Doing the right thing

Research has found that people with disabilities, including those with the most severe disabilities, do better in all areas of life when they live in homes rather than institutions.

Disabled child in special wheelchair 370 (photo credit: Courtesy Chimes)
Disabled child in special wheelchair 370
(photo credit: Courtesy Chimes)
The minister of welfare and social services, Meir Cohen, recently decided to close down the San Simon institution in Jerusalem for people with physical disabilities. This is good news, especially for the dozens of people who lived there under dangerous conditions. But it will take more than closing this one institution for Israel to show its support for the right of people with disabilities to be treated as equal citizens.
Throughout the world, countries are closing institutions for children and adults with disabilities. Italy has closed all of its mental institutions; the US has drastically reduced the number of its institutions; and, in Europe too, institutions are closing.
The European Court of Human rights last year declared that the institutionalization of people with disabilities can constitute cruel and inhumane treatment in violation of human rights law, and the US Supreme Court has declared that institutionalization can amount to illegal discrimination in violation of the Americans with Disabilities Act.
There is now a worldwide campaign to end the institutionalization of children, mounted by Disability Rights International.
The trend of closing institutions and instead developing housing in the community for people with all types of disabilities is caused by several factors. First, professionals throughout the world agree that living in a homelike setting is preferable to living in an institution.
Research has found that people with disabilities, including those with the most severe disabilities, do better in all areas of life when they live in homes rather than institutions.
Second, people with disabilities, their families and their supporters have shown that living in the community is more respectful of rights and dignity than living in institutions where residents are told when to get up, when to go to sleep, what they will do each day and with whom they will share a room.
Third, government officials and policy makers are realizing that living in the community has financial advantages over maintaining large and often remote institutions. Yet Israel has continued its policy of institutionalization. The Israeli government claims it cannot afford homes in the community for everyone who needs one and that institutions are more cost effective. But that is not the case, as numerous studies worldwide have shown.
Even Israel’s own Brookdale Institute found that small, homelike settings are more cost effective than large institutions. Why then, despite the overwhelming evidence establishing the social and economic benefits of community living, does the Israeli government continue to support institutions? Perhaps it is because of the Israeli impulse to care for children and adults whom the government decides cannot take care of themselves.
But this attitude contradicts the rights of people with disabilities and deprives them of their dignity and their ability to become part of Israeli society. The government could and should divert funds from institutions and support the right of people to live in the community.
In September 2012, Israel ratified the UN Convention for Rights of People with Disabilities (CRPD). This Convention is the most comprehensive international law on the rights of people with disabilities. It was drafted with input from the Israeli government and organizations such as Bizchut. The CRPD affirms the right of all people with disabilities to be treated on an equal basis with others in all areas of life. It requires Israel and all the other 132 countries that have ratified it to date to provide support to people with disabilities in homes in the community.
The CRPD recognizes “the equal right of all persons with disabilities to live in the community, with choices equal to others” and that state parties such as Israel, “shall take effective and appropriate measures to facilitate the full enjoyment by persons with disabilities of this right and their full inclusion and participation in the community.”
Yet the Israeli government refuses to create the necessary opportunities for community living that the new treaty (as well as Israel’s own domestic laws) require. Children and adults with disabilities are forced to stay in institutions since their government claims there are no other options.
But there are other options, and the government knows they exist.
The Israel Unlimited Project – a partnership of the government of Israel, Ruderman Family Foundation and the American Jewish Joint Distribution Committee (JDC), supports some excellent community housing programs for people in various neighborhoods throughout Israel, as does the Health Ministry. Welfare and Social Services Ministry officials and staff also have visited model housing programs in New York City and Boston, on a study tour that I helped to arrange in 2010. These are programs that support people to live in housing like yours and mine, and they are cost effective, too.
IT IS time for Israel to follow through on its legal commitment to its citizens.
First, Israel must simply stop the admission of children and adults to institutions. This could be done tomorrow – Israel has the funds and the expertise. Second, Israel must begin to invest more in housing in the community for people with disabilities and to integrate people with disabilities in existing housing.
There is a serious shortage of housing in some areas of Israel. But when new housing gets built (and it will), the government should make sure that at least some of those units are fully accessible and available for people with disabilities. In terms of existing housing, the Welfare and Social Services Ministry already offer some apartments in the community.
They know how to do it; they just need to do more of it.
Third, the government has to begin to close institutions now or at least develop and implement a plan for their closure.
Israel claims to support community living for all people with disabilities “with choices equal to others.”
That is what its ratification of the CRPD means. The right to live in the community does not guarantee the right to a particular home in a particular neighborhood, nor does it mean having to work alone.
But it does mean the right to live in a home and with the necessary support.
It is time for the new ministers of health and welfare and social services to act. During the recent elections, they both promised that “there is a future” (Yesh Atid). It is time for them to show that this future includes people with disabilities living in homes like the rest of us, as required by Israeli law. The Israeli government should stop hiding behind excuses. All people – with and without disabilities – have the right to live in homes in the community.
That is what the law requires; it is also the right thing to do.
The author is the Syracuse University College of Law’s Bond, Schoeneck & King Distinguished Professor of Law.
She founded and directs the College of Law’s Disability Law and Policy Program.
She has served as a consultant to Bizchut, JDC Israel’s Unlimited Project, Israel’s Commission in Equality for People with Disabilities (the Netzivut) and the National Insurance Institute (Bituach Leumi).