Houston County Schools Policy Regarding Homebound Services (Updated 2013) 1
Superintendent Date: 2
Houston County Schools Policy Regarding Homebound Services In accordance with School Board Policy, Houston County Schools provides homebound instruction as a service to students who are not able to attend school for medical and/or mental health reasons. Homebound services are designed to provide continuity of educational services between the classroom and home or hospital for students currently enrolled in Houston County Schools whose medical needs, either physical or psychiatric, do not allow them to attend school for a limited period of time. If a student s anticipated duration of absence from school exceeds 3 weeks, the student will be eligible to request services under these provisions of these procedures. Homebound services are not intended to supplant regular school services and are, by design, temporary. The purpose of homebound instruction is to help students keep up with their work even though they are unable to attend school or have been excluded from school for disciplinary reasons. IEP/504 teams may, in accordance with state and federal guidelines, remove a student from regular attendance and place them on homebound services. To be considered for homebound services, a student s parent/guardian must present written documentation from a licensed physician or psychiatrist who is currently treating the student for the diagnosis presented prior to consideration for services. In addition, a student may become eligible for homebound services based upon a finding by the student s Individualized Education Program (IEP) or 504 Team that homebound services are necessary and appropriate for the students. In all cases where a student is placed on homebound instruction, the appropriate Committee/Team shall provide a copy of IDEA procedural safeguards to students with IEPs and a 504 Form C to parents of all other students. 3
Houston County Schools shall provide homebound instruction to students with and without disabilities. In accordance with appropriate state and federal provisions, Houston County Schools will provide homebound services based upon the following guidelines: Eligibility: 1. The student must be currently enrolled in Houston County Schools. Private or home school students are NOT eligible for homebound services from Houston County Schools. 2. In the case of a student not otherwise in need of special education and related services or services under Section 504, homebound or hospitalized instruction shall maintain the continuity of the student s regular program. The requirements of the IEP development or 504 Plan development shall not apply and a district-level Homebound Services Committee shall coordinate these services through the school-level counselor based on his/her individual needs. 3. In the case of a child receiving special education and related services or services under Section 504, the IEP Team/504 Team shall, where necessary, modify the individualized education program and its instructional goals and objectives as necessary and in accordance with all state and federal provisions to reflect the need for and provision of homebound services. 4. The student must have a medical and/or psychiatric condition that is documented by a physician licensed by the State of Alabama. Only a psychiatrist can submit a medical request form for an emotional or psychiatric disorder. The psychiatric condition presented must be listed in the latest edition of the Diagnostic and Statistical Manual (DSM). The referring licensed physician and/or licensed psychiatrist must be treating the student for the condition for which the student is requesting homebound services. 5. Students who have any form of influenza or other airborne contagious diseases will not be provided services until the licensed physician certifies that the student is no longer infectious. 6. Houston County Schools may require the parent, guardian, emancipated minor, or student over the age of 18 to sign the HIPAA form relating to the reason for the request 4
for homebound services. If the HIPAA form is required, it must be submitted before services can be provided. 7. In order to extend homebound services beyond the originally identified return to school date, the licensed physician or licensed psychiatrist must submit an updated medial referral request form. Application Process: The school counselor shall be the initial contact for parents requesting homebound instruction for students. The counselor will provide information regarding the policies, procedures, and the application process. 1. The parent should contact the school counselor to obtain an application for homebound services. 2. The parent should read and sign the Statement of Understanding of Homebound Policies. 3. The parent should take the Physician s Statement to the licensed physician or licensed psychiatrist treating the student for the medical condition. The completed statement must be returned to the school counselor. An incomplete application may cause a delay in services. Only the original paperwork will be accepted as application for homebound services. 4. The school counselor will review the documents to ensure that the student meets the minimal eligibility requirements and submit the documents to the system personnel in the Office of Special Education at the district office for action. 5. The school counselor will also forward the documents to the IEP team for special education students. An IEP meeting will be held to discuss homebound services, necessary placement changes, and accommodations/modifications recommended by the licensed physician or licensed psychiatrist. 5
