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PEP – Treatment in fear of exposure to HIV

The following is a translation and edit of an article on www.aidsisrael.org.il. For more information see the full article [Hebrew] by clicking here

PEP

PEP – Treatment given in cases of fear of exposure to the HIV virus. Your condom is torn during sexual intercourse; Are you afraid of being exposed to HIV? There are some things that everyone needs to know:

What is PEP?

POST 

EXPOSURE 

PROPHYLAXISpreventive treatment 

PEP is a treatment given after exposure to HIV and its goal is to minimize the risk of infection.

Is  PEP  a new invention?

For years, PEP has been used to prevent HIV infection in cases of high-risk exposure. For example, if a medical staff member is exposed to a contagious fluid (for example, stabbed from a syringe containing HIV positive blood), he or she is offered the preventive treatment that should significantly reduce the chances of contracting the virus. This treatment is also offered in hospitals to victims of sexual assault or to partners of HIV positive people if the condom is broken. PEP is actually a drug that is taken for 28 days and is based on the combined drug therapy that people living with HIV take throughout their lives.

In what situations should I consider PEP ?

If one of the following conditions occurs:

1. Almost certain exposure to the virus, for example, you are HIV negative and in a relationship with someone who is positive. Although you are always careful about protected sex – something happens and the condom breaks at the time of penetration.

2. Possible exposure to the virus, such as having unprotected sex with a partner whose HIV status is unknown, and a condom rupture during penetration.

3. Having unprotected sex that involves penetration with a partner whose HIV status is unknown or known to be positive.

Some clear cases in which treatment is recommended: 

  1. A needle stabbing from a person living with HIV (mainly occupational exposure).
  2. People who have been penetrated without a condom by a person living with HIV and whose therapeutic status is unknown.  
  3. Victims of sexual assault. (If a call to the ER is made up to 72 hours).

How do you get and who decides on it?

If you are concerned about HIV, contact the emergency room of one of the listed hospitals below as soon as possible (and no later than 72 hours after exposure). Treatment can be requested 24 hours a day, 7 days a week.

Where can I get the treatment?

In each of the following seven emergency rooms (24 hours a day, 7 days a week):

  • Soroka, Beer Sheva
  • Kaplan, Rehovot
  • Hadassah Ein Karem, Jerusalem
  • Sheba, Tel Hashomer
  • Ichilov, Tel Aviv
  • Meir, Kfar Saba
  • Rambam Medical Center, Haifa

Remember: the treatment is not given to anyone who wants it, and the decision is made by the doctor in the emergency room.  The doctor will decide whether or not to prescribe the treatment, only after consulting an infectious disease specialist or an HIV doctor from the hospital’s AIDS center, since this is a treatment with rare but life-threatening side effects, the doctor will try to see if the risk of infection in your case justifies the chances The doctor will ask you some questions related to your sex habits and the last time you have unprotected sex.

Can I go directly to the emergency room or need a referral?

A visit to the hospital must be paid by a fee, unless there is a commitment from the health fund (hitchayvut/Form 17), or in cases defined in advance by the Ministry of Health and in the regulations of the health funds. HIV prevention is not one of these cases, so in order to be exempt from a screening visit, you must have a hitchayvut. How do you do this? One way is to visit a family doctor and ask for a referral to the ER. It may be a cumbersome way of scheduling or trying to get into a doctor without a queue because of an emergency, and time is pressing. The simplest and fastest way would be to call the HMO call center and ask to speak to the nurses’ center. If the nurse at the center approves the need for an emergency appointment, the telephone call is recorded on the computer and is considered according to the fund’s regulations as a liability of the fund for all intents and purposes. In some cases the nurse may require you to visit your GP. In such a situation, you must clarify the urgency of the matter and insist on receiving a referral from the call center.

In any case, remember: Arriving at the ER without a commitment from a doctor or a nurses’ center will cost you NIS 715, even if the visit is medically justified.

What happens to a caller when he arrives at the ER?

