a child, there are special products for adults.
- Toilet chairs. Wheelchair users who are not paralyzed, but at the same time experience significant mobility problems, use toilet chairs. They can be placed next to the bed.
- Devices for gripping objects are means of rehabilitation that are suitable not only for the disabled, but also for people suffering from diseases of the musculoskeletal system. With the help of such simple devices, you can reach a fallen object, as well as a thing that is located unattainably high.
- Similarly, such patients need to use devices for putting on clothes or self-shoeing slippers, boots, and other types of shoes. Especially for them, frames are provided for tightening, putting on socks / stockings, fastening buttons, holding hats, etc.
Devices and mechanisms for movement
These devices allow a person to move comfortably and safely. The patient can move independently, and he can also be seated and less often put in a chair to move with the help of an outsider. The most common devices are:
- , as well as . Shown at the first stage of rehabilitation after fractures, dislocations and other leg injuries.
- - for the movement of a patient with poor health: the elderly, people with impaired body coordination, neurological patients, completely or partially paralyzed. There are mechanical and electrical devices, the latter allow you to move completely autonomously, without the help of another person.
- serve as a reliable support for movement around the room or on the street. They can be equipped with wheels (so-called rollators) for more comfortable movement.
Note! Each technical means of rehabilitation of the disabled has its own indications for use, as well as instructions and guidelines, presentations describing the features of use. The brochure should be read first, even if the terms of use are intuitive.
Hearing aids
The main mechanism in this case is the hearing aid. This is an electronic, fully automated device that greatly amplifies the sound wave, so that a patient with severe hearing loss can recognize human speech and other sounds.
Apparatus and means for visual impairment
For blind people, there are several means of technical rehabilitation - the current list for the disabled is as follows:
- , which allow you to feel the nature of the surface, nearby objects, as well as attract the attention of other passers-by (due to red transverse stripes).
- Guide dogs undergo special training, after which they accompany a blind owner for several years.
Prostheses
In general, the prosthesis is a means of rehabilitation of disabled people or people with health problems, which partially or completely replaces the function of a certain part of the body, limb: arm, leg (for example, the hip joint in case of a fracture of the femoral neck). To date, a very large number of various prostheses have been developed, for example:
- shoulder
- finger;
- forearm;
- hips;
- feet
- sky;
- ear prosthesis;
- nasal prosthesis and many others.
The main task of these products is an adequate replacement of the corresponding part of the body, unloading the body, the ability to maintain the ability to move (for example, a knee joint prosthesis).
The cost of various means of rehabilitation
Technical means of rehabilitation for the disabled and other patients with poor health can be bought at pharmacies, specialized orthopedic stores, as well as on websites on the Internet. The price depends on several factors - the manufacturer, warranty, material of manufacture, etc. As a rule, delivery is paid separately.
It is carried out throughout the country - both in large cities (Moscow, St. Petersburg, Krasnodar) and in small ones (Irkutsk, Novokuznetsk). Delivery is also possible to small settlements, for example, in the Krasnodar Territory, the Omsk Region and in all other regions. Goods are also delivered to other countries - for example, to Ukraine, China. Under certain conditions (for example, a purchase from 5000 rubles), delivery is free of charge.
Table 1. Overview of means of rehabilitation
| Model name | Description | price, rub. |
|
Designed for the movement of a disabled child, as well as children with cerebral palsy; movement is possible both at home and on the street (but only on a hard surface) | 13 900 |
|
Convenient and inexpensive model on wheels, made of durable metal alloy. It is possible to adjust the height, as well as sit on a soft seat | 4 400 |
|
Made of durable aluminum alloy, adjustable in height | 2 300 |
|
Thanks to its two-tier design, this inexpensive model allows you not only to move easily, but also to get out of bed. | 2 300 |
|
Equipped with underarm supports and 2 brakes; support patient weight up to 100 kg | 7 500 |
|
Functional chair with a sanitary container made of durable plastic; warranty period 1 year | 3 300 |
|
Convenient folding model of the chair with a sanitary container takes up little space, so it can be placed even in a small room next to the patient's bed | 2 300 |
|
Produced in Germany, the model is new, because it was practically not used | 12 500 |
|
Durable body, the stroller is suitable for walking around the house and on the street, made in Germany | 9 000 |
|
Reliable crutch, equipped with an anti-skid system | 690 per piece |
|
Small crutches, designed for patients with average height (150-160 cm), made in the USA, service life 7 years | 1 300 |
Note! When choosing a specific mechanism or device, you need to make sure that it is in good technical condition (especially when it comes to used goods). It is best to choose goods not earlier than 2013 of production (preferably not earlier than 2015-2016).
You can get acquainted with the latest technical means of rehabilitation in the video material:
Each tool in one way or another makes the patient's life more comfortable. For proper use, you must carefully select the most suitable model, if necessary, consult a doctor before buying.
Most citizens who have received an illness or injury as a result are unable to perform any activities without outside help or without the use of technical means of rehabilitation (TCP). Most often this is due to negative changes in the musculoskeletal system. The legislation of the Russian Federation provides. These measures include a number of different benefits, the most important of which are benefits for the purchase of medicines, medical care and the provision of individual rehabilitation equipment for people with disabilities.
Legislative framework and a special program for the provision of persons with disabilities
The provision of assistance to persons with disabilities is regulated by a number of state acts. Most of them were adopted in the 90s, so many articles of these laws have been repeatedly changed and supplemented.
Benefits for disabled people under federal law and the order of the Department of Labor
All benefits to which persons with disabilities are entitled are spelled out in the following documents. These are the federal law on disabled people No. 181-FZ dated 15.11.1995, as last amended on 14.12.2015, and the Decree of the Government of the Russian Federation on the provision of disabled people TSR No. 240 of 07.04.2008, as last amended on 07.03 .2016 . Questions about technical means of rehabilitation are discussed in more detail in the order of the Ministry of Labor No. 374 "n" dated July 18, 2016.
Classification - basic and auxiliary means
It is very important for the disabled to receive technical means of rehabilitation. Classification - such means can be basic or auxiliary. Without fixed assets, the patient cannot perform the most important basic activities, such as movement and the administration of natural needs. Auxiliary means can be used in the process of rehabilitation and preparation of a disabled person for integration into social structures.
If, for some reason, the department of social protection cannot provide the disabled person with the necessary technical equipment, he can purchase it on his own. Its cost will be paid only if the application for the provision of a means of rehabilitation has been officially registered with the relevant service. If the necessary device was purchased before the application was submitted, the cost of the device will not be paid.
List of technical means
The technical means of rehabilitation include the following devices:
- canes, crutches and other supporting products;
- manual and electric wheelchairs;
- various types of prostheses;
- special shoes;
- devices for capturing and holding objects;
- armchairs and chairs equipped with sanitary equipment.
As a means of rehabilitation of the disabled, one of the innovative developments is considered - prostheses with bionic control. Such devices are still undergoing laboratory tests, but in the near future they can be expected to appear in medical centers.
Group of products for personal hygiene
A separate group of funds allocated funds for personal hygiene. These include:
- urine and feces receivers;
- absorbent underwear with absorption function;
- special bedding;
- diapers.
For disabled people with visual, hearing and speech impairments, electronic technical means for self-service are provided:
- optical correctors for persons with severe visual impairments;
- e-books with voice text synthesizer;
- "talking" instruments for measuring pressure and temperature;
- speech synthesizers;
- vibration and light signaling devices for the deaf;
- individual hearing aids;
- televisions equipped with the Teletext function;
- telephones with an information display.
In addition, guide dogs with additional equipment can be provided for the rehabilitation of disabled people. To do this, a citizen who needs such a dog must write an application to the social service. After a certain time, he will be given a dog from the kennel. Food and treatment of the dog is carried out from the funds of the social body.
If the dog is donated or bought, the state does not compensate for the cost of its maintenance.
Previously, technical means included special cars or motorized wheelchairs for the disabled, but since 2005 this benefit has been suspended.
Provision of repair work
In accordance with Law No. 30-FZ of March 7, 2017, amendments and additions were introduced to Government Decree No. 240. All repairs of rehabilitation technical equipment are carried out without a queue and free of charge. If a technical device cannot be repaired for any reason, it will be replaced free of charge. For early replacement of the product, technical expertise may be required, which is also carried out free of charge.
