SSPS:Hospital Homebound

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State Hospital Homebound Rule Requirements

State Board of Education Rule 6A-6.03020, F.A.C.: Specially Designed Instruction for Students Who Are Homebound or Hospitalized


(1) Homebound or hospitalized. A homebound or hospitalized student is a student who has a medically diagnosed physical or psychiatric condition which is acute or catastrophic in nature, or a chronic illness, or a repeated intermittent illness due to a persisting medical problem which confines the student to home or hospital, and restricts activities for an extended period of time. The medical diagnosis shall be made by a licensed physician.

  • Guidance from the FLDOE Bureau of Exceptional Education and Student Services also allows an advanced registered nurse practitioner (ARNP) or a physician's assistant (PA) working for a licensed physician to sign this medical statement required for HHB eligibility. For an ARNP or PA’s signature to be accepted, the name of the licensed physician must be noted on the statement.


(2) The term licensed physician, as used in this rule, is defined in Chapters 458 and 459, F.S., and is one who is qualified to assess the student’s physical or psychiatric condition.

  • Signature of a midwife, counselor, or psychologist will not be accepted.
  • If the student is being seen by multiple Florida physicians, any of them can complete the medical as long as they are qualified to make the diagnosis.
  • If a physician signs the medical who is not responsible for implementing the treatment plan for the identified medical condition, the IEP team may request additional medical information from the treating physician related to the student’s education, if it is needed to make an informed eligibility or service delivery decision.
  • Examples of licensed physicians include pediatricians, chiropractors, psychiatrists, etc. If you are unsure if the individual signing the medical report is a physician, please contact the HHB supervisor.


(3) Criteria for eligibility. A student, who is homebound or hospitalized, is eligible for specially designed instruction if the following criteria are met:

  • A licensed physician must certify that the student:
  • Is expected to be absent from school due to a physical or psychiatric condition for at least fifteen (15) consecutive school days, or the equivalent on the block schedule, or due to a chronic condition, for at least fifteen (15) school days, or the equivalent on a block schedule, which need not run consecutively;
  • The student does not have to be absent for 15 days (or the equivalent on a block schedule) before services are initiated. Knowledge from the physician that the student is expected to be absent for those days will warrant the initiation of the homebound referral.
  • Students who qualify for intermittent services must have a physician document that they will be out of school due to their medical condition for periods of consecutive days that would result in the student not being able to obtain meaningful benefit from their free appropriate public education (FAPE.) The IEP team will need to have discussions regarding the length of the period of time that will impact the student being able to benefit from instruction, therefore initiating the need for services.
  • Is confined to home or hospital;
  • There are different levels of confinement which include intermittent, part-time and full-time.
  • Will be able to participate in and benefit from an instructional program;
  • Is under medical care for illness or injury which is acute, catastrophic, or chronic in nature; and
  • Can receive instructional services without endangering the health and safety of the instructor or other students with whom the instructor may come in contact.
  • The student is enrolled in a public school in kindergarten through twelfth grade prior to the referral for homebound or hospitalized services, unless the student meets criteria for eligibility under Rules 6A-6.03011, 6A-6.03012, 6A-6.03013, 6A-6.03014, 6A-6.030151, 6A-6.030152, 6A-6.030153, 6A-6.03016, 6A-6.03018, 6A-6.03022, 6A-6.03023, and 6A-6.03027, F.A.C.; and
  • Ages served: Age 5-18 (grades K-12), unless the student is in an additional ESE program and qualifies to be served until age 22, or age 0-3 for hearing impaired and visually impaired children.
  • Students must turn five (5) on or before September 1st to be eligible for the kindergarten program, and may continue to age twenty-two (22) if working toward graduation requirements as specified in the district Pupil Progression Plan.
  • Pre-school students enrolled in full-time Exceptional Student Education (ESE) classes in Pasco County Schools will be provided HHB if the IEP team determines services are appropriate.
  • A parent, guardian or primary caregiver signs parental agreement concerning homebound or hospitalized policies and parental cooperation.


(4) Procedures for student evaluation.

  • The minimum evaluation for a student to determine eligibility shall be an annual medical statement from a licensed physician(s) including a description of the disabling condition or diagnosis with any medical implications for instruction. This report shall state that the student is unable to attend school, describe the plan of treatment, provide recommendations regarding school re-entry, and give an estimated duration of condition or prognosis. The team determining eligibility may require additional evaluation data. This additional evaluation data must be provided at no cost to the parent.
  • A physical reexamination and a medical report by a licensed physician(s) may be requested by the administrator of exceptional student education or the administrator’s designee on a more frequent basis than required in paragraph (4)(a) of this rule and may be required if the student is scheduled to attend school part of a day during a recuperative period of readjustment to a full school schedule. This physical reexamination and medical report shall be provided at no cost to the parent.


(5) Procedures for determining eligibility. Procedures for determining eligibility shall be in accordance with Rule 6A-6.0331, F.A.C.


(6) Procedures for providing an individual educational plan. The individual educational plan shall be developed or revised prior to assignment to the homebound or hospitalized program placement as required in Rule 6A-6.03028, F.A.C. A student may be alternatively assigned to the homebound or hospitalized program and to a school-based program due to an acute, chronic, or intermittent condition as certified by a licensed physician, as specified in subparagraph (3)(a)1. of this rule. This decision shall be made by the individual educational plan (IEP) team in accordance with the requirements of Rule 6A-6.03028, F.A.C.


(7) Instructional services. The following settings and instructional modes, or a combination thereof, are appropriate methods for providing instruction to students determined eligible for these services:

  • Instruction in a home. The parent, guardian or primary caregiver shall provide a quiet, clean, well-ventilated setting where the teacher and student will work; ensure that a responsible adult is present; and establish a schedule for student study between teacher visits which takes into account the student’s medical condition and the requirements of the student’s coursework.
  • Instruction in a hospital. The hospital administrator or designee shall provide appropriate space for the teacher and student to work and allow for the establishment of a schedule for student study between teacher visits.
  • Instruction through telecommunications or computer devices. When the individual education plan (IEP) team determines that instruction is by telecommunications or computer devices, an open, uninterrupted telecommunication link shall be provided at no additional cost to the parent, during the instructional period. The parent shall ensure that the student is prepared to actively participate in learning.
  • Secondary students pursuing Florida Standards use an online curriculum through the REACH program and may qualify for additional ESE services as supports.

Hospital Homebound Process and Responsibilities

Note: A designee is defined as a full-time school based employee appointed by the administrator (e.g., case manager, team leader, department head, secretary).

Responsibilities for In-State HHB Transfer Student

  • If a student transfers to Pasco County from another district in-state with a current HHB eligibility, the school designee must obtain the medical report from a Florida licensed physician’s office from the parent, doctor or previous school.
  • The staff member welcoming the family should notify the school administrator for HHB, who will notify the school-based Compliance Resource Teacher (CRT) and school nurse to initiate the process.
  • The school-based CRT will consult with the team to ensure that the correct transfer paperwork is issued.
  • For unique situations, the school-based CRT will contact the designated district Compliance Specialist for assistance.

Responsibilities for Out-of-State HHB Transfer Student

  • The school designee must immediately contact the HHB administrator, school-based CRT and school nurse so that the out-of-state-transfer process can be expedited.
  • The school-based CRT will follow the required procedures for out-of-state transfers and initial Florida HHB eligibility as required by State Board of Education Rule.
  • For unique situations, the school-based CRT will contact the designated district Compliance Specialist for assistance.

Responsibilities Upon Enrollment/Record Keeping

  • The school nurse is responsible for notifying the physician that the Hospital Homebound Medical Report is being faxed to his/her office.
  • The school nurse is responsible for emailing the HHB Intake Form to the HHB secretary with a Cc: to the school-based CRT, HHB administrator, assigned HHB case manager, school counselor and any other relevant personnel at the school.
  • The school nurse is responsible for informing the guidance secretary and CRT when the medical report has been received from the physician, so that Consent for Evaluation (MIS 425) and Procedural Safeguards can be provided to the parent and the ESE staffing can be scheduled.
  • The school nurse is responsible for providing the medical report to the school designee for the working file and submitting the medical to the HHB secretary. The HHB secretary will submit the medical to the REACH/district staff.
  • The HHB secretary at the district office is responsible for entering information into the HHB Database using the HHB Intake Form submitted by the school nurse.
  • The school-based CRT is responsible for submitting a copy of all HHB ESE Staffing Form, Consent for Placement, Student Attendance Agreement and HHB Dismissals to the Compliance secretary. The Compliance secretary will submit all documentation to the HHB secretary.
  • Each administrator/designee is responsible for using the HHB Database to monitor service provision for all HHB students and for alerting the HHB Compliance Resource Teacher if any information needs to be updated in the database (e.g., new teacher.)
  • The zoned/school of attendance continues to maintain responsibility for the student receiving HHB regardless of service delivery models (e.g., REACH, Virtual or with itinerant teacher). Assigned school responsibilities include, but are not limited to, maintaining all cumulative records, initial or reevaluations, inclusion in all state/district wide assessments, notification of all requirements/events and graduation information.
  • The zoned/school of attendance administrator must ensure a case manager is assigned for HHB student’s enrolled in their school.
  • Case managers are responsible for all aspects of compliance and maintaining the student’s red file regarding the following documents: IEPs, quarterly goal reports, report cards and progress reports, and time sheets. They also are responsible for notifying all team members (i.e., nurse, school-based CRT, administration, teachers) at least a month ahead of the reevaluation due date (which is the same as the medical report expiration date) and ensuring the necessary meetings are scheduled when required.

*Please see school boundaries (for zoned school) and ESE program boundaries for ESE program school.)

Zoned/School of Attendance Responsibilities Prior to Staffing for HHB

School Designee Responsibilities Prior to Staffing

Anyone who discusses HHB with a parent or student is responsible for notifying the school nurse and HHB administrator:

  • When a medical condition is identified, but the student may not meet HHB criteria, the school based intervention team should convene to discuss the student’s needs. This may result in opening an initial or reevaluation, referring to an outside agency, conducting an FBA/BIP, or developing a 504 plan.
  • Anyone with knowledge of the following should contact the school nurse:
  • The parent makes a request for homebound services
  • It is known that the student has been hospitalized
  • The parent informs the school that the student has been absent directly related to a medical/psychiatric condition, and is confined to the home
  • Upon receipt of the intake from the school nurse, the assigned designee is responsible for creating the student’s working file (ESE cumulative file) and starting HHB Checklist (MIS 826.


