Definition/Overview of Services
Georgia State Board of Education Rule 160-4-2-.31 Hospital/Homebound (HHB) Services
Hospital/Homebound (HHB) services are designed to provide continuity of educational services between the classroom and home or hospital for students in Georgia public schools whose medical needs, either physical or psychiatric, do not allow them to attend school for a limited period of time. HHB instruction may be used to supplement the classroom program for students with health impairments whose conditions may interfere with regular school attendance (e.g., students receiving dialysis or radiation/chemotherapy or students with other serious health conditions). Students must be enrolled in a public school in Georgia in order to receive HHB services.
HHB services are not intended to supplant regular school services and are by design temporary. The student must anticipate being absent from school for a minimum of ten consecutive or intermittent school days due to a medical or psychiatric condition. The student’s inability to attend school for medical or psychiatric reasons must be certified by the licensed physician or licensed psychiatrist who is currently treating the student for the diagnosis presented.
- The student must be enrolled in the Georgia public school system in which he or she is requesting the service.
- The student must have a medical and/or psychiatric condition that is documented by a licensed physician. Only a psychiatrist can submit a medical request form for an emotional or psychiatric disorder. The psychiatric condition presented must be listed in the latest edition of the Diagnostic and Statistical Manual (DSM). The referring licensed physician and/or licensed psychiatrist must be the treating physician or psychiatrist for the medical and/or psychiatric condition for which the student is requesting HHB services.
- The student must be anticipated to be absent from school for a minimum of ten consecutive school days or for intermittent periods of time anticipated to exceed ten school days during the school year.
- Students who have been declared emancipated by a court or are 18 years of age or older are eligible to request and sign for HHB services.
- Students who have any form of influenza or other airborne contagious diseases will not be provided services until the licensed physician certifies that the student is no longer infectious.
- Students approved for intermittent HHB services must be absent for three consecutive school days on each occurrence before HHB services will be provided.
- The school counselor, school administrator, or school social worker is the initial contact for parents/guardians to provide information regarding policies, procedures, and the application process.
- The parent/guardian, emancipated minor, or student 18 years of age or older must read and sign a document to certify his or her understanding of the HHB policies, procedures and application process.
- The parent/guardian, emancipated minor, or student 18 years of age or older must take the HHB application to the licensed physician or licensed psychiatrist treating the student for the medical condition.
- The completed application must be returned by the physician by mail or fax to the school HHB contact.
- Only the original paperwork will be accepted.
- The appropriate school HHB staff member will review the application to ensure that the student meets the minimal eligibility requirements and submit the application to the system HHB director.
- Following the approval of the system HHB director the application will be forwarded to the appropriate HHB school team for regular education student’s or IEP team for Special Education students.
- Within five school days of receiving the completed Licensed Physician/Psychiatrist Statement and Medical Referral Form, the appropriate HHB personnel shall notify the parent, guardian, emancipated minor or student 18 years of age or older of the time and place of the school team or IEP meeting to discuss HHB services. A telephone conference call or other electronic communication may be considered a meeting.
- The school team or IEP team will develop an Educational Service Plan (ESP) for each designated HHB student. This plan must address the disabling condition, anticipated length of absence, accommodations and modifications recommended by the licensed physician or licensed psychiatrist, instructional delivery method, place of instruction, adult parent designee if the student is under 18 years of age, team members participating, and strategies for the student’s reentry to school upon his or her return.
- If the doctor does not address reentry on the medical referral form, the LEA may want to contact the doctor directly. If such information is not provided, the school team can develop the reentry plan without doctor input.
- The ESP shall identify the number of hours necessary to meet the instructional needs of the student. To comply with the Georgia State Board of Education Rule 160-4-2-.31 Hospital/Homebound (HHB) Services and meet attendance requirements, a minimum of three hours of instruction per week must be provided.
- The ESP shall identify the appropriate course load for the student during the approved period of HHB instruction. It is noted that HHB instruction is not structured to supplant the regular school day and may, therefore limit the number and type of classes offered.
- The student shall be counted present for the entire week when he or she is provided instruction on an individual basis or as part of a group by the HHB teacher for a minimum of three hours per week.