Almost every region has municipal laws to support people with disabilities. They may provide additional benefits to persons with disabilities.
List of medicines - how to get them
For persons with disabilities, medicines are prescribed, including potent ones, which are provided with appropriate discounts or free of charge. This benefit is regulated by the list of medicines. This list was determined by the Decree of the Government of the Russian Federation No. 2782 "r" dated December 30, 2014 and was increased by 25 names of medicines in 2017. This list includes the following groups of drugs:
- opioid analgesics;
- non-narcotic pain relievers;
- remedies for gout;
- anti-inflammatory drugs;
- antiallergenic and anticonvulsant drugs;
- agents for the treatment of Parkinson's disease;
- sedatives and antidepressants;
- drugs that affect the central nervous system;
- antibiotics and synthetic antibacterial agents;
- antiviral and antifungal drugs.
In two large groups allocated means that affect the cardiovascular system and the gastrointestinal tract. One of the diseases for which you can get a disability group is a sharp decrease in the level of insulin in the blood, therefore, for many disabled people, diabetes treatments are important and provided free of charge.
The list of medicines that a disabled person can receive free of charge, but only by decision of the medical commission, includes a large group of medicines. Some of them are narcotic or expensive drugs of foreign production and can be obtained in pharmacies with a special prescription.
In order to implement the Agreement between the Ministry of Health and Social Development of the Russian Federation and the Government of Moscow on the transfer to the Government of Moscow of part of the federal powers to provide disabled people with technical means of rehabilitation and the provision of state social assistance to certain categories of citizens in terms of providing vouchers for sanatorium treatment, as well as free travel by long-distance transport to the place of treatment and back, approved by Decree of the Government of the Russian Federation of December 31, 2008 N 2065-r, as well as improving the quality and efficiency of the activities of state authorities for the rehabilitation of disabled people The Moscow Government decides:
1. Approve:
1.1. Rules for the provision of disabled people with technical means of rehabilitation, including prosthetic and orthopedic products (except for dentures) at the expense of subventions from the federal budget provided in accordance with federal legislation, in accordance with this resolution.
1.2. List of technical means of rehabilitation obtained through the departments of social rehabilitation of disabled people of centers (complex centers) of social services of the Department of Social Protection of the Population of the City of Moscow, the Moscow Center for Technical Means of Rehabilitation of the Department of Social Protection of the Population of the City of Moscow (state institution) and manufactured by prosthetic and orthopedic enterprises that have contractual relations with the Department of Social Protection of the Population of the City of Moscow following the results of the competition for the placement of a state order for the provision of prosthetic and orthopedic care to the population, in accordance with this resolution.
1.3. The list of technical means of rehabilitation for medical purposes, issued by institutions of the Department of Health of the city of Moscow, in accordance with this resolution.
2. Establish that the authorized bodies of the Government of Moscow to provide disabled people with technical means of rehabilitation, including prosthetic and orthopedic products (except for dentures), within the framework of the federal list approved by order of the Government of the Russian Federation of December 30, 2005 N 2347-r, are:
Department of social protection of the population of the city of Moscow;
Department of health of the city of Moscow.
3. The Department of Social Protection of the Population of the City of Moscow and the Department of Health of the City of Moscow to exchange information by entering information into the Citywide Special Register of Persons with Disabilities - Recipients of Social Support Measures in the Field of Rehabilitation.
4. Financing of expenses for the execution of part of the federal powers transferred to the authorized bodies of the Government of Moscow shall be carried out at the expense of budgetary appropriations of the federal budget transferred to the budget of the city of Moscow in the form of subventions for these purposes.
5. Control over the implementation of this resolution shall be entrusted to the First Deputy Mayor of Moscow in the Government of Moscow L.I. Shvetsova.
| Mayor of Moscow | Yu.M. Luzhkov |
rules
providing disabled people with technical means of rehabilitation, including prosthetic and orthopedic products (except for dentures), at the expense of subventions from the federal budget provided in accordance with federal legislation
These Rules determine the procedure for providing technical means of rehabilitation (hereinafter referred to as technical means) and prosthetic and orthopedic products (hereinafter referred to as products) included in the Federal List of Rehabilitation Measures, Technical Means of Rehabilitation and Services Provided to a Disabled Person, approved by order of the Government of the Russian Federation dated December 30, 2005 N 2347-r, persons recognized as disabled (with the exception of persons recognized as disabled due to accidents at work and occupational diseases), persons under the age of 18 who have the category "disabled child" (hereinafter referred to as disabled), institutions social protection of the population and healthcare of the city of Moscow.
I. Functions of the Department of Social Protection of the Population of the City of Moscow in terms of providing disabled people with technical means and products
1. The provision of disabled persons on personal applications (or applications of persons representing their interests) with technical means (products) is carried out in accordance with individual rehabilitation programs developed by federal state institutions of medical and social expertise.
2. Providing disabled people with technical means (products) is carried out by:
2.1. Provision of an appropriate technical means (product).
2.2. Provision of services for the repair or replacement of previously provided technical means (products).
2.3. Payments of compensation for expenses for the activities specified in this section (in the case of these expenses at the expense of the disabled person), including payment for banking services (postal services) for the transfer (transfer) of compensation funds.
2.4. Providing disabled people with guide dogs, including the payment of annual monetary compensation for the costs of maintaining and veterinary services for guide dogs.
2.5. Provision of sign language interpretation services to persons with disabilities.
3. A technical device (product) provided to a disabled person in accordance with these Rules is transferred to him free of charge for free use on the basis of an acceptance certificate and is not subject to alienation in favor of third parties, including sale or donation.
4. An application for the provision of technical equipment is submitted by a disabled person (a person representing his interests) to the departments of social rehabilitation of centers (complex centers) of social services of the Department of Social Protection of the Population of the City of Moscow at the place of residence (stay) of the disabled person.
An application for the provision of high-tech and expensive technical means that require individual selection is submitted to the Moscow Center for Technical Means of Rehabilitation of the Department of Social Protection of the Population of the City of Moscow (state institution).
5. An application for the provision of a product is submitted by a disabled person to any prosthetic and orthopedic enterprise that has a contractual relationship with the Department of Social Protection of the Population of the City of Moscow following the results of a competition for placing a state order for the provision of prosthetic and orthopedic care to the population.
6. Technical means are provided on the day of the appeal of the disabled person (the person representing his interests).
In the absence of a technical means available on the day of the appeal, the department of social rehabilitation of the center (complex center) of social services, the Moscow Center for Technical Rehabilitation Means of the Department of Social Protection of the Population of the City of Moscow (state institution) considers the application specified in these Rules, notifies the disabled person in writing about putting it on the account for the provision of technical means. The department of social rehabilitation of the center (complex center) of social services, within 5 days after the receipt of the necessary technical means, issues it to a disabled person (a person representing his interests). An individual selection of technical equipment and training in its use is carried out.
7. If the technical tool (product) provided for by the individual rehabilitation program cannot be provided to the disabled person in kind or if he independently acquired the specified technical tool (product) at his own expense, the disabled person is paid compensation in the amount of the cost of the technical tool (product) , which must be provided to a disabled person in accordance with an individual rehabilitation program.
The list of submitted documents includes:
An application submitted by a disabled person (a person representing his interests) for reimbursement of expenses for the acquisition of a technical device (product);
Individual rehabilitation program;
Documents confirming the expenses incurred;
A certificate for a technical device (product), a license for the right to engage in activities for the manufacture of prosthetic and orthopedic products (in the case of purchasing a prosthetic and orthopedic product).
The department of social rehabilitation of the center (complex center) of social services forms a register for the payment of compensation for a technical device (product) purchased by a disabled person on his own, which is sent to the State Institution Center for the Automated Calculation of Social Payments and the Preparation of Analytical Information on Social Protection of the Population of the City of Moscow to pay the disabled person the indicated compensation.
The refusal of a disabled person to provide a technical device (product) does not give the right to receive compensation in the amount of the cost of such a technical device (product).
8. Repair of a technical device (product) is carried out free of charge on the basis of an application submitted by a disabled person (a person representing his interests) to the Moscow Center for Technical Means of Rehabilitation of the Department of Social Protection of the Population of the City of Moscow (state institution) (prosthetic and orthopedic enterprise) and the conclusion of a medical and technical examination of the Moscow Center for Technical Means of Rehabilitation of the Department of Social Protection of the Population of the City of Moscow (state institution) (medical and technical commission of the prosthetic and orthopedic enterprise providing prosthetic and orthopedic care on the basis of state contracts concluded with the Department of Social Protection of the Population of the City of Moscow based on the results of competitions) . The procedure for the implementation of the medical and technical expertise and the form of the conclusion of the medical and technical expertise are determined by the Ministry of Health and Social Development of the Russian Federation.