A number of tests are performed at the ER. First, an HIV test that checks whether there has been past infection (and then any unnecessary preventive treatment). In addition, a blood count is performed and a liver and kidney function test is performed to determine a health condition that does not allow taking the treatment. In addition, in case of exposure to sexual relations, antibiotic treatment was provided to cover other sexually transmitted diseases (gonorrhea and chlamydia). At the end of the tests, and after the consultation of the emergency doctor with a physician aids are given in sorting out several doses of treatment for the next day or two. During the course of the treatment, the person is instructed to perform additional tests, the most important of which is, of course, HIV testing after three weeks of treatment. Which prevents, to ensure that no adhesion occurred.

What would they ask me in the emergency room? 

The questions that the doctor will ask you in the emergency room can be very personal and cause a feeling of discomfort. You will be asked to talk about the partner with unprotected sex, you will be asked about the sexual act, when was, what included what was your role in sex and whether there was ejaculation inside or outside. Remember that the doctor asks for all this information not to satisfy his curiosity but to make the right decision about your health. In any case, all the information you tell your doctor needs medical confidentiality so that you can be calm. The more accurate information you provide, the more appropriate a decision can be made by your doctor regarding the need for preventive care and its composition.

So take or not take?

Whether to take or not to take lies in the benefit of treatment versus its risks. Treatment is not easy in many cases and sometimes even life-threatening. Another important fact is that the side effects of the treatment may be difficult. Usually more severe than the side effects experienced by people living with HIV and taking the treatment for many years. For these reasons, complex therapeutic protocols have been written that weigh the risk of infection compared with the risk of side effects, according to which the AIDS doctors decide whether to give the treatment or not. 

When should I seek treatment?

The faster the better! The efficacy of the treatment depends on the time that has passed since the exposure: the closer the treatment is to the time of exposure, the more effective it is. If 72 hours have elapsed since the exposure, PEP will not be given in any case because treatment is no longer effective.

It has recently been shown that taking the treatment more than 48 hours after exposure reduces its effectiveness significantly, so in situations where PEP is recommended, this should be done as soon as possible !!!

Some things to know about  PEP :

– PEP is not a “day after” pill and is definitely not a substitute for condom use.

Treatment reduces the chances of HIV infection but is not 100% effective.

– Treatment must commence as soon as possible as of the date of exposure, and in any event not later than 72 hours from the moment the incident occurred.

– The treatment is not given to anyone who asks, and in any case, it is possible to receive it only in emergency rooms with the instruction of a specialist.

– Treatment is based on some of the combined drug therapy taken by people living with HIV.

Treatment has short- and long-term side effects. Sometimes these are serious phenomena. (And therefore, as noted, can not be given to any person who requests it and under the instruction of a specialist doctor only).

So now I know there is a PEP, why should I continue using the condom?

Well, simply because PEP is not a protective measure and it certainly is not a substitute for a condom. This is not a “day after” pill, but a complex drug treatment with side effects that can be determined by an emergency room doctor. In the case of PEP, the doctor will decide for you. They have the full professional authority to refuse you.

Ezer Mitzion’s Respite Program for Children with Special Needs

Empowering Children and Giving Caregivers Respite

respite

Ezer Mitzion’s respite program, allows your child to benefit from a change of scenery by spending time with a host family  in a warm, supportive and caring environment. The program is designed to empower children, promoting their independence, while simultaneously giving caregivers a well deserved break.  

Host families are individually chosen to meet children’s needs, and are trained by Specialist staff to care for their special guests.  

Parents can choose their child’s host family from people they already know, or from the pool of host families at “Ezer Mitzion.” All host families, undergo rigorous testing and training process and are monetarily compensated for hosting children.

  • The service is provided under the supervision of the Ministry of Social Affairs and Social Services and supervised by qualified Social Workers.
  • The program is available Israel-wide and available year round, including Shabbat and Chagim.
  • Professional Staff accompany the host family during the child’s stay.
  • The service is open to all citizens of Israel, irrespective of religion, race or gender.
  • There is an 24-hour emergency response.

