Home Hospital 101

What exactly is homebound instruction in an IEP? Who qualifies for the program, and is it the right fit for your family? What are the steps to request it?

We talked to Dr. Sarah Pelangka BCBA-D, special education advocate and owner of KnowIEPs, and special education attorney Grace Clark to help us break it down.

Known as Home Hospital (HH) in many states, home-based instruction is available to children who have a temporary disability, whether physical, emotional, or psychological, or who are recovering from a surgery or other illness that requires them to stay at home for a temporary period of time. Home Hospital isn’t meant to replace independent study or in-person learning indefinitely. The program is designed to help a child:

• continue their studies at home or in the hospital when it isn’t possible or advisable to attend regular classes
• maintain their current performance level so they can return to their regular program without falling behind

Home Hospital may also be a viable option for students with disabilities who cannot attend school or partake in alternative programs because of significant health needs or behavioral challenges. In these cases, the program must still:

• give a child access to the general education curriculum
• ensure continued progress toward their IEP goals
• provide a free, appropriate public education (FAPE)

Home Hospital instruction is meant to be a temporary placement to help a child maintain their current levels until they are able to return to their previous program. It is not meant to be a replacement for either in-person or remote learning.

Independent Study, on the other hand, is designed as an alternative to in-person learning, and allows children to learn remotely. This option works best for children who are able to work independently. However, if a parent requests independent study their child can still qualify for a home-based aide if the IEP team determines there is a need.

Other alternative learning programs include homeschool or homeschool charters.

Typically, a teacher will work with the child off-campus, either in the home or a hospital. Other locations such as a library can be approved for sessions as well. For children with IEPs, the teacher assigned to them will be a credentialed special education teacher, and any qualifying educator in the district can accept the position.

The hours of instruction your child receives will depend on your state. For example, in California, one school day equals one hour of Home Hospital instruction, so the typical child would clock a minimum of five hours per week.

If a child with HH placement has an IEP, their IEP team will work together to determine the amount of time they need, along with whatever accommodations and services are required.

1. Get a note from your doctor explaining the specific health-related reason your child cannot attend school safely and is therefore eligible for HH, along with a date the team can check your child’s status and/or when the order may be lifted. The end date is decided on a case-by-case basis, depending on the risk to your child. Grace Clark suggests choosing a date that the risk might be alleviated and extend if needed.

2. Provide the doctor’s note to your child’s IEP team and request a meeting to discuss changing their placement, along with:

• what accommodations and goals can transfer to the HH environment
• how many hours your child will receive
• what services your child will receive at their location or virtually, and what those minutes will look like

Dr. Pelangka also shared some tips for what to keep in mind when adding HH to your child’s IEP:

• Be aware of the laws regarding IEPs and Home Hospital programs, as well as your child’s Present Levels of Performance (PLOPs). This will help you advocate for your child’s needs.

• Remember, the district cannot cut your child’s services without a legitimate explanation. The provider’s availability is not a valid reason.

• You don’t need to accept what the IEP team says at face value. Goals that can be worked on individually can continue as usual.

When your child is ready to return to school in person, you will need to request another IEP meeting to evaluate your child’s status and change their placement back to its previous setting.

While your child is apart from their peers, you will likely want to ensure they have other opportunities to socialize. Get creative! For example, you could try setting up a virtual speech therapy session with classmates or working with family members or friends on group goals, like having peer conversations.

There may also be community resources you can use, such as extracurricular classes or clubs through organizations that regularly run virtual programs. For ideas, check out our article Socialization and Inclusion: Nurturing Authentic Peer Relationships