Payments under the Zemsky Doctor program to medical workers in rural areas

About the program for rural doctors

The essence of the government initiative is to encourage young doctors to move to rural areas.

According to official statistics, before the start of these measures, the number of doctors in the Russian outback decreased by 4% over five years.

On the other hand, university graduates did not want to go to the village for the following reasons:

• small salary;
• lack of housing.

To solve the above problems, a program has been created that is aimed at solving the housing problem of rural doctors with a higher education diploma.

Only qualified specialists—doctors—are covered by the project.

Those who wish to treat village residents within the framework of the program are entitled to receive one million rubles. This assistance is tax-deductible. The law does not specify the targeted nature of the payment; the rural doctor can dispose of the payment at his own discretion.

Documentary base

The implementation of the federal program for rural health workers is regulated by Federal Law No. 326-FZ of November 29, 2010 “On Compulsory Medical Insurance.” In 2011, the law was amended to reform the healthcare system. They describe the procedure and conditions for receiving assistance by doctors who have moved to work in the village.

A million rubles are issued exclusively to specialists with a higher education diploma. Funding is allocated in a lump sum.

Changes have been made to the events over the years. Thus, by 2016, the age limit of specialists falling under their scope increased. If at the very beginning the project was designed for young people up to 25 years old, now it applies to doctors up to 50 years old. In addition, in 2021 the range of settlements where it operates has expanded.

Starting from 2021, doctors living not only in rural settlements, but also in urban-type settlements or workers’ settlements can apply for financial support from the state.

Goals of the program for doctors

The government allocates funds to provide doctors with financial support when moving to rural areas. The citizen who receives the money decides for himself how and what to spend it on. Most likely, the doctor will deal with the housing issue. But this is the visible result of the project. The goals embedded in it are much deeper.

This:

• improving the system of providing medical services to the population;
• attracting specialists to the village;
• employment of young doctors;
• increasing the level of medical care for village residents;
• social support for specialists who agree to work in rural areas.

Features of financing

Budget issues are important for participants in any federal and local events. Before you count on help, you need to find out the sources of funding to make sure they are viable.

The program for rural doctors was initially paid jointly. That is, half of the amount was provided by the federal government, the rest by the local government. There have been changes to this issue in 2021.

Changes were brought about by monitoring the implementation of activities called “Zemsky Doctor” (2016). It turned out that the program for doctors is not fully implemented in all subjects of the federation. Control is carried out by fiscal authorities and the Accounts Chamber of the Russian Federation.

Thus, good results were shown in such areas as:

• Moscow;
• Smolenskaya;
• Kaliningradskaya;
• Tomskaya;
• Irkutsk;
• Volgogradskaya.

Other regions did not employ a single doctor. The issue comes down to the impossibility of providing the financial part. In order to eliminate the shortcomings, the government in 2021 decided to take on 60% of the program budget, leaving only 40% for local authorities. In future plans, the state is ready to finance 70% of such payments.

Potential participants are advised to find out whether funding is included in the region's budget.

Conditions for participation

The Zemsky Doctor program has undergone some changes since 2021. As mentioned above, legislators removed the age barrier: previously, only doctors under the age of 50 could take advantage of the program’s conditions; now there are no such restrictions. But the amount of payments for doctors under 50 years of age and after will become differentiated: doctors under the age of 50 years can count on payments of up to 1 million rubles. to improve their living conditions, while doctors over 50 years old can only receive 500 thousand rubles.

The program operates in workers' towns, villages, urban settlements and small towns with a population of up to 50 thousand rubles. The list of participants is regularly revised: for example, in 2015, Crimea was included in it. And today the program covers all Russian regions.

After receiving payment for the purchase of housing, the employee undertakes to work in the village for at least 5 years. If the employee terminates the employment contract early, he undertakes to return payments in an amount proportional to the time he worked.

Funds under the program can only be used to improve living conditions.

The conditions for the participation of medical workers in the program are given in Appendix No. 8 of Government Decree No. 1640 of December 26, 2017 . The following requirements apply to the candidacy of a specialist:

1. Availability of higher education.
2. Moving to the countryside.
3. Availability of an employment contract with a medical institution for a period of at least 5 years.

The payment has a targeted nature and can be spent on the following:

1. Buying a house or apartment in the region where the doctor works.
2. Purchase of land for construction.
3. Construction of residential premises.
4. Paying off a mortgage or down payment on it.

There is no control over the expenditure of funds, but it is believed that after working in the village for 5 years, a specialist will have to solve the housing problem.

It is worth noting that if there are two doctors in a family, then payments are due to each: that is, the family will receive 2 million rubles in total. Maternity leave does not necessitate continued participation in the program.

Among the proposed changes is the introduction of an increasing coefficient of 1.4 for zemstvo doctors working in the Far North and the Arctic zone. This would make it possible to additionally attract medical personnel to such regions.