Target Population and Eligibility

Children and teens meeting the following criteria:

  • Aged 3-21 years old (in specific cases from 0-3 and 21-25).
  • Registered in one of three programs with Misrad Harevacha – Ministry of Social Affairs, Department for People with an Intellectual disability,  Department for  Treatment for People with Autism and  Department for Rehabilitation.

How to participate in the program?

  • Interested families are advised to contact the secretary of the program,  to join the database of host families.
  • Contact the Ezer Mitzion  respite program, via phone 073-3956783/4, or by email: chavim@ami.org.il Fax: 073-951120

Important Information:

  • The host family receives payments for hosting and accommodation, (the payment amounts to 180 Shekel for a midweek stay and 360 shekel for a weekend.

For more information from Ezer Mitzion click here.

Medical Cannabis

סוכנות ישראלית ממשלתית לקנאביס רפואי

סוכנות ישראלית ממשלתית לקנאביס רפואי

“Cannabis is a substance that is defined as a “dangerous drug”. Medical Cannabis is not a medicine, it is not registered as a medicine, and its efficacy and safety when used for medical purposes has not yet been established. Nevertheless, there is evidence that cannabis could help patients suffering from certain medical conditions, and alleviate their suffering.”

Thus opens the homepage of the Medical Cannabis Unit of the Ministry of Health (MoH)  with as much clarity of purpose as can be mustered for the apparently loaded subject.

Over twenty thousand patients currently have permits for the use of medical cannabis in Israel, and over many years the means of supplying the substance to those in need have slowly progressed to the point where Israeli researchers, growers and distributors have gained international recognition as innovators. The evolution of policies is ongoing, with an expansion of availability seemingly around the corner. Still, the following is a summary of the current state of affairs, and will be updated when the MoH administration plans are fully implemented.

Cannabis is Not in the Healthcare Basket

“The Ministry of Health wishes to remove obstacles to the supply of this drug to patients who could benefit from it medically and who wish to purchase it at their own expense.”

MoH website

This means that the MoH regulates who is allowed to use medical cannabis and who is allowed to supply it, but they are not obliged to provide it through the public healthcare system or cover its cost. Instead, permitted patients subscribe to a specific licensed supplier and pay a monthly fee. Currently this fee is NIS 380 per month, to which additional charges may be added for delivery, equipment, or other accompanying expenses.

One issue that has been recognized by patients and officials is the fact that the monthly fee bears no relationship to the prescribed amount of the drug that the patient receives. This may be changed in future policies, and there is always the possibility that eventually the committee in charge of the health basket will add cannabis to the list of medications that the government primarily finances for patients.

Another innovation that is planned by the MoH is to have the drug available from regular pharmacies instead of specially designated distributors, though this plan has not yet been implemented.

How to Receive a License

The request for a permit is an electronic form available on the MoH website that is filled out on the computer and then printed to be faxed or mailed to the Medical Cannabis Unit by a doctor specializing in the medical field of which the patient is afflicted. One notable exception The Ministry of Health has given oncologists in most of the major hospitals in the country the direct authority to issue medical cannabis licenses.

Currently, requests are not accepted from family doctors and general practitioners, though ministry officials have stated their plan to offer a short training course to any doctor in order to qualify for prescribing the drug. Theoretically, they will even be allowed to issue licenses directly, though this will not be clear until the plan is implemented.

The Recommending Doctor’s Responsibilities

The patient-doctor relationship plays a central role in the MoH’s approach to issuing licenses. The recommending doctor is specifically associated with the license that is issued and if the patient changes doctors the license will have to be updated. If there is any change of status of the patient under treatment, it is the responsibility of the doctor to update the Medical Cannabis Unit’s administration. The doctor must perform medical follow-ups with the patient every three months for the first year of treatment and every six months afterwards.

Recognized Conditions and Indications

The following conditions are currently recognized explicitly by the Ministry of Health as entitled to consideration for a license:

  • Oncology Patients
  • Chronic Pain
  • Crohn’s Disease
  • Ulcerative Colitis
  • HIV/AIDS
  • Multiple Sclerosis
  • Parkinson’s Disease
  • Tourette’s Syndrome
  • Terminally ill patients
  • Post-Traumatic Stress Disorder (PTSD)

In most cases patients are expected to have exhausted other conventional treatment options before they can receive a license. There are also other explicit indications for treatment for each condition.