6. If the doctor does not address re-entry on the medical form, the staff will contact the doctor directly. 7. Once the packet is completed, the District Homebound Services Committee shall meet and review the referral. If the committee approves the referral, the Director of Homebound Services at the district level shall complete a Notice of Homebound Instruction and forward copies to the parent, the principal of the child s school, the guidance counselor at the child s school, and any other individuals who may require a copy. 8. The guidance counselor will meet with the parent to provide a copy of the district s 504 Parental Rights. Homebound will be governed by a Homebound Services Plan, which will fall under the procedural requirements of the district s Section 504 policy. 9. The guidance counselor and principal shall make arrangements with a teacher who can deliver homebound services to the student. The teacher will complete a Contract for Provision of Homebound Services prior to delivery of any instructional services. 10. To comply with state and federal standards and to meet attendance requirements, a minimum of three hours of instruction per week must be provided. Attendance and Scheduling: 1. If the student is unable to receive homebound instruction during the school week due to his or her medical condition, the school may, at the school s discretion, schedule a make-up session. 2. The time of the instructional session shall be arranged by the homebound teacher in cooperation with the parent or guardian. The time of instruction may occur during the school day or after school hours. 3. The parent, guardian, or pre-approved adult designee must be present at the student s home (if instruction is being provided in the home) during the entire instructional period. If an adult is not present at the time of the scheduled sessions or leaves the home at any time during the scheduled session, that session shall be considered cancelled without notice. 6
Instructional Delivery: 1. Homebound teachers must hold a valid Alabama teacher s certificate. 2. Homebound instruction can be offered on a one-to-one basis or in a small group. Services may be offered at the home of the student, at the health care facility where the student is confined, through online learning courses, or at the school during or after hours of operation. 3. Other locations that may be considered are as follows: public libraries, community centers, police departments, municipal buildings, etc. 4. If instruction is provided in the student s home, the following must be provided: a table/desk in a work space that is well ventilated, smoke-free, clean, and quiet. The area must be free from distractions such as radios, televisions, pets, visitors, siblings, etc. A schedule for student study time between teacher visits should be established and the student should be prepared for each session with the teacher. 5. For students participating in online learning courses, the homebound teacher may facilitate the learning process, monitor testing, collect/monitor assignments, and provide tutoring. Participation in an online course will meet the requirement of a minimum of three hours of homebound instruction per week. 6. The homebound teachers shall provide direct delivery of the materials provided by the student s classroom teacher. The classroom teacher is required to provide to the homebound teacher a course syllabus, assignments, tests, and any supplementary materials in a timely manner. Completed work must be submitted weekly. Assignments will be checked/graded by the regular classroom teacher. 7. All state mandated tests shall be administered during the designated testing period. The student will report to the school to take state mandated tests. Any alteration to these guidelines may require prior approval. Exception: The student is approved to take the Alabama Alternate Assessment as stipulated by his or her IEP. There may be times that 7
the student is unable to attend school for the state mandated tests, but prior approval for these rare situations must be given by the ALSDE. 8. Homebound instructional delivery shall focus on the core subjects (Reading/ Language Arts, Mathematics, Science, and Social Studies). For high school students, elective courses and those required courses determined based upon the specific diploma option must be completed for credit to be awarded. 9. The homebound student shall use instructional materials issued by the student s classroom teachers. The parent shall be responsible for obtaining all of the student s books from the school prior to the first homebound session. 10. Although the homebound instructor shall be limited to meeting with the student for the determined number of hours per week, the student will be responsible for completing assignments independently and returning all assignments to the homebound teacher at the designated time. Failure to complete assignments by specified due dates will adversely affect the student s academic grade. Failure to complete assignments could result in the student s failure of course(s) or grade level. Termination of Services: 1. A student is released from homebound instruction when: a. The projected return date on the original application is reached. b. The licensed physician or licensed psychiatrist indicates the medical condition has changed so that the student is eligible for re-entry into school. c. The student is employed in any capacity, goes on vacation, regularly participates in extracurricular activities, or is no longer confined to home. d. The regular school year ends. e. The student is able to return to school or is able to return to school for any portion of the school day other than to participate in state-mandated testing. f. The parent/guardian/student cancels three homebound instructional sessions without a doctor s excuse or without providing 24 hours of notice. 8
