The Ministry's march back to the Middle Ages

Restraint bed: Illustration from a Disability Rights California guide 

This month, Israel's Ministry of Welfare and Social Affairs (משרד הרווחה והביטחון ההחברתי) announced that it will be enacting a law which will regulate the use of "restrictive protective measures" in institutions for people with disabilities.

The mere phrase sounds alarm bells. 

That is, for anyone concerned about the welfare of our most vulnerable citizens and, of course, for those citizens themselves. 

But, somehow, these words are used acceptingly by most everyone else. That would explain why the infliction of such measures - which include restraint chairs, bed restraints and isolation - has thus far been dealt with only in the Ministry's internal procedures. 

The institutions have enjoyed extremely broad discretion in their use. According to the Ministry's recent memorandum, this practice has "increased the potential for harming the rights of people with disabilities and the staff working in the frameworks".

That new memorandum of the law states that a restrictive protective measure will be defined as one that 

"reduces the movement of a person in space, including the movement of his body, with the aim of maintaining the personal safety of the person or others from actual risk."

Beyond this, it does not specify the restrictive measures that will be regulated. Nor the duration and frequency of their use.

Moreover, once it is enacted, the use of such measures against a person will only be permitted after other options to prevent the danger have been examined and ruled out. The prior approval of professionals as will be stipulated in the regulations will also be required. 

And, finally, the use of these measures will be brought to a re-discussion once every period of time to be determined later.

However - and this creates a huge loophole - the amendment continues:

"In exceptional emergency cases that could not be foreseen in advance, it will be possible to take restrictive protective measures that were allowed to be used in the regulations in emergency cases without prior approval from the authorities, provided that their use is reported as soon as possible to the authority authorized to do so to be determined by the minister."

In other words, whenever the institution's employees deem a situation to be an "emergency" they are free to act as they please. Not surprisingly, advocates for the rights of people with disabilities are outraged by the Ministry's decision. 

Bizchut, The Center for the Human Rights of People with Disabilities, had already submitted a petition to the High Court protesting the use of such measures months prior to the memorandum.

The group's attorney, Vered Bar, now said of the impending amendment that it 

"reflects shocking perceptions regarding people with disabilities. We could not imagine a parallel procedure which allows restrictions regarding any other population."

She added that it 

"will allow the Minister to determine the use of restraints as he sees fit. Those staff members who have been exposed just this past year as having perpetrated violence, abuse and neglect will be the very ones to determine whether a person will be locked up or tied to a chair."

Naama Lerner from Hatnuah L'Atzmaut - the Movement for Independence, an organization working to promote "independent life with personal assistance for every person with a disability in Israel", warned that accepting the memorandum of the law would cast a "terrible stain on the State of Israel".

According to her, the "calming measures" that the Ministry will adopt include

"tying people to a heavy metal chair so that they cannot get up from it and move around or locking people in isolation rooms that have nothing but a thin mattress on the floor."

She explained that "These are means of intimidation, humiliation and abuse.". And noted that after receiving a permit, "it is unlikely that the caregiver in the institutions will comply with the usage restrictions that will be established."

This amendment is propelling us back to the middle ages.

But we may succeed in blocking its enactment by inundating the Ministry with our objections. Here is the link for lodging your complaint. The cutoff date is March 5, 2023

The following (translated by me from the Hebrew original) is an excerpt from the response of a person diagnosed with Autism to the proposed amendment: He is non-verbal and communicates only via his keyboard:

"The thin veil of civility that has covered society since dark times is crumbling. We are a society where there are laws against abuse of the helpless, like in advanced societies in the western world. A person is no longer put in a dungeon just because he looks different and behaves differently... And suddenly, someone in the Welfare Ministry woke up, scratched his scalp and enacted a law that means: the celebration is over. Enough, you've had enough. You are the disease, and we have a cure - punishment for "bad behavior"...  Someone in the Welfare office thinks we are very spoiled and need to be restrained. It was important to him to convey to us the message that life is not therapy but survival. A jungle!" [Source: Shavvim]

Let's not abandon him and others sharing his plight.

