El Dorado County Office of Education, Placerville

Independent Study, Home-Hospital Instruction, and Home Instruction

In the incidence that a student is unable to attend school due to a medical disability such as illness or hospitalization, an LEA/district may implement one of the following programs to meet the student's general and/or special education needs for the duration of their absence from the school setting: Home and Hospital Instruction, Home Instruction, or Independent Study. The purpose of this section is to outline which instructional program is most appropriate based on the student's educational program and level of need.

What is Home and Hospital Instruction?

California state law affords all students enrolled in a public school the right to access the Home and Hospital Instruction ("HHI") Program. The HHI Program serves students with temporary disabilities for whom it is impossible or unadvisable to attend regular classes, regardless of their disability status. Examples of when HHI may be appropriate for a student include when the student is in the home or hospital setting for a temporary period due to pneumonia, a communicable disease, a broken limb significantly impacting mobility, or is unable to attend school due to the death of a loved one and subsequent emotional impact.  *Medical documentation of a return date, written by a physician, is a required element of HHI.

A temporary disability is defined as a physical, mental, or emotional disability incurred while a student is enrolled in regular day classes or an alternative education program, and after which the student can reasonably be expected to return to regular day classes or the alternative education program without special intervention" ¹ (CDE Home and Hospital Instruction Program Summary). A temporary disability does not include a disability for which a student is identified as an individual with exceptional needs pursuant to EDC §56026.

The primary outcome of HHI is to maintain a student at their former level of performance while recovering from the temporary disability so as not to jeopardize the student's future performance upon returning to their education program.

Home and Hospital Instruction (HHI): Eligibility

It is the responsibility of the parent/guardian of a student with a temporary disability to notify the LEA/district of the request for Home and Hospital Instruction. If a parent/guardian notifies a school of the request, the school must determine the appropriateness of HHI services within five days of the request. Determination of a temporary disability should be based on a physician's written description of the disabling condition for which the student cannot attend school.

Charter Schools and Home and Hospital Instruction: Considerations for General Education
There is no law that expressly authorizes nor prohibits a charter school from providing home-hospital instruction. Therefore, a charter school may choose to either provide HHI services directly or work with the district of residence to ensure services are provided. Under current guidance, it is not recommended that a charter school refuse to provide HHI services if required for a student with a temporary disability to access their education. Assembly Bill 2109, which took effect on January 1, 2019, made several changes to the laws governing home-hospital instruction for students with temporary disabilities. AB 2109 authorizes, but does not require, an LEA/district to continue to enroll a pupil who is receiving individual instruction in a hospital, regardless of district boundaries, to facilitate timely reentry following the hospitalization and limit barriers to re-enrollment. AB 2109 provides a right for the student to return to the school of origin (the student attended prior to the health issue) if the student is well enough to attend school and returns prior to the end of the school year in which the home and hospital instruction was initiated. Accordingly, all schools must re-enroll a student who receives home-hospital instruction in another school district but is well enough to return during the same school year. AB 2109 also authorizes the school of origin to provide a partial week of instruction to a pupil who is receiving individual instruction in a hospital for fewer than five days per week. For example, a student receiving medical treatment in a hospital on Monday and Tuesday may receive individual instruction from the district in which the hospital is located on those days. Then, the student may receive instruction from the school of origin on Wednesday through Friday. This instruction may occur within the school setting or home, depending on the student's level of need. It should be noted that AB 2109 particularly affects general education students with temporary disabilities. Any decision regarding the appropriateness of individualized instruction for students receiving special education services pursuant to an IEP must be made by the student's IEP team³.

Charter Schools and Home and Hospital Instruction: Considerations for General Education

There is no law that expressly authorizes nor prohibits a charter school from providing home-hospital instruction. Therefore, a charter school may choose to either provide HHI services directly or work with the district of residence to ensure services are provided. Under current guidance, it is not recommended that a charter school refuse to provide HHI services if required for a student with a temporary disability to access their education.

Assembly Bill 2109, which took effect on January 1, 2019, made several changes to the laws governing home-hospital instruction for students with temporary disabilities. AB 2109 authorizes, but does not require, an LEA/district to continue to enroll a pupil who is receiving individual instruction in a hospital, regardless of district boundaries, to facilitate timely reentry following the hospitalization and limit barriers to re-enrollment. AB 2109 provides a right for the student to return to the school of origin (the student attended prior to the health issue) if the student is well enough to attend school and returns prior to the end of the school year in which the home and hospital instruction was initiated.

Accordingly, all schools must re-enroll a student who receives home-hospital instruction in another school district but is well enough to return during the same school year.

AB 2109 also authorizes the school of origin to provide a partial week of instruction to a pupil who is receiving individual instruction in a hospital for fewer than five days per week. For example, a student receiving medical treatment in a hospital on Monday and Tuesday may receive individual instruction from the district in which the hospital is located on those days. Then, the student may receive instruction from the school of origin on Wednesday through Friday. This instruction may occur within the school setting or home, depending on the student's level of need.

