FOR INFORMATION ONLY Homebound Instructional Services / Jefferson County School/ April 2013 Goal of Homebound Services: To sustain continuity of instruction and to facilitate the student s return to school Who Qualifies? - Students who, due to injury or for any other reason as certified in writing by a licensed physician or other licensed health care provider, are temporarily confined to home or hospital for a period that has lasted or will last more than three consecutive weeks.(126csr42, 6.2.d.1)) Note: Students are also served in public places and in schools. - Students whose acute illnesses prevent them from attending school for short period of times or intermittently such as students with chronic illnesses, cancer, or diabetics as deemed necessary by a physician. - Students not meeting state immunization requirements. Procedures for Approval: Completion of a Homebound Form annually which contains the information that follows: Student s personal information Medical Certification of Need / Documentation of student s illness Estimated length of recovery time Treatment plan Parental permission to contact the treating Physician or licensed clinical psychologist Approval at the county level A written statement by a licensed physician or other licensed health care provider must be resubmitted every six months if student s temporary home/hospital instruction is prolonged. (126CSR452) (6.2.d.2) Homebound Coordinator: - Receives approved HB form and coordinates the delivery of instruction to the student. - Contacts parents, school personnel, and HB teachers to initiate a meeting. - Helps decide appropriate subjects for HB students and scheduling of instructional time. - Contacts attendance office of dates and duration of illness. - Provides the organization of delivering WV State Assessments - Completes an annual report. - Oversees continued homebound services until student has successfully transitioned back to school. School: - Sets up SAT, IEP, or 504 meetings with necessary school based personnel and parent. - Considers best alternative placement to minimizing the interruption of instruction. Note: Instruction should take place in the school setting to the fullest extent possible. - Coordinates with HB teachers and classroom teachers to provide appropriate materials, supplies, and books for instruction. - Meets guidelines for homebound exceptional students (IEP) and changes placement to Out of School Environment (OSE) in accordance with requirements defined by WV 125CSR16, WVBE Policy 2419. Homebound Teachers: - Responsible for facilitating instruction on the core courses content standards and objectives as guided by the student s classroom teacher(s). (126CSR42, 6.2.d.5) - Collects, secures, and understands instructional plans to be delivered. - Delivers assignments and instruction to the student, and monitors testing. - Returns student work to classroom teacher for assessment. Classroom Teachers: - Decides education plan and makes necessary modifications to instructional objectives to meet student s needs. - Provides homebound teacher with lesson plans, worksheets, and/ or assessment materials. - Reviews and grades completed work. - Meets with HB teacher to provide continuity of class assignments to home. Excellence in Teaching and Learning 1
Jefferson County Schools Request for Homebound/Hospitalized Instruction SOP 7.13a Application requires physician signature, parent/guardian signature and treatment plan. The homebound/hospitalized instruction program shall provide educational services to a student who has an injury or health problem/condition as diagnosed and confirmed by a licensed physician that requires the student to be homebound or hospitalized for a period that lasted or will last more than 15 consecutive school days. This instruction represents a minimal educational program designed to make returning to school a smooth transition. Please note that if absence is due to pregnancy, students are encouraged to attend school as near to their due date as possible and to return to school as soon as health conditions will allow. To be completed by the parent or student: Name of Student School Parent/Guardian Address Telephone - Home Birth Date Grade Work Parent permission for Jefferson County Schools to exchange information with medical and mental health providers A second opinion may be requested at the expense of the Board of Education. Parent s Signature: To be completed by physician: 1. Specific reason(s) the student must remain on homebound and/or hospitalized for 15 or more consecutive school days 2. Date student is expected to return to school 3. Physician or psychiatrist's statements indicating under what conditions the student can return to school 4. Students recommended for homebound instruction for emotional problems must have the attached treatment plan developed by either a psychiatrist or mental health counselor. 5. Physician's/Psychiatrist's Name Address Phone # Date Signature MD Return Completed Form to Jefferson County Schools Department of Pupil Services, 110 Mordington Avenue, Charles Town, WV 25414 304-728-9236 Phone 304-724-9071 Fax ----------------------------------------------------------------- For School Use Only Date Received Effective Date Date Granted Date Denied Authorized Signature Excellence in Teaching and Learning 2
SOP 7.13b Updated 3/12 Jefferson County Schools Treatment Plan Name of Student School Grade Treatment: (Include frequency of visits, medications, etc.) Signature of Psychiatrist/Physician Date Excellence in Teaching and Learning 3
Dear Parent/Guardian: Homebound/Hospital Instruction Guidelines SOP 7.13c 1. The request form for homebound instruction needs to be completed and return to: Department of Pupil Services, Jefferson County Schools, 110 Mordington Avenue, Charles Town, West Virginia 25414. 2. If possible, the student shall attend school until officials receive the necessary forms and shall abide by the attendance policies of that school until the homebound instruction has been approved. 3. The homebound instructional program is provided to students who due to injury, noncommunicable illness or health condition are unable to attend school for at least 15 consecutive school days as verified by a medical doctor. 4. It should be understood that homebound instruction represents a minimal educational program designed to make the student's return to school a smooth transition. This program in no way can replace a student's full-time school attendance. 5. The homebound teacher is a facilitator of instructional goals determined by the student's regular classroom teacher. 6. Whether a student passes or fails a course during homebound instruction is left to the discretion of the regular course instructor. Additional make-up work may be required of the student upon return to school. 7. A student may be removed from the homebound program if the student fails to cooperate with the homebound instructor or does not do the required work. 8. Some courses are not appropriate for homebound instruction and may not be able to be provided (i.e., driver's time in Driver's Education). 9. Home Instruction is provided at a time when a responsible adult is in the home. 10. Jefferson County Schools can request a second opinion from a medical doctor at the expense of the Board of Education if concerns arise about the student's current request for homebound instruction. Until the homebound teacher makes the initial home/hospital visit, the parent/guardian is required to pick-up any course work the student may have missed prior to the start of the program. Excellence in Teaching and Learning 4
