Israel Considers Overhauling Autism Services, Potentially Affecting Benefits

A professional committee, led by Nir Kedar, Director General of the Taub Center, has proposed significant changes to how Israel diagnoses and supports children on the autism spectrum. The recommendations aim to shift the responsibility for private diagnoses to health maintenance organizations (HMOs) and move away from the current model where all children diagnosed with autism receive the same package of services, regardless of their individual functioning levels and needs.

These proposals come in response to a dramatic increase in state spending on disability benefits for children with autism. National Insurance benefit expenditures for these children have surged from NIS 1 billion in 2013 to an estimated NIS 9 billion in 2025, with projections reaching NIS 18 billion by 2030. Concurrently, the number of autistic children in Israel has grown by 490% since 2013, an exceptionally high rate internationally.

The committee highlights that the current eligibility system is primarily based on the diagnosis itself rather than the child's actual needs. This often results in children with higher functioning levels receiving extensive benefits, while those with more complex difficulties may not get the necessary support due to a shortage of professionals. The proposed solution is a tiered model where each child's needs are assessed across six different areas to determine their tailored package of treatments and services.

Under the new model, children requiring more significant support could receive more services, while those with fewer needs would get a smaller, adapted package. The committee also recommends that HMOs take over diagnostics, effectively ending the current system where private diagnoses determine public eligibility and eliminating reimbursements for private treatments. The implementation would require substantial budget increases to attract professionals to the public system, with a gradual rollout starting with younger children and complex cases.

While the committee, initiated by Ministry of Health Director General Moshe Bar Siman Tov, does not directly set National Insurance benefit amounts, its recommendations could influence them. The proposals also suggest that all public bodies, including the National Insurance Institute, Ministry of Health, Ministry of Education, and Ministry of Welfare, should rely on a single, mandatory diagnosis instead of requiring separate assessments. However, these are recommendations that still require government adoption and decisions, and the timeline for implementation remains unclear.