Administrative Procedure 5011 - Home and Hospital Teaching

I. Purpose

To establish procedures regarding the provision of instructional services to students who are unable to participate in their school of enrollment due to a physical or emotional condition.

II. Background

1. Home and Hospital Teaching (HHT) services provide continuity of instruction to students who are unable to participate in their school of enrollment due to any of the following conditions:
   1. A physical condition, which may include alcohol or drug dependency;
   2. Pregnancy;
   3. An emotional condition; or
   4. A physical condition that requires the student to be absent on an intermittent basis (i.e., including but not limited to: kidney failure, cancer, asthma, cystic fibrosis, and sickle cell anemia).
      
      Only those students registered in Prince George’s County Public Schools are eligible for service.  Students who are home schooled or parentally placed in private and religious schools are not eligible for home and hospital services. This procedure also excludes disabled students served through the Maryland Infants and Toddlers Program from birth through age two.

III. Procedures

1. Referral Process
   
   1. Required Documentation
      1. The Principal/Designee of the student’s school of enrollment must provide a copy of the Initial Contact/Referral form (DSS-21) and Physician’s Verification to the parent within two school days of the request for home and hospital teaching.
      2. The Principal/Designee must inform a parent about home and hospital teaching services if the student will be absent for an extended period due to a medical or psychological condition or a hospitalization. The Pupil Personnel Worker (PPW) must be notified if a parent fails to complete the request for home and hospital teaching in the case of an extended absence.
      3. The Initial Contact and Referral must be completed by the parent and the Principal/Designee.
      4.  The Physician’s Verification (DSS-22) must be completed by a licensed physician or certified nurse practitioner for physical conditions which prevent the student from participating in the school of enrollment.
      5.  The Verification for Students with Emotional Conditions (DSS-22A) must be completed by a licensed psychiatrist or licensed psychologist if an emotional condition prevents a student from participating in the school of enrollment.
      6.  The Principal/Designee must forward the completed and signed Initial Contact/Referral form and Physician’s or Psychologist’s/Psychiatrist’s  Verification to the Office of Home and Hospital Teaching by fax or email within one school day of receipt from the parent.
   2.   Approval Process
      1. The Office of Health Services shall review the Physician’s Verification to ensure that it documents a physical condition that prevents the student from attending his or her school of enrollment.
      2. The Office of Psychological Services shall review the Psychiatrist or Psychologist Verification to ensure that it documents an emotional condition that prevents a student from attending the school of enrollment.
      3. The Office of Health Services or the Office of Psychological Services, as appropriate, may consult with the physician, certified nurse practitioner, psychologist or psychiatrist if the Verification does not sufficiently address the student’s need for home and hospital teaching.  If the medical or mental health professional is unable to sufficiently address the questions from the school system relative to the Verification of need, the school system may deny the request for home and hospital teaching.
      4. The Office of Home and Hospital Teaching shall notify the school and parent if a request for home and hospital teaching is denied.  The notice shall include an explanation of the reason for the denial and a notice of the parental right to appeal the decision. 
      5. Home and hospital teaching shall begin within ten (10) school days of receipt, review and approval of required documentation.  
   3. Service Delivery
      1. The school of enrollment shall provide course work and appropriate instructional materials to the home and hospital teacher within two (2) school days of notification of service approval.
      2. The location and hours of services will be determined by the school team, parent, and home and hospital teacher.  Home and hospital teaching services are provided in accordance with the Prince George's County Public Schools’ calendar.
      3. Home and hospital teaching may take place in the home, hospital, therapeutic center or another location agreed upon by the school team, parent, and home hospital teacher.
      4. Instruction may be provided to secondary school students through approved online, virtual instructional support models.
      5. The length of instruction for homebound/hospitalized students in a full-day program is a minimum of six (6) hours per week, and for homebound/hospitalized students in a half-day program is a minimum of three (3) hours per week.
      6. The school team, in consultation with the Office of Home and Hospital Teaching may modify the student’s course schedule or instructional program to reflect only standard core classes if the student requires long term services.
      7. A responsible adult must be present during Home and Hospital instruction.
   4. Termination or Continuation of Services
      1. Home and hospital teaching may be provided for up to sixty (60) calendar days.  Continuation of home and hospital teaching beyond a 60-day period requires an updated Physician’s Verification or Psychologist’s/Psychiatrist’s Verification. Re-verification may be requested sooner than 60 days at the request of the parent, guardian, or local school system. Services must be terminated after sixty (60) calendar days if an updated verification is not received by the Office of Home and Hospital Teaching.
      2. Service needs shall be re-verified annually for students who receive concurrent delivery of instructional services pursuant to COMAR. Re-verification may be requested sooner at the request of the parent, guardian, or local school system.
      3. A general education student requiring home and hospital services beyond sixty (60) calendar days shall be referred to the School Instructional Team (SIT).
      4. The school of enrollment must develop a written (transition) plan for students with emotional and chronic conditions to support the student’s return to school.  The transition plan may include phased re-entry into the school.
      5. If the student does not return to school, the PPW must follow the PGCPS attendance policy and make appropriate referrals to address the attendance concern.
2. Pregnant Girls
   