School Nurse Responsibilities Prior to Staffing

  • Providing information regarding where to obtain the Application for Initial or Continuing Hospital/Homebound Services from the Wiki and receiving the completed application from the parent.
  • Ensuring the Hospital/Homebound Medical Report is faxed to the physician’s office once the application has been received, and the HHB criteria (i.e., true confinement to the home, frequency, service delivery options, attendance, accommodations that can be provided in the school, Family Agreement, Medical Report role in decision making process) is explained.
  • Verifying the medical with the licensed Florida physician’s office (SBR 6A-6.03020 for specific description of Florida physician) and clarifying current information.
  • The school nurse may document verbal communication without resubmitting the medical form to the medical provider’s office.
  • If the condition is psychiatric, the school nurse should ask the school psychologist for assistance in contacting the psychiatrist to verify and discuss the implications and confinement level.
  • If the student has had prior agency involvement, the school nurse may ask the social worker to assist in contacting the agency where the physician is located to verify.
  • The school nurse will also verify that the physician has seen the student recently since the condition has developed, changed or worsened.
  • The school nurse will ask the following clarifying information as needed for the IEP team to make and informed decision at the eligibility staffing:
  • Is the student truly confined to the home due to the medical condition
  • The accommodations/services that can be provided to the student in the school setting through an IEP or 504 plan (if they already have one in place)
  • The student’s best interest and the effects that being in the most restrictive setting can have on a student’s education
  • HHB is not intended to replicate the school setting and that the student will only be getting limited hours of direct instruction per week
  • The importance of socialization to student growth and development
  • Any unique situations that would warrant HHB, such as changing medications or considering a parental choice of residential placement
  • The anticipated reentry plan to school for the IEP team to consider when developing the IEP.
  • Emailing the HHB Intake Form to the HHB secretary with a Cc: to the school-based CRT, HHB administrator, assigned HHB case manager, school counselor and any other relevant personnel at the school.
  • Informing the guidance secretary and CRT when the medical report has been received from the physician, so that Consent for Evaluation (MIS 425) and Procedural Safeguards can be provided to the parent and the ESE staffing can be scheduled.
  • Emailing/scanning the HHB application and medical report to the SSPS HHB secretary @ 42117 to upload to the HHB files.
  • Providing the original copies of the HHB application, intake, and medical forms to the school designee to include in the cumulative folder.
  • Keeping updated files with copies of the HHB application, intake forms, medical reports and any other relevant documentation for all HHB students on their caseload and monitoring medical report expiration dates.

HHB Administrator Responsibilities Prior to Staffing

  • If a student has accumulated absences prior to the initiation for HHB services, the administrator or designee should ensure that the content area teachers have missing work available from the first date of absence due to the medical condition, until the date of the staffing.
  • It is the student’s and parent’s responsibility to make arrangements to obtain all missing assignments and work that was not completed prior to the staffing.
  • The administrator or designee must ensure that the teachers follow up with the student to make sure all work has been turned in prior to the end of the quarter.
  • Ensuring that instructional time is provided by a liaison for any absences after the date that the physician determined the student should not be in attendance (i.e., date the medical is signed,) regardless of the date of the HHB staffing.
  • Contacting the HHB Compliance Resource Teacher for any unique situations where input is needed prior to the meeting, or if the attendance of a HHB program representative is requested.
  • For middle and high school students pursuing Florida Standards:
  • Prior to the IEP meeting, the student’s medical condition, current academic levels, restrictions, limitations and the graduation plan should be taken into account by the IEP team when determining the least restrictive environment (LRE). School counselors must attend the meeting or provide input to assist in determining what classes are needed.
  • The school administrator must designate a staff member to contact the HHB case facilitator to discuss availability of classes prior to the IEP meeting. A REACH Services Plan will be provided for you to complete to inform REACH of the student’s current schedule, completed graduation plan, list of any itinerant teachers, etc. The REACH Services Plan does not have to be fully completed before REACH services start, but must be fully completed as soon as information is obtained to ensure the student is getting all of the services determined by the IEP team. For example, you may submit the student schedule, but do not know who will be assigned as an itinerant. The schedule may be submitted so that the student's schedule can be reflected in MyStudent, but the plan will not be considered complete until all of the information on the REACH Services Plan is received by the REACH Case Facilitator.
  • If a course is not offered through REACH/APEX, the administrator must collaborate with the school counselor to select another available course to meet graduation requirements or find and alternate course through another virtual platform (i.e., FLVS, eSchool.) Only courses that are required for graduation will be provided through a highly qualified itinerant teacher in the home if a REACH course is not available.
  • For any students that need an itinerant teacher (e.g., elementary, access points, intermittent, individual instruction for organization and work completion,) the school-based administrator should start the hiring process to find a highly qualified teacher or liaison by accessing the HHB database, advertising the opportunity to their school and neighboring school staff, or placing an ad with Human Resources. If a teacher cannot be found using these methods, then the HHB CRT can be contacted for coaching through the process.
  • If the team believes that HHB services are needed, but the family has not provided the HHB Application, the administrator or designee should ensure the following:
  • The student services team meets to discuss the student situation.
  • Absences are documented as excused or unexcused as indicated in the Student Code of Conduct, and truancy should be pursued if criteria are met.
  • If the condition is medical, the school nurse should contact the parent to discuss the condition and ask for a HHB Application, including the release of records for the physician.
  • If the condition is psychiatric, the school psychologist may assist the school nurse with contacting the parent to ask for a HHB Application, including the release of records for the psychiatrist.
  • The school social worker should assist the nurse with contacting the parent and possibly doing a home visit to inform the parents that if the appropriate paperwork has not been provided, the student needs to be in school.
  • The school counselor should provide the parent with a copy of the student’s graduation plan and stress the implications of the absences on promotion/obtaining credits.

Responsibilities During and After Staffing

Responsibilities for Initial Eligibility

Scheduling of Staffing/Team Analysis of Data
  • The school nurse is responsible for informing the guidance secretary and school-based CRT when the medical report has been received from the physician, so that Consent for Evaluation (MIS 425) and Procedural Safeguards can be provided to the parent and the ESE staffing can be scheduled by the guidance secretary.
  • If the consent sent home by the guidance secretary is not received from the parent prior to the staffing, then it may be obtained by the CRT at the scheduled meeting.
  • The CRT will provide the guidance secretary/ESE secretary/case manager their availability so that the guidance secretary can schedule ESE Staffing, which includes the Team Analysis of Data (TAD).
  • CRTs and Nurses are excused from their assigned schools to attend HHB staffings in order to facilitate the meeting in a timely manner, as long as they do not have any staffings previously scheduled at this time.
  • The eligibility staffing must be held within 10 days of when the school nurse (in collaboration with other identified staff members) verifies the medical with the physician.
  • If the school nurse is unable to verify with the doctor within 10 days, all attempts must be documented in Health Tracker and the School Health or HHB Supervisor should be contacted for assistance.
  • If the student has an existing ESE area of eligibility then a Recommendation for Reevaluation Meeting (MIS 809) and Consent for Reevaluation (MIS 444) must be obtained by the CRT by the ESE staffing date (This can also occur at the meeting.)
  • For anticipated complex eligibility decisions, the team may contact the HHB Compliance Resource Teacher to problem-solve prior to the meeting.


Invite and Input
  • The guidance secretary or designee issues the Staffing Invitation and input forms to the family. They should also contact the family to notify them of the ESE staffing date and time and determine if they want to waive the 10-day notice so that services can start as soon as possible.
  • The guidance secretary or designee sends the Staffing Invitation to required and requested school-based personnel to notify them of the meeting time/date and requests that the teachers compile data for the meeting regarding how the student is performing and current grades.
  • If related services are being considered, a "related service representative(s)" must be present or provide written input to use when the team is determining the educational relevance of the services in the home.
  • The school nurse must always be invited to the HHB ESE staffing.
  • If the student has a psychiatric condition, the psychologist must be invited.
  • If the student was involved with outside mental health agencies, the social worker must be invited.
  • When considering the service delivery via Virtual Instruction or REACH (for secondary students) the administrator or designee must consult with and invite a representative of that program to discuss implications based on the student needs to share with the IEP team.
  • The case manager should develop a draft IEP to present at the staffing. Contact the REACH Case Facilitator for questions about IEP development or to review the draft IEP for guidance.


ESE Staffing
  • The case manager will complete the Demographic section of the draft TAD and the Parent and Adult Student Input Form (MIS 455).
  • The school nurse is responsible for providing information to the case manager regarding the Parent Contacts and Medical Diagnosis sections of the draft TAD.
  • The bottom Eligibility Determination section of the TAD is left blank for the team to answer the questions and come to agreement during the formal staffing.
Note Regarding HHB Eligibility Decisions:
The IEP team must make decisions regarding eligibility based on all available information. The physician's medical report required by law is one piece of information the team considers when determining the student's least restrictive environment (LRE.) The physician is the expert regarding the medical condition, but the school-based staff are experts on the LRE in an educational setting. Teams do not make eligibility decisions because the doctor indicates the need for HHB on the medical report alone. The team must consider if the student is truly confined to the home, if absences are related to the medical condition or other reasons, and/or if HHB is the student's LRE. If there is sufficient evidence that the student does not require special education services in the area of HHB, then the team should answer "no" to that eligibility question on the TAD and the student would not be eligible for HHB.
  • After the TAD, the CRT will have the staffing paperwork ready to finalize eligibility.


Responsibilities for Schedules and Graduation Plans for Secondary Students

The school counselor (for Florida Standards students) or the case manager (for Access Points students) is responsible for providing a current schedule and the completed graduation plan to the REACH program. Although graduation plans are not typically developed for all students until their last year before graduation, graduation plans should be developed for all secondary HHB students so that the options and requirements are clearly outlined based on what the student can tolerate on their schedule. Because students may take a lighter course load when they are ill, it is imperative that families understand the impact on graduation.


Responsibilities for the Initial IEP Meeting

  • The school-based case manager must update the reevaluation date on the IEP based on the medical expiration date, once the student is found eligible for HHB.
  • The school-based case manager must submit a draft IEP to the HHB Case Facilitator prior to the IEP meeting for review or assistance with the correct development of the HHB IEP.
  • The school-based case manager will present the draft IEP and the team will add input to finalize.
  • Teams should discuss and consider the difference between related services and accommodations required in the school setting vs. the home (e.g., occupational therapy, additional breaks.)
  • If a related service is determined as a need, the case manager must inform the Related Services Supervisor, Glennda McCallister, via email a gmccalli@pasco.k12.fl.us, so that a provider can be assigned.
  • The CRT will ensure that the Notice and Consent for ESE (MIS 755) and/or Informed Notice (MIS 757) and the the Student Attendance Agreement is signed, and the Data Entry for ESE (MIS 729) has been completed.
  • The school-based case manager, school-based teachers and the HHB itinerant teachers will need to collaborate quarterly to assess progress towards the student’s goals on their IEP.


Responsibilities for Obtaining Current Grades

  • If the student’s teachers will change for any class/course, the school-based case manager will send out an email with a Cc: to the administrator with the Hospital Homebound Grade Blending Form for the current school-based or HHB teachers to complete. The case manager will compile and provide this information to the student’s HHB or REACH teachers and place it in the red file as documentation. The new teachers should use all information provided when determining final grades.


HHB Administrator Responsibilities for Hiring Itinerant Teachers

For secondary Florida Standards students in the REACH program, please see the REACH Procedures and IEP Sections regarding when a student may qualify for a teacher in the home.

