home Internet professions An autonomous institution is a type of government organization. Characteristics of organizational and legal forms of medical organizations - "Social aspects of public health" electronic scientific journal State Autonomous Medical Institution

An autonomous institution is a type of government organization. Characteristics of organizational and legal forms of medical organizations - "Social aspects of public health" electronic scientific journal State Autonomous Medical Institution

"Advisor to an accountant in healthcare", 2008, N 7

Since the beginning of 2007, organizations of a new organizational and legal form began to appear in the Russian Federation - autonomous institutions. An autonomous institution is a non-profit organization created by the Russian Federation, a constituent entity of the Russian Federation or a municipality to perform work, provide services in order to exercise the powers of state authorities provided for by law, the powers of local governments in the fields of science, education, healthcare, culture, social protection, employment population, physical culture and sports, as well as in other areas (Article 2 of the Federal Law of November 3, 2006 N 174-FZ "On Autonomous Institutions").

What are the features of this organizational and legal form - an autonomous institution (hereinafter - AU)?

The founder is obliged to form the task of the AU for the provision of services and finance the implementation of this task in the form of a subsidy to the institution. In addition, the founder cannot allow a situation where the AC does not have the funds to maintain the state or municipal property assigned to it.
The Autonomous Institution has the right to spend the grant funds received for the performance of the assignment at its own discretion in order to make the most rational use of them for the performance of the assignment.

When spending funds, an institution may not apply the procedures provided for by federal legislation on placing orders for state and municipal needs.

Thus, despite the fears of the medical community about the "death of free healthcare for the population" in connection with the advent of AC (probably, everyone is frightened by the term "autonomous"), we can note the main points.

First, the AI, just like a budget institution, retains the guarantee of budget financing. The founder cannot but give the AU a task to provide state or municipal services and a subsidy for the implementation of this task, in other words, he cannot leave the institution without funding.

Secondly, just like in a budgetary institution, the property of the AU is owned by the founder, that is, either in federal or municipal ownership, or in the ownership of a subject of the Federation.

Thirdly, just as in a budgetary institution, the founder actually retains full control over the activities of the head of the AC. The head of the AC has much more freedom and independence in making managerial decisions: in spending funds, in managing personnel, in managing income and expenses from entrepreneurial activities. However, it is the founder who appoints and dismisses the head of the AC. Therefore, if the founder does not like what decisions the head makes, then, as in the case of a budgetary institution, the founder can change the head.

The following principles of restructuring the public sector are being implemented through the creation of an AC:

Create a clearer separation between buyers and service providers in the social sphere and promote the development of the practice of contractual relations between organizations and public authorities at all levels.
Form, implement and change the structure and management mechanisms that meet the needs of consumers (unlike traditional institutions operating on the basis of standard industry regulations, organizations of other forms have greater rights in organizing their work).
Become a means of attracting investments in the social sphere and expanding the sources of financing for the current activities of these organizations.
Apply to solve the problem of optimizing the number and composition of its employees.
To create conditions for legalizing the participation of the population in paying for social services.
Create the necessary incentives and conditions for a significant increase in the efficiency of the use of human, material, technical and financial resources.

Thus, the various officially formulated tasks of transforming budgetary institutions into autonomous ones can be summarized in two tasks - the rationalization of the management of the institution and the increase in extrabudgetary funding for its activities. At the same time, the achievement of the first task is ensured by the very change in the type of institution and the rules of its functioning (which is the non-proliferation of the “beloved by all” Federal Law N 94-FZ to AC), and the achievement of the second task, of course, depends on the specifics of the services of the institution, its existing personnel and financial resources. -technical resources, external conjuncture and activity of the management of the institution. Therefore, in the worst case, the life of an institution that has become autonomous will become easier, and in the best case, it will become even richer.

From the point of view of rationalization of management ("simplification of life"), any budgetary institution can, in principle, be transferred to AC. But from the point of view of increasing extra-budgetary revenues, it makes sense to acquire the "autonomous" type, of course, for those institutions that are really capable, finding themselves in more favorable institutional conditions, to increase these revenues. First of all, they include those budgetary institutions that, even in their current status, can, want and know how to earn money.

