Posts Tagged ‘Basics’

Our Collaboration Program

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Engaging Israeli Health and Support Organizations

The Shira Pransky Project has a simple and powerful program for engaging Israeli health and support related organizations in collaborative partnerships. We offer free translations of certain relevant material, incorporate English speaking volunteers into their programs, and help asses and expand the general English accessibility of the invaluable work that these organizations do.

Translations

Way too often the only English content you will find on an Israeli organization’s website is a donation page and other fundraising focused materials. The same goes for print materials. Sometimes, simply by engaging these organizations they wake up to the need to address and assist the English speaking community as they do other immigrant populations.

We do not offer free translations or services for fundraising or other promotional activities. When an organization contacts us, we analyse the most useful and efficient way to increase their English accessibility which most often boils down to translating basic information about the organization and its services, and additional content of particular use to the organization’s target population. For example, information about clinics or services in Israel dedicated to a particular disorder.

This initial stage always develops in a way that is unique to the needs of each individual organization, and forms the basis of an ongoing relationship of assistance in English Accessibility.

Getting English Speakers Involved

We also find ways to incorporate English speakers into an organization’s programs. We find volunteers to help with English content management and website updating and then we also see if they have volunteer programs for any of their activities to promote direct involvement from the English speaking community. Our database of volunteers is growing, allowing us to simply distribute descriptions of particular initiatives that they can get involved in.

Involving natural English speakers in an organization’s internal activities, bringing them into an organization’s family, provides both extra help relating to English speakers, and a channel for promoting the interests of the community from inside an organization.

Content Distribution

Practically all of the materials that we translate for free become our own content resource, for incorporating into our information repository, or distributing it as we see fit. Getting useful information out there to any possible destination for English speakers looking for assistance truly expands the general level of familiarity and accessibility of rights and opportunities.

We are simplifying the sharing and updating process for any organization we work with, so that they have easy access to even more content than they started with for helping the English speaking population that turns to them. They can redistribute content that we have created or collected from elsewhere to their unique populations, expanding the horizons of these populations in need with greater awareness.

What about Nefesh B’Nefesh?

Of course, there are some organizations out there simply dedicated to assisting olim, and not limited to the health and support sector. As many English speakers turn to them for guidance and education on integrating in to Israel, redistributing useful content to these organizations is another form of collaboration that has tremendous impact potential. We’ve already started on this, and expect much greater expansion as we move forward.

Supplemental Insurance

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The Kupat Cholim is permitted to offer supplemental health service plans (‘Shaban’- Sherutei Briut Nosafim) that offer additional medical services beyond those included in the Health Basket. These plans are optional and require additional payment to the Kupat Cholim beyond the basic health insurance contributions that all residents pay to Bituach Leumi.

A health fund is forbidden to make the provision of services included in the basket of services conditional on enrollment or membership in its supplementary health services plan.

Differences between Kupot

There are differences in the supplementary plans offered by the different health funds. Each fund is free to choose which services it will offer its members under its supplementary plan, providing that these services are not included in the basic “basket of services.”

Waiting period

The health fund may set a reasonable “qualification period” (waiting period), i.e. a certain period between the date when the member joined the supplementary plan and the date when he will be entitled to rights under the plan. (There are funds that exempt a person switching from another fund in which he was insured under a supplementary plan from all or a part of the waiting period).

Comparison to Private Insurance Policies

The supplemental plans can be compared to private insurance policies that also cover additional medical services beyond those included in the Health Basket, but with some important differences, including:

The health fund is obligated to accept any member requesting to join the plan, regardless of his state of health, and the rights of an enrolling member may not be made conditional or restricted in any way.
The price of the plan must be uniform for each age group, regardless of the number of years of membership in the plan or the member’s state of health or finances.

In addition, a health fund may introduce changes in its supplementary plan (e.g. payments, addition or removal of medical services, etc.) only after it received the approval of the Ministry of Health. Private insurance policies, on the other hand, are regulated by the Finance Ministry.

Waking Up!

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I just got back from an amazing/inspiring/motivating yom iyun, focusing on the accessibility of patient rights. There were presentations from doctors, professors, administrators, social workers and government officials, all surrounding this urgent objective.

A few important points:

Everybody knows the challenge

Only within the past few years the concept of bridging the awareness gap between patients and the help and support that they are entitled to has gained a life of its own. There are now several organizations dedicated to finding and implementing solutions, and many more institutions collaborating on these initiatives.