All specialist doctors may make a recommendation for a medical cannabis license and either petition the indications committee of the Ministry of Health to add a new indication to the list or request individual exceptions for conditions not currently in the list that the doctor feels warrants the use of cannabis for the patient.

Further Resources

Ministry of Health:

Tikun Olam, Israel’s most prominent growing, research, and distribution organization:

Subsidized therapy for those coping with illness and loss

Tishkofet Ma’agan (Life’s Door) offers subsidized therapy for those coping with illness and loss. The basic subsidized rate is 180 NIS per session, but further subsidies are available and each client’s needs and means are assessed individually.

For more information, contact Margo: mhelman@tishkofet.co.il, 02-631-2635.

Tishkofet Therapy Program

“Fast Track” for Submitting a General Disability Pension Claim

Those submitting any type of health-related claim in Israel whether it be to the National Insurance Institute (Bituach Leumi), the kupot cholim, or the Ministry of Health, unfortunately often have to wait a long time for the claim to be processed and approved.

Fortunately, at least with regard to General Disability Pension claims, there is some relief available in the form of a “Fast Track” process for those suffering from serious conditions.

As part of our on-going collaboration with Kol-Zchut, we are proud to have translated and published this easy-to-read, critical and unique resource that was not previously available in English. You can either view the information below or click here to follow an external link. 

 

Related information:

 

Not familiar with The Shira Pransky Project?

 The Shira Pransky Project was founded to help English speakers in Israel better navigate the Israeli healthcare system and make use of the rights and services that are out there.

 

If this information was helpful to you, please enable us to help others by supporting the project:
Donate Now!

 

 

To your health ! לבריאות

Eating Disorders – Treatment and Support Options in Israel

An eating disorder refers to a number of psychological disorders related to insufficient food intake or overeating. Individuals suffering from them may have difficulty admitting that they have a problem before seeking help.
Coverage and provision of services for eating disorders is essentially the same as any other psychological disorder.

How do I get treatment for an eating disorder?

  • Discuss the steps to finding treatment with your general practitioner. You may need to see a diagnostic psychiatrist or psychologist to get referred to specific treatment.
  • You can also make an appointment with a kupah social worker at your local clinic for additional guidance.

Where can I get treatment and what does it entail?

  • There are clinics specializing in treatment of eating disorders that are either directly operated by the kupat cholim, or are private and may or may not be affiliated with a specific kupah.
  • Treatment options  may be either in-patient or out-patient and the specific type of referral is based on the severity of the patient’s condition.
  • The vast majority of eating disorders are treated through out-patient care, while those who are hospitalized are generally placed in the facility’s mental health ward or a department specializing in eating disorders.
  • Care is generally provided by a multi-disciplinary professional team comprised of doctors, mental health professionals, dieticians and other professionals.
  • Updated listings of treatment facilities with which the kupah is affiliated should be requested directly from the kupah.
  • The Israeli Association for Eating Disorders (IAED) website has a comprehensive listing of public and private facilities specializing in treatment of eating disorders (in Hebrew). 

What organizations offer support for eating disorders?

 
Related Information:

Diabetes Portal

Diabetics being treated for diabetes with insulin or other medications are considered to be chronically ill and are thus entitled to various benefits from the health plans and related to various medical services. Due to the fact that each health plan has different policies, it always recommended to clarify all relevant rights and entitlements with your health plan.

As part of our on-going collaboration with Kol-Zchut, we are proud to have translated and published the Diabetes Portal in English. While a number of the links in the portal still lead to Hebrew content, it is an easy-to-read, critical and unique resource of information that was not previously available in English. You can either view the guide below or click here to follow an external link. 

 

Related information:

 


Not familiar with AACI’s Shira Pransky Project?

AACI’s Shira Pransky Project was founded to help English speakers in Israel better navigate the Israeli healthcare system and make use of the rights and services that are out there.