What are the advantages of creating an AU for consumers, institutions and founders?

For consumers, changing the type of a budgetary institution and transforming it into an autonomous one does not in itself provide noticeable direct benefits. But the rationalization of the management of the AC will help the management of the institution to pay more attention to the substantive issues of service delivery, and not to such issues as coordinating the transfer of funds between budget items, etc. It can also be assumed that a possible increase in non-budgetary incomes of the AU and the use of these incomes to strengthen the personnel and material and technical base of the institution can generally affect the improvement in the consumer properties of services, both those that the institution provides on the instructions of the founder, and those that are provided for on a paid basis at the initiative of the institution itself - ultimately to improve the quality of medical care for the population and expand the range of services provided on a paid basis.

For the institution, the benefit of moving to AU is to become more self-reliant, to simplify administrative procedures and lower administrative barriers, and, in addition, to earn more money for themselves. Moving to AU means relative freedom in managing the resources of the institution.

For the founder, the benefit may be a reduction in the expenses of the founder for the maintenance and development of the property complex of the institution (the property of the founder!) By increasing the extra-budgetary income of the institution and directing part of these incomes to these expenses. Reduction of liability for the obligations of the AI in connection with entrepreneurial activity while maintaining guarantees for the provision of state (municipal) services and observance of the constitutional rights of citizens.

The main regulatory framework for the creation of AC is the Federal Law of November 3, 2006 N 174-FZ "On Autonomous Institutions" (hereinafter referred to as the Law).

In accordance with the Law, the creation of an AC is possible either by reorganizing an existing federal, state or municipal institution, or by creating a new institution. In the first case, changes are made to the existing constituent documents, that is, the license, state registration certificate, etc. are preserved.

In the second case, it is necessary to go through the state registration procedure, obtain a new license, etc.

The property of the AC worth more than 50,000 rubles, real estate, as well as especially valuable movable property (that is, property without which the activities of the institution will be impossible or significantly hindered) remain on the balance sheet of the relevant property management body and are transferred to the operational management of the AC. Property, however, acquired at the expense of funds received from entrepreneurial and other income-generating activities, is not taken into account on the balance sheet of the property management committee, but is taken into account on the balance sheet of only the AU itself and is placed at its independent disposal.

An autonomous institution shall have a supervisory board consisting of no less than five and no more than eleven members. The Supervisory Board of the AC includes representatives of the founder of the AC, representatives of the executive bodies of state power or representatives of local governments, which are entrusted with the management of state or municipal property, and members of the public, including persons with merits and achievements in the relevant field of activity. The Supervisory Board of the AI may also include representatives of other state bodies, local governments, representatives of employees of the AI. The number of representatives of state bodies and local governments in the composition of the Supervisory Board must exceed one third of the total number of members of the Supervisory Board of the AC. The number of representatives of AC employees cannot exceed one third of the total number of members of the AC Supervisory Board. The term of office of the Supervisory Board of the AC is established by the charter of the AC, but cannot exceed five years. The same person may be a member of the Supervisory Board of the AC an unlimited number of times. The head of the AC and his deputies cannot be members of the Supervisory Board of the AC. The head of the AC without the decision of the supervisory board cannot independently make decisions on major transactions and transactions with interest.

In addition to the annual report on activities and on the use of property, annual audit and ensuring the transparency of information, the features of the activities of the AC (in comparison with budgetary institutions) also include a commercial chart of accounts and a plan of financial and economic activities (approved by the supervisory board) instead of estimates of income and expenses . Accounts of AUs, we recall, are located in credit institutions independently chosen by them. Summing up, let's analyze the pros and cons of AI in comparison with budgetary institutions.

AU cons

Independent distribution of AU

all income.

Lack of control

for spending funds from

Treasury (AC accounts in credit

organizations).

Absence of necessity

use Law N 94-FZ.