  • The school-based administrator must find itinerant teachers by accessing the HHB database, advertising the opportunity at his/her school and to neighboring school staff, and/or placing an ad with Human Resources.
  • If a teacher cannot be found after these attempts, the administrator should contact the HHB Compliance Resource Teacher for coaching through next steps.
  • The process of hiring teachers should take no longer than 10 school days.
  • At the beginning of the year, and quarterly, an ad is sent out by SSPS advertising for HHB teachers. If the teachers express interest, they are placed into the HHB Database, which can be accessed by administrators only. Therefore, administrators do not have to re-advertise for each HHB position.
  • While attempting to obtain an instructor, the school-based administrator must ensure that the current content area teachers send home assignments.
  • It is the student’s and parent’s responsibility to make arrangements to obtain all missing assignments and work that was not completed prior to the staffing.
  • The administrator or designee must ensure that the current teachers follow up with the student to make sure all work has been turned in prior to the end of the quarter and assign a grade accordingly.
  • The school-based case manager must provide the Hospital Homebound Grade Blending Form for the current school-based or HHB teachers to complete and compile all of the forms for determining grades if a student is changing to REACH mid-semester.
  • The school-based administrator must ensure instructional time is provided for any absences after the date that the physician determined the student should not be in attendance (i.e., date the medical is signed) regardless of the date of the HHB staffing.
  • The school-based administrator must ensure that a teacher or staff member is assigned to provide required statewide assessemnts in the home.
  • Currently, HHB students are not required to participate in district Quarterly Checks or district EOCs because the focus on the limited amount of direct instruction provided in the home is dedicated to content instruction and student progress is determined through individualized assessments.
  • Currently, the platform for statewide computer-based assessments cannot be provided in the home. Based on the student's individual needs and tolerance level, testing can be scheduled in the school setting, or via paper-based testing in the home.
  • If a related service is determined as a need, the school-based case manager must inform the Related Services Supervisor, Glennda McCallister, via email a gmccalli@pasco.k12.fl.us, so that a provider can be assigned.
  • The school-based administrator is responsible for monitoring the provision of instruction in the home. Please contact the HHB CRT to obtain an example monitoring Excel database to track the hours owed and hours submitted by teachers on timesheets.


Responsibilities for Required Paperwork/Records

  • The school-based administrator or designee must ensure that the Student Attendance Agreement is signed prior to the provision of instructional services.
  • The school administrator or designee will give the itinerant HHB teacher(s) or other service providers the link to the Instructor Forms section on the Wiki.
  • The school administrator or designee should review the HHB Instructor Agreement and the Biweekly HHB Timesheet with the hired HHB teacher(s) or other staff who will provide services in the home.
  • The teacher or other service providers should sign Instructor Compliance Agreement then return it to the case manager.
  • The case manager should place the forms in the student’s red (ESE) folder (right side) and send a copy of the forms to the HHB secretary.
  • The school administrator or designee will give the data entry operator a completed scheduling form so the new HHB schedule can be created.
  • For students participating in the REACH program, the school-based team will work with the REACH Compliance Resource Teacher based on promotion/graduation requirements to develop a new schedule and the REACH secretary will enter the schedule into the system.
  • For students receiving intermittent services, the school-based teacher of record will need to keep attendance daily if the student attends school or is absent.
  • HHB teachers must indicate attendance on the Biweekly HHB Timesheet.
  • The student’s records will remain at the zoned or program school of attendance and will be ‘tied’ to that school for accountability, even if the teacher(s) who are serving the student work(s) at a different school.
  • If the homebound teacher is unsure where the paperwork should be submitted to, they should contact the administrator who hired them for clarification. If further clarification is needed, please contact the REACH program staff for assistance.


Responsibilities for Grades & Report Cards

  • When a student is on intermittent HHB, the classroom teacher is the teacher of record and the H/HB teacher is the liaison to provide the student work. The classroom teacher is responsible for grading work and assigning grades.
  • When a student is on part-time HHB, the classroom teachers for the period when they are in school are their teacher(s) of record, and the HHB teacher is the teacher of record for the periods when they are at home. Both the classroom teacher and the HHB teacher are responsible for grading work and assigning grades for the content areas that they are providing services. Depending on the student’s grade level, the teachers may have to work collaboratively to enter grades.
  • For part and full-time HHB students, the HHB teacher(s) are the teacher of record and are responsible for grading work and assigning grades for the content areas that they are providing services. The data entry operator will create a course for the HHB teacher in TERMS, which will provide access to eSembler.
  • If a student reenters school before the end of a quarter, the classroom teachers and HHB teachers must average their grades.
  • If an HHB student has not demonstrated mastery of the curriculum at the end of the grading period, but all instruction was provided as scheduled or absences were related to the medical diagnosis, the content area teacher should contact the principal to approve an extension on a case-by-case basis. As indicated in the Student Progression Plan, grades can be based on mastery of the work completed or the student can be given an “I” to allow additional time to continue the work. If the student did not get instruction for reasons unrelated to his/her HHB diagnosis (vacations, schedule conflicts, etc.) the student should not be given additional time to complete the work. The assigned administrator will collaborate with the HHB teacher and data entry operator to determine when work is completed to update the “I.”
  • All grades should be reported by the teacher(s) of record, but the report cards should be distributed to the parents by the student’s home/zoned school of attendance. Case managers are responsible for ensuring that this has been done. For elementary students and students pursuing special standards, the report cards must also be placed in the cumulative file.
  • If the student’s teachers will change for any class/course, the school-based case manager will send out an email with a Cc: to the administrator with the Hospital Homebound Grade Blending Form for the current school-based or HHB teachers to complete. The case manager will compile and provide this information to the student’s HHB or REACH teachers and place it in the red file as documentation. The new teachers should use all information provided when determining final grades.


Responsibilities for Quarterly Goal Reporting

  • The case manager and the HHB teachers will need to collaborate with HHB teachers quarterly to assess progress towards the student’s goals on their IEP. The case manager will provide the parent with their copy.


Responsibilities for Curriculum Resources

  • The administrator must designate classroom teachers to provide the itinerant HHB teacher(s) with textbooks, teachers edition (or access to codes for online textbooks) assignments, tests, etc., that will allow the student to keep up with the curriculum.
  • A teacher hired for HHB may be certified in the content area (e.g., Science), but not teach the class during the day. Therefore, they wouldn’t have access to any materials or be expected to develop unit plans for one student.
  • Because the zoned/school of attendance receives FTE funding for the student, they should designate a teacher, based on the situation, to provide assistance and resources to the HHB teacher to keep the student on track with their peers in the school setting. This also applies to students who aren’t expected to return to the school setting.

Responsibilities for Planning and Resuming HHB Services for the Next School Year

  • For many students, the medical date and IEP do not expire until after the school year has started. During the summer, administrators should review the list of HHB students enrolled at the school for the upcoming year to plan for instruction so that that a break in services does not occur.
  • Once schedules are developed for all students, the assigned administrator can begin the process of obtaining highly qualified teachers for the courses needed. This includes contacting the students' current teachers to see if they are still interested in providing instruction in the home and searching the HHB Database to find potential teachers for new subject areas. For secondary students, administrators should contact the REACH program to develop a schedule in conjunction with the student’s school counselor. Services should start the same week that school begins for all students.

Responsibilities for Continuation of HHB Eligibility

School Nurse Responsibilities for Continuation of HHB Eligibility

  • The school nurse will monitor medical report expiration dates and send a HHB Notice of Medical Report Expiration to the physician and parent at least one month prior to the expiration date, if HHB is expected to continue.
  • Once the HHB Application has been received from the family, the school nurse must obtain and verify a new Homebound Medical Report from a Florida licensed physician at least one month prior to the expiration of the existing medical. The new medical report must be sent to the HHB secretary at the district office. The nurse should document telephone, email or personal contacts made to the physican's office when attempting to verify the Medical Report by asking the designated confinement and least restrictive environment questions.
  • The school nurse will inform the case manager if there is a recommended change in the level of services on the new Medical Report so that an IEP meeting can be scheduled. Change in level includes any change in the HHB Instructional Services.


Case Manager Responsibilities for Continuation of HHB Eligibility

  • School-based case managers must monitor the IEP and Reevaluation due dates for all HHB students. These meetings should be held within a reasonable amount of time before any IEP or Medical Report expiration dates.
  • Medicals that are set to expire over the summer need to be obtained before the end of the school year, so as not to cause a break in service at the beginning of the school year.
  • Because the review of the new Medical Report and all other current data is considered an evaluation, the case manager must update the reevaluation date in PEER.
  • The case manager can continue to update the reevaluation date based on the updated medical report. If the medical report provides substantially different information, then the case manager and/or school nurse should ask the team to consider if the student needs a reevaluation to conducted additional assessments.
  • The case manager should review the IEP to ensure that the student’s current needs are being met with the current plan. If needed, either an IEP revision or a new IEP needs to be developed as to not cause a break in the student’s services. Please see the IEP section for more information.
  • The case manager must ensure that a new Student Attendance Agreement is signed when HHB services are continuing.
  • The case manager will print and submit a new Data Entry Revision Form to the data entry operator and/or a new REACH Services Plan to REACH case facilitator.


HHB Administrator Responsibilities for Continuation of HHB Eligibility

  • The administrator or designee should email the itinerant teachers, if applicable, of the students continuing on long-term HHB to inquire if they want to continue providing services in the home and/or are still highly qualified for the upcoming school year.
  • Students who require long-term HHB for a chronic condition should always be considered as continuations. The administrator or designee should schedule an meeting prior to the new school year to review thte medical report, schedule, current progress in the program and any other concerns of the IEP team.

Responsibilities for Articulation

  • Schools should follow the same articulation procedures for HHB students that they do for all ESE students, but it is extremely important to do this properly for HHB students because they may not be visible on campus. Unless a sending school properly notifies the receiving school that the student is articulating, the receiving school may not even be aware that the student is HHB, and may withdraw them for non-attendance when they do not show up on site in the fall. To ensure that there is no break in services, the student’s current administrator and case manager must work together to collaborate with the receiving school to make sure that the transition is smooth so that the student is set up for success.
  • It is the responsibility of the sending school’s administrator to contact the administrator at the receiving zoned or program school by the district articulation date for all students. Because service delivery for HHB students differs between elementary, middle and high school depending on the student’s schedule, which directly correlates with the minutes of service provided in the home, it is imperative that a IEP meeting be held prior to the end of the school year. The administrator or designee of the sending school will contact the receiving school to invite them and any potential services providers to the IEP meeting, and provide the following information to prepare for the meeting:
  • Student name and contact information
  • Date of expiration of current medical report
  • Student course selection for the upcoming school year
  • Current schedule, service delivery model and actual minutes served
  • Current related services provided
  • Any other pertinent information regarding the family and student
  • The sending school nurse is responsible for mailing home a medical update and parent/student agreement if the current medical expires before August 30th of the upcoming school year. The contact information on the forms should include the receiving school nurse contact information.
  • If the student plans to reenter school because he/she will not continue to meet eligibility for HHB, or his/her confinement level has changed, the case manager will schedule a meeting with the IEP team to develop a reentry plan. The reentry plan should ensure that the proper accommodations are provided and that all restrictions and limitations have been discussed and shared with the new teachers and staff.


