Statutory Basis for Medical Homebound Instruction - South Carolina Law

South Carolina’s mandates regarding medical homebound instruction appear in State Board of Education Regulation 43-241. Put in the simplest terms, R 43-241 defines “homebound instruction” as teaching that is offered to the student who has an acute or chronic medical condition that prevents him or her from attending classes at school, takes place “in a room especially set aside for the period of instruction,” and is conducted by an individual who holds a South Carolina teacher’s certificate.

Specifically, Regulation 43-241 says that students who cannot attend public school because of illness, accident, or pregnancy, even with the aid of transportation, are eligible for medical homebound instruction. A physician, nurse practitioner, or physician's assistant must certify that the student is unable to attend school but may profit from instruction given in the home or hospital. Any student participating in a program of medical homebound instruction or hospitalized instruction must be approved by the district superintendent or his or her designee on standardized forms provided by the State Department of Education. All approved forms must be maintained by the district for documentation.

Regulations Update

Homebound Resources

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How does a parent arrange for his or her child to receive medical homebound eLearning instruction?

The procedure for requesting medical homebound instruction is not determined at the state level but is established by the individual school district. A licensed physician, nurse practitioner, or physician assistant must complete a medical homebound instruction form that the local school district provides. The parent and/or physicians office will need to send the completed medical homebound forms to the student's school, the school counselor will then begin submitting the documents for the Homebound approval process. The district Homebound Coordinator may or may not then approve the student’s participation in a program for medical homebound instruction.

If the child is receiving services through the school district’s special education program and has an individualized education program (IEP), then the parent should also notify the designated school or district contact person for special education regarding the request for medical homebound services. If the child has an accommodations plan under Section 504 of the Rehabilitation Act of 1973, then the parent should notify the Section 504 school or district coordinator about the request.

Can a parent request medical homebound instruction for a child because of a mental health issue?

Yes. A mental health issue may be a legitimate reason to request medical homebound instruction. However, a licensed physician, nurse practitioner, or physician assistant must certify that the state of the child’s mental health is the cause of his or her inability to attend school. If the mental health diagnosis indicates that long-term medical eLearning homebound instruction will be necessary, parent(s) should also be advised to make arrangements for a licensed mental health professional to develop a treatment plan and strategy for reentry into the school environment and a meeting should be held with school personnel to discuss the option of the student enrolling full time in the virtual academy for the remainder of the school year.

If a physician writes a prescription for medical homebound instruction or completes a medical homebound application, isn’t the school district required to provide medical homebound instruction?

No. The Homebound Coordinator of the school district must approve any medical homebound instruction request. Upon the signed authorization of the parent, the district’s medical representative may ask the physician to supply additional documentation in order to determine if medical homebound instruction is appropriate. Parents are encouraged to discuss with physicians accommodations and modifications that can be made to keep students in school.

What happens if the Homebound Coordinator denies my request for medical homebound instruction for my child?

The district Homebound Coordinator has the authority to approve or deny the physician’s medical homebound recommendation. A parent may choose to go through the appeal process.

Can the Homebound Coordinator request a second medical opinion if he or she disagrees with the first physician or feels that inadequate information has been provided?

There is no regulation in federal or state law that prohibits a Homebound Coordinator from doing so. If the Homebound Coordinator feels that additional information is needed, then he or she may request a second medical opinion in order to gain the necessary information to approve medical homebound instruction, deny medical homebound instruction, or determine possible accommodations or modifications to allow the student to continue in his or her regular school program.

Fulfilling Roles and Responsibilities

What are the student’s responsibilities in the medical homebound instruction process?

 The student must realize that medical homebound instruction is an extension of regular school and all classroom rules and regulations, as well as school district policies, apply.

In addition, the student should:

  • be available for all scheduled eLearning instruction
  • have all books, materials, & student device needed for instruction
  • complete all homework assignments
  • remain courteous, comply with teacher requests, and use appropriate language
  • dedicate instruction time to instruction only (no phone calls, visiting, radio, television, and so on).

What are the parents’ responsibilities in the medical homebound eLearning instruction process?

The parents should:

  • realize that before instruction can begin, all necessary paperwork must be completed;
  • ensure that the child is prepared for the eLearning.
  • provide an area in the home that is conducive to learning and suitable for instruction (e.g., is quiet and free of distractions, has good lighting and a desk or table)
  • understand that during the course of medical homebound instruction, adult supervision in the home may be required in order to ensure a healthy and safe environment for both the student and the teacher
  • make certain that the student is available for all scheduled eLearning instruction, if the student misses more than two sessions, the district may terminate homebound instruction;
  • contact the students’ teacher to cancel the scheduled period of instruction in cases of emergency;
  • inform the teacher of the child’s future medical appointments as early as possible if such appointments will interfere with instruction time
  • understand that if the student is absent for his or her scheduled period of instruction, he or she is considered absent from school on that day
  • understand that the state’s compulsory attendance laws fully apply to medically homebound students
  • communicate with the district’s medical homebound instruction coordinator or the school’s contact person about changes in the child’s health and return-to-school plans
  • monitor and encourage the child to plan his or her time in order to accomplish assigned work
  • understand that medical homebound is designed to support students for short-term absence from school due to a medical condition. Any homebound request over the 4 week span will be considered for recommendation of the student to attend the Greenville County Virtual Academy full time.