Rehabilitation day center - everything you wanted to know

Parents of a toddler, who is being monitored for the child's development due to prematurity (or any other reason), and at the clinic they recommended that you place him in a rehabilitation day care center? Confused and don't know where to start?
In this article I will explain what a rehabilitation day center is, what are the considerations if yes or no,  And what should you do if you decide that it is.

Rehabilitation day care? what is it Anyway?

The rehabilitation day care center is a setting intended for toddlers between the ages of six months and three years, who need intensive developmental treatments. Most rehabilitative day care centers treat toddlers with significant developmental delay, motor and/or lip delay, or complex medical needs, which may also result from prematurity. There are also designated dormitories for specific populations: deaf and hard of hearing children, blind and visually impaired children, or children diagnosed on the autistic spectrum.
The rehabilitation day care center is for the toddler a framework of a kindergarten, where educational activities take place as in any kindergarten, on topics such as the seasons, holidays, family, etc., kindergarten meetings are held, and games are played in the playground. Unlike a regular daycare center, in this framework only 10 children fit into a kindergarten class (in special cases up to 14), and the kindergarten staff includes a special education kindergarten teacher, and up to 3 aides at the same time.
In addition to this, within the daycare center there are individual and group treatments of the health professions, in the following subjects: physical therapy, occupational therapy, speech therapy (communication clinic), parent guidance and accompaniment by a social worker, and follow-up by a nutritionist. In multidisciplinary daycare centers there is a standard of a certified nurse At all hours of the daycare center, emotional therapy is also provided in special settings for autism.
A personal treatment plan is built for each child, which is implemented by the kindergarten team in accordance with the training provided by the health professions team.

Isn't this a framework intended only for children with severe disabilities?

Not necessarily. In recent decades we see more and more children being born with diverse developmental needs. The number of applications for rehabilitation day care every year is increasing, which is why more and more facilities are being opened.

What are the advantages of a rehabilitation day care center?

1. Two birds with one stone, kindergarten and treatments together. The child comes every day to a setting that is for him a kindergarten for everything, and during the day he receives intensive treatments for his development and advancement.
2. The child is treated for 8 hours a day. It is not only about the developmental treatments of the health professions, but the kindergarten staff continues what is done in the treatments throughout the day within the kindergarten, in accordance with the therapists' training.
3. All treatments take place under one roof, which may save you time, travel and sometimes even money.
4. While the child receives the treatments he needs, during the hours he visits the facility, you can go back to leading a normal life routine, and of course work.

5. Multi-system teamwork and cooperation between the kindergarten team and the health professions team. Everyone knows the child, holds frequent team meetings about him, coordinates common methods of treatment among them, and of course is in continuous contact with the parents. 

6. The family at the center - the parents are an integral part of the care process in the kindergarten, the parents determine the goals of the care together with the kindergarten staff. And there is cooperation of the parents with the kindergarten team - educational and therapeutic. The team is in continuous contact with you for the purpose of promoting the child's development.

And what are the disadvantages?

1. You cannot know what the level of functioning of other children in the daycare class will be, compared to your child. Sometimes the division into kindergarten classes is done according to age group, and not necessarily according to level of functioning, but as mentioned, a personal plan is built for each child according to his ability, so it is usually possible to overcome this.

2. The frame will not always be close to the house. Sometimes it will even be far away, either because of a lack of space in closer settings (especially if the placement is in the middle of a school year), or because it is a daycare that provides services to a specific population, such as deaf and hard of hearing toddlers, or the blind and visually impaired. These dedicated dormitories are less common. Even this disadvantage can be overcome, because Regardless of whether the facility is close to home or not, the toddler is entitled to special transportation from his home to the facility, back and forth.

But how will I send my little son in a transport?

It sounds scary, but it really doesn't have to be. Many toddlers are taken to the dormitory by shuttles every day. In the transportation, there is an attendant attached, whose role is to take care of the child's safety and needs during the transportation. The attendant has often been trained for her role by the local authority, and has even participated in a CPR course.

Who finances the toddler's visits to daycare?

Ministry of Social Affairs, with self-participation on the part of the parents. The amount of the deductible will be determined by the local welfare office, depending on the family's financial situation, and is the same as the amount that would be paid for a regular residence of a Vizo, Naamat or Emunah.
The cost of the treatments of the health professions, a dietician and the nurse in the residence is financed by the health fund/the Ministry of Health.