It should be noted that AB 2109 particularly affects general education students with temporary disabilities. Any decision regarding the appropriateness of individualized instruction for students receiving special education services pursuant to an IEP must be made by the student's IEP team³.

A school must begin HHI services within five days of determining eligibility. While out of school due to a temporary disability, a student may receive individual instruction either in the home, hospital, or other residential facility. A student may receive one clock hour of instruction per calendar day of school, up to five hours per week through the HHI program. Services are not provided over the summer or holiday breaks. Additionally, electives such as foreign languages or PE are typically not provided through HHI.

For purposes of computing Average Daily Attendance ("ADA"), the district in which the hospital or other residential health facility is located may only claim ADA for the days of the week the student is receiving individual instruction, and the school of origin may only claim ADA for the days the student attends the school. The total combined ADA cannot exceed five school days or the equivalent. As a reminder, each hour of individual instruction may be counted as one day of attendance. It is recommended that charter schools research ADA collection for home/hospital instruction and collaborate with their CALPADS administrator to ensure appropriate rules regarding enrollment and attendance reporting are followed.

As a reminder, if a student with an IEP is unable to attend school due to a temporary disability, the LEA/district where the student is enrolled continues to be responsible for provision of special education and related services during that time. General education supports would also be provided through the Home Instruction program as indicated in the IEP. For additional information please refer to the Home Instruction section below or visit the CDE Home and Hospital Instruction Guidance page: https://www.cde.ca.gov/sp/eo/hh/.

Home and Hospital Instruction: Credentialing

HHI shall be provided only by teachers with valid California teaching credentials who consent to the assignment. As a reminder, there is no provision in the statute that specifically addresses instructional content; however, the goal of home or hospital instruction should be the maintenance of the student's former level of performance.

For more information on credentialing, see California Commission on Teacher Credentialing (CTC):https://www.ctc.ca.gov/credentials/leaflets/Ed-Specialist-Instruction-Cred-(CL-808CA)

What is Home Instruction?

Home instruction is also referred to as Homebound Instruction or Instruction in the Home and is considered a placement on the continuum of services for students receiving special education services. If a student with an IEP is deemed unable to attend school due to a temporary or ongoing medical or psychological disability, the school is obligated to continue to provide special education and related services to the student during that time. Home instruction is also available to students with disabilities who are hospitalized for medical or psychiatric purposes or who cannot be educated in the public school setting due to significant health or behavioral needs which may not be temporary in nature.

Home Instruction: Eligibility, Services, and Teacher Requirements

To qualify for home instruction, a student must have an Individualized Education Program (IEP) or Section 504 plan. Home instruction may only be provided under the following circumstances (5 CCR § 3051.4):

Student has been identified as having exceptional needs (IEP or 504)
IEP team has recommended home instruction
IEP team recommendation is based on a medical report which:
- Is from the student's attending physician, surgeon, or psychologist;
- States the diagnosed condition;
- Certifies that the student's condition prevents attendance in a less restrictive setting;
- and Contains a "projected calendar date for student's return to school."

*Note: As a reminder, procedures followed by the IEP team in developing an IEP for a student receiving home instruction are the same as those followed for any other student with special education services. The IEP or 504 team will determine the duration and type of instruction required to address the student's unique needs (may be more or less than five hours per week of instruction and may require related services). If home instruction is intended to be temporary, please include an end date.

Any home instruction program must be individually designed to ensure that the student continues to make progress on goals and objectives. The law also requires that students have access to and make progress in the general education curriculum. Home instruction may be provided over the summer if required to provide FAPE (Free Appropriate Public Education). It may be provided more than five hours per week if required for the student to continue progressing on goals and objectives. Equipment or technology necessary to enable the child to benefit from home instruction to access and make progress in the general curriculum or to ensure progress on IEP goals must be provided as part of FAPE. The teacher providing home instruction shall contact the student's prior teacher to determine:

The coursework to be covered;
Books or other materials to be used; and
Who is responsible for issuing grades and/or promoting the student?

For grades 7-12, a school must determine:

Hours earned toward course credit in each subject;
Student's grade in each subject; and
Who will issue credit or diploma when work is completed.

Home Instruction: Credentialing

Home instruction services may include individual, small group, or virtual instruction. They must be provided by a regular education teacher or a specialist with the appropriate teaching or related services credential. There is currently no law in California requiring a parent to be home during periods of instruction; however, it may be within the best interest of the educator and student to schedule instruction while parent/guardians are home whenever possible.

What is Independent Study?

Independent study provides an alternative education program available to all students across all grade levels. Independent study programs are voluntary and use alternative instructional strategies that respond to individual student needs and learning styles. Students may access independent study through a range of quality educational options that include classroom-based, hybrid, and non-classroom-based virtual programs. While a student is participating in independent study, the LEA/district is responsible for the provision of general education as well as special education and related services as deemed appropriate by the IEP team.

