Israel Education 

In conducting this research, it has become apparent that Israel has the best options for housing the disabled. The housing locations are set up to serve all the needs of the disabled people, including shelter, employment, counseling, and family support. 

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Similarly to here in the United States, in the past two decades there has been a push for those with mental disabilities to be discharged from hospitals and return to the community. There was collaboration between social activists, mental health experts, and legislators, and the Rehabilitation of the Mentally Disabled in the Community Law of 2001 was passed. The law dictates that people with a level of 40% or more of psychiatric disability are entitled to a “basket” of rehabilitation services. This basket includes different levels of housing and support staff. At the lower end are rental apartments for 1 to 3 tenants, with regular visits from a staff member. At the opposite end are hostels housing 20 to 30 people with staff present 24 hours per day seven days per week. At present, 60% of those receiving housing services are in supported apartments and 40% are in hostels. These rehabilitation services have been shown to improve outcomes for psychiatric patients, but only about half the people referred for these services used them. Still, there has been a great increase over time of people participating in rehabilitation services. Before the law, 4600 people use the services. In 2008, the number climbed to 16,000. 

The question of housing alternatives in Israel is like the age-old glass half empty or half full. Though I thought Israel had a good range of services, there are those who feel differently. Avital Sandler-Loeff is one of those people. She is the director of the JDC-Israel Unlimited, and oversees the development of inclusion services for people with disabilities. She states “there are some 1 million adults with disabilities living in Israel, with approximately 10,000 living in institutions and nursing homes. This might sound like very few people, but once you compare the numbers to the US, for example, it is a completely different picture…In the US, they have the option to choose between living in institutions and living in the community with supportive services that allow them to integrate into society… We have a long way to go to allow people with disabilities to live in a respectable manner in a community to allow them this alternative.” 

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To this end, JDC-Israel Unlimited began a pilot program of supported housing two years ago. The program operated sites in three locations – Western Galilee, Ramat Gan, and Ashdod. The goal was to assess the feasibility of a supported housing network in Israel. The program would provide assistance for people with disabilities to transition from their parents’ homes or institutions. 

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The program would be individualized, and each person would have a case manager and a life skills coach. The pilot program was a success, and in 2015 it expanded to nine locations. As Sandler-Loeff noted, the program not only benefits the disabled population. It is also cost effective compared to care in institutions. 

Nonetheless, there are some obstacles. In Israel, like here, there is a NIMBY attitude. Shira Ruderman, of the Ruderman Family Foundation, said that public attitudes often go against inclusion of the disabled in their communities. She has found more support for supported housing recently and is optimistic that it will continue. “My hope is that this will soon become the normative approach in Israeli society.” 

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Although most of the housing facilities are for disabled adults, there are some children in residential care centers. As Merrick et al tell us, children with severe disabilities were historically persecuted. Religious or charitable organizations set up shelters to protect these children. The first residence for children with intellectual disabilities was opened in Jerusalem in 1931. The Division of Mental Retardation now treats 30,000 people, and 7000 of them are housed in 63 facilities. Besides providing care to the individuals, these facilities provide support to parents and healthcare professionals. In line with the trend toward deinstitutionalization, the number of children in residential facilities has steadily declined since 1999. 

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There are a number of noteworthy programs that are currently providing care for disabled adults in the community. One of these is Israel Elwyn’s Community Living Services. The agency was set up to provide individualized support services to adults 21 and older with developmental disabilities. Some of the clients have physical disabilities as well. Israel Elwyn has six apartment and a group home in Jerusalem, and three apartments in Herzilya. All residents work in the morning. Depending on their level of functioning, this might be an adult day center or supported employment in the community. In the afternoons, they have a choice of recreational activities. To take part in this program, one must apply to the social worker in their local municipal welfare office. After evaluation, if accepted, Israel Elwyn conducts its own acceptance process, including a home visit to determine the individual’s specific needs. 

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Israel Elwyn also operates Supported Living Services. This is actually a network of three centers. Each center has its own director, case managers, support staff, and therapists. There is also a work center where residents learn basic skills and appropriate behavior. One of the centers serves 70 adults with severe developmental disabilities. The second serves 90 older adolescents and adults with severe to moderate disabilities, as well as behavior problems. The third center houses 89 adults with moderate developmental disabilities; most are senior citizens. 

Care is provided in a very different environment by Kfar Rafael. This is a rural community for adults with disabilities. They live in group homes with host families. The community strives to provide all the best for the residence. This includes integrating them socially into the community, as well as providing a healthy lifestyle, nutritious meals, and physical activity. 

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To reside in this village, one must apply to the Division for the Provision of Treatment Services for Individuals with Developmental Disabilities in the Ministry of Social Affairs. 

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The staff of Kfar Rafael describe three housing options for adults with developmental disabilities. The first is to remain at home with the parents. But as parents age, it may become harder to provide necessary care. Then it may be harder for the disabled person to adapt to another housing setting. 

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The second option is community housing. This is usually a group home in the city, usually with sheltered employment. Though it provides close to a “normal” life, there is limited supervision. 

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The Kfar Rafael staff aim to combine the best of both settings. They provide a “normal” life in a protected setting.