Possibility to exercise

borrowing.

Separation of responsibility

head with NS.

The ability to "return" to the form

budget institution

without renewal of permits

documents

Transition from budgetary

funding receivable

budget subsidies.

Limited powers

manager (including

the need for decisions of the National Assembly on major

deals and deals

with interest).

Interaction of AC with creditors

and suppliers due to limited

property liability

and lack of subsidiary

founder's responsibility.

Big reporting requirements

and publicity.

The need for an annual

obtaining an audit opinion.

Need for yourself

interact with credit

organizations, communities...

So who benefits from moving to AU? These are, first of all, institutions that provide services that are in demand among the solvent population and have the material, technical and human resources to meet this demand.

In conclusion, we note that although paragraph 3 of Art. 20 of the Law states that a change in the type of existing state and municipal health care institutions is not allowed, the transition to a single-channel financing mechanism will allow the formation of state (municipal) tasks for health care institutions and will give impetus to changing the regulatory framework in order to create the possibility of the emergence of state and municipal health care institutions created on the basis of existing budgetary institutions.

E.V. Kulakova

Chief Editor

magazine "adviser accountant

in healthcare"

On the basis of the regional clinical hospital, a conference was held dedicated to a very topical issue of improving the legal status of state and municipal medical institutions, which was attended by almost all the chief doctors of various medical institutions of the region and nearby regions.

Since January 1, 2011, many chief physicians have decided to transfer their medical institutions to autonomous status. All of them believed that this organizational and legal form would give medical facilities the opportunity to earn money through the provision of paid medical services and would allow them to bring the salaries of doctors and other medical personnel to a decent level.

↯ More articles in the journal

Sources of information

See for example: Zalessky V.V. New legal entity (autonomous institution) // Journal of Russian law. 2007. No. 4;
Rybalchenko I.E. New forms of intensification of the activities of a medical institution in the field of paid services // Healthcare Manager. 2005. No. 11;
Selyukov A.D. Legal Aspects of Financial Support of Budgetary Institutions // Law and Education. 2002. No. 3;
Siburina T.A. Future directions of institutional development of health care // Manager of health care. 2005. No. 7;
Starodubov V.I., Tikhomirov A.V. Establishment: pro et contra // Head physician: economy and law. 2004. No. 1;
Stetsenko S.G. Paid medical services: topical issues of legal regulation // Medical Law.2003. No. 1.

Characteristics of organizational and legal forms of the medical organizations
Kuznetsova T.V.
Peoples" Friendship University of Russia

This article discusses various organizational and legal forms of medical organizations and also provides a detailed description of each of the considered commercial and non-profit forms of medical organizations. A detailed description includes various comparative aspects of the legal status, managerial, property and economic nature, the content of constituent documents, the right to operate in the CHI system, depending on the organizational and legal form of the medical organization. The most common form of a non-profit medical organization today is characterized in detail - a state (municipal) medical institution, as well as the most promising form, taking into account the realities of today - a state (municipal) autonomous non-profit medical organization.

In the present article, various organizational and legal forms of medical organizations are considered; the detailed characteristic of each commercial and noncommercial forms of medical organizations considered is also given. The detailed characteristic includes various comparative aspects of legal status, administrative, property and economic characters, contents of constituent documents, the right to provide activity in the MHI system depending on the organizational and legal form of the medical organization. The detailed consideration is given to the most widespread form for today of noncommercial medical organization state (municipal) medical facility, and also to the most perspective, in view of today’s realities form state (municipal) autonomous noncommercial medical organization.