How to become a member of the Zemsky Doctor in 2021

Vacancies for program participants are created by regional authorities.

To move to a village and receive allowances, you must first find a place for yourself. To do this, view official announcements. When you find something suitable, contact a medical organization with a request for employment.

And they will pay you lifting allowances if you meet the criteria laid down in the legislation.

The criteria for potential participants are:

• age limit - up to 50 years;
• higher education in a medical specialty, including pre- or postgraduate specialization;
• concluding an employment contract with a medical institution operating in the village for a period of five years;
• arrival or relocation to a rural settlement, working settlement or urban settlement.
• conclusion of an agreement with the authorized executive body of the subject of the agreement in pursuance of the terms of the program.

All specified criteria must be documented. Assess your capabilities!

List of required documents

A potential million-dollar applicant needs to be well prepared. The state (the specialist representing its interests) needs to prove your right to assistance.

The following documents are required for this:

• passport of a citizen of the Russian Federation (and a photocopy) and a document on the individual taxpayer number (to confirm identity);
• a copy of the agreement with the medical institution for a period of five years;
• a duplicate of the employment order;
• a copy of the diploma of education, necessarily indicating the specialization;
• data on place of residence in the village;
• bank account information;
• application to be placed on a waiting list for assistance.

During your appointment with a specialist, you will also be asked to sign a consent to enter into an agreement with the Ministry of Health.

All the above documents must be photocopied and presented with the originals.

What to do if it is impossible to get to the MHIF office

Modern government agencies provide citizens with the opportunity to submit their applications remotely. If for some reason a visit to the MHIF office is not possible, you should use an alternative option:

1. Collect a package of documents and send by mail. Required with notification of receipt. Application and consent forms for concluding an agreement should be obtained from the official website of the Compulsory Medical Insurance Fund.
2. Contact the specified organization directly via the Internet. On the official website of the Compulsory Medical Insurance Fund, you can create your own account where you can fill out paperwork, attaching electronic copies of documents to them.

With an alternative method of applying to the MHIF, the papers must also be certified by a notary.

Procedure for participation

To participate in the program, you need to contact your local Department of Health with a set of documents. The agreement on the provision of subsidies is concluded between the medical institution and the program participant.

Where to look for vacancies

Subsidies for health workers are provided only for vacancies that are in short supply. Their list can be clarified in the personnel department in village hospitals, as well as using special resources on the websites of executive authorities.

To participate in the program, a person must contact the personnel department of the medical institution where such an interested person will work to confirm that the vacant position is included in the register of shortage vacancies.

Today, the most in-demand specialists are general practitioners, therapists, gynecologists, cardiologists, neurologists, and ultrasound specialists.

Algorithm of actions

Participation in the Zemsky Doctor program involves completing the following steps:

1. Receiving confirmation that the vacancy is included in the register of shortage vacancies.
2. Contact the Department of Health or the Compulsory Medical Insurance Fund and fill out the appropriate application.
3. Along with the application, you must attach a certain set of documents: passport, higher education diploma, copy of the employment contract at the medical institution, TIN certificate, SNILS, employment order, account details for transferring money.
4. The application with supporting documents will be considered within 1 month. Based on the results of its consideration, the person must re-visit the health department and enter into an agreement on payment of compensation.
5. Payments must be transferred to a special account within a month after signing the employment contract and subsidy agreement.

Additional benefits for medical workers may take the form of compensation for housing and utility bills . The monthly subsidy is 1200 rubles.

Where to apply for payment

An employee of a medical organization who agrees to move to a rural area and meets the criteria described above must submit an official application to the local office of the Ministry of Health.

You need to bring an application to this organization, as well as a package of documents. First, you need to independently assess whether you are entitled to the described benefit.

How quickly will the money be paid?

Financing of lifts is carried out by two budgets.

Nevertheless, it is legally stipulated that the million must be transferred to the doctor within thirty days. The period is counted from the date of signing the agreement with the executive authorities.

The federal part is transferred to the local budget within three days. After this, the executive bodies add their “share”.

When the amount is generated, it is sent to the account specified when submitting the application.

Be careful with documents. If the money goes into someone else's account, you will still have to answer for it!

Can they refuse?

We will not consider cases when unscrupulous citizens who do not have the right to a monetary payment apply to the Ministry of Health. Refusal is quite likely; civil servants may make a mistake.

If you are sure that you are entitled to a million, then you should collect the following documents:

1. A copy of the previously submitted application. It is advisable to take it during your appointment. If you applied via the Internet, print it from your office. Or a notification that the addressee has received your letter.
2. Response from the MHIF department about refusal.

These documents, as well as the entire package that was provided earlier, are attached to the application to a higher organization or to law enforcement agencies, with a request to understand the situation.