Responsibilities for Dismissal (HHB Eligible Only)/ Discontinuation (HHB and Eligible for Additional ESE Programs)

  • The school nurse will provide the HHB Notice of Medical Report Expiration to the physician and parents at least one month prior to the expiration date. The nurse will document telephone, email or personal contacts made to the physician and parent on a copy of the notice to verify that they received the letter and to explain the implications of the medical expiration/next steps. This documentation should be given to the case manager to determine next steps and then be placed in the student file.
  • If a student plans to return to school once the medical has expired, the IEP team should meet to discuss plans for successful reentry prior to the medical expiration date. Students with expired medicals should not be denied reentry to the school.
  • If a student with a current medical provides appropriate documentation from a physician stating that a return to school is safe, they should not be denied reentry. An administrator should be contacted immediately to assess the unique circumstances and work with staff to transition the student as soon as possible. The nurse should immediately be informed so that they can contact the doctor to verify the student’s status, limitations and restrictions.
  • If a student with a current medical returns to school without appropriate reentry documentation from a physician, the school should inform the family that a status update would be required and discuss the process for reentry depending on the situation. The nurse should immediately be informed so that they can contact the doctor to verify the student’s status, limitations and restrictions.
  • Students who require long-term HHB services for a chronic condition should never be dismissed unless new data is provided and the team meets to consider the information. The team should document attempts to obtain the necessary paperwork from the physician. If these attempts are unsuccessful, please call the HHB supervisor for guidance.


Dismissal/discontinuation is determined for one or more the following reasons:
  • A Homebound Status Update form or a note from the doctor is received indicating that the student is able to reenter into his regular school program on or before the date the medical expires. The nurse should verify that the information is accurate and from the same doctor/facility that signed the original medical report.
  • Upon failure of parents, guardian or medical provider to comply with the Homebound Agreement, a meeting should be scheduled with appropriate parent invitation documentation to discuss the infraction and determine alternative ways to serve the student. It is recommended that an administrator or REACH representative attend this meeting and meeting notes be placed in the student’s folder.
  • The current medical has expired and the required annual updated medical information has not been received. The school nurse, case manager and possibly the social worker should make multiple attempts to obtain the medical documents.


When it is determined that a student is recommended for dismissal/discontinuation, the following steps should be taken:
  • The school administrator will determine if the CRT, school nurse or case manager is the best suited to contact the family regarding dismissal/discontinuation, based on the unique situation and relationships with the family.
  • If the student is an existing ESE student, then a reevaluation meeting (MIS 809) should be held prior to dismissal to update the reevaluation date (to the date of the meeting.) The MIS 809 may indicated that no further data is needed. The team should fully consider all the needs of the student reentering the school environment.
  • The case manager, after collaborating with the nurse, must notify the CRT/Compliance Specialist that the student no longer requires services.
  • The CRT/Compliance Specialist will complete and mail an informal ESE Services Staffing (MIS 795.) This form should include the “mailed on date” on the parent signature line. In the additional information section, attempts to contact parent should also be included. If there is an additional eligibility, the form should state that an IEP meeting will be held within 10 days.
  • The CRT/Specialist will also complete and mail an Informed Notice (MIS 757) to parents.
  • The case manager must notify all of the student's homebound teachers/REACH Compliance Resource Teacher that the student is dismissed and will no longer need instruction in the home. The case manager should obtain the grades from these teachers so that they can be entered or blended with the school-based teacher's grades, if needed, based on the time of reentry.
  • If any team member has concerns about the student’s restrictions or limitations in the school setting, the case manager should be contacted to schedule a reentry meeting to discuss needs (e.g., learning needs, health care plan, safety plan for behavioral needs, independent functioning.)
  • If the student continues to meet ESE eligibility in another area, the HHB case manager should schedule an IEP meeting within 10 days of the Informed Notice (MIS 757) being sent, to remove the HHB services and review/revise the student’s current needs on the IEP with the team.
  • The CRT will complete the Data Entry form to reflect dismissal/discontinuation.
  • The CRT will send a copy of the Data Entry form to the SSPS HHB secretary so that it can be entered into the HHB database and provided to the HHB supervisor/REACH.
  • The IEP team should consider if the student requires a Section 504 Accommodation Plan upon reentry to school.

IEP Considerations for HHB

Case managers are responsible for all aspects of compliance and maintaining the student’s red file regarding the following documents: IEPs, quarterly goal reports, report cards and progress reports, and time sheets. They also are responsible for notifying all team members (i.e., nurse, school-based CRT, administration, teachers) at least a month ahead of the reevaluation due date (which is the same as the medical report expiration date) and ensuring the necessary meetings are scheduled when required.


These considerations are specific to IEPs for HHB students. Please refer to Quality IEP Training for guidance regarding IEP requirements for all ESE students.

The following scenarios for HHB may be referenced in the information below:

  • The student has an existing eligibility or IEP
  • The student is only eligible for HHB and does not have an existing IEP
  • Relevant in both situations for HHB students


Prior to TIEP Meeting:

  • Parent and student input and participation is required prior to the development of the IEP, even if the student isn’t in attendance at school due to medical reasons. If written input cannot be obtained, then the case manager should make every effort to secure any type of input (e.g., faxed input from the hospital, phone conversation with student, documentation of Skype.)
  • Procedures for obtaining agency input (See Agency Involvement) only apply to HHB students with additional exceptionalities. HHB only students would not necessarily require post-school service involvement. Input from medical providers would be important data to consider in any decisions made by the IEP team.
  • A Student Attendance Agreement must be signed prior to the initiation or continuation of HHB services.


Special Note Regarding HHB IEP Revisions:

Note: This information is relevant for all current IEPs that are written in PlanMaker. Once the full transition to PEER occurs, this section will not be relevant.

Pasco procedures allow for one revision to a student’s IEP. Based on the nature of the HHB program, students may need several revisions per year when schedules, location or frequency need to change based on the medical condition. Therefore, staff are approved to make more than one revision, for HHB students only, if changes are needed within the year timeframe for the annual IEP. The following procedures must be followed for HHB IEP revisions:

  • The case manager must verify that a printed copy of the most current HHB IEP is in the student’s red file.
  • When more than one revision is needed, staff must make changes electronically in PlanMaker on the HHB IEP for the same year.
  • The changes to the HHB IEP must be printed, dated and initialed, with a new signature page for the team to sign.
  • Each time a new revision is needed for a HHB student the process above must be followed.
  • Once the annual HHB IEP revision date is due, a new HHB IEP must be developed.


HHB General/Student Information

  • Reevaluation Due Date: The expiration date of the medical report should match the reevaluation date for HHB students, not three years from the initial staffing or the most recent evaluation.
  • Primary Exceptionality: The primary exceptionality for all full-time HHB students must be Hospital/Homebound, as indicated by the “M” code. When a part-time or intermittent student who is already eligible for ESE becomes eligible for HHB, the team should determine which exceptionality requires the most services (e.g., HHB, SLD, ASD) to determine which should be listed as primary. In this case, HHB may be considered an additional exceptionality.
  • Related Services: HHB students receiving therapy from outside agencies do not automatically meet eligibility for related services in the educational setting. If the team suspects that the student may need related services due to their medical condition, evaluation procedures for these services in the school must be initiated and followed.
  • Recent Evaluations: For HHB students, medical evaluation should also be checked in this area.
  • Special Considerations: For students on part-time HHB, the team should consider and check if there is a Need for Special Transportation Services.
  • Transition Services: There are no special considerations for HHB beyond what is required for all ESE students.


HHB Present Level Statements

  • It is very important to include relevant medical information exactly as stated on the medical report in the present level statement. Additional sources of information may also be included, as needed when considering goals.
  • The following examples will assist teams when considering information to be included in the IEP and provide sample wording that would provide a clear picture of the student’s medical needs:
  • If parent shares that there is another medical diagnosis or any other information that is not documented, it can be listed in the first paragraph: “Parent reports [student] also has a diagnosis of ______________.”
  • Include information regarding the result of the student’s disability: “As a result of [his/her] ________________(medical condition as it is written on the medical), [Student] now requires instructional services provided in the home as [he/she] recovers/receives treatment due to the medical implications for instruction (as it is written on the medical). Include limitations and restrictions in the school setting provided by the physician on the HHB medical report.
  • Include information regarding student’s priority educational need: “[Student’s] priority educational needs include ____________.” Examples for this section may include maintaining [his/her] academic progress, requesting assistance as needed, organizational skills, work completion, goal-setting, self-determination due to their new medical condition, attendance, time-management, and/or coping skills.

HHB Goals

Due to the medical condition of an HHB student, goals may need to change or be added depending on the student’s priority educational needs. Examples of goals related to the medical condition include:

  • Due to the change in educational setting, the student may now have difficulty with organization and work completion:
“When working with the homebound teacher, [Student] will use a planner to keep track of and complete assignments as indicated by due dates given 8 out of 10 opportunities during each quarter.”
  • Due to a change in medical condition, a student will need to be taught self-advocacy skills:
“When faced with challenging material, [Student] will request assistance or clarification from the homebound instructor [percentage] of the time during the grading period.”
  • It is extremely important for HHB students to attend their scheduled instructional services because they are already getting a limited amount of time compared to students who attend school regularly. If scheduled H/HB services are missed frequently, attendance must be addressed in PLS, including the number of days absent, and attendance must be one of his/her priority needs before truancy is pursued:
“When unable to attend scheduled HHB instructional services, [Student] will let the homebound teacher know ahead of time, seek the content covered in order to make up missed work, and provide corresponding medical excuses [percentage] of the time for [number] of weeks.”


HHB ESE/Special Education Services

HHB Service Type

Note Regarding HHB Services Decisions:

The IEP team must make decisions regarding student confinement level (intermittent, part-time, full-time) based on all available information. The physician's recommendation on the medical report required by law is one piece of information the team considers when determining the student's confinement level. The physician is the expert regarding the medical condition, but the school-based staff are experts on the LRE in an educational setting. Teams do not make confinement level decisions because the doctor is asked to recommend a confinement level. If there is sufficient evidence that the student does not require the confinement level recommended by the physician, then they should determine what level would best meet the students educational needs in the LRE.

Note Regarding HHB Services Decisions for Secondary Students:

Secondary IEP teams must use the REACH Service Delivery Decision Matrix to help guide decisions regarding HHB service delivery based on student need with supporting data.