The main criterion for the classification of organizational and legal forms is the purpose of creating a medical organization. According to this criterion, all organizations are divided into two categories: commercial and non-profit.

commercial organization is a legal entity established for the purpose of entrepreneurial activity. The main objective of the activities of such an organization is to make a profit. Commercial organizations can be both private (business companies and partnerships, production cooperatives), and state and municipal (unitary enterprises). A unitary enterprise is a commercial organization that is not endowed with the right of ownership of the property assigned to it by the owner. The property of a unitary enterprise is in state or municipal ownership and belongs to the unitary enterprise on the right of economic management. Right of economic management- this is the right to own, use and dispose of property within the limits determined in accordance with the civil code. An enterprise is not entitled to sell property belonging to it under the right of economic management, lease it, pledge it, contribute to the authorized capital of business companies and partnerships, or otherwise dispose of property without the consent of the owner.

One of the forms of unitary enterprise - state enterprise, which differs in that the property is transferred to it not for economic management, but for operational management. The right of operational management- this is the right to own, use and dispose of property within the limits established by law, in accordance with the goals of the enterprise, the tasks of the owner and the purpose of the property. The owner of property assigned to a state-owned enterprise has the right to seize excess, unused or misused property and dispose of it at his own discretion.

Thus, unitary enterprises own and use someone else's property - state or municipal: the owner of the property does not lose rights to it, creating a unitary enterprise and endowing it with the necessary material resources.

The executive body of a unitary enterprise is the head, who is appointed by the owner or a body authorized by the owner (in our case, the health management body) and is accountable to him.

A unitary enterprise is not liable for the obligations of its founder, and the founder is not liable for the debts and obligations of a unitary enterprise. At the same time, the responsibility of a unitary enterprise to a certain extent depends on the scope and nature of the rights to property assigned to it by the owner - on the right of economic management or on the right of operational management.

A unitary enterprise is quite independent in its activities: it is not financed according to the estimate, the founder can pay for its services on the basis of concluded agreements. This provides the possibility of operational resource maneuver, and the absence of restrictions on the wage fund creates commercial incentives for the team of a unitary enterprise.

Despite the fact that the activity of a unitary enterprise is subordinated to making a profit, its constituent documents should also contain substantive goals - for example, meeting the needs of the population in certain types of medical care, which makes it possible to keep a unitary enterprise within certain boundaries of activity. However, within these boundaries, a unitary enterprise behaves like a commercial organization. His desire for profit may be in conflict with the objectives of the activity. For example, a medical unitary enterprise may refuse to provide unprofitable types of services, to comply with part of the obligations to the attached population. It may be interested in replicating more profitable proven medical technologies by artificially narrowing the choice of services. Therefore, if a unitary enterprise operates in the CHI system, additional costs will be required to organize control against these negative trends. This limits the possibility of using unitary enterprises to exercise the rights of citizens to free medical care.

The same restrictions exist for the use of private commercial medical organizations in the CHI system: limited liability companies, open and closed joint-stock companies, and others.

However, sometimes work in the CHI system can be beneficial for a commercial organization - even in the case when, on formal grounds, the services provided are unprofitable, and the commercial enterprise seeks to receive an assignment for the provision of medical care within the framework of compulsory medical insurance - in particular, offering assistance at affordable prices. Therefore, the possibility of using such organizations in the CHI system should not be completely rejected.

Non-profit organization- this is a legal entity that does not set profit making as the main goal of its activities and does not distribute profits between participants.

Both public and private medical organizations can be non-profit.

All non-profit organizations have special legal capacity, the content of which depends on the purpose of creating a particular organization and its legal form. The purpose of a non-profit medical organization is to protect the health of citizens. A non-profit organization can carry out commercial activities only to the extent that this corresponds to the goals of its creation. Such activity for a medical organization, for example, may be the provision of profitable paid medical services in addition to the CHI program.

A non-profit organization owns or manages separate property, is liable for its obligations with this property (with the exception of institutions that are liable for obligations only with their own money), can acquire property or non-property rights on its own behalf, incur obligations, be a plaintiff and a defendant in court.

Bodies of state power and local self-government, within their competence, can provide economic support to non-profit organizations in various forms, including:

Provision in accordance with the legislation of benefits for the payment of taxes, customs and other fees and charges (taking into account the legal form of a non-profit organization):

full or partial exemption from payment for the use of state and municipal property;
placement among non-profit organizations on a competitive basis of state and municipal social assignments;
providing, in accordance with the law, tax benefits to citizens and legal entities that provide financial support to non-profit organizations.

