HOSPITAL AND HOME SETTINGS

Homebound and/or instruction within a hospital setting are part of a district’s continuum of educational placements. When an eligible individual’s physical, mental health, or medical condition impedes participation in general and special education, the IEP team will consider alternative settings such as homebound or within a hospital.

The district where the student is being educated is responsible to provide or make arrangements for the provision of that instruction. Ordinarily, instructional services shall be provided by the LEA but may be provided by a contractual agreement, subject to the approval of the LEA board, by the AEA or another qualified agency. The AEA shall provide any necessary support or related services to a homebound or hospitalized student, but with AEA board approval may contract with another qualified agency to provide these services.

For all homebound and hospital services, IEP teams must:

• Develop an IEP which specifies the service(s) and the location of the service(s).
• Establish a plan to periodically review the status of a student to determine the continued need and appropriateness of the service(s).
• Ensure all procedural safeguards must be afforded to the parent(s) and individual.
  • For example: If a review IEP or amendment IEP initiates home or hospital services, an IEP review or amendment must also occur at the end of home services or when the student returns to school. The IEP team must review the need for home or hospital services for medical reasons at least annually.

IEP team may request a physician’s written statement to determine that the student’s condition is such that the individual cannot attend school and that the home or hospital service will not interfere with the student’s health or recovery. The prognosis should indicate that the student will be out of school for more than a few days.

IEP team should keep in mind that failing to serve a student whose condition does not preclude instruction or other services for more than 10 days would be considered a change in placement.

Note about Psychiatric Units: Iowa LEAs that have a hospital psychiatric unit within their district are required by Iowa Code to provide instructional services. The LEAs whose students are served in those units are required to pay for those services. Also, some hospitals routinely provide educational and related services to all school-age patients (both special and general education students) and bill the resident district or AEA. In those circumstances, the resident LEA or AEA shall pay for the services delivered in the hospital setting.

Notes about Homebound Placements for Behavioral Reasons: An IEP team may make a decision to place an eligible individual on homebound instruction due to extreme behavioral issues when a temporary placement, as part of an evaluation process, is necessary. In making a temporary placement, IEP teams must be certain that the home is an appropriate educational setting and that the placement assists in the completion of the evaluation process.

Homebound instruction, even when temporary and used for an evaluation purpose, is rarely the best solution. Districts have an obligation to provide the appropriate instructional program for students with behavior disabilities. When an IEP is written that places a student on homebound instruction for behavioral reasons, this is considered to be an interim IEP. An interim IEP shall not be in place for more than 30 school days. The IEP must be implemented by appropriately licensed staff.

Therefore, a home placement for behavior reasons must not bypass appropriate safeguards related to student discipline and may not be used in lieu of establishing an appropriate school program for a student.