Are you parents of a toddler whose child's development is being monitored due to prematurity (or any other reason), and the clinic has recommended that you place him in a rehabilitative daycare? Are you confused and don't know where to start?
In this article I will explain what a rehabilitation daycare is, what the considerations are if it is or not,  And what should you do if you decide yes?
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Rehabilitation daycare? What is it anyway?

A rehabilitative daycare is a setting designed for toddlers between the ages of six months and three years, who need intensive developmental treatments. Most rehabilitative daycares treat toddlers with significant developmental delays, motor and/or language delays, or complex medical needs, which may also result from premature births. There are also designated daycares for specific populations: deaf and hard of hearing children, blind and visually impaired children, or children diagnosed on the autistic spectrum.
The rehabilitation daycare center is a kindergarten setting for the toddler, where educational activities take place like 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 setting only 10 children are included in a kindergarten class (in special cases up to 14), and the kindergarten staff includes a special education kindergarten teacher and up to 3 assistants at a time.
In addition, the daycare center provides individual and group treatments from health professionals in the following areas: physiotherapy, occupational therapy, speech therapy (communication clinician), parent guidance and support from a social worker, and monitoring by a nutritionist. In multidisciplinary daycare centers, there is a certified nurse present at all hours of the daycare center. In specialized autism settings, emotional therapy is also provided.
A personal treatment plan is developed for each child, which is implemented by the kindergarten staff in accordance with instructions from the health care team.

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

Not necessarily. In recent decades, we have seen more and more children being born with diverse developmental needs. The number of requests for rehabilitative day care centers is increasing every year, which is why more and more facilities are opening.

What are the benefits of a rehabilitation daycare?

1. Kill two birds with one stone, kindergarten and therapy together. The child comes every day to a setting that is essentially kindergarten for him, and during the day he receives intensive therapy for his development and advancement.
2. The child is treated for 8 hours a day. This is not just about the developmental treatments of the health professions, but the kindergarten staff continues the treatments throughout the day within the kindergarten, in accordance with the caregivers' instructions.
3. All treatments take place under one roof, which may save you time, travel, and sometimes even money.
4. While the child is receiving the treatments he needs, during the hours he visits the facility, you can return to a normal routine, and of course work.

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

6. The family is at the center – parents are an integral part of the care process in the kindergarten. Parents determine the goals of care together with the kindergarten staff. And there is cooperation between the parents and the kindergarten staff – educational and therapeutic. The staff is in continuous contact with you to promote the child's development.

And what are the disadvantages?

1. You have no way of knowing what the level of functioning of other children in the daycare class will be, compared to your child. Sometimes the division into daycare classes is done according to age group, and not necessarily according to Level of functioning, however, as mentioned, a personal plan is built for each child according to their ability, so this can usually be overcome.

2. The setting will not always be close to home. Sometimes it will even be far away, either due to a lack of space in closer settings (especially if the placement is made 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 blind and visually impaired children. These designated daycares are less common. This disadvantage can also be overcome, because Whether the setting is close to home or not, the toddler is entitled to special transportation from his home to the setting, back and forth.

But how will I send my son, who is so young, on a shuttle?

It sounds scary, but it really doesn't have to be that way. Many toddlers are transported to daycare by shuttle bus every day. The shuttle bus has a close companion, whose job is to ensure the child's safety and needs during the trip. The companion has usually been trained for her role by the local authority, and has even attended a CPR course.

Who finances the toddler's visits to the daycare?

The Ministry of Social Welfare, with a co-payment from the parents. The co-payment amount will be determined by the local social welfare office, depending on the family's financial situation, and is the same as the amount they would pay for a regular daycare center run by Yitzchok, Naamat, or Emunah.
The cost of treatments by the health professionals, dietitian and nurse at the residence is funded by the health insurance fund/Ministry of Health.

Am I obligated to send my son/daughter to a rehabilitation daycare?

The answer is no. The decision whether to place your 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 keep your child at home, or send him/her to a regular day care center near your home (in certain cases you will be entitled to a personal assistant at the regular day care center). You can have the health professions' treatments carried out within the framework of the child development clinic, or in the community, funded by the health insurance fund. In this case, you will be entitled to treatment once a week for each profession, and during the treatment you will receive guidance for daily implementation at home.

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

A prerequisite for admission to a rehabilitation daycare is the toddler's eligibility to receive a disabled child benefit. To do this, you must contact the National Insurance Institute with a claim for a disabled child benefit. The claim can be submitted manually, or online via the National Insurance Institute's website. You must fill out a "Claim for a Disabled Child Benefit" form, attach the recommendations from the child's development, and any other relevant medical documents, in accordance with the institution's requirements (a breakdown of the required documents appears on the National Insurance Institute website, depending on the type of disability).

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

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. It is important to remember that this is a concept defined by the state.  Decades ago, and before the demand for rehabilitative daycares increased. Today, there are tens of thousands of children in Israel who are eligible for 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 National Insurance, you should contact the welfare office closest to your home and contact the social worker who is treating you. If you do not have a file with 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??

Generally yes. However, there are certain cases in which the child is not eligible to receive a disabled child benefit, but needs intensive medical and developmental treatments. In these cases, the family social worker can contact the Ministry of Health, requesting exceptional approval of eligibility for a rehabilitation day care center. You can contact the social worker to request an eligibility check in this case..

Why should we contact the welfare office? We are not a family in need of welfare services.

Indeed, the Welfare Office helps low-income families, but it also helps in many other areas. Every Welfare Office has social workers whose job is to help families with children or adults with special needs. Such families are not necessarily low-income; they can be families in an average or even well-off financial situation..
When contacting the social worker, you must provide her with the recommendation from the child development department, confirmation of eligibility for a disabled child benefit from the National Insurance Institute (once you receive it), and other relevant medical documents. The social worker will contact the district supervisor at the Ministry of Social Affairs, and 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 Social Affairs, a developmental physician,  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, so that they can get to know him appropriately, and thus help them adjust the framework for him..

Can I decide which daycare my son will attend??

The placement committee representatives decide where your child will be placed, based on proximity to home and the number of available places in the setting, but there is an open discussion, where you can request a specific setting you want, and they will do their best to consider your request to the extent possible..   If you are still not satisfied with the placement, you have the option to file an appeal. 

I received a placement in a rehabilitation daycare for my son. What now??

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

Can I transfer her to a regular daycare next school year??

Certainly, as long as she is still of the appropriate age for daycare (under 3 years old). 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 considers the best interests of your child, and your own as a family. Even if you find it hard to believe, in the end, you are the one who knows your child best and will know what is best for them..

Written by Dana Weingarten-Private social worker Accompanying families in medical crises and special needs, dealing with bureaucracy and exercising rights.
Dana is a mother of a premature baby and a child with special needs, with extensive experience in rehabilitative daycares, both as a social worker and as a mother.. 

danaweingaretn@gmail.com 054-5827482