Mental Health Care Rights

Different Populations

In discussing mental health care rights it is important to distinguish between several populations that these rights address. First, there is the general population in Israel that may encounter acute or ongoing psychological issues, and have rights addressed in the National Health Insurance Law. Another sub-population is considered the “mentally disabled” (nachei nefesh) who have particular rehabilitation rights due to their disorder. The “mentally ill” is another limited group defined by law as suffering from impaired judgment and sense of reality, with particular arrangements regarding treatment and protection of rights.

The following is an overview of rights regarding these three populations with links to sections with more information on the latter two. Some specific psychology related conditions are discussed in other sections.

Universal Rights to Mental Health Care

According to the National Health Insurance Law, all of the rights given to someone who is ill with a non-psychiatric illness are also given to someone afflicted with a psychiatric illness. 

Dispute over responsibility

Originally, mental health services were under the responsibility of the Ministry of Health. However, the law has been reformed to pass this responsibility on to the health funds. This transition has been under dispute for many years, and as a result, responsibility for mental illness treatments has not yet been arranged between the health funds and the Ministry of Health. 

The health basket specifies entitlement to 60 psychological treatments  (30 treatments per year for two years)  from psychologists, psychiatrists, trained social workers, and other treatment professionals, subject to medical necessity. Currently, fulfillment of this obligation by the health funds varies in the number, type, and co-payment of treatments, as well as the benefits added to supplemental plans. Contact your Kupat Cholim to determine your rights. The Ministry of Health may also be contacted for help.

Rehabilitation for the Mentally Disabled

The Rehabilitation of the Mentally Disabled in the Community Law refers to the rehabilitation and integration of the mentally disabled in the community while maintaining their dignity. The law defines “rehabilitation” as a process aimed at developing the abilities and skills of the mentally disabled in a community framework in order to guarantee the achievement of the greatest possible level of functional independence and quality of life accompanied by medical oversight, including the receipt of rights in the fields of housing, employment, education and professional training, as well as training in the development of social skills and use of leisure time.

For more information see: Community Rehabilitation of the Mentally Disabled

Treatment of the Mentally Ill

A mentally ill individual is one who suffers from impaired judgment and sense of reality. The Law for Treatment of the Mentally Ill defines the rights of the mentally ill, as well as the measures that can be taken for them, including voluntary or involuntary commitment to a psychiatric hospital or clinical treatment, and how this applies to minors. This law does not refer to mental disturbances that do not fit this definition of mental illnesses (i.e. personality disorders, delinquency, etc.). 

For more information see: Rights and Treatment of the Mentally Ill

Related information

Rights of Patients After a Cardiac Event

After a heart attack or surgery, patients feel vulnerable and anxious and are sometimes afraid of losing their ability to function; they do not always know what action is required in their situation. To alleviate these problems, heart rehabilitation programs have been developed, which are designed for those who suffer from one of the following:

  • Patients who have had a heart attack
  • Patients who have undergone coronary artery bypass surgery
  • Patients with Class II-III heart failure and/or LVEF < 35% decrease in left ventricular functionality with intermediate severity and above
  • Patients who have undergone pacemaker/defibrillator implantation

Before Implantation or Open Heart Surgery

The Ministry of Health requires that before a transplant or open heart surgery, the patient must undergo a comprehensive dental examination and treatment of all of the infections found in the patient, as well as preventive action against infections in the patient.

Recovery and Rehabilitation in a Convalescent Home

Included in the health basket is eligibility for five days of recovery in a convalescent home that has an agreement with the kupat cholim, without any co-payment. In order to obtain the service contact a kupat cholim representative in the hospital before being released or in a kupat cholim branch within 24 hours of being released from the hospital and present a medical recommendation from a cardiologist. As part of a stay in the convalescent home, the patient is entitled to medical oversight, instruction and follow-up, nutritional lectures and supervised exercise.

Also note that every kupat cholim offers an extended stay in the convalescent home in their supplemental health services plan (Shaban). Contact a representative for the details of your plan.

Rehabilitative Exercise

Anyone is who is insured is eligible to receive rehabilitative exercise services for a period of 4 months, with a co-payment. The program includes supervised physical activity with monitoring and follow-up by a cardiologist, a Holter stress test, relaxation and anxiety reduction, plus lectures on proper nutrition and risk factors.