   Pregnant girls may receive a range of services; home teaching is only one of many options.  Schools are directed to follow Administrative Procedure 5119.3 to provide appropriate services to pregnant girls.
3. Students with Chronic Health Conditions
   
   Students diagnosed with chronic medical conditions (i.e. cancer, cystic fibrosis, sickle cell anemia, depression or bipolar disorder) that adversely affect their ability to attend school on a consistent basis may receive intermittent home and hospital teaching. Concurrent delivery of home and hospital instructional services and attendance in a public school shall be provided for a student whose physical or emotional condition requires the student to be absent from school on an intermittent basis.
   
   The student’s plan of instruction will be determined by the appropriate school team (SIT, SST, IEP, 504 Team) which shall include a representative of the Office of Home and Hospital Teaching.  The team will determine the hours of service, which are generally, one to two hours for each day of school missed each week.  A student who does not attend school for a full week due to a documented chronic health condition shall be eligible to receive a minimum of six (6) hours of instruction. The school team, in consultation with the Office of Home and Hospital Teaching services may modify the student’s course schedule or instructional program to reflect only standard core classes if the student requires long-term services for a chronic condition.
4. Students with Disabilities
   
   The IEP team shall meet to review and revise the IEP of a student with a disability who requires home and hospital teaching. The IEP team shall determine the hours of service that the child shall receive as well as the goals that will be addressed during the convalescence.  The student may receive related services, such as speech and language services, physical therapy and/or occupational therapy while on home and hospital teaching, if recommended by the IEP team. The related services will be provided by the school-based related service providers.  
   