If a disabled person has repaired a technical device (product) at his own expense, he is paid compensation. The decision to pay compensation for the repair of a technical device (product) made by a disabled person on his own is made by the Department of Social Protection of the Population of the City of Moscow on the basis of an application submitted by a disabled person (a person representing his interests) for reimbursement of expenses for the repair of a technical device (product), the conclusion of a medical and technical examination, as well as documents confirming these expenses.
9. Terms of use of technical means of rehabilitation (products) before their replacement are established by the Ministry of Health and Social Development of the Russian Federation.
10. Replacement of a technical means of rehabilitation (product) is carried out at the request of a disabled person (a person representing his interests):
After the expiration of the established period of use in the presence of an individual rehabilitation program;
If it is impossible to carry out repairs or if early replacement is necessary, which is confirmed by the conclusion of the medical and technical expertise of the Moscow Center for Technical Means of Rehabilitation of the Department of Social Protection of the Population of the City of Moscow (state institution) or the medical and technical commission of the prosthetic and orthopedic enterprise.
11. Technical means (products) issued to disabled persons are not subject to surrender.
12. Provision of disabled people with guide dogs, including the payment of annual monetary compensation for the costs of maintenance and veterinary care of guide dogs, is carried out in accordance with the Rules for the Provision of Disabled Persons with Guide Dogs, including the payment of annual monetary compensation for the costs of maintenance and veterinary care of guide dogs, approved Decree of the Government of the Russian Federation of November 30, 2005 N 708.
An application for providing a guide dog to a disabled person is submitted by the disabled person (a person representing his interests) to the social rehabilitation department of social service centers (complex centers) at the place of residence of the disabled person. The department of social rehabilitation of centers (complex centers) of social services within 5 days from the date of acceptance of the application notifies the disabled person in writing about his registration to provide a guide dog.
The Department of Social Protection of the Population of the City of Moscow, on the basis of the documents provided by the centers (integrated centers) of social services, sends a referral for a guide dog to an organization that trains guide dogs, selected by the department in the prescribed manner.
The authorized body that accepts documents for the payment of annual monetary compensation for the costs of maintenance and veterinary care of guide dogs is the department of social rehabilitation of the center (complex center) of social services at the place of residence of the disabled person.
The decision to pay compensation is made by the department of social rehabilitation of the center (complex center) of social services.
13. The provision of sign language services to persons with disabilities is carried out in accordance with the Rules for the provision of sign language services to persons with disabilities at the expense of the federal budget, approved by Decree of the Government of the Russian Federation of September 25, 2007 N 608.
An application for the provision of sign language interpreting services is submitted by a disabled person to an enterprise providing sign language interpreting services that has a contractual relationship with the Department of Social Protection of the Population of the City of Moscow.
II. Functions of the Department of Health of the city of Moscow in terms of providing disabled people with technical means of rehabilitation for medical purposes
1. The provision of disabled persons with technical means of rehabilitation for medical purposes is carried out by providing (installing) an appropriate technical means in accordance with individual rehabilitation programs developed by federal state institutions of medical and social expertise.
2. A technical device provided to a disabled person in accordance with these Rules is transferred to him free of charge for gratuitous use and is not subject to alienation in favor of third parties, including sale or donation.
3. An application for the provision of technical equipment is submitted by a disabled person (a person representing his interests) to medical institutions according to the profile of the disease, determined by the Moscow Department of Health.
4. Medical and prophylactic institutions determined by the Moscow Department of Health, on the basis of the conclusion of the clinic-expert (medical) commission of the institution, within the time period established by the Moscow Department of Health, notify the disabled person of registration for the provision of technical equipment.
5. In the event that the technical means provided for by the individual rehabilitation program cannot be provided to the disabled person in kind or if he independently acquired the specified technical means at his own expense, the disabled person shall be paid compensation in the amount of the cost of the technical means, which must be provided to the disabled person in accordance with individual rehabilitation program.
The refusal of a disabled person to provide a technical device does not give the right to receive compensation in the amount of the cost of such a technical device.
The decision to pay compensation is made by the Moscow Department of Health on the basis of the application of the disabled person and documents confirming the expenses incurred for the purchase of the product, with the issuance of a written opinion on the right to receive compensation.
Documents for the payment of compensation are accepted by the department of social rehabilitation of the center (complex center) of social services at the place of residence of the disabled person.
Registration of documents for the payment of compensation is carried out in the manner determined by these Rules.
6. The replacement of a technical device is carried out by medical institutions determined by the Department of Health of the city of Moscow on the basis of an application submitted by a disabled person (a person representing his interests):
After the expiration of the established period of use and on the basis of the conclusion of the clinical expert (medical) commission;
If it is impossible to carry out repairs or if early replacement is necessary, which is confirmed by the conclusion of the medical and technical commission determined by the Moscow City Health Department.
7. A technical device provided to a disabled person is not subject to surrender.
8. Terms of use of technical means before their replacement are established by the Ministry of Health and Social Development of the Russian Federation.
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technical means of rehabilitation obtained through the departments of social rehabilitation of disabled people of the centers (complex centers) of social services of the Department of Social Protection of the Population of the City of Moscow, the Moscow Center for Technical Means of Rehabilitation of the Department of Social Protection of the Population of the City of Moscow (state institution) and manufactured by prosthetic and orthopedic enterprises that have contractual relations with Department of social protection of the population of the city of Moscow following the results of the competition for the placement of a state order for the provision of prosthetic and orthopedic care to the population
Support and tactile canes, crutches, supports, handrails.
Wheelchairs with manual drive (room, walking, active type), with electric drive, small-sized.
Anti-decubitus mattresses and pillows.
Devices for dressing, undressing and grasping objects.
Special devices for reading "talking books", for optical correction of low vision.
Medical thermometers and tonometers with speech output.
Light and vibration sound signaling devices.
Televisions with teletext for receiving programs with closed captions.
Telephone devices with text output.
Chair-chairs with sanitary equipment.
Absorbent underwear, diapers.
Prostheses, orthoses.
Orthopedic shoes.
Special clothing.
Guide dogs.
Sign language translation services.
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technical means of rehabilitation for medical purposes, issued by institutions of the Department of Health of the city of Moscow
Hearing aids, including those with custom made earmolds.
Endoprostheses, including endoprostheses of joints, ligaments, heart valves, cochlear implants.
Eye, ear, nasal, combined facial, palate, genital prostheses.
Special means in case of impaired excretion functions (urinals, including catheters, urocondoms).
Decree of the Government of Moscow of August 25, 2009 N 841-PP "On the procedure for providing disabled people with technical means of rehabilitation, including prosthetic and orthopedic products (except for dentures) at the expense of subventions from the federal budget"
Technical means of rehabilitation of the disabled(information letter for social work and rehabilitation specialists)
In accordance with Art. 10, 11 of the Federal Law of November 25, 1995 No. 181-FZ “On the Social Protection of the Disabled in the Russian Federation” (as amended on August 22, 2004), the state guarantees the disabled at the expense of the federal budget to carry out rehabilitation measures, receive technical equipment and services, provided for by the federal list approved by the Government of the Russian Federation.
For the first time, the Federal List of Rehabilitation Measures, Technical Means of Rehabilitation and Services Provided to a Disabled Person was approved by Decree of the Government of the Russian Federation dated October 21, 2004 No. 1343-r (hereinafter referred to as the Federal List), entered into force on January 1, 2005. Now a new, extended federal list, approved by order of the Government of the Russian Federation of December 30, 2005 No. 2347-r.
The main mechanism for the implementation of these guarantees are individual rehabilitation programs (IPR) for disabled people, developed by federal state institutions of medical and social expertise (ITU Bureau).
The concept of medico-social examination, as a determination in the established manner of the needs of the person being examined for social protection measures, including rehabilitation, based on the assessment of disability (LIA), is given in Article 7 of the said Federal Law. And the main functions of the ITU Bureau are set out in Article 8. These include the development of IPR for people with disabilities.
