District Home

Homebound Flowchart

How does a parent arrange for his or her child to receive medical homebound instruction?

The procedure for requesting medical homebound instruction is established by the school district. Therefore, a parent should start by contacting the school guidance counselor or a school administrator. State Board of Education Regulation 43-241 requires that a licensed physician certify that the student cannot attend school as a result of an accident, illness, or pregnancy, despite the aid of transportation, and that he or she may profit from instruction given in the home or in a hospital.

In addition, the physician must complete the state’s medical homebound instruction form that the school district provides. The district superintendent, or his or her designee, may or may not then approve the student’s participation in a program for medical homebound instruction.

When can medical homebound instruction begin?

State Board of Education Regulation 43-241 stipulates that a student is eligible for medical homebound instruction on the day following the last day of his or her school attendance or on the first day of the regular nine-month academic year in which the student would otherwise be enrolled if he or she were able to begin the school year. The student remains eligible until the day before he or she returns to school or until the last day of the regular academic year, whichever occurs first.

What is the procedure for requesting medical homebound instruction for a pregnant student?

First, you must let the school know that the student will be a school-aged parent. Then, a licensed physician must certify that the student cannot attend school because of prenatal or postnatal complications associated with the pregnancy. In general, abdominal pain, back pain, fatigue, and vomiting are common to pregnancy but are not usually considered serious enough to warrant medical homebound instruction.

Who teaches the student receiving medical homebound instruction?

Medical homebound instruction is provided either by a teacher who is regularly employed in the school district or by a teacher whom the district contracts to perform the service. State Board of Education Regulation 43-241 specifies that any teacher providing medical homebound instruction to students residing in South Carolina must hold a valid South Carolina teacher’s certificate. In most instances, the teacher providing medical homebound instruction will not be the student’s current classroom teacher. A South Carolina school district may count in membership a student who is compelled to reside outside the state to receive medical services, provided the student’s teacher is certificated by the Department of Education in the state where services are rendered.

Can a parent request medical homebound instruction for a child because of a mental health problem?

Yes. A mental health problem may be a legitimate reason to request medical homebound instruction. However, a licensed physician must certify that the state of the child’s mental health is the cause of his or her inability to attend school. If the mental health diagnosis indicates that long-term medical homebound instruction will be necessary, the parent(s) will need to make arrangements for a licensed mental health professional to develop a treatment plan and strategy for reentry into the school environment.

If a physician completes a medical homebound application, isn’t the school district required to provide medical homebound instruction?

No. The superintendent of the school district or his or her designee must approve any medical homebound instruction request. Upon the signed authorization of the parent, the district’s medical representative may ask the physician to supply additional documentation in order to determine if medical homebound instruction is appropriate. The absence of this authorization could affect the approval process. School districts are encouraged to discuss with physicians the accommodations and modifications that can be made to keep students in the least restrictive environment.

Can the superintendent request a second medical opinion if he or she disagrees with the first physician or feels that inadequate information has been provided?

There is no regulation in federal or state law that prohibits a superintendent from doing so. If the superintendent feels that additional information is needed, then he or she may request a second medical opinion in order to gain the necessary information to approve medical homebound instruction, deny medical homebound instruction, or determine possible accommodations or modifications to allow the student to continue in his or her regular school program.

What is the policy for a medically homebound student taking a subject that requires a lab or some sort of equipment that is not accessible to the student in the home—subjects such as chemistry, keyboarding, and driver’s education?

Medical homebound instruction is designed to aid students who are sick and unable to attend school so that they will not fall behind in their subject areas. If a student becomes medically unable to attend school while taking classes that require a lab and/or the use of school equipment, the classroom segment of the instruction could possibly be done at home, while the student would have to make up the lab portion of the class after he or she returns to school. Districts are encouraged to explore a variety of instruction methods such as audiotapes, videotapes, computer software, and Internet resources to supplement the instruction provided by the teacher who comes to the home.

What are the students’ responsibilities in the medical homebound instruction process?

 The student must realize that medical homebound instruction is an extension of regular school and all classroom rules and regulations, as well as school district policies, apply.

