Physical therapy services in Israel for clients with developmental disabilities from a legal perspective

Background: In Israel, physical therapy (PT) services for clients with developmental disabilities (DD) and with intellectual developmental disabilities (IDD) are based on several laws. Similar to other health services, they are provided to children 0-3 years provided at ambulatory Child Developmental Centers, at ages 3-21 years provided at special-education settings, or at the residential centers in which they live. At ages 21 years and older, clients residing in supported living centers, are treated at their place of residence, and the rest are treated in their respective communities. This study aimed to describe PT services available to clients with DD and IDD throughout the lifespan and to assess the degree to which these services are provided as intended by the legislators. Methods: This is a qualitative study using data from the websites of the Ministries of Health, Education and Social Affairs, and from personal interviews with heads of PT services in Israel. Results: All over Israel, clients with DD and IDD are entitled to receive health services, including PT, throughout their lifespan. However, physical therapy services provided by Health Maintenance Organizations (HMOs), which act under the National Health Insurance Law, are limited after the age of 3 years. The Ministry of Education's PT system mainly provides a response to clients with chronic conditions, whereas the Ministry of Social Affairs serves the entire population with IDD, in the absence of a suitable response by the HMOs. Supervision of PT services in both ministries is partial and performed within the system. Conclusions: PT services for clients with DD and IDD are provided throughout Israel and to all ages, as dictated by the law. However, the HMOs only provide services to very young clients.