g. The conditions of the location where homebound services are provided are not conducive for instruction, or threaten the health and welfare of the homebound teacher. h. The student fails to comply with homebound regulations. 9
Houston County Schools Homebound Plan Student Information: Homebound Services Request Form (To be completed by parent/guardian) Student Name: Address: Gender: Date of Birth: Parent/Guardian: Phone (h): (w): (cell): (cell): School Name: Grade: Counselor: Do you have a computer with Internet access at the instructional location? Yes No Do you have a computer at home? Yes No 10
Do you have Internet access at home? Yes No Student Email Address: Parent Email Address: Houston County Schools Homebound Plan Parent/Guardian Agreement for Homebound Services Cause for dismissal: A student is released from homebound instruction when: i. The projected return date on the original application is reached. j. The licensed physician or licensed psychiatrist indicates the medial condition has changed so that the student is eligible for re-entry into school. k. The student is employed in any capacity, goes on vacation, regularly participates in extracurricular activities, or is no longer confined to home. l. The regular school year ends. m. The student is able to return to school or is able to return to school for any portion of the school day other than to participate in state-mandated testing. n. The parent/guardian/student cancels three homebound instructional sessions without a doctor s excuse or without providing 24 hours of notice. o. The conditions of the location where homebound services are provided are not conducive for instruction, or threaten the health and welfare of the homebound teacher. p. The student fails to comply with homebound regulations. I have read the homebound services policies for program eligibility and I understand the reasons for possible dismissal from the program. I agree to the policies and requirements for the program and request homebound services for my child. 11
Parent/Guardian Printed Name: Date: Parent/Guardian Signature: 12
Houston County Schools Homebound Plan Authorization for Exchange of Health and Educational Information (The Health Insurance Portability and Accountability Act--HIPAA) System Name: Houston County Schools Address: 404 West Washington Street Dothan, Alabama 36301 Phone: 334-792-8331 Fax: 334-673-8991 Student Information Student Name: Address: M ( ) F ( ) Date of Birth: Parent/Guardian: School Name: Grade: I hereby authorize and Houston County Schools, located at 404 West Washington Street, to exchange health and educational information/records. Authorization: I understand that I may revoke this authorization at any time by submitting written notice of the withdrawal of my consent. I recognize that health records, once received by the local education agency (LEA) may no longer be protected by HIPAA, but they will become educational records protected by the Family Educational Rights and Privacy Act (FERPA). Parent/Guardian Signature: Date: 13
Houston County Schools Homebound Plan Licensed Physician/Psychiatrist Statement and Medical Referral Form (Note: This form must be completed by a physician or psychiatrist licensed by the State of Alabama) Physician/Psychiatrist Name: AL License #: Address: Phone Number: Fax Number: Student Information Student s Name: Address: Male ( ) Female ( ) Student s Date of Birth: Parent/Guardian: Phone: (H) (W) (C) Physician/Psychiatrist Statement and Diagnosis: Patient s Diagnosis: (Please Include a description of the condition) 14
Duration of Homebound Services: Starting Date: Ending Date: Date of Initial Evaluation: Date of Next Scheduled Appointment: Physician s Statement: (Please answer the following questions keeping in mind that the least restrictive environment is preferred). Is the student unable to attend school? Yes ( ) No ( ) Will the student be able to benefit from an instructional program during this time of confinement? Yes ( ) No ( ) Could the student attend school with accommodations? If so, describe. Yes ( ) No ( ) Recommendations for Accommodations: Could the student attend school regularly and receive homebound services on an intermittent basis as needed? Yes ( ) No ( ) Is the student confined to the home or hospital and full-time homebound services are recommended? Yes ( ) No ( ) Is the student free from communicable diseases or contagious airborne illnesses? Yes ( ) No ( ) 15
Can instruction be provided to the student without endangering the health of the teacher or other students whom the teacher may contact? Yes ( ) No ( ) Treatment and School Reentry Plan (The following information is required to determine eligibility for homebound services and must be completed by the licensed physician or licensed psychiatrist who is currently treating the student for the diagnosis presented.) What is the scheduled frequency of treatment/therapy for this student? ( ) Daily ( ) Weekly ( ) Monthly What is the expected duration of the treatment/therapy? Will the student take medication? Yes ( ) No ( ) Medications student will take for diagnosis: Name of Medication Effects on student s Effects on student s Effects on student s ability to comprehend ability to complete ability to relate to independent teachers and other assignments students 16