The following chart must be used as a guideline for teams when making decisions regarding HHB service delivery:

hhb_chart.png

HHB Service Dates

  • The IEP expiration date is not tied to the medical expiration date regardless of whether the student continues to have another ESE eligibility. Because we write annual IEPs, the services span from one year from the date of the IEP meeting (e.g., 1/10/2016 – 1/10/2017). There are many instances where an existing medical will be updated for continuation or a new medical is received prior to the original medical expiring, so writing the IEP for one year prevents a break in HHB services in these situations.
  • Medicals are tied to reevaluation dates, not the duration of the IEP. When a IEP runs past a medical date, it does not mean the child will continue to get HHB services. If they reenter school prior to the IEP expiring, we dismiss from HHB and revise the IEP based on the student’s needs. The school-based CRT will facilitate the dismissal and write the following statement on the MIS 795 Staffing form: "Discontinuation of HHB will occur upon full-time reentry or expiring medical."


HHB Frequency

Elementary, middle and high school students receive different frequencies based on the required curriculum and courses. The IEP team makes decisions regarding frequency on a case by case basis using data. See the Frequency by School Level section for more information regarding hours and scheduling.

HHB Related Services

--- Coming Soon!


HHB Accommodations

The team should consider HHB accommodations based on the location of the services. Many accommodations, like extended time or additional breaks, are inherent components of the HHB program because the setting in the home is individualized. For secondary students using an online curriculum, many accommodations are already inherent to the online platform, such as auditory presentation, highlighting, note taking, copy of directions, etc. The team should thoughtfully consider the accommodations needed related to the setting, while remembering that the accommodation may still be required for statewide assessments.


HHB Extended School Year (ESY)

  • ESY can be provided in the student’s least restrictive environment, which would include the home if appropriate.
  • ESY procedures for HHB students are the same for all ESE students, but itinerant instruction must be indicated on the ESY paperwork.
  • After Spring Break, the case manager should review the list of HHB students on his/her caseload and collaborate with HHB teachers serving the students to review data in regards to consideration of ESY services.
  • All compensatory services for HHB that are provided int he summer fall under ESY for allocations. HHB Compensatory hours are not included on the actual IEP in the ESY section. HHB Compensatory hours are included in the IEP meeting notes, which are a part of the student file, and and ESY paperwork must be submitted to the district office prior to summer so that the assigned instructors can receive compensation.
  • Hours for ESY HHB instruction in the home are listed for the entire summer, not weekly. All determinations for ESY hours are based on the individual student needs based on data. School-based ESY is typically 10 days, which would be the equivalent of 10 hours in the home over the summer. If data indicates that more or less time is needed, there must be evidence to justify the recommendation.
  • HHB ESE Frequency: _________ hours over the summer
    HHB ESY Dates: List the first day after school is out for the summer, and the Friday before students return to school in the fall.

Instructional Services for Hospital Homebound

Attendance for HHB

It is extremely important for HHB students to attend their scheduled instructional services and/or participate in the HHB academic curriculum, because they are already getting a limited access to instruction compared to students who attend school regularly. If scheduled HHB services are missed frequently, attendance must be addressed in PLS with number of days absent and a statement that attendance is one of his/her priority needs before truancy is pursued. A Student Attendance Agreement for Hospital/Homebound Services must be signed annually, or when the team determines that HHB services will continue.


Attendance Code: [B] HospitalHomebound

An HHB attendance code has been developed to differentiate between time that the student is actually present for services or absent and not receiving services. The [B] code is a placeholder that can only be entered by the data entry operator at the school once the instructor timesheets have been submitted by the administrator. The [B] code indicates that the student was neither present or absent because they were not scheduled to receive services in the home on that date/time. The [B] code is used by teachers on their timesheets to indicate when they have canceled services, because the student was neither present or absent.


Attendance Documentation on HHB Timesheets

H/HB teachers must document the provision of HHB instructional services on the timesheet as follows:


[P] The student received instructional services from the HHB teacher for that date

[B] The HHB teacher cancelled instructional services

[M] The parent cancelled the scheduled HHB instructional services due to a medical reason

[U] The parent cancelled the scheduled HHB instruction for reasons not related to a medical reason, or the parent is refusing services

[C] Compensatory services were provided as make up for previous time missed


*Note: All efforts should be made to schedule medical appointments during times where regular instruction has not been previously arranged between the family and teacher. If there are repeated absences due to the medical condition, verification of why instruction in the home cannot be tolerated during those times may be requested from the physician.

*Note: More than 5 unexcused absences for scheduled services due to parent cancellations should initiate an IEP meeting regarding attendance.


Administrator Responsibilities for HHB Attendance:

It is the administrator's responsibility to monitor the provision of services by reviewing timesheets. If timesheets are not being submitted by HHB teachers, the attendance will not be accurate and it may indicate that the teacher is not seeing the student for the courses scheduled. Using the timesheets to monitor attendance will assist in identifying if a student is receiving the services as determined on the IEP. The administrator must also confirm that the teacher is not documenting HHB services during scheduled work hours or supplemental hours and that there is reasonable travel time between the school and the student home. Once the timesheet is signed by the administrator, a designee must put a copy in the student’s red folder, and submit the original timesheet to the SSPS HHB Secretary via courier for payment and to update student attendance.


Data Entry Operator (DEO) Responsibilities for HHB Attendance:

When the timesheet is submitted bi-weekly by the HHB teacher, the current attendance codes shall be updated, if applicable, to reflect the provision of services as indicated by the HHB teacher. Teachers will indicate a [B] when they cancel instructional services because the student is neither present or absent. [B] will also have to be entered by the DEO, once the timesheet has been received, as a placeholder for the days when the student was not scheduled to receive services in the home. When teachers indicate a [C] to indicate that compensatory time has been provided, the student should be marked as present. Differentiating it on the timesheet is a record-keeping tool when determining how much compensatory services have been provided, but does not have an effect on attendance. The timesheet must be filed by the DEO and submitted to the SSPS office for pay. The SSPS HHB secretary will review data to ensure that the student's attendance has been updated according to the timesheet.

*Note: For all other absence reasons (e.g., death in the family), follow the district attendance procedures for coding.


Teacher Responsibilities for HHB Attendance:

Attendance for services in the home must be documented on the timesheet and submitted to the administrator at the student's school for signature. Teachers must use the notes section to document all attempts to schedule services. The homebound teacher should not enter HHB attendance into eSembler. Attendance for services in the home must be documented on the timesheet and submitted to the school administrator so that they can monitor the actual services provided.

  • For part-time and intermittent HHB students, regular attendance codes should be used for the time-period in which the student is expected to attend school. When the student is not present in the school setting due to his/her documented medical condition and is expected to be receiving HHB services outside of the school, attendance is reflected on the timesheet and updated by the SSPS HHB secretary.

Frequency

Frequency Recommendations by Confinement Level

Note Regarding HHB Confinement Level Decisions: The IEP team must make decisions regarding student confinement level (intermittent, part-time, full-time) based on all available information. The physician's recommendation on the medical report required by law is one piece of information the team considers when determining the student's confinement level. The physician is the expert regarding the medical condition, but the school-based staff are experts on the LRE in an educational setting. Teams do not make confinement level decisions because the doctor is asked to recommend a confinement level. If there is sufficient evidence that the student does not require the confinement level recommended by the physician, then the IEP team should determine what level would best meet the students educational needs in the LRE.

Intermittent

  • Intermittent Definition: Students who qualify for intermittent services must have a physician document that they will be out of school due to their medical condition for periods of consecutive days that would result in the student not being able to obtain meaningful benefit from their free appropriate public education (FAPE.)
  • Although a medical report is obtained annually for HHB eligibility for up to 12 months, a status update may be requested from an intermittent student’s physician for each intermittent period. This status update must indicate the recent date that the student was assessed by the physician since the previous IEP meeting and the dates that the intermittent period starts and is expected to end, so that HHB services can be initiated.
  • For students who are not expected to be out of school for a designated period of consecutive days, medical absences will be excused and students are able to make up work missed as indicated in the Student Code of Conduct.
  • Intermittent Frequency Guidelines: All frequency decisions are made by the IEP team on a case by case basis, but typically, an intermittent student would get one hour per day absent due to the medical condition, as indicated on the Status Update form.
  • For intermittent services, the student remains scheduled with the school-based teacher of record, and a teacher liaison provides Individual Instruction for Organization and Work Completion to assist them with making up the work from days missed.


Part Time

  • Part-time Definition: Students who qualify for part-time services are unable to attend school because he/she is currently confined to the hospital or home part-time during the school day.
  • Part-time Frequency Guidelines: All frequency decisions are made by the IEP team on a case by case basis, but typically, a part-time student would receive:
  • REACH Services: Secondary, part-time students should be enrolled in the REACH program for for 50 minutes of online instruction per day for each class/course (250 minutes per course) that is not scheduled in the school setting, with REACH teacher assistance daily
  • Itinerant Services: Itinerant services are provided for all elementary courses and for secondary courses that are not available through REACH. One hour per week is provided for each class/course that is not scheduled in the school setting by a highly qualified teacher in the content area.


Full Time

  • Full-time Definition: Students who qualify for full-time services are unable to attend school because he/she is confined to the hospital or home full-time.
  • Full-time Frequency Guidelines: All frequency decisions are made by the IEP team on a case by case basis, but typically, a part-time student would receive:
  • REACH Services: 50 minutes of online instruction per day for each class/course (250 minutes per course), with REACH teacher assistance daily
  • Itinerant Services: Itinerant services are provided for all elementary courses and for secondary courses that are not available through REACH.
  • One hour per week is provided for each class/course by a highly qualified teacher in the content area.

Frequency Recommendations by School Level

  • Homebound students must be provided instruction in core academic subjects required for promotion or graduation with highly qualified teachers. According to language in 34 Code of Federal Regulations 200.55(c), the term "core academic subjects" means English; reading or language arts; mathematics; science; foreign languages; civics and government; economics; arts; history; and geography.
  • The IEP team determines decisions based on data regarding frequency and location. Guidelines are set regarding the HHB minutes provided each week by school level because of the differences in required curriculum. If the team has any questions regarding service delivery frequency based on unique situations, they may contact the HHB supervisor to assist with facilitating discussions. If the team comes up with a question about additional hours during an IEP meeting, the team may have to reconvene after looking at the data with the supervisor to review recommendations and consider hours.
  • Elementary and Access Points Recommendations - Four hours per week to cover all core academic subjects
  • Middle Recommendations - Four hours per week to cover all core academic subjects taught via itinerant teachers or 250 total minutes per week per course when instruction is provided through the REACH program.
  • High Recommendations - One hour per week for each core academic subject taught via itinerant teachers or 250 total minutes per week per course when instruction is provided through the REACH program.
  • It is imperative that school counselors be invited to all secondary IEP meetings to provide input when service delivery options are discussed to ensure that the recommendations for minutes provided are in-line with the student’s graduation requirements (e.g., intensive reading, CARP-D, online course requirement, EOCs, PERT score). School counselors must be prepared to provide the IEP team the student’s graduation plan in writing. This includes student's on Access Points.