New rule: It's alright to restrain if the victim is disabled

Doron Almog may have won the 2016 Israel Prize and amassed a horde of friends in high places. But I have photos of the bedrooms in the Jerusalem branch of ADI, a large, closed institution for children and young adults with disabilities in which he plays a lead role. They are damning.

A notice was circulated last week by the Director General of Israel's Ministry of Welfare. It's entitled (my translation from the source Hebrew) "Tools and procedures for identification, prevention and response/remedy for challenging, dangerous behavioral situations in facilities of the Disabilities Administration" 

Dated May 23, 2022 and downloadable (in Hebrew) from here, the circular formally declares the use of the "crib-beds" in which Almog's people have been been enclosing ADI's institutionalized residents to be banned.

I made an unannounced visit to ADI Jerusalem (then known as Aleh Jerusalem) in 2018. See "Making history: After the raid". During that visit, we were shown beds, one of them occupied, that are best described as "cages". The person in the bed below was photographed at 12:30 pm, the middle of the day. 

2018: Bed-cages in use at the ADI Jerusalem institutional residence

This is not to say that the Ministry of Welfare's other regulations were welcomed by defenders of the human rights of people with disabilities. In fact those with whom I was in touch were infuriated. Disturbingly wide discretion is granted to staff members in institutions to restrain the movement of residents. The regulations say they may do so "only in unusual instances, and only to prevent actual, immediate danger to a person or to another and only to the extent that is required for that purpose."

Included specifically in that carte blanche is the use of hand splints for 45 minutes; fastening to chairs during meals; and locking up and isolating residents in a "protection room" for up to an hour at a time. 

These measures may be used on anyone with disabilities aged 6 years or more, who engages in "challenging, dangerous behavior" (again my translation of the Hebrew).

The new regulations will go into effect in six months from now. Among other reasons, this is to enable institutions to prepare for their implementation.

Here's what Adv. Naama Lerner of the Movement for Independence (a group I mentioned in this earlier post a week ago) wrote in reaction to the new regulations (again my translation from the source Hebrew):

"I urge you to read this circular with great interest. It permits harsh restrictions on people in institutions with "challenging behavior". It permits fastening to a chair, isolation, tying up, in very pretty words and with 'professionalism'. For now, this is for your information. In the future we intend to act forcefully against these regulations."

Too bad all those well intentioned donors to ADI institutions have never seen these bed-cages.

A press conference isn't bad - but it's not action

Cohen (R) and Lapid (L) speak to the media

February 6, 2022 [Image Source]

In the wake of the rash of violence and abuse at the Bnei Zion institution ["Again: An institution, a scandal, a petition", February 4, 2022], a press conference was held today. 

Yair Lapid, Israel's Minister of Foreign Affairs, and Meir Cohen, Minister of Welfare, both spoke.

"We don't intend to close all the institutions tomorrow morning," said Cohen. "This is accelerated process. We will limit them. But the personal choices of the families and people with disabilities will be wider."

The event coincided with the presentation of a memorandum of a new Welfare Law for People with Disabilities, and the invitation of public comments ["New bill to legally define rights, services for disabled citizens"]. Cohen said the law is expected to ease the lives of people with disabilities.

One reporter asked Minister Cohen what steps were being taken against Gidon Shalom, head of the Disabilities Administration, in reaction to his phone conversation with a distraught mother. 

I wrote about Shalom's outrageously dismissive and disrespectful response to that same woman when she  called him to report signs of abuse she had discovered on her son at B'nei Zion. That was one full year ago.

Had he acted then as his position compels him to, then the hundreds of subsequent cases of abuse could have been averted.

Yesterday, Minister Cohen answered: 

"We're looking into it. He has been summoned. I think everyone, including us, deserves several hours to check out the matters."

I would add that everyone, including us, deserves straight talk from our politicians at long last - unambiguous, free of sand in our eyes - about the end of institutionalization in Israel.  

A clear plan of action and time-line would be a good start. This conference did not deliver any of that.

Silencing the whistleblower?

Nofer Moshe Fredo, a journalist at Kan, Israel's government TV station, tweeted what follows below and urged her followers to circulate it further. 

