Reforms in early intervention for kids with special needs may mean disaster

Plans to shift services from private and municipal options to Israeli HMOs will likely cause critical delays in providing crucial support
A young girl with special needs at an early childhood center. (Source: Alei Siach)

Health Minister Yuli Edelstein announced recently that a sweeping reform to Israel’s early intervention services for children with developmental delays and disabilities will be implemented this coming September.

I believe this reform is one we will look back on with tremendous regret in the coming years.

Around 40,000 children in Israel are referred to early intervention services yearly. These therapies are designed to help babies and toddlers gain critical skills needed for development, like crawling, walking, talking, and playing and interacting with peers in social settings.

Countless studies have proven the strong impact of early intervention therapies. Research shows that learning and development are at their peak during a child’s preschool years, and therapies for children under the age of five are the most effective way to get them on track with their peers and help them develop skills that will serve them for the rest of their lives.

Another important benefit of early intervention services is the support they provide to the families of children with special needs. Many families rely on these services for best practices and guidance about their children’s conditions, and these conversations often lead to a better home life for the child.

The reform’s goal is to centralize early intervention services for children by shifting responsibility from private and municipal options to Israeli HMOs.

At the moment, children who are referred for early intervention services must receive it within three months from their family’s HMO. If they can’t access the services they need within that time frame, the family is entitled to a 50 percent refund on private options.

The refund helps take pressure off overburdened HMOs, which typically have a six-to-eight month wait time for early intervention services. While this may not sound like a huge delay, six to eight months is absolutely critical in the life of a baby or toddler, who may not reach crucial developmental milestones without intervention.

The reform cancels this refund policy, which will likely leave around 14,000 children without access to private care. With a record number of Israelis out of work, taking away the 50 percent subsidization means that early intervention services will be off-limits to children whose families simply can’t afford it.

Additionally, the reform may cancel governmental funds for municipal early intervention centers that aren’t affiliated with a specific HMO.

The reform sets aside 80 million shekels for Israeli HMOs to “invest” in early intervention services. However, there are no standards that must be met by the HMOs in order to receive funds. While 80 million shekels is a generous amount, it is useless without clear guidelines.

“These reforms will harm children in the periphery in an extreme fashion, as well as harm children from families which struggle financially, and children with complex developmental issues,” said Rotem Ezer Eliyahu, Director of Keren Rashi, a social welfare organization, to Israel Hayom.

In 1989, my daughter Rivky was born with special needs. At that time, resources for early intervention in Israel were extremely limited. Over the last three decades, we’ve come a long way in terms of therapies and different frameworks for supporting children with special needs.

But this reform is a step backwards. Parents deserve the widest range of choices possible when it comes to options for their children with special needs.

I understand that the intention of this reform is to centralize early intervention services in Israel. In reality, it will leave tens of thousands of families without the support they need. Some families will suffer under the crushing financial burden of paying out of pocket for these essential services, and some families will have no choice but to stop therapies for their children and hope for the best.

Limiting private and municipal options and throwing 80 million shekels at the HMOs will not lead to better early intervention services for children with special needs. We must go back to the drawing board.

About the Author
Rabbi Chaim Perkal is the Director and Founder of Alei Siach, a Jerusalem-based nonprofit organization providing all-inclusive solutions for people living with special needs and their families.
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