Art. 11 of Law 181-FZ defines an individual rehabilitation program for a disabled person, which is a list of rehabilitation measures that are optimal for a disabled person, including types, forms, volumes, terms and procedures for the implementation of medical, professional and other measures aimed at restoring or compensating body functions, restoring or compensation for the ability of a disabled person to perform certain types of activities, i.e. OZD.
The volume of such recommendations cannot be less than the established federal minimum, determined by the federal list, with exemption from payment, but may also contain rehabilitation measures, in the payment of which the disabled person himself or other persons or organizations participate. If the selected rehabilitation measure that is optimal for a disabled person is included in the Federal List, the specialists of the bureau do not have the right not to include it in the IPR.
On the one hand, the IPR is mandatory for execution by the relevant state authorities, local governments, as well as organizations and institutions, regardless of organizational and legal forms and forms of ownership. On the other hand, IPR is advisory in nature for a disabled person, he has the right to refuse one or another type of event or the entire program as a whole.
The form of an individual rehabilitation program for a disabled person, issued by federal institutions of medical and social expertise, was approved by Order of the Ministry of Health and Social Development of the Russian Federation dated November 29, 2004 No. No. 287.
The Law specifically stipulates the procedure and conditions for the provision of technical means of rehabilitation (TRM) to persons with disabilities. Article 11.1 defines TSR and their classification. The decision to provide disabled people with TMR is made when establishing medical indications and contraindications, which are based on an assessment of persistent disorders of body functions. Financing of expenditure obligations to provide disabled people with TMW, including the manufacture and repair of prosthetic and orthopedic products, is carried out at the expense of the federal budget and the Social Insurance Fund of the Russian Federation. The list of TRMs and indications for providing them to disabled people, as well as the procedure for providing them, are determined by the Government of the Russian Federation.
Thus, the state guarantees the disabled to carry out rehabilitation measures, technical means and services provided for by the Federal List approved by the Government of the Russian Federation.
The guaranteed provision of technical means for the rehabilitation of citizens who are not disabled and injured at work is regulated by the Federal Law of January 12, 1995 No. 5-FZ “On Veterans” (as amended on August 22, 2004). Articles 14 - 19, among other measures of social support, provide for the provision of prostheses (except dentures) and prosthetic and orthopedic products in the manner established by the Government of the Russian Federation. (It should be noted that the legislation of the Russian Federation on veterans, in addition to the named federal law, consists of other regulatory legal acts of the constituent entities of the Russian Federation). Veterans who have the right to receive prostheses (except dentures) and prosthetic and orthopedic products at the expense of the federal budget, excluding disabled people, include participants in the Second World War, combat veterans, servicemen who served in military units, institutions, military training institutions that were not part of the active army in the period from June 22, 1941 to September 3, 1945 for at least 6 months, military personnel awarded orders and medals of the USSR for service in the specified period, persons awarded the badge "Inhabitant of besieged Leningrad", persons who worked during the Second World War at air defense facilities, local air defense, construction of defensive structures, naval bases, airfields and other military facilities within the rear borders of the active fronts, operational zones of the active fronts, on the front-line sections of railways and roads. If a veteran has grounds for receiving the same form of social support for several reasons, i.e. for example, he is both a veteran and a disabled person, then this form is provided on one basis at the choice of the veteran.
The formation of IPR in determining the need for a disabled person in the TSR is currently associated with certain difficulties associated with an underdeveloped regulatory framework. At present, the procedure for the development and implementation of IRP, medical indications for providing disabled people with TMR, and the range of funds related to the Federal List have not been approved.
However, an analysis of the available regulatory and methodological documents shows that there is a sufficient information base for the work of specialists from ITU institutions.
What is a TSR?
In the Federal Law 181-FZ, they are defined as devices containing technical solutions, including special ones, used to compensate for or eliminate persistent disability.
They include:
- special means for self-service;
- special care products;
- special means for orientation, communication and information exchange;
- special means for training, education and employment;
- prosthetic products;
- special training and sports equipment, inventory.
There are other classifications of TSRs: according to their functional purpose (for taking off and putting on clothes and shoes, for personal hygiene, for cooking and eating, etc.), by types of rehabilitation (TS of medical, vocational, social rehabilitation).
Separately, in various literature, typhlotechnical and surdotechnical means can be distinguished, i.e. facilities for the "blind" and "deaf" disabled people. The tiflo means include means for optical correction of vision (hyperocular glasses, manual reference magnifiers, telescopic glasses, magnifiers with a hyperocular), for orientation in space (canes, photoelectric probe, ultrasonic locators and signaling devices), for reading and writing (devices for writing and Braille readings, typewriters, special drafting, measuring instruments, computing devices), household appliances (dispensers, sewing accessories, Braille clocks). Vibrating signaling devices that amplify the means of communication and information transmission, decoders for televisions, telephone sets with amplifiers, a running line, belong to the sign language devices.
When determining the need for TMR, the IPR includes specific means, forms of provision of TMR (outpatient, inpatient, at home), volume (i.e. the number of products and components for TSR), terms of provision (within a year, 1 time in 4 years and etc.), and in the case of complex or atypical prosthetics, the implementing agency. In other cases, the contractor is determined by the executive body of the FSS RF.
When determining a specific TSR, you can focus on the following regulatory documents:
1. The list of technical means used exclusively for the prevention or rehabilitation of disabled people, the sale of which is not subject to value added tax, approved by Decree of the Government of the Russian Federation of December 21, 2000 No. 998 (as amended by Decree of the Government of the Russian Federation of May 10, 2001 No. 357) (hereinafter - List of TSRs used for rehabilitation);
2. An indicative list of technical and other means of rehabilitation of victims of accidents at work and occupational diseases and the terms of their operation (reference material sent to the regional offices of the FSS of the Russian Federation by letter of the FSS of the Russian Federation of 05.02.2002 No. 02-18 / 10-783) (hereinafter - Indicative list);
3. The list of typical representatives of prosthetic and orthopedic products used in the implementation of work and services for the provision of prosthetic and orthopedic care, and subject to approval as licensed reference samples, approved by order of the Federal Service for Supervision of Health and Social Development dated October 21, 2004 No. 279 -PR/04 (hereinafter - the List of type representatives);
4. The nomenclature of technical and other means of rehabilitation of disabled people of domestic and foreign production, subject to state registration, approved by order of the Federal Service for Supervision in Health and Social Development dated March 14, 2005 No. 505-Pr / 05 (hereinafter referred to as the TSR Nomenclature);
5. Terms of use of technical means of rehabilitation, prostheses and prosthetic and orthopedic products before their replacement, approved by order of the Ministry of Health and Social Development of the Russian Federation dated April 12, 2006 No. 283 (hereinafter referred to as Terms of Use).
What kind of TSRs are currently included in the Federal List?
1. Support and tactile canes, crutches, supports, handrails.
Canes are produced in the following modifications: metal, wooden, fiberglass; solid and folding; with 1, 3, 4 and 5 legs. Components for them are also produced (tips, anti-skid devices, handles (handles), light reflectors).
According to the information of the regional branch of the Federal Insurance Fund of the Russian Federation, enterprises that passed the competitive selection for the supply of TSR in 2006 produce the following canes: a support cane with a height of 800, 850, 900, 950 mm, a four-support cane with a pyramidal base (adjustable in height and intended mainly for stroke survivors), tactile folding cane (4-section) lightweight.
The rationale for determining the need for this TMR is the limitation of the ability to move 2, 1 degrees; self-service 2, 1 degree; orientation 3, 2 degrees due to disease, consequences of trauma, a defect with a violation of statodynamic or sensory functions of 2, 3 degrees.