Location

  • All instruction for HHB students is provided in their home or in unique circumstances, at a nearby, agreed upon, public location. Currently, Pasco County does not have a pediatric hospital that houses children long-term; therefore, Pasco teachers do not provide instruction in the hospital. Please see the Students Hospitalized in Another District section for more information.
  • If the parent and/or doctor report that the student cannot tolerate instruction, please contact the H/HB supervisor.


Service Delivery Options

Services need to be determined based on data through a formal IEP meeting. Services available are:


Consultation/No specific service needed (Pasco eSchool/Florida Virtual School)

  • Available as school choice option for all students on Florida Standards.
  • The IEP team could consider classes via Pasco eSchool/Florida Virtual School if data indicates that it could meet the student’s educational needs.
  • Consultation from an ESE certified teacher may be listed as a service provided to the virtual teacher regarding the student’s IEP, based on the student’s needs (e.g., assistive technology, visual schedule, screen reader.)
  • There may be instances where no specific ESE service is required for instruction in virtual courses, because virtual is an option for all students, not just students with IEPs.


Flexible Online General Curriculum

  • Available for all secondary HHB students on Florida Standards
  • Meets the needs for flexible scheduling, blending of grades mid-quarter, and curriculum access in the home.
  • Provided through support from core content REACH teachers for academics, and attendance via online, phone, and web conferencing communication


Additional Assistance for General Curriculum

  • Available for all HHB students who need task adaptations and collaboration with teachers, families, agencies and other providers due to the nature of their medical condition (e.g., fatigue, tolerance, recovery from treatment, effects of medications)
  • Meets the need for students who require adaptations to length, type or amount of work based on the students needs related to the medical condition; requires collaboration with teachers, families, agencies and other providers
  • Provided through support from core content REACH teachers via online, phone, and web conferencing communication


Specialized Instruction for General Curriculum

  • Available for secondary HHB students on Florida Standards who have an additional identified ESE eligibility category with a documented learning or behavioral difficulty on the IEP (e.g., SLD, EBD, ASD)
  • Meets the needs for students with a documented learning or behavioral difficulty on the IEP
  • Provided through support beyond what is provided from core content REACH teachers from the REACH case facilitator/ESE teacher via online, phone and webinar communication


Individual Instruction for Organization and Work Completion

  • Available for HHB students who have an additional identified ESE eligibility category with a documented learning or behavioral difficulty on the IEP (e.g., SLD, EBD, ASD)
  • Meets the needs for students who have a learning difficulty with data indicating direct ESE support is needed to make academic progress and that the student requires a higher level of individual instruction for organization and work completion
  • Provided through a certified teacher liaison in the home to support curriculum provided by the REACH teachers of record
Note: 2 Matrices (One at 255 for individual instruction hours in the home)
Note: Teacher liaison is scheduled in the Homebound Course Code (Elementary – 7755020, Middle School – 7855020, High School – 7900030)


Intermittent Individual Instruction for Organization and Work Completion

  • Available to all Intermittent HHB students
  • Meets the needs of students absent for a period of consecutive days due to the medical condition that affects the student from obtaining meaningful benefit from their education; a new status update, or verification from the nurse on the status update, may be required from the physician to begin services
  • Provide through instruction, from a certified teacher liaison in the home to support curriculum provided by the school-based teacher of record
Note: 2 Matrices (One at 255 for individual instruction hours in the home)
Note: Teacher liaison is scheduled in the Homebound Course Code (Elementary – 7755020, Middle School – 7855020, High School – 7900030)


Individual Instruction for General Curriculum

  • Available for all Florida Standards elementary students
  • Meets the needs of elementary students who meet the HHB eligibility criteria
  • Provided through instruction from a Highly Qualified teacher in the home


Individual Instruction for Modified Curriculum

  • Available for all Florida Standards Access Points students
  • Meets the needs for students who meet the HHB eligibility criteria and require a modified curriculum
  • Provided through instruction from a Highly Qualified (ESE and Elementary Ed) teacher in the home

REACH Procedures (Secondary Florida Standards Students Only)

Once the HHB medical for a secondary Florida Standards student has been received at the school level, the following procedures should be implemented regarding REACH instruction:

  • Once the school nurse has verified the medical report, the medical form will be faxed to the district HHB secretary at extension 42117 or via email to dstaylor@pasco.k12.fl.us.
  • The HHB secretary will confirm receipt of the medical via email reply to the school nurse (please only send medical once via fax or email). The HHB secretary will submit all paperwork to the REACH program staff.
  • All secondary Florida Standards students will participate in APEX as the online REACH curriculum, with additional supports provided if they are documented as a need based on data using the REACH Service Delivery Decision Matrix.
  • If a secondary student is participating in Florida Standards (grades 6 – 12), the administrator must assign a school-based case manager who will make contact with the REACH Compliance Resource Teacher, Shelley Hellendrung, via email at mhellend@pasco.k12.fl.us, prior to the ESE Staffing or IEP meeting to discuss service delivery options using the REACH Service Delivery Decision Matrix, program accommodations, related services and the REACH Course Offerings.
  • The administrator or designee must include the student’s current class schedule, graduation plan (for high school students) and relevant background information about the student that will be considered to recommend the appropriate supports.
  • Please contact the REACH teachers for questions regarding the curriculum at 47886.
  • The REACH Compliance Resource Teacher will reply to the administrator or designee with a proposed schedule regarding available courses, conflicts, or concerns related to the student needs (if applicable) to be considered at the IEP meeting.
  • A representative of the REACH program should be invited to the IEP meeting, but are not required to attend due to the intensity of their schedule. Written input can be requested as needed.
  • The school-based case manager will send a copy of the IEP meeting notes to HHB Case Facilitator (e.g., best contact number and time for parents, notes from TAD, up-to-date grades in current courses, decisions that were made during the meeting.)
  • The HHB Secretary will enter the schedules for all students in the REACH program.
  • REACH teachers will submit grades via eSembler for students in the program. If the grades need to be blended because the student will arrive or leave in the middle of a quarter, the school-based case manager should work with the REACH teachers to combine for a final grade.
  • School-based teachers must provide grades for the student until the date the medical was signed. Once the student enters the REACH program, the REACH teachers will assess where the student should be using the district curriculum maps/teacher syllabus.
  • The student will be given make-up work from the REACH teacher for any time after the medical was signed through the time they start the REACH program.
  • A timeline for work completion will be provided to the student in accordance with the absence policy to finish the make-up work while starting the current work.
  • An assigned REACH teacher will provide the students with login information during a scheduled orientation session to familiarize the student and parents to the online curriculum program.
  • If a student does not have a computer or Internet, the REACH Case Facilitator should be notified so that the parents can be contacted.
  • The school-based case manager is responsible for contacting the REACH teachers to gain input and collaborate on progress towards the student’s quarterly IEP goals.
  • When REACH adds a student to their classes as the teacher of record, the location on the MIS 614 screen will show 0801 (LOLHS,) however the student will remain enrolled in the zoned/program school of attendance.
  • After REACH has attempted and documented interventions, but there are still concerns about student progress, work completion rate or performance, the REACH teacher will contact the zoned or program school administrator to inform them of the issue. The administrator will contact the case manager to set up an IEP meeting to discuss the reasons the student is not being successful. The IEP should be updated to include concerns regarding work completion and quality of work in the PLS and goals.
  • The school-based case manager is responsible for maintaining up-to-date records including ensuring that the medical has not expired, the IEP is appropriate, up-to-date quarterly goals are reported, and progress and report cards are provided to the parents. The school-based case manager should contact the HHB Case Facilitator for assistance with this process if needed.


REACH Contact Information

Office Phone: 47886
Office Fax: 49492
REACH Teachers:

Schedules/Courses

  • Homebound students must be provided instruction in core academic subjects required for promotion or graduation with highly qualified teachers. According to language in 34 Code of Federal Regulations 200.55(c), the term "core academic subjects" means English; reading or language arts; mathematics; science; foreign languages; civics and government; economics; arts; history; and geography.
  • It is imperative that school counselors be invited to all secondary T/IEP meetings to provide input when service delivery options are discussed to ensure that the recommendations for minutes provided are in-line with the student’s graduation requirements (e.g., intensive reading, CARP-D, online course requirement, EOCs, PERT score).
  • For secondary students participating in the REACH program, school counselors must provide a copy of the current schedule and graduation plan to the REACH Compliance Resource Teacher.
  • HHB teachers going to the home for Individual Instruction for Organization and Work Completion should be scheduled in a HHB Course (Elementary – 7755020, Middle School – 7855020, High School – 7900030)
  • Courses that require specialized materials, equipment, or facilities (e.g., digital design, robotics, engineering, cosmetology, etc.) may have to be postponed until the student returns to school.
  • If a teacher cannot be found who can provide the course (e.g., AP, industry certification, dual-enrollment at the school, medical skills) it will not be available for the student. Specific courses listed in graduation requirements (e.g., Algebra I, Biology) are priorities for HHB students. The IEP team should consider if virtual school is an appropriate service delivery model to access specialized courses.
  • If a student becomes eligible HHB toward the end of the grading period and has shown mastery of a course that is not listed as a specific graduation requirement (e.g., Driver’s Ed, Psychology,) current Grades can be frozen and included as the final grade for that grading period as determined by a school administrator. Then, the student’s HHB teacher can blend the frozen grade with the newly earned grade for the next grading period, if applicable.
  • In some cases, students may be enrolled in high school and adult education classes simultaneously for additional credit recovery or GED programs. Some students are also in dual-enrollment at a college campus with instruction provided by the college professor. These additional classes are not provided through Hospital/Homebound services because they are under ADA not IDEA, so the IEP does not get implemented.
  • The REACH teachers can provide credit recovery and credit earning as part of a student’s schedule.
  • Physical Education (PE)
  • All high school students are mandated to take one credit of PE provided by a highly qualified teacher to satisfy graduation requirements. Because of this mandate, there is no way to waive the requirement for high school level HHB students. If HHB students are not able to complete activity portions of a PE course then more cognitive based lessons or activities should be given to the student in the place of the physical types of activities. State statute does not list a specific amount of time that is to be spent on activity versus classroom-based assignments, so teachers do have the flexibility to adapt the course descriptions to meet the needs of a student.
  • High school students pursuing a standard Access Points diploma must take one credit of the Access Hope course, which can be provided by a teacher with ESE or adaptive PE certification.
  • Elementary and middle school students can get a medical note to excuse them from PE due to their medical needs. If the homebound medical report documents medical restrictions or limitations related to physical activity, then it can be used as justification for the excuse from the PE requirement. Also, the general K-5 PE waiver can be completed with the parent indicating the choice that their child is receiving remedial support (through HHB instruction in the home.)
  • There are modified standards for PE that are available to teachers of students with significant cognitive disabilities.

