Background.By decision of the Commission under the President of the Russian Federation for the Disabled, the Ministry of Labor of Russia was entrusted with monitoring the implementation of federal and regional action plans road maps to increase the accessibility of facilities to people with disabilities. Aim.Monitoring the implementation by state authorities of the constituent entities of the Russian Federationof action plans (road maps) to increase the values of accessibility indicators for disabled people in healthcare facilities. Material and methods.The indicators of accessibility for disabled people of facilities in the healthcare system based on the results of implementation of action plans by executive authorities of 85constituent entities of the Russian Federation in the field of healthcare, obtained as a result of monitoring the achieved values in the indicators of accessibility for disabled people of facilities in 2019 and 2020, were analyzed. The availability of facilities was calculated on the basis of information from the state authorities of the constituent entities of the Russian Federation, prepared in accordance with the recommendations of the Ministry of Labor of Russia, using the analysis and generalization of the received materials, using the method of comparing absolute and relative indicators. Results.The accessibility of medical organizations for the disabled is created in two ways from the standpoint of universal design (inclusion of measures to organize the accessibility of facilities and services for the disabled when designing and building new facilities, as well as during reconstruction and major repairs) and using the principle of reasonable accommodation for existing facilities (before their overhaul and reconstruction). Ranking the indicators of the e150domain (design, nature of design, construction and arrangement of buildings for public use) on the basis of a unified assessment scale of the International Classification of the Functioning of Disabilities and Health made it possible to identify regions of the Russian Federation with varying degrees of accessibility of healthcare facilities: absolutely accessible in 10(11.8%) regions of the country; with a significant levelof accessibility in 53(62.4%) regions; with a moderate level of accessibility in 8(9.4%) regions; with a low or insignificant level of accessibility in 9(10.6%) regions of the Russian Federation; with a very low levelof accessibility of healthcare facilities in 5(5.8%) regions of the Russian Federation, respectively. Conclusion.According to the monitoring of the state of accessibility of facilities for the disabled in the healthcare sector in the constituent entities of the Russian Federation, the level of accessibility varied from 100% to 0.5%. The planned indicators of increasing the availability of facilities in the healthcare sector have reached 100% in 52constituent entities of the Russian Federation.

In the Russian Federation, comprehensive rehabilitation and abilitation of the disabled is actively developing effected by the UN Convention on the Rights of the Disabled. In 2018-2019, the quantitative indicators of comprehensive rehabilitation and abilitation were studied in 85 regions of Russia. In 36 regions (42/4%) formation of system of comprehensive rehabilitation and abilitation was necessary. The remaining 49 regions required improving their systems of comprehensive rehabilitation and abilitation (57.6%, respectively). The study results demonstrated that significant increase in rehabilitation organizations (from 12.0% in 2018 to 100.0% in 2021) to be included in regional system of comprehensive rehabilitation and abilitation is expected. In the Republic of Dagestan, the final rating of comprehensive rehabilitation and abilitation system was from 6.5 to 7.6 points that indicates the need to organize and to improve comprehensive rehabilitation and abilitation system in the region. The experience of the Sverdlovsk Oblast and the Perm Krai where pilot project on comprehensive rehabilitation and abilitation system was carried out proved that one of the effective mechanisms of organizing comprehensive rehabilitation and abilitation system is development of state regional program by the authorities with involvement of all interested players and public organizations.

The right of every person to free movement, choice of place of stay and residence is guaranteed by the UN Convention on the Rights of Persons with Disabilities [1], the Constitution of the Russian Federation [2] and the Law of the Russian Federation of 25.06.1993 No. 5242-1 "On the right of Citizens of the Russian Federation to freedom of movement, choice of place of stay and residence within the Russian Federation" [3]. The priority direction of the State's social policy is to provide all citizens with equal opportunities for access to social, economic, and cultural values, guaranteeing all members of society respect for the individual and respect for everyone's rights. In order to realize their civil rights and duties, disabled people need the support of society and the state. To integrate disabled people with impaired mental functions into society, the indicators of activity and participation of disabled people living in inpatient social service institutions and families based on the International Classification of Functioning, Disability and Health (ICF) were studied. This study is necessary for further selection of citizens with impaired mental functions for accompanied accommodation and determination of the type of escort.Aim. Research of indicators of activity and participation of disabled people living in inpatient social service institutions and families.Materials and methods. The study of activity and participation indicators was conducted in social service institutions of the population of St. Petersburg. The study involved a multidisciplinary team consisting of employees of the G.A. Albrecht Federal State Budgetary Research Center of the Ministry of Labor of Russia and employees of the CSRIDI (teachers, AFC specialists, psychologists, orderlies). The selection of the Center's clients living in families and graduates of inpatient social service institutions who currently live independently was carried out. The study involved 27 people with impaired mental functions of working age (from 17 to 43 years). Methods and principles of medical and social assessment are used to assess the abilities of persons with mental disorders. Interviewing (interviewing) of the surveyed persons, their relatives and guardians, employees of the PSNI. Documentary data collection (collection of necessary information on the documents of the examined persons). Medical assessment of the condition of the examined persons. Expert assessment of the abilities of persons with impaired mental functions using diagnostic tools by a multidisciplinary team. The data from the clients' documentation was recorded in the developed personal cards. General scientific methods (content analysis, analytical, system-structural, comparative, statistical) and methodological methods of systematization, comparison, generalization, interpretation using the standard Excel-7.0 software package for IBM PC are applied.The object of the study. People with disabilities with impaired mental functions who need accompanied accommodation.The subject of the study. Assisted living services required by disabled persons with impaired mental functions.Results. According to the results obtained, 6 (22.2%) people with impaired mental functions have no restrictions in autonomy, which means they do not need periodic or constant support. It is possible for them to use periodic patronage in order to identify difficult life situations. The rest of the persons with mental disorders have different degrees of difficulties of the person's autonomies and need support of different frequency. Of these, 5 (18.5%) have minor difficulties with facial autonomy, 8 (29.6%) have moderate difficulties, 5 (18.5%) have severe difficulties with facial autonomy, and 3 (11.2%) have significant limitations of facial autonomy and need constant care. It is worth noting that three disabled people with impaired mental functions, two of whom, according to the results of the study, were in the group of persons with severe difficulties of facial autonomy, and one with moderate difficulties of facial autonomy have significantly pronounced disorders of neuromuscular, skeletal and movement–related functions, which is why they constantly need help when moving. At the same time, they have mastered secondary general education, can read, count, performs written and oral commands, is able to maintain a conversation, is able to build interpersonal interactions. To clarify the degree of violation of the person's autonomy and the need for support in the presence of restrictions on independent movement, the b760 domain "Control of voluntary motor functions" and the domains of the "Mobility" section were calculated separately.Discussion. The development and implementation of an assessment system for disabled people based on the study of indicators of functioning, activity and participation of citizens with impaired mental function with an assessment of medical and social factors affecting their livelihoods and an assessment of the degree of autonomy of persons living in inpatient social service institutions and families will solve questions about the form of life of citizens suffering from mental disorders, and organize work on their employment.Conclusions. Depending on the indicators of activity and participation of disabled people living in inpatient social service institutions and families, based on the provisions of the international classification of functioning, disability and health, it allows you to determine the degree of expression of a person's autonomy, the volume and duration of support services.