 

If this information was helpful to you, please enable us to help others by supporting the project:
Donate Now!

 

 

To your health ! לבריאות

In Vitro Fertilization (IVF) – Informational Videos

Women are entitled to have up to four IVF treatment cycles included in the healthcare basket for their first and second children and up to eight treatment cycles over the course of two years with district committee approval. For more information on rights related to IVF and fertility treatment in general, check out our All Rights Index (which is searchable and browseable), especially the Fertility Treatments Portal and the In Vitro Fertilization (IVF) page.

Not sure what to expect in terms of the IVF treatment process? The Ministry of Health has produced the following informational videos with English subtitles to explain how the process works and what steps are involved in terms of preparation, treatment and follow-up: 

The first step: receiving the couple for treatment

A detailed review given by a doctor and a nurse regarding the entire in-vitro fertilization process, including chances for success and possible risks.

 

Hormone treatment procedure

A detailed explanation given by a doctor and a nurse regarding the hormone treatment procedure, the treatment protocol, and the method of hormone injection.

 

Ovum retrieval procedure

A detailed description of the ovum (egg) retrieval procedure, performed under general anesthesia, and the procedure of obtaining sperm until the egg and sperm are transferred to the lab.

 

The fertilization process in the lab

Fertilization of the egg and the sperm in the lab using the appropriate method, while ensuring correct identification, sterilization, and strict work procedures.

 

Embryo transfer procedure

A description of the embryo transfer procedure. This movie includes a discussion regarding the number of the transferred embryos and details of the continued hormonal treatment.

 

Summary of treatment results

The pregnancy test performed after embryo transfer, description of the continued hormonal support in cases with a resulting pregnancy, and possible courses of action in unsuccessful cases.

 

If this information was helpful to you, please enable us to help others by supporting the project:
 www.shirapranskyproject.org/donate/ 

Emergency Information for People with Special Needs

emergency information

The following emergency information and recommendations for people with the special needs provided by Pikud HaOref (Home Front Command) is intended for individuals with medical problems, limited mobility (and the home-bound), deafness or hearing impairment, blindness or visual impairment, intellectual developmental disorders, autism or dementia.  

The Home Front Command’s English website can be found here: http://www.oref.org.il/894-en/Pakar.aspx and the source page for this information here: http://www.oref.org.il/10660-en/Pakar.aspx.

Information for people with special needs concerning protection against rocket attack

These instructions are intended for people with special needs. Their aim is to help people with disabilities and their families, caregivers, friends, neighbors, acquaintances and professionals prepare properly and act in accordance with the required procedures in case of rocket attack.

Tips:

  • If you are in a secure space it is desirable that you remain with other people, especially people you know who can create a supportive environment.
  • It is a good idea to notify a neighbor, relative or friend as well as the assistance providers in the Authorities of the presence of a handicapped person at this location, and to give them telephone numbers, e-mail and SMS addresses, etc where you can be reached.
  • It is recommended that you apply to a relevant organization, to a professional association with which you maintain ties, or to the municipal call center to ensure beforehand that there is someone who will be able to help you in time of need. 
  • Prepare in advance all essential telephone and fax numbers, e-mail addresses and Internet support sites of contact persons.
  • For owners of mobile phones – ensure that the battery is fully charged and that the battery charger can be reached at all times.
  • You can call the service call center of the Ministry of Social Affairs and Social Services (118) or the Local Authority (106) for the general community of handicapped and elderly residents