It highlights how brazenly ruthless facilities for people with disabilities can be. Their right to control and abuse our most vulnerable is so precious - and lucrative - they will even head to court to protect it. 

This specific instance, involving Neve Ha'Irus, about which I've written often (May 9, 2021; November 4, 2017; February 23, 2017; February 9, 2017; February 2, 2017; December 24, 2016) may confront the new Minister of Welfare, Meir Cohen, with his first real test.

It reads [my translation]:

Update on Neve Ha'Irus for the attention of the new Minister Meir Cohen. After the airing of an investigative segment on that place, among other things, about a resident who became physically disabled [due to mistreatment there] and about another one who died as a result of neglect and also about the locking of residents in the "white room", while several guards were fired and the Ministry of Welfare conducted a hearing that led to a series of procedural changes. Nevertheless, at the same time, the administration of that place decided to sue one of the employees who revealed and warned of incidents of violence against and injury to residents. They argue that he violated the privacy of residents. But don't be confused, this is a cynical lawsuit that is making use of a law intended to protect residents in order to signal to other employees that it would be worthwhile to keep quiet.

The court document, which Fredo posted, demands the following court orders:

• That the respondent be obligated to hand over all the photographs in his possession that he took of residents at Neve Ha'Irus.
• That the respondent be forbidden from using in any way either now or in the future photographs that he took at Neve Ha'Irus...

From one of my earlier Neve Ha'irus

posts - click image to enlarge [Link]

It goes on

The interest of the plaintiff [Neve Ha'Irus] and the context of the lawsuit, as detailed below, relate to the crude and serious violation of the obligations of the respondent who has a past rich in fraud and acts of deceit, towards the plaintiff.

There was more outrageous legal nonsense in Neve Ha'Irus' complaint but I'm sure you get the picture. 

It reminds me of the times I attempted to document neglect in other institutions for people with disabilities only to cop reprimands from the administration and staff for "violating the privacy of residents".

Verbal accounts, minus supportive photographs, are light on impact and accomplish little - as we all know. It remains to be seen whether the court will agree. For now, please help Nofer and circulate this further.

Israel's Ministry of Welfare is still concealing information

The ministry's Jerusalem head office [Image Source]

Here in Israel, we are still anxiously awaiting a significant drop in the upsurge of Covid-19 infections, to enable an easing of our restrictions. And to think, just a few months ago we led the world with our low Covid-19 stats.

In the meantime, the wall of silence I have hit remains intact [see "Freedom of information"]. There is no sign that our government will enlighten us about our Covid-19 victims with disabilities any time soon. 

The Ministry of Welfare (משרד העבודה הרווחה והשירותים החברתיים to give them their full and current name - translates to Ministry of Labor, Welfare and Social Services which no one ever calls them) was legally obligated to provide us with the information we seek by October 10th, under the Freedom of Information Act.

But it's a safe bet that the "check isn't even in the mail".

So we remain in the dark about "segmentation", to use the Ministry's favored term... meaning we still don't know the names of the institutions in which those victims were locked.

Not only is the public entitled to that information, for many parents of children with disabilities it is crucial.

As this pandemic stretches on, many parents are left in a quandary. Should they keep their children at home or relinquish them to institutions, as our government urges us all to do? Should they struggle to provide their children with the specialized care and therapies they need or hand them over to government subsidized, large, closed institutions where such amenities are purportedly provided?

Before Covid-19 struck, professionals the world over maligned those institutions for robbing children of the love, attention, constancy and emotional stability that every child deserves and needs. But now, in the Covid-19 era, it could well be that removing a child from his family will actually endanger his very life. 

Bear in mind that most of them are at high risk for being severely ill with the virus. It has been proven that those with neurological impairment or genetic mutations are in the high risk category.

Life in a large, closed facility with rotating care-givers is obviously not the ideal setting for avoiding Covid-19 infection.

Once the holiday season is over and this strict lockdown is eased, I hope that the Ministry of Welfare will fulfill its obligations to release the information it has been concealing for so many months.