In addition, the student should:

• be available for all scheduled instruction;

• be dressed appropriately;

• have all books and materials needed for instruction;

• complete all homework assignments;

• remain courteous, comply with teacher requests, and use appropriate language; and

• dedicate instruction time to instruction only (no phone calls, visiting, radio, television, and so on).

What are the parents’ responsibilities in the medical homebound instruction process?

The parents should:

• realize that before instruction can begin, all necessary paperwork must be completed;

• ensure that the child is prepared for the arrival of the medical homebound teacher;

• provide an area in the home that is conducive to learning and suitable for instruction (e.g., is quiet and free of distractions, has good lighting and a desk or table);

• understand that during the course of medical homebound instruction, adult supervision in the home may be required in order to ensure a healthy and safe environment for both the student and the teacher;

• make certain that the student is available for all scheduled instruction;

• contact the homebound teacher to cancel the scheduled period of instruction in cases of emergency;

• inform the homebound teacher of the child’s future medical appointments as early as possible if such appointments will interfere with instruction time;

• understand that if the student is absent for his or her scheduled period of instruction, he or she is considered absent from school on that day;

• understand that the state’s compulsory attendance laws fully apply to medically homebound students;

• communicate with the district’s medical homebound instruction coordinator or the school’s contact person about changes in the child’s health and return-to-school plans;

• sign the homebound teacher’s time sheet, which logs the hours and days that the teacher has worked with the student;

• monitor and encourage the child to plan his or her time in order to accomplish assigned work; and

• understand that although medical homebound instruction usually takes place at home, an alternative site may be designated if circumstances warrant.

What are the medical homebound teacher’s responsibilities in the instruction process?

The homebound teacher should:

• call the district’s homebound instruction coordinator if medical homebound instruction does not begin on the anticipated date;

• keep a time sheet that logs the hours and days that he or she has worked with the student;

• notify the family or hospital if he or she is unable to attend a regularly scheduled session due to illness or an emergency;

• notify the district’s homebound instruction coordinator immediately if the teacher expects to be absent from the regularly scheduled sessions for more than a few days;

• never arrange for a substitute without prior approval;

• maintain close contact with the student’s regular teachers and counselors to ensure that the student is working on the appropriate assignments and is receiving the appropriate grades or credit that he or she has earned;

• keep documentation to ensure the student receives credit for the work that he or she accomplishes;

• notify the building principal and the district’s homebound instruction coordinator if one of the student’s school-based teachers is not cooperating in the homebound instruction process;

• consult periodically with the student’s regular teachers regarding the long-term planning of the student’s education program;

• meet on a regular basis with the student and the family or hospital staff;

• understand confidentiality requirements;

• call the district’s homebound instruction coordinator immediately if the student is absent from home at the scheduled instruction time and the session has not been cancelled by the family;

• call the district’s homebound instruction coordinator immediately if there are concerns about the safety of the situation in the home;

• report (or cause a report to be written) to the Department of Social Services or to local law enforcement if he or she believes that the student’s physical or mental health or welfare has been or may be adversely affected by abuse or neglect;

• maintain written documentation of work assigned, student absences, and meetings with parents and school staff;

• call the district’s homebound instruction coordinator if there are problems with school personnel, the family, or the student;

• remember that motivation can be a problem with a sick or injured student;

• notify the district’s homebound instruction coordinator and the school contact person as soon as it is known when the student will return to school; and

• return assignments, books, and materials to the school when the student is authorized to return to classes.

• complete homebound instruction in a timely manner to prevent delay of instruction to the student.

What are the student teachers’ responsibilities in the medical homebound instruction process?

The medically homebound student’s teachers should:

• determine the student’s interim and final grades with input from the medical homebound teacher;

• understand confidentiality requirements;

• assigns grades to the medically homebound student, following the regular grade-reporting processes including interim reports and report cards;

• collaborate and consult regularly with the medical homebound teacher regarding all the student’s assignments, projects, and assessments;

• provide long-term planning of instruction in collaboration with the medical homebound teacher;

• provide the students’ assignments on a regular basis;

• clearly communicate with the medical homebound teacher about the student’s progress;

• collaborate with the medical homebound teacher to send frequent progress reports to the student’s parent(s) or guardian;

• avoid assigning busywork or excessive practice to the student; and

• be flexible and remember that the homebound student is experiencing medical or mental difficulties.