Medical Homebound Instruction is available to students who are medically unable to attend school because of illness, accident, or pregnancy, even with the assistance of transportation. Eligibility for Medical Homebound Instruction requires certification from an authorized medical provider that the student is unable to attend school but is able to benefit from instruction provided in the home or hospital setting. The request for Medical Homebound Instruction originates through the student's school and must be approved in accordance with district procedures.
For additional information regarding the general Medical Homebound process, consult the Greenville County Schools Medical Homebound information.
Approval for Medical Homebound Instruction establishes the student's medical eligibility for homebound services. For a student with an IEP, medical approval does not independently determine the student's special education services, related services, instructional minutes, or educational placement.These decisions are made by the IEP team based on the student's individual educational needs.
When Medical Homebound Instruction is being considered for a student with an IEP, the following procedures will be followed:
The school's Homebound Contact will submit the required Medical Homebound Instruction Form to the Office of Homebound Services in accordance with district procedures.
Once the student is approved for Medical Homebound Instruction, the student's Case Manager will be notified.
Medical Homebound Instruction may not begin until the school receives the approved homebound packet and assigned case number from the Office of Homebound Services.
The Case Manager will schedule an IEP meeting and notify the appropriate Special Education Specialist. The parent/guardian and required IEP team members will be invited to participate. Medical Homebound Instruction is a restrictive educational setting because it may significantly limit a student's access to the school environment and opportunities for interaction with nondisabled peers. The IEP team must make an individualized determination regarding the student's educational placement and consider whether the student's educational needs can be appropriately addressed in a less restrictive setting with supplementary aids, services, accommodations, or other supports. The meeting will generally be conducted as a Special Review meeting. Staff will follow the district's established IEP amendment/revision procedures. During the meeting, the IEP team will consider the effect of the student's medical condition on the student's ability to access instruction, participate in the general education curriculum, and make progress toward annual IEP goals. The team will review and revise all portions of the IEP affected by Medical Homebound Instruction, as appropriate.
The IEP team will review the student's current IEP, medical information, present educational needs, parent input, and other relevant information to determine the special education, related services, supplementary aids and services, accommodations, and supports necessary for the student during the period of Medical Homebound Instruction.
The type, frequency, amount, and duration of services must be determined individually by the IEP team and may not be based solely on the number of instructional hours generally associated with the Medical Homebound program.Consideration of Educational Placement
A medical recommendation regarding the student's ability to attend school is an important consideration; however, decisions regarding the student's educational program, special education and related services, and placement remain the responsibility of the IEP team.
When appropriate based on the student's medical needs and individual circumstances, the team should consider opportunities for participation in school-based instruction, virtual instruction, extracurricular and nonacademic activities, or other educational opportunities that can be safely accessed by the student.
IEP Documentation
When the IEP is revised to address Medical Homebound Services, the projected duration of homebound instruction should be documented consistent with the medical certification and decisions of the IEP team.
If the "Next Review Due By" date is adjusted to correspond with the anticipated end of Medical Homebound Services, the revised date may not extend beyond the original annual review due date.
The Notice of Meeting will indicate that the purpose of the meeting includes a Special Review of the student's IEP related to Medical Homebound Services.
Development and Revision of the IEP
Areas that may require review or revision include:
Present Levels of Academic Achievement and Functional Performance
Document relevant information regarding the student's current medical circumstances and their impact on educational access, participation, academic achievement, and/or functional performance. Relevant information from the Medical Homebound Instruction Form may be incorporated into the appropriate area of the IEP.Annual Goals and Objectives/Benchmarks, When Applicable
The team will review the student's existing goals and determine whether they remain appropriate and how they will be addressed during Medical Homebound Instruction.
Accommodations, Modifications, and Supplementary Aids and Services
The team will determine which existing accommodations, modifications, supplementary aids, services, and supports remain necessary and whether additional or revised supports are required during Medical Homebound Instruction.
Any changes affecting assessment participation must also be addressed in the appropriate assessment section of the IEP.
Special Education and Related Services
The Services section will identify the special education and related services required during Medical Homebound Instruction. For each service, the IEP will clearly identify the frequency, amount/duration, location, and projected beginning and ending dates.
The amount and type of services must be determined according to the student's individual needs and must support the student's continued access to and progress in the general education curriculum, as appropriate, and progress toward annual IEP goals.
Related services must be considered individually. A related service should not be discontinued solely because the student is receiving Medical Homebound Instruction. If a service is changed, reduced, provided through a different delivery method, or discontinued, the decision must be based on the student's individual needs and documented through the IEP process.
Participation in Statewide and District Assessments
The team will review the student's assessment participation and accommodations and make any revisions necessary to ensure consistency with the student's current needs and instructional setting.
Participation with Nondisabled Peers
The team will document the extent to which Medical Homebound Instruction affects the student's participation with nondisabled peers in academic, extracurricular, and nonacademic settings and consider appropriate opportunities for participation when medically and educationally appropriate.
Following the IEP meeting, Prior Written Notice (PWN) will document the actions proposed or refused by the IEP team and the basis for those decisions.
As applicable, the PWN should clearly address:
Once the IEP meeting has been conducted and services have been determined, the school is responsible for securing the appropriate homebound teacher(s)/instructor(s) in accordance with district procedures.
If the IEP team determines that the student requires more than five hours of homebound instruction per week, the Case Manager will notify the school's Homebound Contact of the number of instructional hours identified by the IEP team.
The Homebound Contact will forward the required information resulting from the IEP meeting to the Office of Homebound Services for processing.
The IEP must accurately reflect the services determined necessary by the IEP team. The student's services may not be limited solely because of the number of hours generally provided or funded through the Medical Homebound program.
Medical Homebound Instruction may begin only after the school has received the approved homebound packet and assigned case number and the necessary instructional arrangements have been completed.
If the student's medical provider indicates that Medical Homebound Services are expected to extend beyond 45 days, a Special Review IEP meeting will be held prior to the< 45th day.
At this meeting, the IEP team will review:
Medical Homebound Instruction is intended to address the period during which the student's medical condition prevents school attendance. The student's return to the school setting should be considered as soon as medically and educationally appropriate.
Prior to or upon the anticipated conclusion of Medical Homebound Services, the IEP team will review the student's needs and determine whether revisions to the IEP are necessary to support the student's return to school.
The team should consider, as appropriate:
If instruction, special education, or related services required by the student's IEP are delayed, interrupted, or not provided as identified in the IEP, the school and appropriate district special education personnel will review the circumstances and the impact on the student.
When appropriate, the IEP team will consider whether additional or compensatory services are necessary to address the impact of services that were not provided.
If a student has a recurring medical condition that intermittently makes him or her unable to attend school that student may be eligible to receive medical homebound instruction during those periods, coming back to school and leaving school again as the need dictates. An agreement should be set between the parent of the student and the district that specifies when homebound services will begin and end on an intermittent basis. The agreement will specify what will trigger the Intermittent Medical Homebound Services.
Intermittent Medical Homebound Services will be documented following the same procedures described above under Medical Homebound Services.
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Medical Homebound Services