Also note that every kupat cholim offers  an extended program for an additional period in their supplemental health services plan (Shaban). Contact a representative for the details of your plan.

Heart Rate Monitoring/Follow-up

Included  in the health basket is eligibility for receiving a personal monitoring device (cardiobeeper)  for 6 weeks, allowing the E.K.G to be broadcast directly to the medical center which is manned at all times.

Also note that every kupat cholim offers an extension of the service for an additional period of approximately one year  in their supplemental health services plan (Shaban). Contact a representative for the details of your plan.

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

Get Involved!

There are plenty of ways that the Shira Pransky Project could use your help promoting English accessibility in Israeli Healthcare and support. Here are just a few opportunities:

 

 

Join our volunteer database

We are always expanding our database of volunteers interested in working directly with Israeli health organizations specifically in English content management such as proofreading/editing and updating website content. You will not necessarily be placed immediately, but added to a database to call on as opportunities arise. Please email volunteers@shirapranskyproject.org to join!

Submit, Edit, Curate or Distribute Useful Content

Volunteers interested in submitting content that is useful to the English speaking community in Israel should take a look at our Contributed Content Guidelines, and email us. You can also volunteer to help edit, curate and distribute useful information.

Communities, Social Media and Cool Tools

Please follow, join, like, share, and participate on Facebook and Twitter. You can also volunteer to help manage these various communities and expand our reach and cater specific activities and participation to this wide world of ever expanding tools and resources for spreading awareness. For the even more industrious, you can help us explore and develop even more cool tools like Prezi, Slideshare, and YouTube for spreading awareness, or more social networking, like Google Plus, Pinterest, Tumbler, Linkedin, etc. Please email volunteers@shirapranskyproject.org.

Help Engage Israeli Health Organizations

Our offer of free translations and other services is a standing open invitation to fitting Israeli health organizations. So if you know of, or are involved in any such organizations, feel free to have them email us.

In general…

Writers, editors, health care professionals, government officials, graphic designers, social workers, PR experts, social media experts, resource development experts (if you know what that means, you are one), web developers, chocolatiers, babysitters, um… well, if you do or know something that can help us achieve our goals, please contact us and let us know you’re out there, eager to help. You are cordially invited to help make life a little more secure, and a little less frustrating for English speakers in Israel (and those on their way too).

 

Healthcare News Roundup

Here are some news articles about Israeli healthcare that we have recently shared on our twitter feed-

Hadassah Hospital is taking health care to new heights- Haaretz 

Mortlity high in psych hospitals- Hrtz  -Would b more intrsting w/ comp 2 intrntl data, still thumbs up 4 reform

Health Ministry to probe new Meuhedet rules that dentists say endanger kids teeth- Haaretz 

Ichilov head Barbash- new emergency facility/why only central Israel hospitals get donations- Haaretz 

American CEOs Get an Israeli Medical Education 

@mominisrael Risks of Homebirth 

Turning things around at Bikur Cholim- JPost 

Public funding for updating health basket eroding-JPost 

Really interesting- Surrogacy law in Israel 

I love docs but hubris is a professional hazard-60% of docs punch in, others protest “demeaning”-JPost 

Hearing Devices – Kupat Cholim and Misrad Habriut Funding

Kupat Cholim

Eligibility for anyone who is insured

Anyone who is insured by a Kupat Cholim is eligible for a Kupat Cholim contribution towards the purchase of a hearing device.

Accurate as of August 2010, the Kupat Cholim contribution is a total of 851 NIS per year per ear.

Eligibility for those who are age 65 and above

The Kupat Cholim contribution is a total of 3,000 NIS towards a device for each ear, once every three years.

Eligibility for Additional Health Services (Shaban)

The Kupat Cholim’s Supplementary Health Services (Shaban) include an additional contribution towards the purchase of hearing devices and it is recommended to clarify this eligibility with the Kupat Cholim.

Misrad Habriut

Children under the age of 18

Children with hearing impairments are entitled to a contribution from the Misrad Habriut towards the purchase of a hearing device.

Cochlear Implant

Cochlear implant surgery is included in the health basket for children and adults.

Additionally, maintenance and care of wear to the cochlear implant, including the battery, is included in the basket.

Assistance in the educational system for students with hearing impairments

Student with hearing impairments are entitled to receive assistance in the educational system.