At the same time, it is not allowed to provide tax benefits on an individual basis to individual non-profit organizations, as well as to individual citizens and legal entities that provide material support to these non-profit organizations.

The dominant form of non-profit medical organization is currently institution.

An institution is an organization created by the owner of the property, including the state, local governments, legal entities or individuals, to carry out managerial, socio-cultural or other functions of a non-commercial nature and financed by the owner in whole or in part.

The founder-owner (or a body authorized by him) appoints the head of the institution as the sole executive body.

The owner finances the activities of the institution in whole or in part, transferring funds to it or assigning other property to it on the basis of the right of operational management, which imposes significant restrictions on the institution to own and dispose of this property. The institution is not entitled to alienate or otherwise dispose of property assigned to it or acquired at the expense of funds allocated by the owner according to the estimate.

The institution is responsible for its obligations with the funds at its disposal. In case of their insufficiency, the owner of the relevant property bears subsidiary liability.

The charter or regulation of the institution may allow the implementation of certain types of profit-making activities (that is, entrepreneurial activities). Incomes from entrepreneurial activity, as well as property acquired at their expense, are the property of the founder and come only to independent disposal, but not to the property of the institution. Thus, an institution under no circumstances can become the owner of its property.

The liquidation of an institution is carried out according to the general rules of civil law, and the rest of the property always becomes the property of the founder.

The state (municipal) institution is still the most common form of state non-profit organization. However, this form of organization is not the only acceptable one; moreover, it has a number of significant drawbacks, the main of which is that this organizational and legal form does not stimulate the desire for efficient use of resources. The reason for this is the use of the principle of maintenance by the owner, rather than payment for final services, restrictions on the maneuvering of resources, and strict regulation of financial and economic activities. The property is assigned to a state (municipal) institution on the basis of the right of operational management; financing, according to Article 161 of the Budget Code, can only be carried out according to the estimate. This does not create incentives, for example, for the introduction of new medical technologies that would reduce the overall cost of treatment by exceeding the costs of any individual item (for example, the cost of medicines and consumables). The subsidiary responsibility of the state owner for the obligations of a medical institution gives rise to the dependency of institutions.

The introduction of compulsory health insurance has significantly changed the activities of medical institutions. Increasingly, they are financed on a service-by-service basis rather than on an estimate of income and expenses. The basis of their relationship with the insurer is a contract for the provision of medical services, according to which the medical institution undertakes to provide services of a certain volume and quality to the insured contingent, receiving payment at tariffs for this. At the same time, the independence of medical institutions expanded. Receiving financial support based on the volume of medical care provided to the population, they use non-budgetary sources of funding, which allows them to quickly resolve medical and economic issues. There was a real opportunity to ensure the dependence of the amount of remuneration on the volume and quality of work performed.

Incomes received as payment for medical care from insurers and from other sources are used by medical institutions at their own discretion to solve statutory tasks.

Thus, the nature of the activities of medical institutions is increasingly acquiring the features inherent in autonomous non-profit organizations. This organizational and legal form is incompatible with a rigid administrative hierarchy and operates on the basis of contractual relations. The activities of such an organization are not aimed at fulfilling the tasks of the founder, but at achieving the statutory goals.

Legislative consolidation The independence of state and municipal medical institutions, assumed when creating new organizational and legal forms, requires their legislative consolidation. The relevant bill is currently under consideration.

The bills propose to add two more forms to the existing form of a state institution. This autonomous institution And state (municipal) autonomous non-profit medical organization.