Expectations for Itinerant Instruction Provided in the Home

  • All students are expected to be provided rigorous instruction based on the standards that they are pursuing. The teacher of record is responsible to provide instruction on all the state standards for the assigned course, which can be found on the appropriate district-developed curriculum maps for the course or on the statewide website CPALMS.
  • For students pursing regular standards, instruction should not be “modified” because the students are still required to show mastery of the content. It is important that all standards are addressed so that students are prepared to meet requirements for graduation (e.g., Statewide Assessments, EOCs.)
  • For students pursuing a modified curriculum due to a significant cognitive disability and taking an alternate assessment, instruction on the modified standards should be provided.
  • Administrators and HHB teachers should collaborate to schedule all assessments provided to students in the school setting to document student achievement levels. Please see the Assessment section for more information on requirements related to assessments.
  • All tasks should be adapted so that the students can access all standards in the limited time provided, taking into account their medical condition. Task adaptations reduce the length or complexity of the practice or test items and make assignments or test items more accessible. Task adaptations do not reduce learning expectations. Examples of task adaptations include:
  • Making assignments or assessments less complex, such as by shortening assignment length, reducing answer choices
  • Allowing the students to do assignments or tests orally or through other methods to demonstrate knowledge
  • Prompting or cueing to direct the student to where the answer can be found or providing open book tests
  • When a HHB teacher is assigned a student, they should be provided access to and review all pertinent information regarding the student’s needs (e.g., IEP, PMP, 504.) This can be done by requesting copies of the documents or scheduling time to review the file at the student’s school.
  • Because HHB teachers provide instruction in the home and cannot be easily monitored in the school setting, evidence needs to be kept regarding the grades assigned and accommodations provided. Evidence of this would include lesson plans or work samples to justify mastery of the standards and accommodations used. This documentation should kept in teacher’s files and must be available when requested by the parent or administrator to be used when there is a question about grades, service provision or promotion.
  • If a HHB teacher is certified and hired to teach a course that they do not teach currently in the school setting, it is appropriate for them to contact the student’s administrator to request lesson plans and curriculum materials (e.g., access to teacher editions, assessments, assignments) to assist with planning for and providing appropriate instruction.

Instructor Compensation for Services and Mileage

Students must not receive services until HHB eligibility has been determined, an IEP has been developed, parental consent has been obtained and an instructor agreement has been sent to the SSPS secretary. All services indicated on the IEP must be implemented and attendance must be documented on the timesheet. For all excused absences, every effort should be made to make up the time and indicate that it was provided as compensatory services. All unexcused absences should be documented on the timesheet and the hours will not be made up.

  • Teachers are paid their standard hourly rate while providing services.
  • Teachers are paid .5 hours of planning time for each 3-hour period of instruction (i.e., 3 hours = .5 hours paid planning; 6 hours = 1.0 hours paid planning). This is calculated by the SSPS HHB Bookkeeper and does not need to be included on the timesheet.
  • Teachers will be reimbursed for .5 hours, along with mileage, for sessions cancelled by the family without prior notice. These cancellations must be documented on the timesheet.
  • Teachers must handwrite the actual service delivery dates, times and information below completely in blue ink. This form will not be accepted if all areas are not filled out with accuracy because it is required documentation as evidence that the student was provided services as scheduled.
  • The timesheets (with parent and administrator signature), and the In-County Mileage Report, must be submitted to the SSPS HHB secretary who will submit them to the SSPS HHB Bookkeeper for payment.
  • Timesheets and mileage forms are auditable documents and must be submitted bi-weekly to verify provision of services. Teachers may not hold timesheets and mileage forms until the end of the year. Timesheets submitted beyond 30 days from the last date services were provided may not be reimbursed, as allocated funds may not be available.
  • A copy of each timesheet should be placed in the student's ESE file (red folder) to document services provided.
  • Mileage is documented via the Pasco County Mileage Tracker. It should be completed by the teacher and verified/signed by a home school school administrator (signs as supervisor) before it is submitted to the SSPS H/HB Bookkeeper for the cost center signature.
  • Original Mileage Forms must be submitted for payment (copied, faxed or scanned copies will not be accepted.)
  • Mileage is paid at the current rate to and from the student’s home, from the teacher’s base school or home (whichever is the lesser distance).
  • Mileage should be verified via MapQuest or Google Maps.

State and District Assessments

  • Each student’s IEP addresses participation in statewide assessment. There are boxes to indicate Standardized State and District Wide Testing or Florida Alternate Assessment participation for each student. HHB students should be administered all assessments that that their peers are provided to assess student achievement.
  • Each school administrator will schedule who will administer the test to students in the HHB program on a case-by-case basis. Students who can tolerate a short period of time at school based on their medical condition (including full-time) are encouraged to take the test in the school setting. If teams are unsure if testing in the school is appropriate, the school nurse can contact the physician who signed the medical to discuss restrictions or limitations.
  • If the student is unable to come to the school, testing needs to be coordinated by the school administrator with the testing coordinator and a teacher(s) will be assigned to administer each individual test. Teachers who are familiar with the student and/or teacher the student that course should be the first consideration. If teachers are not available for testing after hours, the administrator could obtain a sub for their classroom and send the student’s teacher to the home during the day. The accommodation, extended time, needs to be considered when scheduling the assessment with the teacher, because the test needs to be completed by 8pm according to the teacher contract. If administered at home, parents cannot be in the room.
  • The school test coordinator must contact the teacher to provide training and information regarding test administration and security. All standardized assessment protocols must be secured in a locked district location each night. It is best practice for the testing coordinator to order paper-based testing for all HHB students since we will not know if they will be able to be in school when the test window arrives. Please note that testing windows for paper-based and computer-based tests may differ.
  • Additional hours for standardized state and district wide testing must be indicated, by naming the specific test given, in the notes section of the HHB Timesheet to get reimbursed.


Compensatory Services

  • Compensatory services may be provided to a student who has missed instruction due to medical absences or unintended gaps in services. Compensatory services are calculated based on the number of absences from the date the medical report was signed. All compensatory instruction should be made up as soon as possible, but before the end of the quarter. If missed time can not be made up by the end of the quarter, the remaining compensatory hours will must be approved by the H/HB supervisor.
  • If a student’s medical expires or he/she is dismissed from HHB, but are still owed compensatory instruction, a teacher may still provide the hours in the home when the student has returned to school.
  • The teacher must document on the timesheet with a “C” to indicate compensatory time.
  • Compensatory services are not provided for student absences that are not related to the medical condition on the medical report. For unique situations, contact the HHB supervisor to problem-solve.


Other Considerations Regarding Instructional Services

Hours

  • All documented hours from itinerant teachers must occur after their contracted school day, but not to go beyond 8pm, as indicated in the Master Instructional Contract.
  • The HHB teacher can provide instruction on the school campus including PLACE, as long as it’s after the teacher’s contracted day. The PLACE manager or school-based administrator must sign the time sheet.


Non-contracted School Days

  • The student may only receive HHB services during contracted school dates. Services may not be provided during vacation periods, weekends, holidays or student non-school days, such as teacher planning days or district training days.


Contagious Illness

  • The student may not be provided services unless the physician documents that the student can receive an instructional program without endangering the health and safety of the instructor or other students with whom the instructor may come in contact. If the HHB teacher is concerned about contracting a contagious illness:
  • Assignments must be made available to the student
  • The school nurse must immediately be notified to obtain a medical update
  • The teacher must discuss a schedule with the family for when the hours missed can be made up
  • If the teacher (or one of their immediate family members) has a contagious illness that may compromise the student's health, the same steps should be followed to schedule instruction once there is no medical risk.

504s and IEPs for Hospital Homebound

In most cases, when a student who has a current Section 504 Accommodation Plan becomes eligible for an HHB IEP, the 504 Plan would become inactive. However, determinations regarding retaining a student’s 504 Plan must be made on a case-by-case basis:

  • Students receiving HHB services, without any other ESE eligibilities, should retain their existing 504 Plans. This exception is made because these students are expected to return to the traditional classroom setting. Therefore, it is not required to dismiss the 504 Plan even though they will have a concurrent HHB IEP. If the team feels that the accommodations listed on the 504 Plan also need to be listed on the IEP with home as the location, they can be included on both documents. To be more specific, when a student is receiving instruction at home or in the hospital, the IEP would be implemented. When the student is attending school, the 504 Plan would be implemented.
  • A HHB student’s 504 Plan would not apply in the event that the student is eligible for another exceptionality, or the intensity of HHB services required to provide a free appropriate public education are beyond what a 504 Plan can accommodate. At that time, the IEP team would reevaluate student needs with reference to the disability identified through the 504 Plan and provide services and accommodations as needed through the IEP.
  • When a student is dismissed from HHB and is able to return to school, they will no longer have a current IEP. The team should consider the need for any accommodations required in the school environment, which may qualify the student for a 504 Plan, if they did not have one in place previously. The team should use all relevant data collected from the medical reports and the IEP as well as recent data regarding student needs.

Data Entry Considerations for Hospital Homebound

Data Entry for In-County or Out-of-County HHB Student Transfers

  • Students should be enrolled as HHB and a IEP meeting should be scheduled to determine the services needed in the continuum.


Data Entry for Out-of-State HHB Transfers

  • Students who attempt to enroll from another state would have to meet criteria for initial Florida ESE eligibility.
  • Students who attempt to enroll from another state would have to meet criteria for initial Florida ESE eligibility. The school-based Compliance Resource Teacher (CRT) or Compliance Specialist who facilitates the ESE staffing will begin the Data Entry Sheet MIS 729 and provide it to the Data Entry Operator (DEO.)


Data Entry for Zoned School/Program of Attendance

  • Regardless of HHB eligibility, the student would be enrolled in the zoned school or program school of attendance. For example, if the student was not previously eligible for any other ESE category, the zoned school would be responsible for providing instruction. If the student had an additional exceptionality category (e.g., InD, ASD, EBD) that requires a self-contained setting, they would be enrolled in the program boundary school, even if receiving instruction it the home because the goal is to have them return to the school setting if it is the least restrictive environment.


Data Entry for Absences

  • Students eligible for HHB due to their medical condition should not be marked absent, unless they have an unexcused or medical absence that would apply to any other student. HHB students should not be withdrawn for absences unless the case has been documented and reviewed by the SSPS staff and approved for medical withdraw or if truancy has been pursued. Please see the Attendance for HHB section for more information.

Data Entry for Full-Time HHB FTE

  • Students who are receiving full-time HHB services will have a 255 matrix level for the minutes of services entered into TERMS. This matrix number should already be entered throughout the school year because it is anticipated that the student will continue to be full-time.
  • Teachers should make every effort to follow the set schedule for services during all weeks, especially FTE week. If the student has to miss instruction due to their medical condition, services should be made up in the same week, if possible. Minutes should not change during FTE week unless the schedule has changed that week and services were not provided as usual.


Data Entry for Part-Time and Intermittent HHB FTE

  • Part-time and intermittent HHB students will not have a matrix level entered into TERMS until the FTE window because the funding level is based on the actual minutes served. If the student has to miss instruction due to their medical condition, services should be made up in the same week, if possible. The H/HB timesheet completed by all HHB teachers is due to the data entry operator by the Friday of FTE week and the number of minutes at each different funding level will be documented at that time.


