Friday, February 15, 2019

As government funding for institutionalization continues to grow, some questions for Aleh

Israel's Knesset chamber
Some disturbing statistics just landed in my email. They highlight the stagnation in which Israel is mired when it comes to the civil rights of people with disabilities.
"The data indicate that in 2000, the outsourcing budget of the Department for Intellectual Developmental Disabilities was NIS 786 million (in 2015 prices), and that 92 percent of that budget was allocated for services related to institutional settings. In 2015, there was a substantial increase... and it reached NIS 1,993 million. The relative share of expenditures on services in institutional settings dropped to 85 percent. Over the years, we see a trend of the expansion of community-based services and the growth in the relative share for these expenditures." ["The Outsourcing of Welfare Services: Trends and Changes", Taub Center for Social Policy Studies in Israel, 2016 at page 378]
That's an astronomical sum for a not-so-wealthy country to pour into the process of locking up people with disabilities. The drop in funding for institutional settings from 92% of the total outlay to 85% is relatively insignificant bearing in mind its absolute growth.

Obviously, isolating that population in large edifices far away from family, home and community is a top priority for this government.

The mind boggles imagining the superb para-medical therapies, social enjoyment and family love that citizens with disabilities could derive were those many millions redirected to community-based care.

Our Chaya is now receiving individualized occupational therapy, hydrotherapy and - for a fortnight now - speech therapy at home. In-community care in action.

While Aleh boasts about its rehabilitation successes, it is worth recalling that the second in command at its Jerusalem branch which I toured last month [see my posts "Making history: After the raid" (December 24, 2018) and "Notes from an Aleh visit" (January 1, 2019)] in the company of Knesset member Nachman Shai was, despite my repeated inquiries, unable to tell me how many such therapies its 80 residents receive. 

When the numbers aren't embarrassing, you publicize them. That make sense, doesn't it? 

Several days ago, Aleh boasted ["Against All Odds: Aisha Transitions Home"] that a resident of its Aleh Negev facility who had lived there since birth had been so well rehabilitated that she was returning to her family. Sort of like a high school boasting that one of its 800 students had earned a high-school diploma. (Aleh claims it has a total of 800 residents in all its institutions.) Not exactly an emblem of success. 

But the story of Aisha and her "graduation" from Aleh begs many disturbing questions about the Aleh enterprise:
Screen capture
  • For one, if she could live with her family why can't the other residents? 
  •  Must a child "earn" the right to live freely and with his/her family? 
  • Do only children with high scores in para-medical therapies win release from these institutions? 
  • And, last but not at all least, is Aleh's goal really rehabilitation?
The last question is one to ponder particularly in light of the following line I recorded during the Aleh visit I just mentioned. The loquacious assistant director spouted a running commentary to us visitors that included this telling line:
"We view ourselves as a rehabilitative place - well, in medical definitions proper, we aren't denoted as a rehabilitative place."
To which I now say: If you're not technically rehabilitative, Aleh, why does your Facebook page label you as such in this heading?: 
ALEH - Advancement and Rehabilitation of Children with Complex Disabilities
To be clear, and based on my experience with them, I'm not holding my breath till Aleh answers. Though I do think they should.

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