Preparation of the secure room

  • Select the secure space in advance in accordance with the instructions of Pikud Haoref and prepare the path to it in keeping with your needs and disability.
  • Clear away objects such as planters, various decorative objects, etc that might block or hinder your movement to and from the secure space.
  • Make sure that essential things and devices are in their permanent places, identified and easily accessible.
  • Equip the selected secure space with the special auxiliary devices you need, in your judgment, such as hearing aid, cleaning supplies and reserve batteries, television receiver with amplifier (if you have one) and power supply for the amplification system, fax machine with extra paper and spare ink cartridge, mobile phone for sending and receiving SMS messages, Zimunit (beeper) charger and computer batteries with Internet connection, multi-socket electric extension cord, writing tools and notebook, ID tag showing important information (such as “I read lips only”) and any warning systems you may have (such as baby-Minder system, warning of ringing telephone, fax, alarm, amplifier or blinking light indicating knocking on the door or ringing doorbell, emergency button, whistle or bell used to call for help).
  • Be sure that all devices and objects are within easy reach.
  • It is recommended that you equip the room with water (at least one liter per person), some food and a first-aid kit.
  • All Pikud Haoref instructions will be broadcast over the media. Ensure in advance that all communications devices in your secure space are in working order and locate them in a place with good reception.
  • Click here for instructions concerning what to do in case of an event.

For people with medical problems

  • In so far as possible, prepare medical documents signed by your treating physician that indicate the following: the state of your health, the medication you take including required dosage, list of regular tests you have to undergo, an extra prescription and any other information that may be relevant, such as dietary instructions, other doctors’ orders and Health Fund membership card.
  • Be sure you have a sufficient quantity of medicines and take care to prepare a list of times at which you must not take them.
  • Make sure to prepare any equipment you need, such as insulin syringe, oxygen, etc.

Preparations for people who are home-bound

An extended period in the house or secure space may result in attacks of anxiety and stress, which may negatively impact your own function and that of your family members in an emergency. As a rule we recommend that you prepare a family emergency plan, including games, conversation and other activities that will help the family to cope with the challenges and difficulties accompanying an extended emergency situation.

For the deaf and hearing impaired

For the blind and visually impaired

  • Organize the secure space and ensure that it affords maximum accessibility and convenience.
  • Remove any objects that may interfere with unlimited mobility.
  • Prepare a personal identification card including first name and family name, ID number, name of health fund and treating physician, name of accompanying caregiver, list of medications, blood type, special needs, allergies, critical medical information and telephone numbers of family members and friends.
  • In the secure space prepare guide dog equipment and important personal equipment.
  • For additional information, you may contact the Rehabilitation Section, Ministry of Social Affairs and Social Services at Tel 02-6708181 or Fax 02-6703646.

For people with limited mobility

  • Choose a secure space appropriate for the nature of your disability so that when you hear a siren or the “tzeva adom” broadcast alarm you will be able to reach it in safety and within the time specified in the Pikud Haoref instructions. If you need more time to reach the secure space than that specified in the instructions, either choose a different secure space or make preparations in the secure space that will allow you to sleep in the secure space you have chosen.
  • Arrange the secure space and the approach to it in order to ensure maximum accessibility and convenience. Remove any objects that may interfere with unlimited mobility. If you use a motorized wheel chair or a “Kalnoit” mobility scooter be sure that extra batteries, a battery charger and a non-motorized wheelchair are available.
  • Be prepared for situations in which it is impossible to use an elevator and you will have to be carried, without your personal wheelchair.
  • Be prepared for the possibility of a flat tire. Prepare a tire repair kit with the possibility of filling the tire with air as needed or prepare spare inner tubes and a pump.
  • Consider the possibility of equipping yourself with heavy-duty gloves so that you can turn the wheels to move the wheelchair on rough ground.
  • Prepare a folder indicating your personal information and equipment for a prolonged stay in the secure space, packed so that it can be attached to the wheel chair, walker, Kalnoit, etc.

For people with foreign assistants

Advise the foreign assistants of notices published in the media in foreign languages and on the website as well as in the information center of Pikud Haoref at Tel 1207.

For those with intellectual development disorders or autism

  • It is advisable to rehearse  the things they have to do to reach and enter a secure space and what they should do when they hear the “tzeva adom” broadcast alarm or siren.
  • Prepare medications, necessary auxiliary devices and important personal equipment. It is a good idea to prepare extra clothing, personal hygiene necessities, food and drink in accordance with the personal taste of the people in question. If special food is needed, prepare food that has been ground in a blender or food substitutes.
  • It is important to create a calm atmosphere in the secure space, with pleasing and relaxing activities. Tension and pressure can be dispelled through relaxation, involvement, calling the person by name, breathing exercises, etc.
  • If a person with intellectual developmental disorders has additional limitations (such as limited mobility or psychological problems), refer to the pertinent instructions for these limitations.
  • Prepare a personal identification card including: first name and family name, ID number, name of health fund and treating physician, name of accompanying caregiver, list of medications, blood type, special needs, allergies, critical medical information and telephone numbers of family members and friends.

