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Homebound Instructional Services

PROGRAM INFORMATION FOR SCHOOLS 

Homebound Services are provided when students cannot attend school due to a documented condition or circumstance. Short Term or Long Term services are available to any approved student. Contact Homebound Services for applications. 

Short Term: 45 Days and Less 

1. Student is out of school for 45 days or less. 

2. Student remains enrolled in their school and retains a regular class schedule for the duration of services. 

3. School administrator meets with parent/guardian and student to review Homebound Services. The Request for Homebound Services and Homebound Instruction Disclosure Statement forms are completed. 

4. Homebound Instruction Health Professional’s Statement of Need form is given to parents, to be completed by student’s treating health professional and returned to the school. This form may include the professional’s relevant notes/letters as support for the Statement of Need. 

5. If student is being served under an IEP, the school’s Special Education department must schedule a “Change of Placement” meeting. 

6. Once forms are complete, principal may approve student for Short Term Homebound services. 

7. Next, the school sends the three completed forms to Jo Ann Larsen at Homebound Services (Request for Homebound Instruction, Health Professional’s Statement of Need (including relevant notes/letters), and Disclosure Statement. If the student has an IEP, the Change of Placement must also be sent. 

8. The school assigns a teacher to work with student for two hours, once a week, at the student’s home, hospital, or an alternate location. Parent/guardian must provide responsible adult supervision during the entire two hour home visit. Teacher will fill out a Teaching Record each month on each student served. 

9. A completed Teaching Record, timesheet and mileage reimbursement form should be received by Jo Ann Larsen at Homebound Services for payment authorization by the second working day of each month to ensure teacher receives timely payment. 

10. The School should inform Homebound Services immediately upon student’s return to full-time status. 

11. Homebound Services will maintain the student’s homebound instruction records. 

Long Term: More than 45 Days 

1. Student is out of school for more than 45 days. 

2. Student is withdrawn from boundary school and will be enrolled with Homebound Services for the duration of services. 

3. School administrator meets with parent/guardian and student to review the Homebound Services program. The Request for Homebound Services and Homebound Instruction Disclosure Statement forms are completed. 

4. Homebound Instruction Health Professional’s Statement of Need form is given to parents, to be completed by student’s treating health professional and returned to the school. This form may include the professional’s relevant notes/letters as support for the Statement of Need. 

5. If student is being served under an IEP, the school’s Special Education department must schedule a “Change of Placement” meeting. 

6. Next, the school sends the three completed forms to Jo Ann Larsen at Homebound Services (Request for Homebound Instruction, Homebound Instruction Health Professional’s Statement of Need (including relevant notes/letters), and Homebound Instruction Disclosure Statement. If the student has an IEP, the Change of Placement must also be sent. 

7. Parents and students complete registration in Long Term Homebound Services by calling Jo Ann Larsen, Program Assistant at (801) 826-5506 to set up an intake appointment. 

8. Parent/guardian then may choose one of the following options: 

a. A Long Term services teacher meets with student once a week for two hours, in home, hospital, or alternate location (parent provides responsible adult supervision during visit); 

b. Student attends a learning lab for two to three hours per day, four days a week; 

c. Student participates through an on-line education program; or 

d. A student in hospital or other facility with education services will be supported by Homebound Services with student records, transferring credits earned and transition back to boundary school