Medical indications to ensure:
1.1. A walking stick with one leg and a handle (various modifications) can be:
- diseases, consequences of injuries and deformities of the lower extremities, pelvis and spine with moderate or severe violations of the functions of walking and standing;
- Moderate hemiparesis;
- Moderate paresis of one lower limb;
- Diseases of the peripheral vessels of the lower extremities with chronic arterial insufficiency of the 2nd degree, chronic venous insufficiency of the 3rd degree;
- Elephantiasis of one lower limb;
- Endoprosthesis of the knee or hip joint;
1.2. A multi-support cane (three-support - tripod, four-support - quadripod, five-support) can be:
- Moderate paresis of both lower extremities;
- Moderate triparesis (paresis of both lower and one upper limbs;
- Moderate tetraparesis;
- Diseases of the peripheral vessels of the lower extremities with chronic arterial insufficiency of the 3rd degree, chronic venous insufficiency of the 3rd-4th degree;
- Elephantiasis of both lower extremities;
1.3. Cane tactile solid or folding (various sizes):
- Diseases, congenital anomalies, consequences of injuries of the organ of vision, leading to low vision or blindness (impaired visual functions of III, IV degree)
Security standards and terms of operation (in accordance with the terms of use): 1 pc. for 2 years; children with disabilities - sliding canes 1 pc. for 2 years, other models - taking into account the height and other anthropometric data of a disabled child; accessories - 5 pcs. for 2 years (issued in addition to the product in cases where the recommendation to provide them is indicated in the individual rehabilitation program for a disabled person or if they are part of the product as an integral part of it).
Crutches are also produced in various modifications: wooden, metal; with support on the forearm, axillary, with support under the elbow; different sizes, adults and teenagers; adjustable length. Accessories are also provided for them (tips, anti-slip devices, handles (handles), reflectors).
According to the information of the regional branch of the FSS of the Russian Federation, the enterprises that passed the competitive selection for the supply of TSR in 2006 produce the following crutches: axillary crutches that can withstand loads up to 100 kg .; with armrest (adjustable in height); with support on the forearm, withstanding a load of up to 110 kg with a handle height from 45 to 68 cm (small), from 53 to 76 cm (medium), from 73 to 96 cm (large).
The rationale for determining the need for this TMR is the limitation of the ability to move 2 degrees, self-service 2, 1 degrees in combination with the limitation of the ability to move 2 degrees due to a disease, defect, accompanied by a violation of statodynamic or sensory functions 2, 3 degrees.
Medical indications for provision may include:
- Persistent deformities or diseases of the bones and joints of the lower extremities with ankylosis, severe contracture, bone defect, false joint; persistent pain syndrome;
- Amputation stumps of one or both lower extremities;
- Vicious position of the foot with trophic disorders when it is impossible to use orthopedic shoes;
- Fistulous form of osteomyelitis of one lower limb with impaired support ability;
- Endoprosthesis of the knee, hip joints;
- Diseases of peripheral vessels of both lower extremities with chronic arterial insufficiency of the 3rd degree; with chronic venous insufficiency of 3-4 degrees;
- Moderate, severe hemiparesis;
- Moderate, pronounced paresis of both lower extremities;
- Pronounced paresis of one lower limb in combination with paresis of one upper limb (cross).
Maintenance standards (pieces, pairs) and service life: 1 pair for 2 years; disabled children - 1 pair for 6 months; accessories - 5 pcs. for 2 years (issued in addition to the product in cases where the recommendation to provide them is indicated in the individual rehabilitation program for a disabled person or if they are part of the product as an integral part of it).
Supports (walkers, arenas, frames, support sticks) are produced in various modifications (axillary, with emphasis under the chest area, with emphasis under the lumbar region, with armrests, with emphasis on hands, with fixation of the body; folding, adjustable, walking, on wheels , hinged, with rest seat); and accessories for them (tips, wheels, anti-skid devices, handles (handles), clamps, tables, seats, bags).
According to the information of the regional branch of the Federal Insurance Fund of the Russian Federation, enterprises that passed the competitive selection for the supply of TSR in 2006 produce the following supports: small); b) “step by step” supports, withstanding load up to 135 kg, c) walking on 4 wheels with a hand brake, adjustable in height, with a shopping bag, a seat for rest.
The rationale for determining the need for this TMR is the limitation of the ability to move 2 degrees, self-service 2, 1 degrees in combination with the limitation of the ability to move 2 degrees due to a disease, defect, accompanied by a violation of statodynamic functions 2, 3 degrees.
Medical indications for provision may include:
- Diseases, consequences of injuries and deformities of the lower extremities, pelvis and spine with severe violations of the function of walking and standing;
- Pronounced paresis of both lower extremities;
- Moderate tetraparesis;
- Moderate triparesis;
- Severe hemiparesis;
- Severe vestibular-cerebellar disorders;
- Severe amyostatic disorders.
Maintenance standards and service life: 1 pc. for 2 years; disabled children, taking into account the height and other anthropometric data of the disabled child; accessories - 5 pcs. for 2 years (issued in addition to the product in cases where the recommendation to provide them is indicated in the individual rehabilitation program for a disabled person or if they are part of the product as an integral part of it).
Handrails (continuous, removable, for toilets and baths). Competitive selection of supplier enterprises has not yet been carried out. Collateral standards in accordance with the Terms of Use 1 time in 7 years.
2. Wheelchairs with manual drive (indoor, walking, active type), with electric drive, small-sized.
Components and accessories for them are included in a single set with the stroller (wheels, backrests, removable sidewalls, headrests, armrests, footrests, straps for fastening shoes, straps for fastening legs, heel pads, handles (handles) for pushing, seats (with adjustable spacer, for arthrodesis, leather for disabled people with high amputation of the lower extremities, with a removable segment for the toilet), pillows (side, for the back, for sitting, solid, anti-decubitus, head rollers, etc.), anti-tilt supports, parking brakes).
When forming the IRP, it is mandatory to indicate the anthropometric data of the disabled person (height, weight, hip circumference), as well as the age of the child.
2.1. The need for indoor wheelchairs (various modifications) is justified by the limitation of the ability to move 3, 2 degrees, self-service 2, 1 degree, combined with the limitation of the ability to move 3, 2 degrees.
There are modifications for adults (seat width from 340 mm to 490 mm, load capacity up to 100-150 kg), including models with a reclining back, for teenagers, for children (aged 3 to 6 years and from 6 to 14 years), for children with cerebral palsy. The narrowest strollers for adults up to 61 cm wide m.b. recommended for small apartments.
- Rheumatoid arthritis stage III with a predominant lesion of the joints of the lower extremities with a pronounced dysfunction;
- Thromboobliterating diseases of the arteries of both lower extremities with chronic arterial insufficiency of the 3rd degree;
- Diseases of the veins of both lower extremities with chronic venous insufficiency of 3 (4) degrees;
- Elephantiasis of both lower extremities in the stage of lymphedema;
- Tetraplegia, significantly pronounced, pronounced tetraparesis;
- Triplegia, significantly pronounced, pronounced triparesis;
- Significantly pronounced, pronounced hyperkinetic disorders;
- Significantly pronounced ataxia;
- Severe vestibular-cerebellar disorders;
- Diseases of the cardiovascular system with stage III circulatory failure, exertional angina with functional class IV
- Respiratory diseases with respiratory failure of the 3rd degree in combination with circulatory failure of any degree;
- Liver diseases with severe dysfunction, portal hypertension, ascites;
- Diseases of the kidneys with chronic renal failure of the 3rd degree.
Maintenance standards and service life: 1 pc. for 4 years; disabled children - taking into account the height and other anthropometric data of the disabled child.
2.1. The need for walking wheelchairs is justified by the limitation of the ability to move 3, 2 degrees, self-service 2, 1 degree, combined with the limitation of the ability to move 3, 2 degrees.
Models are available with a manual drive from the wheel rim and with a lever drive to the front wheels (it is possible to complete with a lever for the left hand), for adults (with plastic or spoke wheels, with solid or pneumatic tires, with or without parking brakes, folding or non-folding) and for children, incl. with cerebral palsy (equipped with straps for fixing the head, trunk and legs of a sick child).
Medical indications may include:
- Amputation stumps of one or both lower extremities at any level;
- False joint of the bones of the lower extremities with a violation of the function of walking and standing;
- Defect of the bones of the lower extremities with a violation of the function of walking and standing;
- Deforming arthrosis of the hip or knee joint stage III with severe pain or pronounced flexion or adductor contracture;
- Ankylosis or pronounced contracture of both ankle joints with a vicious position of one or two feet;
- Rheumatoid arthritis stage III with a predominant lesion of the joints of the lower extremities with severe dysfunction;
- Thromboobliterating diseases of the arteries of the lower extremities with chronic arterial insufficiency of the 3rd degree;
- Diseases of the veins of the lower extremities with chronic venous insufficiency of the 3rd degree;
- Paralysis of both or one lower limb;
- Hemiplegia, significantly pronounced, pronounced hemiparesis;
- Significantly pronounced, pronounced paresis of both or one lower limb;
- Congenital anomalies (malformations) and deformities of both lower extremities, pelvis and spine with severe violations of the functions of walking and standing;
- Insufficiency of blood circulation III stage;
- Angina pectoris with functional class IV;
- Pulmonary-cardiac insufficiency of the 3rd degree.