Instructions concerning the secure space

In an emergency, warning sirens are sometimes heard. These sirens let us know that we are under missile attack. When you hear the siren, you should act in accordance with the following instructions immediately:

  • If you have a Mamad (a secure space in your home or apartment), enter the room and close both the door and the window. If there is enough time, you can go down to the shelter.
  • If you don’t have a secure space in your home or apartment and there is no way or time to get to a shelter, you should go to the place in your home that offers the best protection possible. The best-protected place in the home is an interior room that has few windows and no outside wall. If you live in a multi-story building, you can go to the stairwell.
  • Wherever you may find yourself at the time, you should stay away from windows and wait until the alarm ends and then wait a few more minutes to be sure that the attack is over.
  • It is desirable to be with other people – in that way you will feel more secure. In the meantime, you can speak with them or think about good things in order to calm yourself. When all is over, you can return to your house. Most important of all – don’t panic!

Preparations for people suffering from dementia

  • Locate a secure space in the house ahead of time and become familiar with it.
  • Become familiar with the shelter procedures for emergencies. 
  • Identify the contacts, treatment and rehabilitation people who can help you in an emergency, if relevant. When escalation occurs, it is advisable to get medications, water and food in time.
  • If you have questions concerning yourself or members of your family, please contact an available clinic or rehabilitation facility.

 

For tips on coping with stress and anxiety see the NATAL (“Israel Trauma Center for Victims of Terror and War”) website in English.

 

If this information was helpful to you, please enable us to help others by supporting the project:
 www.shirapranskyproject.org/donate/

 

Chronic Illness

Who is chronically ill according to the National Health Insurance Law? 

An individual is considered to be chronically ill if one of the following applies:

  • He/she receives a monthly maintenance dosage of at least one of the medications included on the list appearing here.
  • He/she has one of the illnesses listed here.
  • He/she does not meet one of the above criteria, but receives one drug or a group of therapeutic prescription drugs, which are not included in this list, continually for at least half a year.

 

As part of our on-going collaboration with Kol-Zchut, we are proud to have translated and published a comprehensive portal in English about chronic illness and chronically ill patients. For more information including the complete definition of chronic illness, listings of the included illnesses and medications, relevant benefits and specific information for various illnesses, check out:

The Chronic Illness Portal

pillbottle

 

We offer these resources, along with hundreds of pages of other Israeli healthcare-related content for free to Israel’s English-speaking population.

Click here to donate now and please consider an on-going donation as everyone contributing their little part helps us do ours!

You can also help by:

  1. Spreading the word: Tell anyone and everyone you know who might be helped by our site and resources about us and what we have to offer.
  2. Collaborating with us by sharing your own knowledge, thoughts and experiences simply by leaving comments on our site and Facebook page (or simply “Liking” it) or, for the truly adventurous, in the form of a blog post (email us for more info: info@shirapranskyproject.org).

 

Not familiar with SPP?

AACI’s Shira Pransky Project (SPP) was founded to help English speakers in Israel better navigate the Israeli healthcare system and make use of the rights and services that are out there.

What we do:

 

To your health ! לבריאות

post

Cancer Patients – Rights, Benefits and Services

Cancer patients must not only fight the disease, but they and their families must also be aware of all of their rights within the healthcare system, in addition to all options for financial and emotional support.

Know to Ask

Review the various rights, benefits and services highlighted in this checklist to become more knowledgeable about what is available before making an appointment with the Kupat Cholim social worker at your local branch, a social worker at the treating hospital, or another guidance professional for information and assistance in accessing support. Download a printable version of this checklist by clicking here. You can print out that checklist and go over it with the support professional. Please note that many items have eligibility conditions related to age, means, insurance membership or other factors.

