Home and hospital instruction for students with IEPs

Home and hospital instruction means a teacher works with your child at home, in a hospital or in another medical setting when your child cannot attend school for health reasons. Federal law lists home instruction and instruction in hospitals as settings every district must be able to offer.^[1] States set many of the details, such as how long your child must be out and what a doctor must sign.

For a child with an IEP, this is not just a medical form. It is a change in where your child is taught, so the IEP team should decide it and write it into the IEP. Home is one of the most restrictive settings, because your child is apart from other students, so it should last only as long as your child's health requires.

When home or hospital instruction makes sense

Common reasons include:

• Recovery from surgery or a serious injury
• A hospital stay or treatment such as chemotherapy
• A medical condition that flares and keeps your child home for weeks at a time
• A mental health treatment program, in some states

Home instruction should not be used because the school is not sure how to handle behavior or because staff are not available. Those are reasons to add support at school. Placement must be based on your child's IEP and reviewed by a group that includes you.^[2]

How it usually works

States and districts have their own steps, so ask for yours. Many follow a pattern like this:

1. You tell the school. Contact the case manager as soon as you know your child will miss school.
2. A doctor fills out a form. Most districts ask for a statement from a physician or licensed provider about why your child cannot attend and for how long.
3. The IEP team meets. The team decides what services your child needs at home or in the hospital, for how many hours, and who will provide them. This may be a short meeting or a phone call.
4. You get written notice. The school must give you written notice when it changes your child's placement.^[3]
5. Instruction starts. A teacher visits, teaches online, or works with the hospital's school program.
6. The team plans the return. The team meets again before your child goes back to school.

An annotated example you can hold next to your child's IEP

This example is made up. Sofia is in 4th grade and has a learning disability in reading. She will be home for 6 weeks after back surgery. Notes in italics explain each part.

What to watch for

The hours. Home instruction is often fewer hours than a school day. Your state may set a minimum. Ask how the team decided on the number of hours and how your child's goals will be worked on.

Special education services. Your child's IEP services do not stop because your child is home. The team may change them for a time, but it should decide that together and write it down.

Long or repeated stays. If your child has a condition that keeps them home again and again, ask about a plan for partial days at school, online learning on bad days, or other options that keep your child connected.

Mental health. Some children are sent home for anxiety or behavior. Home instruction can be right during a treatment program. It is not a substitute for support at school. Ask what the school will do to help your child return.

Questions to ask the team

1. "How many hours a week will my child be taught at home, and why that number?"
2. "Who will teach my child, and are they certified in special education?"
3. "Which IEP goals will be worked on at home?"
4. "What happens to speech, OT or other services while my child is home?"
5. "Will missed services be made up?"
6. "How will my child stay connected to classmates?"
7. "When will we meet to plan my child's return to school?"
8. "What do you need from my child's doctor, and by when?"

What to do next

1. Call or email the case manager as soon as you know your child will miss school. Ask for the home and hospital form.
2. Ask your child's doctor to fill it out with dates and the reason.
3. Ask for an IEP meeting to set the hours and services.
4. Keep a log of each session: date, time, teacher, and what was taught.
5. Ask for the return meeting date before home instruction starts.
6. For free help, contact your state's Parent Training and Information Center through the Center for Parent Information and Resources.^[4]

The continuum of placements guide explains where home instruction sits among other settings. If your child's day at school is being cut short instead, read about shortened school days. Some families choose a full-time online program instead, which is different; see IEPs in virtual school. The home setting goals page shows goals that can be worked on outside school. For children with complex health needs, the medical accommodations guide may also help.

Frequently asked questions

Use it in IEP Atlas

• Goals for the home setting
• Continuum of placements in the IEP glossary
• LRE in the IEP glossary
• Prior written notice in the IEP glossary

Related guides

• Least restrictive environment, with examples
• The continuum of special education placements
• Shortened school days for students with IEPs
• IEPs in virtual school
• Accommodations for students with diabetes, seizures or allergies
• ESY vs summer school
• ESY eligibility: regression, recoupment and critical skills

Sources

1. 34 CFR §300.115: Continuum of alternative placements, U.S. Department of Education (IDEA website)
2. 34 CFR §300.116: Placements, U.S. Department of Education (IDEA website)
3. 34 CFR §300.503: Prior notice by the public agency; content of notice, U.S. Department of Education (IDEA website)
4. Center for Parent Information and Resources, CPIR

Written and checked by the IEP Atlas editorial team under our editorial policy. This guide describes general practice and federal rules. It is not legal advice; your state may add requirements, and the IEP team makes the decisions for each student.