Aim. To study of medical and social characteristics of persons disabled since childhood of the first group, their needs for various types of rehabilitation and care for the development of a medical-social model of personal assistance. Methods. A sample study of 194 persons disabled since childhood of the first group in eight regions of the Russian Federation was conducted using a specially developed methodology. The calculations were performed by using the IBM SPSS Statistics Viewer 23. Results. The state of health of persons disabled since childhood of the first group is characterized by polymorphism and polymorbidity. 64.3% of people with disabilities have multiple dysfunctions of organs and systems. In this regard, there are pronounced restrictions on the main categories of life activity. Half of the caregivers (47.4%) spend more than 8 hours a day on organizing care for persons disabled since childhood of the first group; between 4 and 8 hours 29.8%; between 2 and 3 hours 12.9%; less than 2 hours 4.1%. It was found that 32.7% of families spend more than half of their family budget on care (organization of medical and household care, transportation and relocation, organization of training, communication in accordance with age). At the same time, only 30.0% of caregivers work, the remaining 70.0% do not work (do not receive seniority) and will not be able to claim a labor pension. Persons disabled since childhood of the first group are characterized by pronounced restrictions on the main categories of life, the need for constant and regular care of all types, however, 28.4% of this group of people can self-service themselves or with little help from other people. With the presented medical-social portrait, state support for this category of citizens should be carried out in a differentiated manner. The personal assistance model allows parents/guardians of persons disabled since childhood of the first group not only to care for a family member but also to find employment as a personal assistant. Conclusion. Families with persons disabled since childhood of the first group need differentiated support that will allow parents/guardians to care for their family members and work; the personal assistance model could solve these problems.

For people with disabilities who have limitations that impede normal life activities, including due to disorders of mental functions, technologies of accompanied living are developing. Development of theoretical foundations for an expert assessment of the ability of citizens with physical / mental disorders to live independently to develop a financial and organizational model for providing them with the necessary social support services, as well as medical, educational and other services within the framework of support. Based on the methodology of the general scientific didactic method of cognition, universal scientific methods, methods and principles of rehabilitation and expert diagnostics are used. The indicators of the number of persons in need of accompanied accommodation were obtained as a result of monitoring in 85 constituent entities of the Russian Federation according to a special methodology developed by Federal State Budgetary Institution Federal Scientific Centre of Rehabilitation of the Disabled n. a. G.A. Albrecht of the Ministry of Labour and Social Protection of the Russian Federation. The conceptual framework of the ICF was used to develop the conceptual apparatus. The term living independently includes measurable criteria for the Activity and Participation Sections, with particular emphasis on the selfcare (d510599) and domestic life (d610699) domains. ICF criteria and domains have great internal coherence, mutual correspondence of clinical, clinicalpsychological and medicalsocial aspects of mental health disorders. In the light of the biopsychosocial model of disability, the following factors have been identified that affect the ability of persons with mental disorders to live independently and be able to work: biomedical factors, factors of activity and participation, personal factors. The theoretical foundations for assessing the ability of persons with mental disorders to live independently, including with accompaniment, are based on the principles of humanism, interiorization, normalization of life for those living in inpatient institutions, an integrated approach, maximum objectification, measurability and uniformity. For these purposes, criteria have been developed using the Unified ICF Assessment Scale. The developed criteria for assessing the ability of persons with mental impairments to live independently, including with an accompaniment, will make it possible to solve questions about the form of life and employment of citizens with mental disorders, introduce inpatientreplacing technologies and carry out the downsizing of inpatient institutions.