- A student shall be counted absent for the week when the HHB teacher’s visit is cancelled by the parent/guardian, emancipated minor or student 18 years of age or older. The LEA may, at its discretion, reschedule the cancelled session. Once the schedule is completed, the student is counted in accordance with the Georgia State Board of Education Rule 160-5-1-.10 Student Attendance.
- If the student is unable to receive HHB instruction during the school week due to his or her medical condition, the school may, at the school’s discretion, schedule a make-up session. Once the session is completed, the student is counted in accordance with the Georgia State Board of Education Rule 160-5-1-.10 Student Attendance.
- Make-up sessions must have documentation that identifies the date of the absence that is being made-up, the number of hours of instruction, the type of instruction provided, and the content area(s) taught.
- Within five school days of receiving the completed medical referral form, the HHB services initial contact shall notify parent of the time and place of the school team for regular education students or the IEP meeting for special education students regarding HHB services and the development of the ESP.
- The time of the instructional session shall be arranged by the HHB teacher in cooperation with the parent, guardian, emancipated minor, or student 18 years of age or older.
- The parent, guardian, or approved adult parent designee as identified in the ESP must be present at the student’s home during the entire instructional period. If an adult is not present at the time of the scheduled sessions or leaves the home at any time during the scheduled session, that session shall be considered cancelled without notice and shall not be rescheduled. The student shall be counted absent for that school week.
- A parent, guardian, or approved adult parent designee is not required to be in attendance during the session with students 18 years of age or older.
- The HHB teacher must hold a Georgia teacher’s certification. He/she must be employed and supervised by a designated official of the LEA.
- HHB instruction can be offered on a one-on-one basis, or in a small group, at the home of the student, at the health facility where the student is confined, or through online learning courses, such as the Georgia Virtual School or other approved online courses.
- Other locations that may be considered are public libraries, community centers, etc.
- If instruction is provided in the student’s home a table, desk in a work space that is well ventilated, smoke-free, clean, and quiet (e.g., free of radio, TV, pets, and visitors) must be provided. A schedule for student study time between teacher visits should be established and the student should be prepared for each session with the teacher.
- For students participating in online learning courses such as the Georgia Virtual School or other approved courses, the HHB teacher may facilitate the learning process, monitor assignments and provide tutoring assistance as defined in the ESP. Participation in an online course will meet the requirement of the minimum of three hours of HHB instruction per school week for the HHB student to be considered present by the school. For more information regarding the use of Georgia Virtual School for HHB instructional delivery, contact the Georgia Virtual School program at GaDOE.
- HHB teachers shall provide direct delivery of the course materials provided by the student’s classroom teacher. The classroom teacher is required to provide to the HHB teacher a course syllabus, assignments, and tests and any supplementary materials (i.e., study guides for quizzes/tests, chapter notes, etc.) in a timely manner.
- All state mandated tests shall be administered unless the student is approved to take an alternate assessment as stipulated in the ESP. The decision to administer final examinations shall be included in the ESP.
- Full credit shall be given for work completed as stipulated in the ESP.
- HHB instructional delivery shall focus on the core subjects, i.e., reading, language arts, mathematics, science, and social studies. However, elective courses may, at the discretion of the LEA, be included in HHB instruction for graduating seniors.
- The HHB student shall use instructional materials issued by the student’s classroom teachers. The student’s parents or guardians shall be responsible for obtaining all of the student’s books from the school prior to the first session of HHB instruction.
- High school students approved for HHB services may receive instruction through Georgia Virtual School (GAVS) or approved online courses. Instructional resources associated with online courses shall be provided by the LEA.
Termination of Services
A student is released from the HHB program:
- As of the projected return date on the Application for Hospital/Homebound Services Medical Referral or if the licensed physician or licensed psychiatrist indicates that the medical condition has changed or as defined in the ESP.
- When the student is employed in any capacity, goes on vacation, regularly participates in extracurricular activities, or is no longer confined to home.
- On the last day of school of the regular school year.
- When the student returns to school or is able to return to school for any portion of the school day other than to participate in state-mandated standardized testing.
- When the parent/guardian cancels three HHB instructional sessions without providing 24 hours notice.
- When the conditions of the location where HHB services are provided, are not conducive for instruction, or threaten the health and welfare of the HHB teacher