Intermittent Medical Homebound Services

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 in Enrich IEP through the following steps:

• The school’s Homebound Contact submits the Medical Homebound Instruction Form to the Office of Homebound Services for approval. If the homebound request is approved by the office of Homebound Services for a student with an IEP then a meeting is conducted as described below.


• The Case Manager will be notified and will schedule an IEP meeting. The Case Manager will notify the Special Education Specialist of the scheduled meeting. The IEP team will convene to make an individualized determination of the Special Education and Related Services the student should receive while on intermittent medical homebound.


• This will most likely be a Special Review meeting. In Enrich IEP, users will follow the IEP amendment process. Typically, users would not change the “Next Review Due By” date in the Dates section of the IEP when amending an IEP. However, in the case of amendments to address Intermittent Medical Homebound Services, users will adjust the “Next Review Due By” date in the Dates section of the IEP to reflect the projected end date of Intermittent Medical Homebound Services as indicated on the Medical Homebound Instruction form completed by the physician. The new end date of the IEP cannot exceed the original end date of the IEP.


• During the IEP meeting the team considers the impact of the student’s medical condition on participating in instruction, and the amount of instruction necessary for the student to continue to progress in the general education curriculum. The team will amend all parts of the IEP that may be impacted during the time the student is receiving intermittent medical homebound instruction. Sections impacted may include:
  
  
  • Present Levels of Performance –The statement provided by the physician indicating how the medical condition impacts educational performance from the “Medical Homebound Instruction Form” will be included in the student’s current Healthcare needs.
  
  
  • Special Education and Related Services – The chart outlining the special education and related services typically provided does not need to be amended in any way for a student receiving intermittent medical homebound services. The user will enter a detailed description of all intermittent medical homebound services to be provided, including general education services, in the “Description of Services” text box. The example below provides a sample of how users will document the services to be provided to allow the student access to the general curriculum and to continue to progress towards the student’s individualized IEP goals while on intermittent medical homebound. The plan should state an “if . . . then” description of services.
    
    
    
  
  
  • Least Restrictive Environment - The “Removal Justification” statement will include the brief summary provided by the physician on the “Medical Homebound Instruction Form” in addition to the removal justification developed by the IEP team during the student's attendance at school.
    
    
    
  
  


• If Medical Homebound Services are being considered, it is the responsibility of the school to secure the medical homebound instructor. Homebound instruction cannot begin until the school receives the approved homebound packet with an assigned case number.


• The Prior Written Notice (PWN) will reflect the IEP team’s proposals for the following items:
  
  
  • Discussion of the amount of services considered and how the IEP team determined the amount of services to be provided while the student is in the Medical Homebound setting?
  
  
  • What are the beginning and end dates of the services?
  
  
  • How will the IEP team ensure goals and services identified in the IEP continue to be implemented and provided during homebound instruction?
  
  
  • How were individual determinations made regarding the hours necessary to support the student in meeting designated goals for academic, functional, and related services?
  
  
  • How will the goals/services identified in the IEP be met during homebound instruction?
  
  
  • What amendments will be required to the IEP?


• Once the school receives the Medical Homebound packet, the school must secure the homebound teacher(s).


• The Intermittent Medical Homebound Services should not extend past the date specified on the Request for Medical Homebound Instruction form completed by the physician. The IEP team must reconvene prior to the end date. If the original meeting was a special review, the user must remember to retain the original annual review end date specified prior to the determination regarding Intermittent Medical Homebound Services.

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