The following services are included:

  • Training and instruction for the school integrating the student, as well as instruction for the classmates, if required.
  • Preparing the school classroom acoustically.
  • Integration plan according to the integration committee decision.
  • Additional tutoring / speech therapy sessions.
  • Different diagnostic testing.
  • Unique programs suited for students with hearing impairments.
  • Accommodation in school examinations and matriculation examinations.
  • Borrowing of amplifier devices.
  • Training and advising for parents; individual support.

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

Speech Therapy

The following describes eligibility for speech therapy under specific conditions as defined on the Clalit health plan website (valid as of January 1, 2011). The health basket also requires the Kupat Cholim to provide speech therapy as part of child development services. The best way to clarify the services available, and any additional entitlements included in the supplemental plans, is to ask the Kupat Cholim.

Voice disorders as the result of surgery

Up to 20 treatments in one treatment sequence, one-time diagnosis according to a speech therapist’s opinion up to two years from the day of the incident.

Language and speech disorders as the result of CVA or MS

Up to 20 treatments in one treatment sequence, one-time diagnosis according to a speech therapist’s opinion up to two years from the day of the incident.

Listening and lip reading exercises for the hard of hearing after hearing device adjustment

Up to 4 treatments only.

Cleft palate and lip

The extent of the treatment is determined by a professional certified by the health plan and is approved by a health plan speech therapist.

Teacher and kindergarten teacher hoarseness in the public education system

With occupational physician approval- Up to 15 treatments only. Treatment may be discontinued before exhausting all eligibility in the absence of a response or if treatments are no longer required.

Hoarseness lasting at least 6 months

Eligibility

Hoarseness lasting at least 6 months since the initial E.N.T. doctor examination and caused by a problem in the vocal chords after all other treatments and after changing the required habits (smoking), when it is not possible to treat using surgery to correct the problem according to the detailed findings.

Extent of treatments

Only up to 20 treatments may be approved according to the medical guidelines and with approval of a professional certified by Clalit (the health plan).

Eligible Conditions
  • Warts (papillomas) on the vocal chords (subject to changing of habits)
  • Swelling of the vocal cords (subject to changing of habits)
  • Sound chord paralysis
  • Lack of chord closure due to weakness
  • Swelling of the vocal cords due to reflux (after exhausting previous treatment)
  • Thickening of the vocal cords – according to etiology
  • Chronic laryngitis – according to etiology

 

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

Kupat Cholim Services for Diabetes Patients

As detailed on the Clalit health plan health services website (January 1, 2010)

Insulin Pump

Clalit customers are entitled to receive an insulin pump free of charge under the following conditions with a referral from the treating doctor:

  1. Children and adults with diabetes who suffer from hypoglycemic attacks marked by spontaneous loss of consciousness, confusion and change in behavior without prior warning.
  2. Those who suffer from repeated attacks of ketosis, acidosis and hypoglycemia requiring hospitalization.
  3. Diabetes patients whose HgA1c level is 7.5 and more.
  4. Diabetes patients who received intensive treatment including three or more injections of insulin throughout the day; however, did not achieve the balance goals.
  5. Women who suffered from diabetes in the period before pregnancy and during pregnancy.
  6. Type 2 diabetes patients in cases of severe resistance to insulin and those treated with high doses of insulin who do not reach the recommended sugar level balance.
  7. For those who suffer from pulmonary hypertension, the service is given with a recommendation from a hospital lung disease specialist. In cases of preliminary pulmonary hypertension, please get approval from the district medical administration.

Reimbursement for a sugar level measuring device

Clalit customers who require a sugar level measuring device may purchase it in a Clalit pharmacy and receive a reimbursement. In order to receive the reimbursement, please obtain a letter from a doctor specializing in diabetes or a family health specialist. The recommendation must be approved by the clinic manager. Additionally, a tax invoice or original receipt indicating the name of the device and the customer for whom the device was purchased must be attached. Such a reimbursement may be given once every three years.

The health plans are responsible for providing device supplies

The Ministry of Health has made it obligatory for the health plans to provide patients with the supplies required to operate an appliance or device which is included in the basket without a co-payment. Click here to download the Ministry of Health notice regarding such supplies.

Syringes for personal use – Diabetes patients who require syringes for personal use may obtain them from Clalit free of charge.