Personally, I’m amazed at how an idea can suddenly be “in the air”, with so many people recognizing it on their own and tackling it from different directions. At the same time that I was first formulating my concept and approach to English accessibility, the Hadassah social work department was just launching their Kivunim information center, Amitai Korn was conceiving Kol Zchut, Bituach Leumi was revamping their website, and many more institutions were waking up!

English is a slice of the (humble) pie

Israel has much to be proud of in its institutions of public support and protection. Universal healthcare, the social safety net, and the protection of patient rights are all enshrined in law and continually maintained and improved upon. But (!), Israelis of all stripes are missing out on some or all of these entitlements. The statistics on uptake of the support programs that are in place (from Bituach Leumi and elsewhere) for all of the relevant populations are dismal.

Still, certain populations are particularly weak, foremost- immigrants. Yes, English speakers in Israel are immigrants, sharing all the challenges of integration encountered by the Russians, French, Ethiopians, etc. with a few unique hurdles of our own. Something must be done to bolster the awareness and acquisition of entitlements among immigrant communities and every participant in today’s yom iyun agrees. The Shira Pransky Project is making sure that the English speaking community specifically is recognized and addressed.

So what is being done right now?

The general director of the Misrad Habriut issued a directive to all medical service institutions in February 2011 that they must reach a certain standard of “cultural competence”. The gist- all information and services must be accessible in Hebrew, Russian, Arabic and… English! Many people and organizations, including The Shira Pransky Project, are working hard to push this objective and assist institutions scrambling to fulfill it (more about that in a moment).

Government institutions are upgrading and updating their websites, opening information centers, and even co-opting social media to inform the public, respond to inquiries and give directions. (We have direct assurance from Gov.il that they respond to English questions on facebook and twitter.)

Kol Zchut, Kivunim and other organizations, are all constantly promoting information and awareness via their programs. The Shira Pransky Project is working directly with these organizations and others to assist them in English accessibility with translations, recruiting bi-lingual volunteers, and more.

The Shira Pransky Project is also constantly engaging more organizations to advocate for the assistance non-profits to adopt, and maybe even lead the way, in meeting the Health Ministry’s standards for cultural competence, and our website is in a constant state of evolution to better simplify and present useful information.

So what can you do right now?

Congratulations!

You read the whole thing! I guess you agree that this is important stuff, so please share it with others, and leave a comment!

5 Things To Know About Your Kupat Cholim

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1. Your Branch Secretary is the Center of the Universe

If you need anything the Kupat Cholim offers and you want to know how to get it, ask the branch secretary. In practically every publication from the Kupah you are told to contact your local branch for clarifications about rights, permissions, required documents, payment authorizations, etc.

There are surrogates, of course. While away from home you can call the closest branch, and you can always call the Kupah’s 24 hour number. You can even directly access most of the information you need straight from the Directory of Services (Madrich Sherutim) or online. But really, learning the local secretary’s name and establishing some sort of rapport might be the most valuable investment in your wellbeing that you could make.

Also, remember you can just call to ask questions, or fax to transfer documents. You may get a small charge if the Kupah has to fax some document to or for you, but the hours saved in making the trip are probably worth it.

Finally, it’s usually not worth it to ‘sort of get’ crucial information, so if you need to, speak English. Most professionals know it, or can pass you on to someone who does. Besides, you’re about to learn the most essential vocabulary-

2. Two Words: Hafnaya and Hitchayvut

Always ask if you need either or both of these to get the service you need.

A Hafnaya (הפנייה) is a referral to a specialist or other medical services, sometimes necessary for internal Kupah services, and very often necessary for services from other institutions.

A Hitchayvut (התחייבות) is a payment voucher from the Kupah, usually necessary for services, including tests and hospitalization, from other institutions.

3. Your Primary Doctor is the Center of your Galaxy

Your primary doctor is the Kupah’s point man for your physical wellbeing. He/she should be the fount from which flows all (or most) referrals, prescriptions, and communiqués.

Got a prescription from a private specialist? Ask your doctor to reissue it as a Kupah prescription. Looking for lab results from blood work? They get sent to your doctor. Need to see a physical therapist? Ask for a referral from your doctor. Etc.

It’s true that you can find your own specialists and services in the Directory of Services, and many will not require a referral. Perhaps you don’t need to check with your primary care physician every time you want to see a dermatologist, but it’s important to keep in mind the Kupah’s point-man perspective when deciding a course of action.

You might even want to consider adopting the philosophy yourself. In many health related situations it’s important to have a professional to rely on with an eye on the big picture.