According to the bills, property autonomous institution belongs to him on the right of operational management. The owner of the property of an autonomous institution is the Russian Federation, a subject of the Russian Federation or a municipality. An autonomous institution is not entitled, without the consent of the owner, to dispose of immovable and especially valuable movable property assigned to it by the owner or acquired by an autonomous institution at the expense of target funds allocated to it by the owner for the creation (acquisition) of immovable and especially valuable movable property. The types of especially valuable movable property, which an autonomous institution has the right to dispose of only with the consent of the owner, are determined by the Government of the Russian Federation. At the same time, an autonomous institution independently disposes of property (including real estate) acquired by it with the income from its activities. The property of an autonomous institution may be used by it exclusively for the purposes determined by its charter.

Unlike an autonomous institution, property state (municipal) autonomous non-profit organization, including transferred to it by the founder during its creation, belongs to this organization on the basis of ownership. At the same time, a state (municipal) autonomous non-profit organization, as well as an autonomous institution, may use its property exclusively for the purposes determined by its charter.

An autonomous institution is liable for its obligations with all the property belonging to it, with the exception of immovable and especially valuable movable property, which an autonomous institution is not entitled to dispose of without the consent of the owner. A state (municipal) autonomous non-profit organization is liable for its obligations with all its property.

The owner of the property of an autonomous institution shall not be liable for the obligations of an autonomous institution, except for the cases provided for by the surety agreement. An autonomous institution shall not be liable for the obligations of the owner of the property assigned to it. In the same way, a state (municipal) autonomous non-profit organization is not liable for the obligations of its founder, and the founder is not liable for the obligations of the state (municipal) autonomous non-profit organization created by him, except for the cases provided for by the surety agreement.

An autonomous medical institution carries out its activities in accordance with the goals defined by law and charter by providing medical services to the population.

An autonomous institution has the right, with the consent of the owner of its property, to act as a founder (participant) of other legal entities whose activities correspond to the goals of the activities of the autonomous institution, if participation in these legal entities can contribute to the quality provision of services (performance of work) by the autonomous institution.

The income of an autonomous institution and a state (municipal) autonomous organization shall be at their independent disposal and used to achieve the goals for which they were created. The owner of the property of an autonomous institution, as well as the founder of an autonomous non-profit state (municipal) non-profit medical organization, does not have the right to receive income from the use of property and activities of an autonomous institution (non-profit medical organization).

An autonomous institution, like a state (municipal) non-profit organization, is obliged to annually publish reports on its activities and the use of its property in the manner determined by the Government of the Russian Federation; keep accounting records and submit accounting and statistical reports in accordance with the procedure established by the legislation of the Russian Federation; provide information about its activities to state statistics bodies, tax authorities, state bodies or local governments and other bodies and persons in accordance with the legislation of the Russian Federation and its charter.

Information about the size and composition of the property of an autonomous institution, a state (municipal) autonomous non-profit organization, the size and structure of their income and expenses, the number and composition of employees, the average level of wages, the use of unpaid labor of citizens in the activities of these organizations cannot constitute a commercial secret. Organizations of both organizational and legal forms provide open access, including access to the media to the following of their documents:

charter (including amendments and additions to the charter);
certificate of state registration;
decision of the founder on the creation of an autonomous institution;
regulations on branches and representative offices;
documents containing information about the personal composition of the board of trustees and the executive body;
information on the size and composition of the property on the balance sheet of the autonomous institution and documents confirming its rights to this property;
plan of financial and economic activity;
annual reports on financial activities, financial statements;
auditors' conclusions.

The main activity of an autonomous institution, a non-profit state (municipal) organization is recognized as an activity directly aimed at achieving the goals for which the autonomous institution was created (in the case of an autonomous medical institution, a non-profit medical organization - to protect public health).

An autonomous medical institution, in accordance with the tasks of the founder and obligations to the insurer for compulsory health insurance, carries out activities for free or partially paid services (performing work) for the consumer, provided with funding from the relevant budget, extra-budgetary funds or funds of the insurer for compulsory health insurance. The state (municipal) non-profit medical organization has the right to provide the same services on the basis of the instructions of the founder.