Needles for diabetes patient self-examinations – Diabetes patients who require needles for self-examinations are entitled to a 90% discount in Clalit pharmacies.

Strips for checking blood sugar – Diabetes patients who require strips for checking their own blood sugar are entitled to a 90% discount in Clalit pharmacies.

Nocturnal erection testing, such as RigiScan

The service is provided to the patient in his home using a designated device in the following cases:

  1. The patient suffers from impotence and is a prosthesis transplant candidate.
  2. The patient suffers from impotence due to diabetes and/or high blood pressure.

Laparoscopic surgery without a band

The service is provided in the following cases according to a referral from the treating doctor:

  • BMI above 40.
  • BMI above 35 with one of the following risk factors
  • Moderate to severe sleep apnea.
  • Right heart failure.
  • Diabetes which is unbalanced under insulin treatment of 100 units per day and more.
  • High blood pressure that cannot be balanced using the best pharmaceutical treatment (make sure to obtain approval from a district-certified doctor).
  • Gallbladder stones (when operating on the gallbladder).
  • Joint replacement due to obesity.
  • Cicatricial hernia or major hiatal hernia.

General Rights for the Chronically Ill and/or Disabled

Medication Co-Payment Ceiling

Diabetes patients are chronically ill and it is their responsibility to ensure that they are considered as such by their health plan. Being defined as chronically ill is primarily important because it entitles the insured to pay less for medications, up to the ceiling which changes every year. Currently, the payment ceiling is 265 NIS per month.

Please note: When calculating the cumulative cost of co-payments, purchases of supplies (syringes, bandages, etc.) must also be included.

Bituach Leumi Rights

General Disability

Anyone who is ill and above the age of 18 is entitled to submit a disability claim to the National Insurance Institute.

The disability rating is defined in proportion to the medical problem, its severity or complications connected to it. Attention must be paid to the existence of complications which raise the disability rating, even if they are not treated on a daily basis.

If the claimant has been defined as at least 40% medically disabled and he/she lost the ability to earn a living, either fully or partially, he/she will be eligible for a disability allowance from the National Insurance Institute.

Click here to see more information about general National Insurance and disability rights.

Income Tax and Municipal Tax Benefits

Income Tax

Parents of children with diabetes are entitled to income tax and municipal tax benefits. Diabetes patients do not generally receive income tax benefits. Those whose disability has been defined as above 90% are entitled to an income tax exemption.

Municipal Tax

The discounts depend on the municipal authority and should be checked on a case by case basis.

Other Rights

Insurance companies – Additional rights to which diabetes patients are entitled are rooted in claims against insurance companies for those with policies including coverage for loss of work capacity if their earning was damaged as the result of diabetes or the detection of serious illness.

Click here to visit the Juvenile Diabetes Research Foundation website.

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

 



Rights for Psoriasis Patients

 

Maximum stay period – 30 days per year.

Contribution for each day in a hotel – Up to 207 NIS per day, or as updated from time to time and in any event, no more than 70% of the actual expense.

Apartmentrental – Someone who is insured and is not interested in staying in a hotel is eligible for a health plan contribution towards an apartment rental according to the conditions detailed above (207 NIS per day and not more than 30 days per year).

Chaperone for a minor – An insured psoriasis patient below the age of 18 is entitled, in addition to that which is listed above, to health plan contribution funding of the escort, at a rate of 50% of that which was determined for the patient.

Entrance to solarium pools – For entrance to solarium complexes, the insured patient is entitled to a reimbursement of 80% of the expense and up to 44 NIS for entrance fees with a maximum of 30 entrances per year.

UVB/UVA Phototherapy or PUVA Photochemotherapy:

 

  • An insured psoriasis patient   is entitled to undergo PUVA treatments in an approved health plan institution for 4 months per year with a dermatologist recommendation.
  • Health plan contribution towards treatment is for a stay at the Dead Sea or PUVA treatments. Patients are not entitled to receive both types of treatment in the same calendar year.
  • Use is given to insured patients suffering severely and extensively from one of the following diseases:

 

    • Psoriasis
    • Mycosis
    • Fungoides (cutaneous lymphoma)
    • Dermatitis
    • Severe atypical – extensive pruritus, ancillary to a liver or biliary tract disease
    • Anti-host implant reaction

 

Vitiligo patients – Eligibility for maximum one time coverage of 40 treatments.

 

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