Development of Russian legislation on medical and social assessment and improvement of interdepartmental interaction

Introduction: the paper presents the results of the analysis of federal and regional legislation on medical and social assessment (MSA) procedure and rehabilitation of disabled people as well as on determining the powers of the subjects of the Russian Federation in this area; it analyzes 2017 Pilot Project implemented in the Smolensk and Voronezh regions to develop new approaches to the examination of citizens under 18, and 2018 Pilot Projects in the Stavropol and Sverdlovsk regions to develop new approaches to determining the degree of loss ofprofessional working ability. It also brings into focus the legal status and role of public organizations of people with disabilities, socially oriented non-profit organizations in social and labor integration of the disabled. Particularly, the study is focused on the procedure for developing an individual program of rehabilitation/ habilitation. Purpose: development of Russian legislation on medical and social assessment and rehabilitation of persons with disabilities in order to enhance the quality, objectivity, patient-centered approach, including the focus on improving interdepartmental interaction. Methods: a complex of methods of scientific cognition was used, including such general ones as analysis, synthesis, induction, deduction, and also specific ones, in particular, comparative, formal legal, statistical and others. Results: based on the results of the study, the authors formulated their suggestion for improvement of the system of managing the relevant bodies and institutions when conducting medical and social assessment and rehabilitation of disabled people, mechanisms of their interaction, optimization of document flow, as well as improvement of the legal status of medical and social assessment subjects. Conclusions: the system of organizational and legal support for medical and social assessment in relation to individual groups (categories) of citizens, as well as individual regions, requires modernization, especially in terms of the quality and accessibility of services provided by MSA institutions. The rehabilitation system for people with disabilities, built on a mixed sectoral and functional basis, belongs to the group of complex systems, which contributes to its failures, requires increased attention to the issues of management, organization and maintenance of subordinate and coordination links.