In addition to these volumes of these services, an autonomous institution and a state (municipal) medical organization are also entitled, at their own discretion, to provide services (perform work) related to their core activities, for a fee for any citizens and legal entities, in compliance with the rules of civil law on a public contract. At the same time, these organizations must ensure the proper fulfillment of tasks and obligations aimed at fulfilling the statutory goals. On the same terms, an autonomous institution, a non-profit medical organization has the right to perform work (provide services) that are additional in nature in relation to the main activity defined by the charter. All of these additional activities must be fully specified in the articles of association.

The decision to create an autonomous institution on the basis of federally owned property shall be taken in accordance with the procedure established by the Government of the Russian Federation.

The decision to create an autonomous institution on the basis of property owned by a constituent entity of the Russian Federation or owned by a municipal formation is taken by a state authority of a constituent entity of the Russian Federation or a local government body within their competence established by acts defining the status of these bodies.

The decision to grant the status of an autonomous state (municipal) institution to an existing institution is made if the following conditions are met simultaneously:

such a decision will not entail a violation of the rights of citizens provided for by law, including the right to receive free medical care and free education;
as of the date of the decision, the state (municipal) institution has no accounts payable overdue by more than three months.

The Government of the Russian Federation may establish additional conditions for making a decision on granting an autonomous status to an existing state (municipal) institution.

The Government of the Russian Federation or an authorized body of state power of a constituent entity of the Russian Federation or a local self-government body may determine lists of state (municipal) institutions that are not subject to the status of an autonomous institution.

The adoption of a decision to endow an existing state (municipal) institution with the status of an autonomous institution entails the introduction of changes to its charter and state registration of these changes in the prescribed manner.

On the same grounds, a decision is made to establish a state (municipal) autonomous non-profit organization. The only difference is that an autonomous non-profit medical organization can be formed either through its establishment or through the transformation of a state (municipal) medical institution, including an autonomous one.

The founder of both organizational and legal forms is the Russian Federation, its subject or municipality. The constituent document is the charter approved by the founder. The state registration of these organizations is obligatory.

The highest body in both an autonomous institution and a non-profit organization is the board of trustees, the decision on the appointment of members of which is made by the founder. The current management is carried out by the sole executive body (in the case of a medical organization - the head physician), the decision on the appointment of which is made by the board of trustees.

The liquidation of an autonomous institution, as well as a non-profit organization, is possible on the grounds and in the manner prescribed by the Civil Code of the Russian Federation. Claims of creditors of a liquidated state (municipal) autonomous non-profit organization shall be satisfied at the expense of property belonging to it by right of ownership, and claims of creditors of an autonomous institution - only at the expense of that part of the property that can be levied.

The property of any of these organizations remaining after satisfaction of creditors' claims shall be transferred by the liquidation commission to its founder.

Thus, two new forms are added to the existing form of a medical institution: an autonomous state (municipal) medical institution and a state (municipal) medical organization.

An autonomous institution differs from an institution in the following main points:

have a broader content right of operational management of property transferred to them by the founder and acquired as a result of income-generating activities permitted by them (the right of autonomous operational management);
the owner-state does not bear subsidiary liability for the obligations of an autonomous institution, while the collection of creditors cannot be levied on buildings and high-tech equipment, that is, an autonomous institution is liable for its obligations independently, but within the limits of its available funds and part of the equipment;
in an autonomous institution, a board of trustees is created, which primarily performs supervisory functions.

A state (municipal) autonomous non-profit organization is characterized by the following features:

the organization is the owner of the property transferred to it by the founder and earned independently:
the transfer of property by the owner to the ownership of the organization upon its creation is not privatization, since the organization remains state (municipal): the founder can transfer part of the property on a lease or gratuitous basis, in which case the property remains in state (municipal) ownership, and the threat of its alienation does not occur;
the organization bears full responsibility for its obligations with all the property owned by it;
The supreme body of the organization is the Board of Trustees, empowered to resolve key issues of the organization's activities.

