Елена Самтынова
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Проект совместного приказа Минтруда России и Минздрава России об утверждении порядка оказания услуг правовой, психологической и медико-социальной помощи разработан в целях реализации п. 9.1 Правил финансового обеспечения расходов на оплату медицинским организациям услуг, оказанных женщинам в период беременности (услуг по оказанию медицинской помощи и по оказанию правовой, психологической и медико-социальной помощи), услуг по медицинской помощи, оказанной женщинам и новорожденным в период родов и в послеродовой период, а также услуг по проведению профилактических медицинских осмотров ребенка в течение первого года жизни, утвержденных постановлением Правительства РФ от 31 декабря 2010 г. № 1233, в редакции постановления Правительства РФ от 27 декабря 2019 г. № 1912, вступившего в силу 1 января 2020 года.
Проект предусматривает1 предоставление указанных видов услуг женщинам в период беременности медорганизациями в рамках программы государственных гарантий бесплатного оказания гражданам медицинской помощи, штатными нормативами которых предусмотрены должности юристов, медицинских психологов (психологов) и специалистов по социальной работе, для чего предлагается создавать кабинеты медико-социальной и правовой помощи и центры для оказавшихся в трудной жизненной ситуации беременных женщин. Оговариваемые услуги могут быть предоставлены женщине на основании ее заявления, предварительно до нее должна быть доведена информация о праве на получение таких услуг при первичном обращении.
Правовая помощь для женщины в период беременности должна заключаться в разъяснении (в устной и письменной форме) законодательства о правах женщин в период беременности, о мерах социальной защиты (поддержки) семьям с детьми и малоимущим семьям, гарантиях, предусмотренных Трудовым кодексом, о порядке обращения в судебные органы для защиты нарушенного права, обжаловании решений, вынесенных органами государственной власти, органами местного самоуправления, организациями. При этом не допускается составление документов правового характера и представление интересов заявительницы в органах госвласти, местного самоуправления. В правовой помощи также может быть отказано, если женщина обратилась по вопросу, не имеющему правового характера, либо вопрос выходит за пределы оказываемой правовой помощи. Специалист по правовым вопросам должен разъяснить право на получение бесплатной юридической помощи согласно Федеральному закону от 21 ноября 2011 г. № 324-ФЗ «О бесплатной юридической помощи в Российской Федерации» при наличии оснований для получения такой помощи.
Согласно проекту специалист по правовой помощи должен иметь:
высшее юридическое образование;стаж работы по специальности не менее одного года;обладать специальными знаниями в области социальной защиты (поддержки) граждан, государственной поддержки семьи, материнства, отцовства и детства, а также трудового законодательства.
При этом в проекте имеется допущение в виде возможного оказания правовой, психологической и медико-социальной помощи женщине медработником с высшим или средним медицинским образованием, прошедшим специальное обучение, в случае, если отсутствует возможность предоставления медорганизацией помощи юристов, психологов или специалистов по социальной работе, в том числе в случае удаленности медорганизаций, оказывающих соответствующие услуги.
Психологическая помощь женщине в период беременности может быть оказана врачом-психотерапевтом, медицинским психологом или психологом (далее – специалист, оказывающий психологическую помощь). Он должен иметь высшее профессиональное образование по специальности «медицинская психология» или «клиническая психология» и дополнительную подготовку по перинатальной психологии, в том числе основам психологии беременности и родов, раннего постнатального периода, и отвечать требованиям к уровню квалификации и трудовым функциям, установленным приказом Минздрава России от 23 июля 2010 г. № 541н «Об утверждении Единого квалификационного справочника должностей руководителей, специалистов и служащих», раздел «Квалификационные характеристики должностей работников в сфере здравоохранения».
Прописываются виды психологической помощи: психологическое консультирование, психологическая диагностика, психологическая коррекция и профилактика, психологическое просвещение и сопровождение, а также основные задачи, которые должен уметь осуществлять соответствующий специалист, в том числе относить женщину к группе социально-психологического риска, разрабатывать психокоррекционную программу (при необходимости), формировать состояние готовности к рождению ребенка, профилактику отказа от новорожденных и суицидальных тенденций и т.д.
Специалист по медико-социальной помощи должен отвечать требованиям к профессиональному образованию, уровню квалификации и трудовым функциям, установленным Профессиональным стандартом «Социальный работник», утвержденным приказом Министерства труда и социальной защиты Российской Федерации от 18 ноября 2013 г. № 677н. Медико-социальная помощь женщинам в период беременности может осуществляться в консультативной форме либо в форме оказания (содействия в оказании) медико-санитарных, социально-бытовых или иных услуг социального характера. В обязанности специалиста по медико-социальной помощи входят: анализ факторов медико-социального риска, профилактика состояний, отнесенных к факторам медико-социального риска; консультирование по вопросам предоставления государственной социальной помощи, решению жилищных и социально-бытовых проблем, организация внутриведомственного взаимодействия с медицинскими организациями, центрами здоровья и другими медицинскими организациями при оказании медико-социальной помощи и т.д.
Если же женщина подверглась насильственным действиям физического или сексуального характера специалисты с согласия женщины принимают меры по защите прав и законных интересов женщины, в том числе по взаимодействию с правоохранительными и иными госорганами, органами местного самоуправления и организациями.
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1 С текстом проекта Приказа Минтруда России и Минздрава России «Об утверждении Порядка оказания медицинскими организациями услуг по правовой, психологической и медико-социальной помощи женщинам в период беременности» и материалами к нему можно ознакомиться на федеральном портале проектов нормативных правовых актов (ID: 01/02/02-20/00099566).
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