Independent study may be offered through a variety of formats, including:

As a program or class within a comprehensive school
Through an alternative school or program of choice (EDC §58500 et seq)
Through charter schools
Through board-approved online courses
As an accommodation for pupil travel
As specialized and/or advanced courses
As a credit recovery method
On a short-term basis (less than 15 total school days per school year)

Students with disabilities may participate in traditional and course-based independent study programs if their individualized education programs (IEP) specifically provide for such instruction. For students with special education services, a determination as to whether independent study is appropriate must be made by the IEP team within 30 days of the request and documented in the IEP prior to initiating independent study. The IEP team may not decline a student's request for independent study based on the student's inability to work independently, the need for adult support, or the need for special education or related services (EDC §51745 (c)).

The offer of special education and related services must continue to be based on student need while enrolled in the independent study program and must not be decreased based solely on the availability of student, staff, and/or resources.

The IEP must specify the appropriate content under the Individuals with Disabilities Education Act (IDEA) 34 Code of Federal Regulations (CFR) 300.302, including:

The percentage of time the student will participate in independent study.
The percentage of time to be spent in regular education, if any.
The percentage of time the student will receive special education support.
Discussions of the placement options and supports considered in developing an independent study program for a student with special needs.
The academic goals and services that are unique to the needs of the special education student.
The accommodations and related services needed to maximize access in an independent study placement.
A plan that outlines the course of study as it relates to the independent study curriculum.

Assembly Bill 181 was signed into law on June 30, 2022 and authorizes LEAs to claim apportionment for students served in nonpublic, nonsectarian schools through a "virtual program," as long as the LEA offers independent study, the parent or guardian requests independent study, and the IEP team determines the student can receive FAPE in the virtual program. This provision becomes inoperative on July 1, 2024. For more information on AB 181 visit: https://www.cde.ca.gov/sp/se/lr/om081922.asp

For more information, please visit the Independent Study section of this procedural guide.

Independent Study, HHI, HI: Quick Reference
	Independent Study	Home and Hospital Instruction	Home Instruction
Brief Description	Provides an alternative education program that is available to all students across all grade levels.	Provides access to a general education curriculum for students with temporary disabilities for whom it is impossible or unadvisable to attend regular classes.	Home Instruction is considered a placement on the continuum of services for students receiving special education services.
Eligibility	Independent study programs are voluntary. Students with exceptional needs may participate in traditional and course-based independent study if their individualized education programs (IEP) specifically provide for such instruction. An IEP team shall not deny a request for independent study based on a student’s inability to work independently, need for adult support, or need for special education or related services. For additional information, please visit the Independent Study section of this procedural guide.	It is the primary responsibility of the parent or guardian of a student with a temporary disability to notify the school of the request for Home and Hospital Instruction, or of the student's presence in a qualifying hospital. Medical documentation of need and return date is required. Note: there is no law which expressly authorizes nor prohibits a charter school from providing home-hospital instruction. Therefore, a charter school may choose to either provide HHI services directly or work with the district of residence to ensure services are provided. It is not recommended that a charter school refuses to provide HHI services if required for a student with a temporary disability to access his or her education.	To qualify for Home Instruction, a student must have an Individualized Education Program (IEP) or Section 504 plan. Placement in Home Instruction program is the decision of the IEP team. Please refer to the section above titled Home Instruction: Eligibility, Services and Teacher Requirements for specific eligibility requirements.
Timelines	For a student who has an IEP and wants to participate in independent study, a determination as to whether independent study is appropriate must be made within 30 days and written into the IEP.	Upon receiving notification of an HHI request from the parent, the school must determine the appropriateness of HHI services within five days of the request. The school must then begin HHI services within five days of determining eligibility. Within five days of beginning such services, the LEA/district must notify the prior LEA/district that the student is receiving HHI and the date on which HHI services began.	If a parent requests Home Instruction based on medical documentation, or if Home Instruction is deemed appropriate due to another medical or mental health need, it is recommended that the IEP team respond to the request within five days by offering IEP dates for scheduling and/or IEP meeting notice to participants. Convene an IEP meeting as soon as possible to consider the appropriateness of Home Instruction.

For additional information, please contact your El Dorado SELPA Program Specialist.

Useful Links:

1California Department of Education (12 September 2018). Home and Hospital Instruction. Retrieved from https://www.cde.ca.gov/sp/eo/hh/.

2California Charter Schools Association (10 April 2018). CCSA Answers: Charter Schools and Home Hospital Instruction. Retrieved from http://library.ccsa.org/blog/members/2018/04/ccsa-answers-charter-schools-and-home-and-hospital-instruction.html.

3Jassawalla, A. (19 February 2019). State Legislature Makes Changes to Home-Hospital Instruction for Students with Temporary Disabilities.

Retrieved from http://girardedwards.com/state-legislature-makes-changes-to-home-hospital-instruction-for-students-with-temporary-disabilities/.

Independent Study, Home-Hospital Instruction, and Home Instruction

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