   The IEP team shall also develop a plan for returning the student to a school-based program.  The student’s IEP must be reviewed and revised when he or she returns to school to indicate the services as well as the placement in the least restrictive environment. Educational placement in the home for a student with disabilities in emotional crisis may not exceed sixty (60) consecutive school days. Home and hospital teaching may not be used as an interim program for a student awaiting nonpublic placement, unless he or she otherwise qualifies for the service.
5. Students Enrolled in Nonpublic School Placement
   1. The nonpublic school is required to notify the Department of Special Education Nonpublic Office within twenty-four (24) hours or one (1) business day after receipt of parental notification that a student will be out for medical reasons and will require home and hospital teaching. The nonpublic school will provide the parent with the appropriate forms to request home and hospital teaching services.
   2. The nonpublic school will forward the completed paperwork to the nonpublic specialist upon receipt. The Nonpublic Specialist will then send copies of the forms via email or fax to the Office of Home and Hospital Teaching for review.
   3. The Office of Home and Hospital Teaching will follow the approval process referenced in Section 2, a through e.
   4. The Office of Home and Hospital Teaching will notify the Nonpublic Office and the parent via letter if the service is denied. The nonpublic specialist will be notified by phone or email of approved HHT services.
   5. The Nonpublic Specialist will notify the base school and the Special Education Instructional Specialist (SEIS) that an IEP meeting must be scheduled at the base school within five (5) calendar days if the service is approved. The boundary school representatives, the Nonpublic Specialist, the nonpublic school staff representative(s), the parent, the Office of Home and Hospital Teaching representative, the Pupil Personnel Worker, the special education chair, the base school psychologist, the school administrator and the school counselor will be in attendance.  The student’s IEP will be reviewed, revised and a class schedule will be developed for home and hospital instruction.  The student will be officially enrolled in the boundary school on or before the meeting. The boundary school will assign a school-based case manager who will provide the student with text books and assignments. The classroom teachers at the base school will grade all completed school assignments and enter grades in the student information system (SIS).
   6. Within two (2) days after the meeting the base school staff must provide appropriate instructional materials to the assigned home and hospital teacher so that services can begin within three (3) school days.
   7. When a nonpublic school student returns to a boundary school that does not provide a program commensurate with the services provided at the nonpublic school, the base school Special Education Coordinator will collaborate with the Special Education Instructional Specialist to manage the case and coordinate the provision and grading of assignments through the special education program at the base school. The base school should contact the Special Education Instructional Specialist (SEIS) and the Community Referenced Instruction Specialist (CRI) to assist the school team with students requiring State Required Testing instruction and services to make the referral to the CRI program.
   8. The boundary school will schedule an IEP meeting with the parent to review and revise the student’s IEP and discuss placement options when the student’s eligibility for home and hospital teaching ends. The participants at the IEP Team meeting will include, but are not limited to, the parent, the base school IEP team, the special education instruction specialist, the nonpublic specialist, the pupil personnel worker, and a representative from the Office of Home and Hospital Teaching.
6. Attendance
   1. Homebound or hospitalized students remain enrolled in their boundary school.  
      1. The attendance code 95 is to be used for any student who has been approved for home and hospital teaching.
      2. This code signifies that the student is absent from the classroom but is still considered in attendance for the building.
   2. A student is considered present when on home and hospital teaching unless not available for scheduled instruction, in which case the student is counted absent. In such cases the code 95 should be updated to reflect an actual absence reason such as code 02 (illness), 13 (lawful absence) or 20 (unlawful absence).
   3. The assigned home and hospital teacher will notify the base school and Office of Home and Hospital Teaching when a student is absent from a home teaching session. The base school is responsible for entering the student’s attendance in the SIS. 
   4. A student with chronic absenteeism shall be referred to the school attendance committee and the assigned pupil personnel worker for appropriate action. In the case of a student with a disability the special education chairperson and/or the SEIS for the boundary school should be notified of the unexcused absences.
   5. Once a student no longer qualifies for HHT, and they do not report back to school, they should be marked absent like any other student. The PPW shall follow the attendance procedures for unlawful absences.
7. Grading Procedures
   1. Schools are responsible for providing assignments/classwork and grades for the approved home and hospital student:
      1. All assignments are to be provided by a highly qualified teacher from the school of enrollment. 
      2. All work/projects completed by the student must be submitted to the school of enrollment by the parent or assigned teacher for grading by the student’s teacher of record, unless the assigned home and hospital teacher is certified in the subject area and is highly qualified. 
      3. Progress summaries submitted to the student’s school, parent and the Office of Home and Hospital Teaching, should list the subjects on the form and the specific assignments that were covered by the teacher and the date that they were submitted to the school for grading purposes. 
      4. The highly qualified teacher(s) is/are responsible for grading the student’s work and entering grades into the SIS grading module weekly. 
      5. The school is responsible for ensuring that the parent receives all quarterly progress reports and final grade reports. 
   2. The home and hospital teacher shall submit progress summaries at midterm, at the end of each quarter, and upon completion of services. The home and hospital teacher shall submit IEP progress summaries for students with disabilities.
   3. The school will issue regular report cards for students receiving home and hospital teaching services.
8. Virtual Learning Opportunities (VLO)
   1. Virtual-live/Online courses may be offered to students on home and hospital teaching.
   2. Students eligible for these courses must be self-directed learners with strong time management skills.
   3. Enrollment in virtual-live/online courses will be coordinated with the counselor of the school of enrollment.
   4. When approved instruction is provided via virtual-live/online courses, the student must have access to both a computer and the Internet.  The student’s family will be responsible for providing the computer and Internet access. The school system will not be responsible for providing technology to the student. 
   5. Students must adhere to the PGCPS Acceptable Use Policy. 
9. Parent and Student Responsibilities
   1. A responsible adult over the age of 18 must be present during all home and hospital teaching sessions.
   2. The parent must ensure that the student is available, on time, prepared and ready for home teaching sessions.
   3. The environment must be clean, safe, adequately lit, quiet and conducive to the learning process.
   4. Uncaged family pets must be excluded from the location where instruction is provided.
   5. The parent must provide the home and hospital teacher with advance notice if a scheduled home teaching session must be cancelled.
   6. If the student will be on a long term absence due to illness or hospitalization that will require a suspension of services, a doctor’s note must be faxed or emailed to the office of Home and Hospital  Teaching at (301) 567-8606 indicating the date that services can  resume.  This information will be provided to the boundary school for entry into the attendance module.
   7. The student is responsible for adhering to the Student Rights and Responsibilities Handbook.
10. Discipline
    1. Students receiving home and hospital teaching are subject to the Prince George's County Public Schools Student Rights and Responsibilities Handbook.
    2. If a student violates the Student Rights and Responsibilities Handbook, the Office of Home and Hospital Teaching will notify the student’s principal, who shall take appropriate disciplinary action.
    3. An emergency Section 504 or IEP Team meeting shall be convened:
       1. If a student with a disability is recommended for suspension from services.
       2. If the student’s behavior adversely impacts the delivery of services.
11. Dispute Resolution
    1. Home and hospital teaching concerns/disputes should first be referred to the Office of Home and Hospital Teaching for resolution.
    2. If the dispute is not resolved, the parent may appeal to the Office of Appeals within ten (10) calendar days. 