Terms of operation in accordance with the terms of use - 4 years.
2.3. The need for a small-sized wheelchair (and accessories for it, including leather insulated mittens and woolen covers for the stumps of the thighs) occurs when the ability to move 3, 2 degrees is limited with high amputation stumps of both thighs.
The term of use before replacement is 1.5 years.
2.4. On determining the indications for the provision of a wheelchair with an electric drive. The rationale for inclusion in the IPR is the presence of a limitation in the ability to move in combination with a limitation in the ability to self-care II, III degree in the presence of established medical indications:
- Persistent deformities or diseases of the lower and upper extremities, pelvis or spine in combination with diseases of the upper extremities;
- paralysis, significantly pronounced paresis of both lower extremities in combination with persistent diseases, deformities, as well as paralysis and paresis of the upper extremities;
- paralysis, significantly pronounced, pronounced paresis of one lower limb in combination with persistent diseases, deformities, paralysis and paresis of the upper limbs.
Terms of use - 5 years.
2.5. The said letter of the main bureau also concerns indications for the provision of active wheelchairs, which have increased maneuverability and are intended for disabled people who lead an active lifestyle, are physically developed, and have the skills of independent active movement in manual wheelchairs.
It should be remembered that for movement on the last two types of wheelchairs, a hard surface of streets and sidewalks, a relatively flat area, is necessary.
Before the approval of medical indications for technical means of rehabilitation, it is allowed to use the “Medical indications for providing the disabled with wheelchairs”, approved by the instructive letter of the Ministry of Social Security of the RSFSR dated 09.06.1989 No. 1-79-I.
Terms of use 4 years.
3. Prostheses, including endoprostheses, and orthoses.
Prostheses (including prostheses of the upper and lower extremities, eye, ear, nasal, palate, dental, breast, genital organs, combined facial and palate).
Orthoses (including orthopedic devices for the upper and lower extremities, reclinators, corsets, obturators, bandages, bras, semi-grace and grace for breast prosthetics, splints, corrective devices for the upper and lower extremities).
The need for prosthetics and orthotics, the provision of orthopedic shoes is included in the IPR based on the conclusion of the medical and technical commission of the prosthetic and orthopedic enterprise (MTK POP). The conclusion should indicate the type of prosthesis and the name. The specific type of prosthesis or product is determined based on the List of Type Representatives. This document contains a list of all prostheses and orthoses proposed for production, manufacture and sale for all types of lesions. For instance. Amputation or disarticulation of the shoulder. A shoulder prosthesis or, after disarticulation of the shoulder, a cosmetic prosthesis, with traction control, with an electric drive, working, may be recommended. In case of scoliosis, a functional-corrective corset of individual production or from semi-finished products of maximum readiness. After a mastectomy, a prosthesis of the breast (mammary) gland is included: a bra, a cover and an exoprosthesis of the mammary gland. Etc. Those. This is a reference point for bureau specialists. The ТСР presented in the List of Type Representatives are recommended for licensing as licensed reference samples. For each of them, a certificate of inclusion in the register of samples of standards of prosthetic and orthopedic products was issued. Thus, in the period prior to the approval of medical indications for the provision of TSR, the List of Representatives can serve as a rationale for the selection by the ITU institution of TSR.
The terms of use before replacement (providing standards) are determined taking into account the Order of the Ministry of Health and Social Development of Russia dated April 12, 2006 No. 282 “On approval of the terms for the use of technical means of rehabilitation, prostheses and prosthetic and orthopedic products before their replacement”, brought to the attention of the ITU bureau by a letter from the main bureau dated May 18 .10.42/1233-2544.
Terms of use of cosmetic prostheses of the fingers and hands of the upper limbs - 3 months;
Upper and lower limb prostheses 2 years (for children - 1 year);
Lower limb orthoses - 1 year;
Lower limb prostheses for swimming - 3 years;
Woolen covers for the stump of the lower limb - 3 months;
Cotton covers for the stump of the lower limb - 3 months;
Covers made of polymer material for the stump of the lower limb - 1 year;
Covers for the stump of the upper limb - 6 months;
Spare cosmetic shells for upper limb prostheses - 4 items per prosthesis for 1 year;
Spare cosmetic shells for lower limb prostheses - 1 item per prosthesis for 1 year;
Support elements - 6 months;
Moisture-absorbing elements - 6 months.
Breast exoprostheses - 1 year;
A bodice (bra, grace or semi-grace) for fixing the exorptosis of the mammary gland - 4 months;
Cover for breast exoprosthesis - 4 months;
Bandages on various parts of the body, slip-on shoes - 1 year;
Orthopedic bandage on the upper limb to improve the dimphovenous outflow, including after amputation of the mammary gland - 6 months.
It should be remembered that the contractor is determined by the regional branch of the FSS of the Russian Federation in accordance with the results of the competitive selection. At the same time, if a disabled person (veteran) independently decides on the issue of his prosthetics in accordance with the IPR, he may be issued a letter of guarantee by the authorized body on payment to the relevant organization for the cost of manufactured products in amounts not exceeding the cost of products manufactured in organizations selected in in the prescribed manner.
For endoprosthetics: The Social Insurance Fund (FSS) of the Russian Federation pays only for the endoprosthesis itself. Surgical intervention is paid from the federal budget (in accordance with the order of the Ministry of Health of Russia and the Russian Academy of Medical Sciences of March 19, 2004 No. 125/13 (see also the order of the Ministry of Health of the Russian Federation of December 29, 2000 No. 459). ), ligaments, blood vessels, heart valves, cochlear implants.Moreover, in accordance with the terms of use, the terms for the replacement of endoprostheses, including joints, ligaments, blood vessels, heart valves, cochlear implants, are determined by medical and preventive institutions (HCI) and are confirmed by ITU institutions .
The need for ocular prosthetics is determined on the basis of the conclusion of an ophthalmologist of a health care institution (for primary prosthetics - a regional consultative and diagnostic clinic). The contractor is also indicated by the executive body of the FSS of the Russian Federation, however, you should know that if in 2005 17 manufacturers were selected, then according to the results of an open competition held in 2006, only three organizations were recognized as winners in ocular prosthetics: FSUE "Ioshkar-Ola POP", Federal State Unitary Enterprise "Nizhny Novgorod POP" and Kemerovo Clinical Ophthalmological Hospital. The executive bodies of the FSS may enter into government contracts with any of the above organizations. At the same time, if a disabled person independently resolves the issue of ocular prosthetics in the presence of IPR, by decision of the executive body of the FSS, a letter of guarantee can be submitted to pay the cost of ocular prostheses to the appropriate organization.
Terms of use of dental, eye, ear, nasal, combined facial, palate, genital prostheses - 2 years (for children - 1 year).
The conclusion about the need for hearing aid is included in the IPR based on the conclusion of the audiologist of the healthcare institution. When preparing a medical opinion, the audiologist must determine the required model from the supplied hearing aids, taking into account the form and degree of hearing loss, the presence of FUNH and the conductive component, the development of hearing and speech, the experience of wearing hearing aids and the state of motor function. In children, if indicated, possible binaural prosthetics, i.e. provision of two hearing aids in accordance with the IPR.
4. Orthopedic shoes.
Orthopedic shoes (complex and uncomplicated), shoes for devices, and prostheses, orthopedic blocks, insert orthopedic corrective devices (insoles, half-insoles).
Security standards and terms of use:
- complex orthopedic shoes and shoes for orthopedic devices - 2 pairs for 1 year, including 1 pair with insulated lining (for children - 4 pairs for 1 year, including 2 pairs with insulated lining);
- uncomplicated orthopedic shoes (with or without a warm lining at the request of a disabled person) - 1 pair for 1 year (for children - 2 pairs for 1 year);
- insert corrective elements for orthopedic shoes (including insoles and semi-insoles) - 3 months;
Shoes for prostheses - with bilateral amputation - 2 pairs for 1 year; with unilateral amputation - 2 pairs for 1 year (including 1 pair with insulated lining at the request of the disabled person.