Private non-profit organizations may also exist in the form of a non-profit partnership or an autonomous non-profit organization. The founders and participants of both of these organizational and legal forms can be any individuals and legal entities, and for a non-profit partnership, at least two founders are required, for a non-profit organization, the number of founders can be any. The activity of these organizations determined by the statute is aimed at achieving public benefits. The supreme governing body in the case of a non-commercial partnership is the general meeting of participants and the executive body - collegiate or sole. In an autonomous non-profit organization, a supreme collegial body (such as a supervisory board) and an executive body - a collegial or sole individual - are created. The rights of the founders in the first case are exercised by participating in the general meeting. In the second - participation in the formation of the highest collegial governing body. Both organizations enter into contractual relations with clients, both bear responsibility for their obligations within the limits of their property. The reports of these organizations are not published, but are provided to the founder and other bodies provided for by law.

All types of non-profit organizations, both public and private, can be involved in the provision of medical care in the CHI system. Having sufficient autonomy, such organizations seek to increase the local (within their own institution) economic efficiency of medical care, and the presence of competition in the struggle for tasks can also be used to increase structural (within the entire healthcare system) efficiency. The presence of independence stimulates the activity of the organization in the provision of new services, earning money for the purchase of more modern equipment, increasing wages depending on the results obtained. However, in order to effectively take advantage of the existing benefits, the leaders of these organizations must have certain methods and tools that allow them to choose the right path to improve efficiency.

List of used literature:

Kucherenko V.Z., Vyalkov A.I., Denisov I.N. and others. Organization and analysis of the activities of medical institutions in the conditions of compulsory medical insurance.-M .: FFOMS, 2000.
Health Economics / ed. THEM. Sheiman / - M. Tasis, 2001.
Kucherenko V.Z., Flek V.O., Vyalkova G.M. Evaluation of the effectiveness of medical organizations / ed. A.I. Vyalkova / - M., GEOTAR-MED, 2004.
Health care management at the present stage: problems, their causes and possible solutions / ed. IN AND. Starodubova, D.V. Pivenya, / - M .: Publishing House "Health Manager", 2006.

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In our country, there is probably not a single person who would not come across state institutions in one way or another. We all went to school, visited polyclinics, stood in long lines at the tax office or the social security. At least one of these places, but certainly familiar to the citizens of Russia. And everyone has heard a lot, and many personally know about the by no means exorbitant salaries of public sector workers. But now it's not about that. For a long time, the concept of "state institution" was identical to the concept of "budgetary institution". However, recently there have been some changes in our legislation. At the moment, municipal and state organizations are divided into state, autonomous and In this article we will talk about one of these types.

An autonomous institution is one established by the Russian Federation, its subject or municipality. Its purpose is to provide services or perform work in scientific, educational activities, in the areas of healthcare, social protection, employment, culture, sports and others.

The state can be created in two ways:

Establishment of a new organization.
Changing the type of an existing organization, i.e., the transformation of a budgetary or state institution into an autonomous one. This procedure requires the decision of the executive authorities. Moreover, when changing the type of institution, the founder, as a rule, does not change.

Why is this procedure necessary? What does the organization get as a result?

An autonomous institution is an organization that has access to most of the benefits due to a budgetary institution, but does not have the same restrictions. Let's try to explain. A budgetary institution receives certain funds from the state according to the expenditure schedule. It can only be used for strictly defined purposes.

By the way, the same applies to his extrabudgetary activities. Moreover, for all expenses and receipts, it must be fully accountable to the Federal Treasury of the Russian Federation. An autonomous institution is an organization with greater financial and economic freedom. It receives funding from the state, which can be spent on expenses for the main activity, on the maintenance of property or the payment of taxes. But she can also receive income from the property assigned to her, for example, by renting out premises. At the same time, the organization itself will determine what to spend the funds received on, and has the right to adjust costs if necessary. It can combine budgetary funds and funds received from extrabudgetary activities. An autonomous institution has the right to allocate funds to receive thereby. In addition, it can take out loans. The reporting to the Federal Treasury of institutions of this type has been simplified.

An autonomous institution is an organization that has the opportunity to increase its profitability, as well as the quality of services due to the factors listed above.