Am I obligated to send my son/daughter to a rehabilitation day care center?

The answer is no. The decision whether to place the child in a rehabilitation day care center is yours, the parents, or for that matter, the guardian in charge of the child. If you are interested, and are able to do so in terms of your daily routine, you can choose to leave the child at home, or send him/her to a regular daycare near home (in some cases you will be entitled to personal assistance at the regular daycare). You can have the treatments of the health professions within the child development clinic, or in the community, financed by the health insurance fund. In this case, you will be entitled to treatment once a week for each profession, during which you will receive training for daily application at home.

I want to enroll my son/daughter in a rehabilitation day care center. What are we doing?

A necessary condition for admission to a rehabilitation day care center is the toddler's eligibility to receive a disabled child's benefit, for this you must contact the National Insurance Institute, with a claim for a disabled child's benefit. The claim can be submitted manually, or online through the website of the National Insurance Institute. You must fill out a "Claim to receive a disabled child's benefit" form, attach the recommendations from the child's development, and any other relevant medical documents, in accordance with the institution's requirement (the details of the required documents appear on the National Insurance website, depending on the type of disability).

Disabled child benefit? But my child is not "disabled.""!

The disabled child benefit is not necessarily intended only for a child with a physical disability, but also for a child with special needs that are not visible to the eye. It is important to remember that this is a concept defined by the state  Decades ago, and before the demand for rehabilitative day care centers increased. Today in Israel there are tens of thousands of children who are entitled to this benefit. My advice is not to get excited about this concept, but to treat it as another milestone towards your child's progress.
At the same time as applying to the National Insurance, you must contact the welfare office closest to your home, and contact the social worker who takes care of you. If you don't have a case at the welfare office, now is the time to open one.


Is receiving a disabled child benefit really necessary for placement in a rehabilitation day care center??

Usually yes. At the same time, there are certain cases in which the child is not entitled to receive a disabled child benefit, but needs intensive medical and developmental treatments. In these cases, the family attorney can contact the Ministry of Health, with a request to exceptionally confirm eligibility for a rehabilitation day care center. You can contact the social worker with a request to check eligibility in this case.

Why should we contact the welfare office? We are not a family that needs welfare services

Indeed, the welfare bureau helps low-income families, but it also helps in many other areas. Every welfare office has social workers whose job it is to help families with children or adults with special needs. Such families are not necessarily poor, they can be families in an average and even established economic situation.
When you contact the social worker, you must provide her with the recommendation from the child's development, confirmation of eligibility for a disabled child's benefit from National Insurance (after you receive it), and other relevant medical documents. The social worker will contact the district supervision at the Ministry of Welfare, and will submit an application to the placement committee for a rehabilitation day care center.

What happens in the placement committee?

The placement committee includes district representatives from the Ministry of Welfare, a developmental doctor,  Relevant professionals and parent representatives. You, the parents, will also be invited to the placement committee, and you can tell the committee representatives about your child, in order for them to get to know him properly, thus helping them adjust the framework for him.

Can I decide which daycare center my son will join??

The representatives of the placement committee decide where your child will be placed, according to the degree of proximity to home, and the number of available places within the framework, however, there is an open discussion, where you can request a specific framework that you want, and they will do their best to consider your request if possible.   If you are still not satisfied with the placement, there is the possibility to file an appeal. 

I was placed in a rehabilitation day care center for my son. What now?

The daycare attorney or the director of the daycare center will contact you when they receive the notification of the placement committee's decision to place your child with them. They will invite you to an introductory meeting, tell you about the setting, and ask to get to know you and the child. My daughter has been in the rehabilitation daycare center for many months, making over To be expected, and it seems to me that she is now suitable for a regular daycare.

Can I move her to a regular daycare center next school year??

Certainly, as long as she is still at the appropriate age for daycare (under 3). It is important to consult with the daycare staff who care for your daughter and know her, and to hear their opinion on this, and it is even desirable to coordinate positions, but the decision is ultimately yours.

In conclusion: it is important that every decision you make should consider the best interests of the child, as well as your best interests as a family. Even if you find it hard to believe it, in the end you are the ones who know your child well, and you will know what is good for him.

Written by Dana Weingarten-Private social worker which accompanies families in medical crises and special needs, dealing with the bureaucracy and exhausting rights.
Dana is the mother of a premature child and a child with special needs, with extensive experience in rehabilitation day care centers, both as a social worker and as a mother 054-5827482

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