Not sure if the doctor you’ve got actually fits the bill for your ideal point-man? The Kupah won’t fuss if you change doctors after one calendar quarter. If you need a more immediate change, consult the branch secretary for advice.

Finally, keep in mind that if your doctor is not available, or you just want to see someone else for some reason, there are other options-

4. Round the Clock Service

Any time you’re in need when the Kupah is closed, or the timing is simply inconvenient, call the Kupah’s 24 hour number to check if the service can be sent to your door, or where the closest emergency medical center is that you can walk into any time.

Despite the operating hours of local branches, the Kupot have admirably committed themselves to round the clock basic medical services like diagnosis and prescriptions, and sometimes even lab tests and imaging.
The Kupah has arrangements with emergency medical centers, like Terem, as well as house-call services, though the services offered by these institutions will vary, as well as the expected co-payment.

It’s worthwhile to know the capabilities of the closest emergency medical center for times when your need is not just a matter of convenience. In certain urgent situations you should go straight to the hospital or call an ambulance.

5. The Highest Level of Insurance is Totally Worth it

In the USA “good health insurance” is so elusive (read: expensive) and coveted it’s almost mythical. Here it’s really quite cheap.

By law, the Kupot cover doctor visits, diagnostic and laboratory services, some paramedical services, medical equipment, rehabilitation, hospitalizations and many prescription medications. Still, what’s left out, and how these services are provided can sometimes feel restrictive.

Supplemental Insurance (Bituach Mashlim) plans cost an extra monthly membership fee but offer a much wider selection of medications, more opportunity for using private doctors and specialists, and more options and benefits in general. If you already have it, review your additional benefits, and remember to check with the Kupah before paying for any medical service out of pocket.

If you don’t, consider joining immediately. The Kupah must accept anyone to their supplementary health insurance plans regardless of age or medical history, but there may be a waiting period before all the extra benefits kick in.

Bonus: Long term care insurance is also worth it, though it’s a different beast all together. Worthy of a separate post…

Principles of the National Health Insurance Law

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National health insurance under this law shall be founded on principles of justice, equality and mutual assistance.

- National Health Insurance Law

Application to all residents:
Every resident of Israel is entitled to health services under the National Health Insurance Law.
Provision of service is not connected to the ability to pay:
A resident pays for health insurance according to his means, and is treated according to his needs. The state is responsible for providing funding, while the health fund in which the insured is registered is responsible for providing the service.
Choice of a fund without limitations:
Every resident is entitled to be registered as a member of one health fund chosen by him, unconditionally and without any limitations due to age or state of health.
Provision of service:
The fund is responsible for providing all the services included in the basket of health services, based on medical discretion, with reasonable quality, within a reasonable time, and within a reasonable distance.
Maintaining dignity and privacy:
Every insured individual is entitled to receive health services while maintaining his dignity, privacy and medical secrecy.
Switching health funds:
Every resident is entitled to switch from one health fund to another.
Selection of service providers:
Every insured individual is entitled to choose service providers, such as doctors, caregivers, hospitals and institutes, from a list of service providers who are affiliated with the health fund in which he is a member and according to the arrangements for selecting service providers as published by the fund from time to time.
Complaints by the insured:
Every insured individual is entitled to submit a complaint to the officer in charge of public inquiries at the medical institution that treated him, to the officer responsible for investigating members’ complaints at the health fund in which he is a member, or to the ombudsman under the National Health Insurance Law in the Ministry of Health.
Application to the court:
Every insured individual is entitled to submit a claim to the Regional Labor Court.

This information was translated and adapted from content provided by The Society for Patients’ Rights in Israel.

Posts Tagged ‘Basics’

Our Collaboration Program

Engaging Israeli Health and Support Organizations

Translations

Getting English Speakers Involved

Content Distribution

What about Nefesh B’Nefesh?

Supplemental Insurance

Differences between Kupot

Waiting period

Comparison to Private Insurance Policies

Waking Up!

Everybody knows the challenge

English is a slice of the (humble) pie

So what is being done right now?

So what can you do right now?

Get Familiar

Speak Up!

Unite!

Get Involved!

Congratulations!

5 Things To Know About Your Kupat Cholim

1. Your Branch Secretary is the Center of the Universe

2. Two Words: Hafnaya and Hitchayvut

3. Your Primary Doctor is the Center of your Galaxy

4. Round the Clock Service

5. The Highest Level of Insurance is Totally Worth it

Principles of the National Health Insurance Law

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