Could this student return to school on an intermittent basis after his or her medication and condition is stabilized? Yes ( ) No ( ) Can this student come into contact with other students? Yes ( ) No ( ) To Physician: The homebound services program is designed to be a temporary educational program (for a minimum of 3 hours per week) to help students who are unable to attend school for medical or psychiatric reasons. Please describe your time frame and transitional plan for the student s reentry to school. Physician s Certification: I certify that this student is under my care and treatment for the listed medical condition. My recommendation has been based on the medical needs of the patient, keeping in mind that the student s least restrictive environment is preferred. Physician s Printed Name: Date: 17
Houston County Schools Homebound Plan Contract for Provision of Homebound/Educational Service Plan for Student Receiving Homebound Services (To be kept in the student s school records) Student Name: Grade: School Name: Guidance Counselor: Number of days student has been absent to date during current school year: Current Course Schedule: Subject Recent/Current Accommodations needed: Regular Teacher s Grade Name Instruction: Begin Date: End Date: 18
Location: Home ( ) Hospital ( ) Other ( ) Specify: Number of hours per week direct instruction will be provided: Certified Teacher providing Homebound Services: Houston County Schools Notification of Homebound Instruction Student s Name: Date: School: Current Grade Level: Anticipated length of Homebound Instruction: Your child has been found eligible for homebound instruction through Houston County Schools. The school guidance counselor will contact you within (5) days to inform you of the name of the homebound tutor and to provide you with a copy of the Contract for Provision of Homebound Services. 19
PARENT/GUARDIAN/STUDENT PROCEDURAL SAFEGUARDS AND RIGHTS UNDER SECTION 504 OF THE REHABILITATION ACT (Form C) Under Section 504 of the Rehabilitation Act of 1973, students with qualifying disabilities have the right to receive a free appropriate public education, which includes the right to an education with students without disabilities to the maximum extent appropriate. In particular, the enabling regulations for Section 504, as set out in 34 CFR Part 104 provide parents and/or students with the following rights: 1. Your child has the right to an appropriate education in the least restrictive environment that is designed to meet his/her individual educational needs as adequately as the needs of nondisabled students are met. 2. Your child has the right to free educational services, except for those fees that are imposed on nondisabled students or their parents. Insureres and similar third parties are not relieved from an otherwise valid obligation to provide or pay for services provided to a disabled student. 3. Your child has a right to non-discrimination and to facilities, services, and activities that are comparable to those provided for non-disabled students. 4. Your child has a right to an evaluation prior to an initial Section 504 determination and placement and any subsequent significant change of placement. 5. Placement decisions must be made by a group of persons (i.e. the Section 504 Team) including persons knowledgeable about your child, the meaning of the evaluation data, the placement options, and the legal requirements for least restrictive environment and comparable facilities. 6. You have the right to examine relevant records prior to any action by the District in regard to the identification, evaluation, or placement of your child or upon request. 20
7. You have the right to an impartial hearing with respect to the District s actions regarding your child s identification, evaluation, or educational placement. You have the right to participate and to be represented by an attorney at your expense. 8. You have the right to obtain copies of your child s educational records at a reasonable cost unless the fee would effectively deny you access to the records. 9. You have the right to receive a response from the school district to reasonable requests for explanations and interpretations of your child s records. 10. You have the right to request amendment of your child s educational records if there is reasonable cause to believe that they are inaccurate, misleading, or otherwise in violation of the privacy rights of your child. 11. You may challenge the actions of the District s Section 504 Team in regard to your child s identification, evaluation, or educational placement by requesting a due process hearing with the District s Section 504 Coordinator, Mrs. Denise Whitfield, within 30 calendar days from the time you received written notice of the Section 504 Team s action(s). A due process hearing will be scheduled before an impartial hearing officer and you will be notified in writing of the date, time, and place for the hearing. You have the right to participate in the hearing and to be represented by counsel if you choose. If you disagree with the decision of the impartial hearing officer, you have a right to request a review of the decision in a court of competent jurisdiction. 12. On Section 504 matters other than your child s identification, evaluation, and/or placement, you have a right to file a grievance with the District s Section 504 Coordinator, who will investigate the allegations to the extend warranted by the nature of the grievance in an effort to reach a prompt and equitable resolution. 13. You also have a right to file a complaint with the Office of Civil Rights if you believe that you or your child has been subjected to discrimination on the basis of disability. The contact information is as follows: Office for Civil Rights U.S. Department of Education, 61 Forsyth Street S. W., Suite 19170, Atlanta, GA 30303-3104. Telephone: (404)562-6350, Fax: (404)562-6455. Email: OCR.Altanta@ed.gov. 21