Data Entry for Schedules/Courses

  • The student’s schedule will need to be revised so that the class code reflects all HHB courses provided in the home on a regular basis, utilizing the “M” code at the end of the course number. The teacher providing the expertise in content will named as the teacher of record, whether it is the teacher at the school or the HHB teacher. The teacher of record should have access to the student in eSembler, whether they are the teacher in the school or the teacher in the home.
  • Students on part-time schedules should have about half of their courses scheduled in the school and about half of their courses in the home, so they would require two different schedules. For all itinerant HHB classes scheduled weekly in the home, the course should end with an “M.”


Data Entry for Matrix Levels/Funding

  • Whenever a student has an itinerant teacher going out to provide individual instruction in the home, a matrix needs to be completed at the time of the IEP. A 255 matrix level of funding would only be claimed for the specific number of minutes that the student is receiving services by a teacher in the home.
  • HHB students may also receive services at school, via REACH, or via Virtual school. The funding level for the minutes of instruction that are not provided individually in the home would not receive a 255 funding level. Other levels of services such as school-based instruction, consultation or group instruction in the home would be documented on a case-by-case basis by looking at the services provided in each domain to calculate the funding level using the Matrix rubric.
  • Students with multiple service delivery models must have multiple matrix levels. For example, a student who is receiving instruction via REACH or Virtual would receive a 112 or 113 level for those classes/courses. Individual itinerant teachers sent to the home for other classes would earn a 255 matrix level for the individual instruction.


Data Entry for REACH (Secondary Only)

  • When a REACH course is scheduled, the SSPS secretary will update the student's schedule. The location on the MIS 614 screen will show 0801 (LOLHS) for that course, however the school of attendance will remain the same.


Data Entry for Reevaluation Dates

  • The student’s reevaluation date is the date that the student’s medical expires. While the annual IEP is valid for 12 months, the medical report may only indicate that the student needs HHB services for only 6 weeks. When the current medical expires, the team must convene to review the most current data and revise the TIEP as needed. When a medical update is obtained, a data entry revision form located in PlanMaker needs to be generated and submitted to the DEO.


Data Entry for HHB Students with Multiple Disabilities

  • The reevaluation date would be the date the HHB medical expires. Upon expiration of the medical, a reevaluation meeting needs to be held to review the most current data, including any medical data provided by the physician through our school nurse and revise the IEP as needed. An updated data entry revision form will be submitted by the Case Manager.


Data Entry Resources

  • Data Entry Operators have access to the online manual for TERMS and can reference the specific section of the manual, which provides information related to HHB. For further questions related to data entry for HHB, the DEO should contact the TERMS Help Desk at extension 42848.

Hospital Homebound Database

A HHB/OCI Database has been created to assist school administrators with accessing information on H/HB students, finding interested and appropriately certified personnel to provide instruction as itinerants and monitoring the delivery of HHB/OCI instructional services. All information included in this database is entered by the HHB/OCI secretary at the district office when information is submitted by staff responsible (i.e., nurse, compliance resource teacher, OCI teachers) as indicated in the HHB Process and Responsibilities section.

Please use the HHB/OCI Database Access Instructions for information on how to find it in FileMaker Pro for the first time.

Only principals, assistant principals and select district personnel have full access to the HHB/OCI database and should log in with the following credentials:

  • Enter user name as: your email name (the part before the @; lower case letters)
  • Enter your myPascoConnect Single Sign On password (may be different from your email password, case sensitive)

Important aspects of the HHB database include:

User Actions

  • To Sort: Click the title of the column and select ascending or descending
  • To Search: Click the “find student” button under the student tabs or “find personnel” button under the personnel tabs at the bottom of the screen
  • To Revert from a sorted list: Click the “show all student records” button under the student tabs or “show all personnel records” buttons under the personnel tabs at the bottom of the screen
  • To Print: Click the “print records” button at the bottom of the screen
  • To Export: Click the "export detail records" under the student tabs or the "export personnel records" button on the personnel tab at the bottom of the screen and the selected information will be exported to your documents folder under the title "students"

Student List Tab

Includes basic information for monitoring current H/HB students:

  • Demographic information, which includes the ability to sort or find students by school to monitor specific students
  • Primary and other exceptionality codes and level of service (intermittent, part-time, full-time,) which directly relates to FTE funding
  • HHB medical expiration dates, with expired medical dates indicated in red and upcoming expiration dates in purple
  • Active status, which can be used to filter out students who are not currently eligible for HHB services
  • To filter out the active students at your school, do a student search and enter your school initials under school, and the word "yes" under the "active" column

Student Tab

Includes basic information regarding each medical that has been received for the student:

  • Diagnosis
  • The date the medical was signed and the medical expiration date
  • Level of service (intermittent, part-time, full-time)
  • REACH instruction indicators
  • A button to indicate if the service was a continuation (a new medical was received when the student was already HHB)
  • Delete button, which should ONLY be used to delete a service entry that was entered incorrectly
  • Student Details Button (opens new screen): Includes more details about the current medical and services
  • Diagnosis
  • Contact information for staff
  • Personnel information for the student’s HHB teachers
  • Notes about the medical condition

Personnel List Tab

Includes basic information regarding personnel who have indicated they are interested in HHB instruction:

  • The teacher’s school and region to determine if they would be near the student’s school
  • Personnel email addresses, including an email icon button that can be used to email one or all staff on the current list
  • ESOL or Reading Endorsements

Personnel Tab

Includes more detailed information regarding the personnel in the database:

  • Multiple certification areas
  • Student(s) served by the teacher
  • Certification Search Button (opens new screen)
  • Search for personnel by multiple certification areas (up to 3) and email one or all of them that appear on the sorted list

Other Hospital Homebound Considerations

Hospital Homebound and Participation in After School Activities

  • Students in the HHB program should have equal opportunities to participate in school activities that receive federal funds, including extracurricular activities (e.g., dances, graduation, sports, clubs, etc.). IEP teams should discuss district events and activities at IEP meetings and make decisions on a case-by-case basis.
  • IEP teams have an obligation to look at the nature of the disability and discuss whether or not the student is able to participate, but decisions are made on an individualized basis. For example, the team should consider:
  • What the student can tolerate
Example: A team may discuss a student with aggressive and inappropriate behaviors participating in sports, but determine that he may not be able to tolerate the unstructured environment.
  • Risk to the student
Example: A team may have the school nurse contact the doctor to clarify if a student with an immune deficiency can safely participate in the activity when there is question about the risk of infection.
  • Risk to other students
Example: If a student has a contagious disease, like the measles, they should not attend school functions because they would be putting others at risk.
  • If the team determines that it is appropriate for a student to participate in an after-school activity, the team then has to determine what accommodations are needed based on the student’s unique needs. Administrators should provide information to their afterschool staff to ensure they understand that students with disabilities should be afforded the opportunity to participate, if he/she is otherwise qualified, and the basic requirements for participation are met.
  • The case manager should inform the student and parent of upcoming events available to all students or provide them information on accessing the schedule of events on the school website. A HHB student does not have to attend school on the same day as the event, because he/she has a unique schedule regarding the time and date of the services provided in the home.
  • It is important to note that the IEP team must consider evidence of participation in outside activities when determining the student’s least restrictive environment (LRE.) If a student shows that he/she can be successful in some areas (e.g., driving a car, holding a job, participation on a sports team) and are not confined to the home full-time, a lesser confinement level (i.e., intermittent or part-time) with accommodations may be his/her LRE. In some cases, participation in extracurricular activities may provide evidence that they do not continue to meet HHB eligibility at all. All decisions regarding these types of situations should be made on a case-by-case basis based on data. Please contact the HHB supervisor to problem-solve any unique situations.


Hospital Homebound for Pregnant Students

  • Schools must treat pregnant students in the same way that they treat other students in a similar medical situation. In other words, pregnant students would be eligible for HHB as long as she meets the state eligibility requirements. The need for HHB services should not be assumed as an automatic requirement for a student based solely on her pregnancy. HHB can only be considered due to medical conditions of the mother and/or complications of pregnancy.
  • Once a pregnant student has given birth, she would not be required to submit medical certification for school participation, unless she had a medical report from a doctor and were made eligible for HHB. Pregnant students who were found eligible for HHB can reenter school either when the medical expires, or when the doctor submits a status update that states she no longer requires instruction in the home, as well any limitations and restrictions for the school to consider. All absences that fall within the dates indicated on the medical report for HHB pregnant students should be excused.
Resources:
Supporting the Academic Success of Pregnant and Parenting Students (US DOE)
Section 1003.54, F.S. Teenage parent programs


Hospital Homebound Students Hospitalized in Other Districts

  • Each district, and even each hospital, has different procedures regarding the provision of Hospital Homebound (H/HB) services. Sometimes the hospital has a teacher on site, and other times the other district provides a teacher that travels to the hospital when students are identified.
  • Pasco County School teachers are not able to travel to another county where the hospital is located to provide HHB services. If information has not been provided by the hospital where the student is admitted regarding how instructional services will be provided, please contact the HHB supervisor to assist with contacting the school district office of the county where the student will be hospitalized. At this time, Pasco County does not have any long-term care hospitals for children, so we do not provide HHB services to students in other districts.
  • If a student who is currently eligible for HHB is in the hospital for a short amount of time (i.e., less than two weeks), other districts may not set up the HHB services in that timeframe. In these cases, the IEP team can determine the best way to keep the student on track, as long as it doesn’t amount to a denial of a free appropriate public education (FAPE) and allows the student to make progress in his/her education. Depending on the intensity of the treatment or seriousness of the condition, the student can be given assignments to complete at his/her own pace, have video or phone conferences with their teachers, enroll in REACH (secondary only,) or be given compensatory make-up time when he/she arrives home.
  • If the student is in the hospital for an extended period of time, he/she will have to be medically withdrawn from Pasco County and enrolled in the district where the hospital is located. Once he/she has moved back into the home located in Pasco County, they may re-enroll at the zoned/program school and would be treated as any other student who would transfer into the county mid-year. In each situation, decisions should be made on a case-by-case-basis with consensus from the IEP team members. For unique situations, please contact the HHB supervisor to problem-solve.

Hospital Homebound Contact Information

HHB Supervisor: Melissa Mangino mmangino@pasco.k12.fl.us Ext: 42625

HHB Secretary: Angle Coleman acoleman@pasco.k12.fl.us Ext: 42626

HHB Bookkeeper: Andrea Jackson amjackso@pasco.k12.fl.us Ext: 42248

HHB Compliance Resource Teacher: Shelley Hellendrung mhellend@pasco.k12.fl.us Ext: 42802

HHB Case Facilitator (ESE Teacher): Eliza Ruthruff ewillett@pasco.k12.fl.us Ext: 42054


For any questions regarding H/HB: Ext. 42852

To submit any paperwork to SSPS via fax: Ext. 42117


Click here for REACH Contact Information

Hospital Homebound Forms

Family Forms


Instructor Forms


Other Documents