Responsibility of the recipient

Doctors who enter into an agreement with the Russian Ministry of Health should understand that they don’t just give a million. These people undertake a commitment to work in the village for at least five years.

If the doctor turns out to be unscrupulous, abandons his work and his patients, he will be fired. Breaking the contract will result in the need to return the funds received to the state in proportion to the time worked. You cannot quit before the contract expires.

Moving to another village in the same region is acceptable. But this should be agreed upon with the organization that issued the lifting permits.

Even if a doctor is called up to serve in the army, he will have to choose:

• return part of the money in proportion to the unworked period of time out of the allotted 5 years,
• renew the contract after returning from the army and work out the remaining period.

In addition, the money will not have to be returned, for example, if there was a staff reduction in a medical organization and the doctor who received financial assistance was laid off. This also applies to cases of liquidation of a medical organization. Such cases include the death of an employee or recognition of him as completely incapable of work, or the occurrence of emergency circumstances that impede the performance of work.

How to become a participant in the program: step-by-step instructions

The whole process consists of several stages:

1. The doctor finds out information about current vacancies in the village where he wants to move, and signs up for an interview.
2. After successfully passing the interview, an employment contract is concluded.
3. The citizen submits documents to the local government or health department along with an application for a one-time compensation payment.
4. An agreement is concluded.

The application is considered within 30 calendar days. After this period, the money is transferred to the account specified in the application.

Documentation

When contacting a health department or administration, you will need:

• passport;
• an employment contract concluded for a period of 5 years;
• a copy of the employment order;
• a copy of the work book;
• bank account details;
• information about the new place of residence in the village;
• copy of education diploma.

Copies are made of the original documents, and then everything is returned to the owner.

Important! A complete list of documents is established by regional authorities.

Document forms

As mentioned earlier, document forms are approved by regional authorities. Below are examples relevant for the Kursk region.

Nuances of implementing a program for rural doctors in Russia

Potential rural medical workers are often faced with issues that are not addressed in the official explanations of the Compulsory Medical Insurance Fund.

So, people are wondering, what should families of doctors do? How much allowance will they be paid? What should they do correctly so as not to lose their opportunities?

Let us repeat, a rural doctor is involved in the project described. That is, it was written for a doctor. Nothing is indicated in the documents about family connections. Each doctor is entitled to a million .

If two doctors got married and decided to move to the outback, then each of them must do the following:

1. Collect the package of the above documents.
2. Apply to the department of the Ministry of Health.

Young female doctors who have received raises worry that their money will be taken away from them if they decide to have children. In this case, the employment relationship is not interrupted. While a woman is on maternity leave and maternity leave, they are waiting for her in the hospital (they save her place). Therefore, no one will take her money away.

Results and prospects of the program

The Russian government regularly sums up the interim results of the impact of lifts on the medical care of rural residents. The conclusions drawn are mostly positive.

According to statistics, more than 20 thousand specialists have already moved to the village, using the lifts to purchase housing. Some federal subjects have fully provided rural citizens with qualified doctors.

Taking into account the positive results of the program, it was decided to extend its validity until 2021.

Results of the program in Crimea

In the regions of Crimea, more than 50 healthcare workers worked under the “Zemsky Doctor” program in 2021.

They received compensation payments in the amount of 1 million rubles. 26 specialists started working in medical organizations.

The program was financed in 2021 from the territorial branch of the Compulsory Medical Insurance Fund and from the republican budget in the ratio of 60 and 40 percent, respectively.

Areas of support for medical personnel

In the Rostov region, a set of measures is being implemented to improve the supply of healthcare institutions with medical personnel.

The following directions are provided:

• targeted contract training of doctors,
• postgraduate training in internship and residency,
• postgraduate training of doctors in narrow specialties,
• advanced training of specialists,
• introduction of a system of additional payments to doctors employed in areas with low staffing levels, including those who came to work in rural areas,
• providing state support to improve the living conditions of young specialists and healthcare workers in shortage specialties, the implementation of which contributes to the preservation of healthcare personnel potential and the influx of young specialists into the state and municipal healthcare systems.

The Ministry of Health of the Rostov Region has many years of fruitful experience of working together with the Rostov State Medical University. Interaction is carried out at all stages of education: pre-university (work with applicants), university (career guidance work with students, including assistance in finding employment for graduates), as well as post-graduate (initial postgraduate training in internship and clinical residency, organization of advanced training courses and professional retraining doctors).

As part of the implementation of measures to provide staffing for medical organizations, at the expense of the regional budget and the budgets of municipalities, advanced training of specialists with higher medical education and paramedical workers is carried out, and certification for the qualification category is carried out.