IV. Related Policies and Procedures

• Administrative Procedure 5113 - Student Attendance, Absence and Truancy
• Administrative Procedure 5119.3 - Educational Programs- Services for Pregnant and Parenting Students 
• Administrative Procedure 5121.1 - Grading and Reporting for Elementary Schools, Early Childhood through Grade 5
• Administrative Procedure 5121.2 - Grading and Reporting for Middle Schools Grade 6 through Grade 8
• Administrative Procedure 5121.3 - Grading and Reporting for High Schools Grade 9 through Grade 12
• Administrative Procedure 5124 - Student Intervention Team (SIT) and Student Support Team (SST)
• Administrative Procedure 5146 - Procedural Guidelines for Students with Disabilities under Section 504 of Rehabilitation Act of 1973
• Administrative Procedure 6150 - Educational Requirements and Options in Secondary Schools
• Administrative Procedure 6161 - Textbooks
• Administrative Procedure 10101 - Student Rights and Responsibilities Handbook
• Special Education Process Guide

V. Related Regulations

• The Maryland State Board of Education Regulation for Administration of Home and Hospital Teaching (COMAR 13A.03.05)
• The Maryland State Board of Education Regulation for Provision of a Free Appropriate Public Education, Least Restrictive Environment (COMAR 13A.05.01.10)
• The Maryland State Board of Education Regulation for Graduation Requirements for Public High Schools in Maryland, Other Provisions for Earning Credit (COMAR 13A.03.02.05-D)
• The Maryland State Board of Education Regulation for General Regulations, Educational Programs for Pregnant Girls (COMAR 13A.08.01.06)

VI. Maintenance and Update of This Administrative Procedure

This procedure originates with the Department of Student Engagement and School Support, Office of Home and Hospital Teaching in the Division of Student Services.  A review of these procedures is recommended every three (3) years or as deemed necessary. 

VII. Cancellations and Supersedures

This administrative procedure cancels and supersedes Administrative Procedure 5011, dated February 12, 2024.

VIII. Effective Date

July 1, 2024

Documents

• Administrative Procedure 5011 - Home and Hospital Teaching.pdf