5. Anti-decubitus mattresses and pillows (seats for wheelchairs) are special care products, and therefore the need is determined by limiting the ability to self-service, movement of the III degree.
Medical indications may be various diseases with a pronounced violation of statodynamic functions; violation of the functions of blood circulation, respiration, digestion, urination (renal failure), mental disorder (dementia). Maintenance standard 1 time in 2 years.
Terms of use - 3 years.
6. Devices for dressing, undressing and grabbing objects.
Devices for dressing and undressing (including for fastening buttons, for putting on and taking off garments, special buttons, a rack for putting on outerwear).
The indicative list provides for the provision by the executive body of the FSS of the Russian Federation with the following products: aids for putting on socks and tights (1 time in 5 years), a shoe horn and a device for removing shoes (1 time in 10 years), clothes holders (1 time in 5 years ), hooks for dressing and undressing (1 time in 5 years), Velcro fastener (1 time in 5 years).
The rationale for the need is the limitation of the ability to self-service I, II degree, due to a violation of statodynamic functions (mainly of the upper limbs), blood circulation, respiration, digestion, liver), urination (renal failure).
Medical indications are:
- diseases, consequences of injuries and deformities of the lower extremities, pelvis and spine with severe dysfunction;
- diseases, consequences of injuries and deformities of the upper limbs, with a pronounced dysfunction;
- moderate, pronounced tetraparesis, triparesis, hemiparesis;
- pronounced paresis of both lower extremities;
- pronounced vestibulocerebellar phenomena;
- severe amyostatic disorders;
- pronounced hyperkinetic disorders;
- pronounced paresis of one upper or one lower limb;
- liver disease with impaired liver function, CRF III;
- kidney disease with renal insufficiency;
Devices for capturing and moving objects are recommended when the ability to self-service I, II degree is limited, associated with a violation of static-dynamic functions.
Medical indications may include:
- moderately pronounced paresis of both upper limbs;
- moderate, pronounced vestibulo-cerebellar disorders;
- severe amyostatic disorders;
- Moderately pronounced hyperkinetic disorders;
- moderately pronounced paresis of one upper limb with slight paresis of the other upper limb;
- diseases, consequences of injuries and deformities of the upper limbs and shoulder girdle with a pronounced dysfunction of the upper limbs;
The indicative list regulates the provision by the executive body of the FSS of the Russian Federation with the following products:
holder: for dishes (removable, stationary on suction cups) with a non-slip base, tiltable and non-tiltable with a flexible tripod, with fastening to a table, wheelchair, bed, with fasteners on the ceiling); for keys (with fastening to a table, wheelchair, bed, with fasteners on the ceiling); handset (cuff holder on the hand, wrist, palm of the hand); anti-slip coatings (mats); anti-slip tapes, stickers; magnetic tapes; clamp, including finger; clamps; frame-limiters; stickers, rugs.
Terms of use - 5 years.
7. Special clothing
Competitive selection of supplier enterprises has not yet been carried out. In the List of TMR used in rehabilitation, these funds are defined as clothing for the disabled for special purposes, made to order, or other special clothing (including compression clothing, compression and protective gloves, stockings, socks, helmets, vests, fixing belts, bags for legs, trousers and skirts for movement in a wheelchair).
Terms of use and security standards:
- functional and aesthetic clothing for disabled people with double amputation of the upper limbs - 2 sets of outerwear (winter and summer) for 1 year;
- leather or knitted gloves (for the prosthesis of the upper limb), a leather glove for the prosthesis of the preserved upper limb with a warm lining - 1 pair for 1 year;
- leather gloves for deformed upper limbs - 1 pair for 2 years;
- orthopedic trousers -1 year;
- leather insulated mittens (for disabled people using small wheelchairs) - 1 pair for 1 year);
- woolen covers for the stump of the thigh (for disabled people using small wheelchairs) - 3 pairs for 1 year);
.
8. Special devices for reading "talking books", for optical correction of low vision.
Competitive selection of supplier enterprises has not yet been carried out.
Special devices for reading “talking books”, according to the Indicative List, include a specialized audio recorder for a “speaking book” of various modifications of domestic production and a specialized audio player for listening to “talking books” of various modifications of domestic production. The justification for inclusion in the IPR may be the limitation of the ability to learn II degree, communication II, III degree, labor activity II degree in violation of visual functions of degrees 3 and 4 associated with diseases, the consequences of injuries of the organ of vision that led to low vision or blindness. Terms of use - 7 years.
For information and use in the work, it is possible to take into account the letter of the President of the VOC A.Ya. on cassettes and CDs with the function of recording on cassettes, including with a CD player in a four-track format (based on the Panasonic RX29 radio tape recorder) (Price 5700 rubles). The named device allows you to play talking books recorded on cassettes, dub from CD to cassette (4 tracks), listen to music recordings on cassettes and CDs in stereo, as well as record from a microphone and other external source; has a built-in radio.
Special devices for optical correction of low vision, according to the Indicative List, include:
a) magnifiers 4, 8, 10-fold (restriction of the ability to communicate II degree, study II degree, labor activity II degree with visual impairment of degree 3, 4 due to illness, the consequences of an injury to the organ of vision that led to low vision or blindness; b) hyperocular glasses (spectacle correction) (limitation of the ability to orientation I, II degree, communication I, II degree, self-service I, II degree, movement I, II degree, training I, II degree, labor activity I, II degree , with visual impairment of 2, 3, 4 degrees due to a disease, the consequences of an injury to the organ of vision, which led to low vision or blindness;
c) contact lens (restriction of the ability to learn, work, self-care, movement, communication in violation of visual functions of 2, 3, 4 degrees due to refractive error, keratoconus, corneal dystrophy; d) intraocular lens (limitation of the ability to learn, work, movement in violation of visual function 2, 3, 4 degrees due to aphakia, cataracts; if necessary;
It is also possible to take into account the above-mentioned letter from the President of the VOS A.Ya. connects to a regular TV using the included adapter and cable.Provides 21x text magnification on a 20" TV screen).
Terms of use - 5 years.
9. Providing disabled people with guide dogs with a set of equipment
regulated by the "Rules for providing disabled people with guide dogs, including the payment of annual compensation for the costs of maintaining and veterinary care of guide dogs", approved by Decree of the Government of the Russian Federation of November 30, 2005 No. 708 (hereinafter referred to as the Rules).
There is no clear regulatory framework for medical indications, however, the Decree of the Presidium of the Central Board of the BOC dated October 31, 1960 No. 28-2 approved the Instruction on the procedure for the distribution and use of guide dogs for the blind, according to which guide dogs are intended to ensure movement (in cities and rural areas) disabled people of group I, mostly working, blind or having such residual vision that does not allow them to independently navigate in space. Together with the dog, a set of special equipment (collar, leash, harness, muzzle, brush and comb) is issued free of charge.
The Rules do not provide for the provision of IPR for compensation by a disabled person who has a guide dog for free use. When submitting an application to the Fund, a disabled person presents a passport of a disabled person or an authorized person, as well as a passport of the established form for a guide dog.
10. Medical thermometers and tonometers with speech output.
Competitive selection of supplier enterprises has not yet been carried out.
Tonometers with speech output, according to the above Indicative list, are intended for people with disabilities with limited ability to self-service I, II, III degree with visual impairment of degree 3, 4 due to a disease, injury to the organ of vision that led to blindness; terms of use 7 years;
According to the proposals of the BOC, the most convenient device that has been tested in medical institutions in Russia and approved for use in Russia is the electronic tiflotonometer TT-01 (TT-01P) with speech output of readings (TT-01P - with memory for 14 readings).
The offered medical thermometer is the Medical electronic thermometer DX6623B with speech output of values. Free from glass and mercury, power consumption 50 mW (for voice messages). Weight 23g (with AG 12 batteries). Terms of use 7 years.
11. Light and vibration sound signaling devices are related to deaf devices (for people with hearing and speech impairments).
According to the above indicative list, these TCPs include a light phone call signaling device, a vibrator and a stroboscope for connection to an alarm clock, doorbell and telephone call.
The indications are a violation of the ability to communicate and orientation, associated with a violation of auditory functions of the 3rd, 4th degree due to a disease, the consequences of an injury to the organ of hearing, which led to hearing loss.
Terms of use - 5 years.
12. Hearing aids, incl. with custom made ear tips
refer to deaf devices (for people with hearing and speech impairments), are produced in various modifications (internal, behind-the-ear with automatic volume control, electronic, etc.), domestic and imported.