Discounts, Exemptions and Assistance from the Health Plans

Financial Assistance and Other Benefits

Employment

Fertility Preservation Treatments

Supportive and Nursing Care

Patient Support Organizations

This is not an exclusive list. If you have a need for a service you do not see here, we urge you to make your need known. If it is not already addressed by an existing program, many organizations will use their resources to facilitate your individual needs in any way possible.

Israel Cancer Association 1800-599-995

Transportation/Ambulance, Equipment Loan and Other General Services 

Counseling, Support and Rehabilitation

Children and Families Support, Recreation and Respite

More Organizations

Cancer Patients in Israel: Where to Turn

Here are your primary avenues for receiving helpful information. Remember to be persistent in seeking clear and comprehensive details about assistance and the means to access it. There are multiple sources for guidance and often you need to pursue more than one.

  • Kupat Cholim Social Workers: Every health fund employs a social work staff with hours available to address any of your needs. Speak to your branch secretary about office hours or to arrange an appointment. 
  • Hospital Social Workers: Hospitals have a social work department to assist patients in need of support. Contact information can be found at the hospital information desk or website. Additionally, many hospital departments have their own dedicated social work staff for specialized assistance. Inquire with the ward secretary for details.
  • Organization Social Workers and Other Assistance Professionals: Many patient support organizations offer guidance to the community they serve through social workers or counselors providing specialized information and assistance.

What Assistance Can You Expect?

  • Information about rights and services that relate specifically to a person’s circumstances, and practical guidance on acquiring them.
  • Practical insight, and some hand holding, on navigating the medical system, whether it be within the Kupat Cholim network, in the hospital, or where the two overlap.
  • More practical insight and assistance with other bureaucratic institutions, like Bituach Leumi.
  • Help finding and connecting with organizations dedicated to particular conditions, where there may be even more resources of specific interest to you.
  • Help with emotional coping in difficult situations.

 A Few Tips:

  •  Schedule a sit-down meeting with enough time blocked out to discuss what you need.
  • Delegate tasks to accomplish your goals. Note the things you need to do (e.g. call this office, obtain these documents, etc.) and the things the social worker is committing to doing (e.g. calling that office, finding out about that service, getting those forms, etc.).
  • Schedule the next contact. e.g. The social worker will call you in two days with some follow-up information, or you will meet again in a week to fill out forms together, etc.
  • Show your appreciation. Everyone in the healthcare sector chose to go into a profession dedicated to helping others. The social workers especially, did not do it for the glamour.

 

The information appearing here, along with some more resources, also appears in the Cancer Patients Portal we translated as part of our collaboration with the Kol-Zchut organization.

Remember that a printable, slightly modified PDF version of this checklist may be found here.

 

If this checklist helped you or a loved one, please consider supporting AACI’s Shira Pransky Project by visiting:
www.razoo.com/Shirapranskyproject

Home Care from the Kupat Cholim

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About this Benefit

All of the kupot cholim (health plans) offer home care services to patients who can’t get all of the medical services they need due to difficulty leaving the home. A full range of medical services are provided with home visits from doctors, nurses, and social workers, as well as paramedical providers, like physiotherapists, occupational therapists, speech therapists, and others.

Who is Entitled

Home care services are intended for patients who are confined to their homes temporarily or permanently due to their medical/physical condition and are not able to receive services in the kupat cholim branches.  For Example: 

  • Patients with chronic illness
  • Patients returning home after hospitalization
  • Oncology patients
  • The elderly

How to Get it

Individuals may be referred to the Home Care Unit (יחידה לטיפול בית or יחידה להמשך טיפול)  by hospital staff, a family doctor, local social services or by contacting the unit directly. Contact information can be obtained from your local branch secretary or your kupat cholim’s information hotline.

Cancer patients may be entitled to additional home care through the Israel Cancer Association. Click here for more information.

Resources

 

If this information was helpful to you, please enable us to help others by supporting the project:
 www.shirapranskyproject.org/donate/ 

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.