Homebound-Hospital Program SOP 7.13 I. Forms II. III. IV. A. All requests for homebound/hospital instruction must be completed on the "Jefferson County Schools' Request for Homebound/Hospital Instruction" form. B. A medical doctor must: 1. Sign the form 2. Verify that the student must remain at home or in the hospital for at least 15 consecutive school days 3. State the reason why the student must remain at home or in the hospital 4. State the conditions under which the student can return to school 5. State the expected date of return. C. Forms are to be picked up from the student's home school. D. Approval for homebound/hospital instruction is the responsibility of the Director of Pupil Services. Attendance A. Attendance in the homebound/hospital instruction will commence with date the approval is granted by the Director of Pupil Services. B. Absences prior to the approval are subject to the school's regular attendance procedure and Jefferson County Schools' attendance policy. C. Students who are denied homebound/hospital services will be notified by the Director of Pupil Services. The school the student attends will also be notified of the denial. Instruction A. Each student whose homebound/hospital instruction is expected to last a semester will be permitted to take only four subjects or classes. The student's program will be determined by the school in conjunction with the homebound/hospital teacher. Certain classes may not be appropriate for the student who is out of school for an extended period of time: (i.e., honors, driver s education, labs in science, business, and family and consumers sciences.) B. Homebound instruction is provided at a time when a responsible adult is in the home. Termination of Services A. Students will be removed from the homebound/hospital instruction if they fail to cooperate with the teacher, are not at home during scheduled times, or refuse to do required school work. Excellence in Teaching and Learning 5
SOP 7.13 - CONTINUED - B. Students who are able to attend extra-curricular activities still need the permission from the attending physician and school principal prior to the attending. C. Students who are able to maintain a work schedule must return to school immediately or be removed from the homebound/hospital instruction unless otherwise prescribed by a physician. V. Responsibilities: Homebound/Hospital Teacher A. Contact the school principal, attendance officer, and on the secondary level the guidance counselor, that the student has been approved for homebound services. B. Contact the parent and notify them that their child is approved for homebound instruction and schedule sessions. C. Check student's schedule, attendance record, and meet with school designee and teacher to help decide subjects that are appropriate for homebound student. D. Request assignments and materials from classroom teacher on a weekly basis and return completed assignments as soon as possible. E. Meet personally with classroom teacher a minimum of once every two weeks to review student s progress during non-instructional time. F. Facilitate the instruction for the classroom teachers by following instructional objectives and/or teacher lessons plans in providing instruction with students. G. Use teacher's answer keys to assist in monitoring student's progress. H. During the home instruction sessions, the homebound teacher will explain lessons to students, supervise students during activities, and teach areas that students are having difficulty understanding. Administer quizzes and tests from the classroom teacher. I. Provide instruction to students from two or three times a week according to students' needs and homebound teacher's availability. Provide from one to two hours of instructional time per session. J. Report back to the building principal and Director of Pupil Services any student who is not home during a scheduled visit, is not completing assignments, or is not participating in the homebound program for any other reason. K. Notify school principal and/or appropriate personnel when student is returning to school. L. Record all contact with students and teachers in student's folder including subject material covered. M. Return student's folder to the Department of Pupil Services once student re-enters school. Excellence in Teaching and Learning 6
SOP 7.13 - CONTINUED - VI. VII. Responsibilities: Building Principal or Designee A. Assures that the school has a supply of homebound forms. B. Work with homebound teacher and classroom teachers on issues related to providing materials, supplies, books, etc. C. Coordinate with homebound teacher, regular classroom teachers and other appropriate personnel on the development of alternative education plans for students when necessary. D. Assure that homebound teacher has appropriate materials to provide instruction. E. Determine student's make-up time on attendance issues that are impacting the school make-up policy. Responsibilities: Classroom Teacher A. Provide homebound teacher with lesson plans, worksheets and/or test for assignments. B. Review work completed by student. C. Grade activity or test completed by the student if answer keys are not supplied to homebound teacher. D. Make time available during non-instruction time to briefly review any concerns raised by them, the homebound teacher or student. E. Decide education plan for student on homebound and make any necessary modifications to instructional objectives to meet student's needs. F. Collaborate with building principal or designee and homebound teacher to determine the appropriate education plan for students when necessary. G. Determine the grades and credits the student receives while on homebound instruction and issue report cards and grades for subject matter that has been completed. Excellence in Teaching and Learning 7