Terms of use: hearing aids - 4 years; ear plugs of individual production - 1 year.
13. Televisions with teletext for receiving programs with closed captions.
We do not have information about the types or brands of such products. Terms of use -7 years.
14. Telephone devices with text output, ie. text telephones can be recommended to disabled people with limited ability to communicate, orientation of the II degree in case of impaired auditory functions of 3, 4 degrees due to illness, the consequences of injuries to the organ of hearing that led to hearing loss. Terms of use 7 years.
15. Voice-forming devices are classified as hearing aids (for people with hearing and speech impairments).
According to the above indicative list, they are assigned to people with disabilities with limited learning ability I, II degree, labor activity I, II degree, communication I, II degree in violation of voice-forming functions of degree 4 due to illness, the consequences of laryngeal injuries that led to a violation of voice formation; term of use is 5 years.
16. Special means for violations of the functions of excretion (urine and colostomy bags) -
body care items - are included as TSR in the IPR of disabled people with limited ability to self-service I, II, III degrees in case of violations of visceral functions (pelvic organs) of degrees 3, 4 due to diseases or consequences of injuries of the pelvic organs, the central nervous system with fecal or urinary incontinence . They are means of individual selection, and the choice of product model, as well as the size of the stoma, are determined by the location of the stoma. The conclusion about the necessary modification and model of the product can be given by specialists (surgeon, oncologist, etc.) of an inpatient (before and after stoma surgery) or outpatient clinic.
Enterprises - performers, produce products of the following names: single-component colostomy bags (for stoma diameter up to 60 mm and over 60 mm) and ileostomy bags (stoma size up to 60 mm); two-component ileostomy colostomy bags (stoma size over 60 mm) and two-component urostomy urinals (stoma diameter up to 60 mm).
Bureau specialists make a record in the IPR about the need for a feces or urinal of a specific name, size (diameter) of the stoma.
Auxiliaries include numerous deodorants, protective creams and powders, protective films, wipes with various types of impregnations, o-rings and pastes.
Collateral ratios in accordance with the Terms of Use:
- two-component colostomy bags and urinals (with a plate and a bag): for plates up to 10 pcs. for 1 month; for ileo- and urostomy bags - up to 30 pcs. for 1 month; for colostomy bags - up to 90 pcs. for 1 month;
- one-component colostomy bags and urinals: layers of ileo- and urostomy bags - for 30 pcs. for 1 month; for colostomy systems and children's colo- and urinal systems - up to 90 pcs. for 1 month;
- clips for open bags - up to 2 pcs. for 1 month;
- belt for feces and urinal - up to 2 pcs. for 1 year;
- paste sealing to the feces or urinal - 1 tube for 1 month;
- absorbent powder - 1 vial for 1 month;
- protective cream - 1 tube for 1 month;
- protective film - 1 pack for 1 month;
- cleaner - 1 bottle for 1 month;
- plastic bag on the belt, complete with bags - up to 6 pcs. for 1 year;
- catheters for stoma, catheters for self-catheterization - up to 120 pcs. for 1 month;
- urinal device included:
urocondoms up to 30 pcs. for 1 month;
day and night bags for collecting urine - for day leg bags - up to 4 pcs. for 1 month; for night leg bags - up to 2 pcs. for 1 month;
straps for attaching the leg bag to the leg - up to 2 pairs for 1 month.
17. Absorbent underwear, diapers.
They belong to the items of body care, are assigned to disabled people with limited ability to self-service I, II, III degree.
The total number of products paid for at the expense of the federal budget is up to 90 pcs. for 1 month (with polyuria syndrome - according to individual medical indications up to 150 pieces for 1 month). The IPR indicates the type of product, size and degree of absorbency.
Absorbent underwear includes absorbent diapers (for additional protection of bedding) of various sizes and degrees of absorbency, urological pads and liners (to protect the clothes of bedridden and mobile disabled people), panties (mesh panties, elastic (for fixing pads and liners).
Pampers (diapers) are produced both for adults (with severe urinary and fecal incontinence for bedridden and mobile disabled people) and for children (with urinary and fecal incontinence).
In adults, diapers are indicated by size (S, M, L, XL) and by absorbency (medium, high). In the IPR, it is obligatory to indicate the volume of the hips. At U= 50-80 cm, a small (S) diaper size is prescribed, but they can be of medium (~830 ml) or high (~1300 ml) degree of absorbency; At U= 70-120 cm, the average (M) size of diapers is assigned, but they can be medium (~ 1170 ml) or high (~ 2230 ml) degree of absorbency; At U= 100-150 cm, a large (L) size of diapers is assigned, but they can be medium (~ 1450 ml) or high (~ 2400 ml) degree of absorbency; With U= more than 150 cm, a very large (XL) diaper size is prescribed, but they can only be of a high (~ 3200 ml) degree of absorbency;
In children, universal diapers are recommended for children of various age groups; the size is indicated by the weight of the child (3-5kg, 5-10kg, 8-18kg, 15-30kg).
It can be recommended in various amounts night and day.
Absorbent diapers as additional protection for bedding.
Disabled people are provided with diapers of three sizes and different degrees of absorbency:
Size 40 x 60 (absorption rate 550 or 750 ml), 60 x 60 (absorption rate 940 or 1150 ml), 60 x 90 (absorption rate 1525 or 1750 ml).
Urological pads and liners:
- with mild and moderate incontinence in mobile disabled people) urological pads (for women) and urological liners (for men);
- with moderate and severe incontinence in bedridden and mobile disabled people;
The dimensions and degree of absorbency are indicated in accordance with the information letter of the regional branch of the FSS of the Russian Federation (they depend on the products supplied by enterprises that passed the competitive selection in the corresponding year). To fix any pads and liners, panties are recommended (panties are mesh, elastic).
18. Chairs with sanitary equipment,
as a means for the administration of natural needs, it can be prescribed to disabled people with limited ability to self-service II, III degree in case of violation of statodynamic functions, circulatory, respiratory, digestion (liver), urination (renal failure), mental functions.
Terms of use 4 years.
Medical indications may include:
- diseases, consequences of injuries and deformities of the lower extremities, pelvis and spine with dysfunction;
- hemiplegia;
- paralysis of the lower extremities;
- pronounced, significantly pronounced tetraparesis;
- pronounced, significantly pronounced triparesis;
- pronounced, significantly pronounced lower paraparesis;
- pronounced, significantly pronounced hemiparesis;
- pronounced, significantly pronounced vestibulo-cerebellar disorders;
- pronounced, significantly pronounced amyostatic disorders;
- pronounced, significantly pronounced hyperkinetic disorders;
- diseases of the cardiovascular system with circulatory failure stage 3 or angina pectoris IV class;
- diseases of the respiratory system with respiratory failure of the 3rd degree;
- liver disease with dysfunction of the 3rd degree with portal hypertension and ascites;
- kidney disease with chronic renal failure of the 3rd degree;
- severe mental disorders (dementia).
Competitive selection of supplier enterprises has not yet been carried out. There are various modifications of this product: without wheels, on 4 wheels, with a toilet lid, with adjustable legs.
The provision of disabled and veterans of the TSR, provided for by the Federal List, is carried out in accordance with the "Rules for the provision at the expense of the federal budget of disabled persons with technical means of rehabilitation and certain categories of citizens from among veterans with prostheses (except for dentures), prosthetic and orthopedic products", approved by a decree of the Government of the Russian Federation dated December 31, 2005 No. 877.
Terms of use of technical means of rehabilitation, prostheses and prosthetic and orthopedic products before their replacement were approved by order of the Ministry of Health and Social Development No. 282 dated 12.04.2006. health and social development dated 10/17/2005 No. 638.
Repair of TSR issued free of charge or purchased at one's own expense with subsequent compensation, as well as replacement after the expiration of the period of use or the impossibility of repair, are carried out without IPR, at the request of the disabled person (clauses 7, 8). Early replacement of the TCP is also possible at the conclusion of the ITU Bureau.
The list of technical means of rehabilitation that are not subject to delivery after the expiration of their use was approved by order of the Ministry of Health and Social Development dated April 12, 2006 No. 283.
You should be guided by the information letters of the regional offices of the FSS on the technical means of rehabilitation supplied by enterprises that have passed the competitive selection in the corresponding year.
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