In order to attract young specialists to healthcare institutions in the region that are in need of specialists, the Ministry of Health of the region, together with the Rostov State Medical University, holds an annual job fair with the participation of medical organizations in areas with low medical personnel, as well as specialized services.

Since 2012, in the Rostov region, graduates of internship and residency employed in health care facilities in cities and regions of the region with the lowest staffing levels have been provided with one-time allowance payments in the amount of 50 thousand rubles. and 200 thousand rubles.

The Zemsky Doctor program is being successfully implemented in the region. In accordance with Part 12 of Article 51 of the Federal Law of November 29, 2010 No. 326-FZ “On Compulsory Medical Insurance in the Russian Federation” and the Decree of the Government of the Rostov Region of February 6, 2012 No. 84 “On the provision of one-time compensation payments to medical workers” to doctors involved in rural healthcare of the region, a one-time compensation payment in the amount of one million rubles is paid.

In addition to the measures being implemented, starting from 2021, one-time payments are provided to doctors employed in medical organizations in “coal mining territories” in the amount of 500 thousand rubles per medical worker, as well as one-time payments to paramedical workers (paramedics, midwives) arriving to work in rural areas. settlements, workers' settlements and urban-type settlements, in the amount of 300 thousand rubles for each paramedical worker.

A gradual increase in the salaries of medical workers is envisaged by 2021. In order to implement the Decree of the President of the Russian Federation dated May 7, 2012 No. 597 “On measures to implement state social policy,” the Government of the Rostov Region adopted Decree No. 986 dated November 12, 2012 “On measures to increase wages for certain categories of workers.” The ratio of the wages of doctors and employees of medical organizations with a higher medical (pharmaceutical education) or other higher education to the average wage in the economy of the Rostov region should be 200% by 2018.

Managers of healthcare institutions in the Rostov region have the opportunity to take part in the state program of the Russian Federation for training management personnel for national economic organizations of the Russian Federation (Decree of the Government of the Russian Federation dated March 24, 2007 No. 177 and Decree of the Government of the Russian Federation dated September 27, 2011 No. 1665-r).

Solving the problem of providing housing for medical workers is a significant incentive for the employment of specialists in healthcare institutions of regional and municipal subordination and reduces the outflow of highly qualified specialists into the private healthcare system and other sectors.

State support in matters of purchasing housing is provided within the framework of the Decree of the Government of the Rostov Region dated August 30, 2012 No. 831 “On approval of the Regulations on the procedure for providing young healthcare professionals and healthcare workers in scarce professions with budget subsidies for the purchase (construction) of housing.”

Reimbursement of expenses for housing and utilities

In accordance with the first paragraph of paragraph 1 of part 1 of Article 1 of the Regional Law of January 17, 2005 No. 274-ZS “On social support for certain categories of citizens working and living in the Rostov region”, doctors, pharmacists, employees with secondary and higher medical and pharmaceutical education, Those directly engaged in medical or pharmaceutical practice in medical organizations of the state regional and municipal healthcare systems are provided with compensation for the cost of living quarters and utilities in the form of a monthly cash payment.

Reimbursement of expenses for housing and utilities is made taking into account family members of doctors, pharmacists, workers with secondary and higher medical and pharmaceutical education, hired before January 1, 2005, if family members lived with them and enjoyed housing benefits and utilities as of January 1, 2005, subject to continued cohabitation.

According to Part 1 of Article 2 of the Regional Law of January 17, 2005 No. 274-ZS, compensation for the costs of paying for living quarters and utilities for the above categories of medical workers is made in the form of a monthly cash payment in the amount of 100 percent of the payment for living quarters and utilities and is calculated according to those established by the Government Rostov region to regional standards for the cost of housing and utilities per 1 square meter of total residential area in municipal districts within the regional standard of social norms for residential area. Moreover, the amount of compensation does not depend on the actual payments of citizens.

Competition "Best Doctor of the Year"

In order to increase the prestige of the medical profession in the Rostov region, the “Best Doctor of the Year” competition is held annually. Decree of the Government of the Rostov Region dated November 18, 2011 No. 141 “On awards from the Governor of the Rostov Region to doctors of regional state and municipal healthcare institutions” established awards in three categories: “Best Rural Doctor”, “Best Young Specialist”, “Best Health Care Organizer”.

Normative legal acts

Decree of the Government of the Russian Federation of November 27, 2013 No. 1076 “On the procedure for concluding and terminating an agreement on targeted admission and an agreement on targeted training”

Subprogram “Staffing of the healthcare system” of the state program of the Rostov region “Health Development”, approved by Decree of the Government of the Rostov Region dated September 25, 2013 No. 593

Decree of the Government of the Rostov Region No. 831 dated August 30, 2012 “On approval of the Regulations on the procedure for providing young healthcare professionals and healthcare workers in scarce professions with budget subsidies for the purchase (construction) of housing”