- Section I: Parent/Student Information - This MUST be completed by the legal parent(s) / guardian(s) prior to full completion by the licensed medical or mental health professional.
- Section II: Medical Professional Statement - This section is to be filled out, signed and dated by the authorized medical or mental health professional. A diagnosis must be listed along with the length of time that Home/Hospital will be needed. The application also should include verification that the illness confines the student to a hospital, nursing facility, or home and that the student is unable to attend school. Please note that HH services for any diagnosis begin based on the date of the doctor’s signature with respect given to when our office receives the application. Additionally, to be in compliance with 702 KAR 7:150, Section 2, (4) 'an application for mental health reasons may be considered if completed by a licensed psychologist or psychiatrist'. Please call if you have questions or need assistance. The application can be faxed (606-573-5767) or preferably hand delivered by the parent or guardian to Harlan County Public Schools, ATTN: Scott Pace, Home/Hospital Director, 251 Ball Park Road, Harlan, KY 40831
- Section III: School District Home/Hospital Review Committee - This section is to be completed by the Home/Hospital Review Committee.
- Section IV: Eligibility for home/hospital instruction for students with disabilities shall be determined by the Admissions and Release Committee (ARC) in accordance with their Individual Education Program (IEP). The ARC chair shall provide written notice of eligibility to the local Director of Pupil Personnel (DPP) for purposes of program enrollment. The form provided in this section shall be used to provide this notice. Note that for ARC placements, Section IV (Page 6), the meeting/conference summary and supporting medical documentation must all be provided.
- Parent Agreement Letter for Home/Hospital Instruction - Along with Section I, the document MUST be completed by the legal parent(s) / guardian(s) before your child can be approved for Home/Hospital.
Parents and Students
- Present the required documentation to the Director; the HH Application noted above.
- Be present for each Home/Hospital session/visit.
- Sign the Visitation and Planning Schedule provided by the Home/Hospital teacher per visit. Please DO NOT sign in advance.
- Provide a safe environment for home teaching.
- Contact the Home/Hospital teacher in the event that the student is unable to make the scheduled appointment; please understand that every visit is the equivalent of 2.5 days of attendance. If a visit cannot be made due to the parent/student being unavailable or uncooperative, absences will be recorded.
- Be on time.
- Bring books and materials to the teaching session/visit.
- Complete all assigned work.
- Work to the best of their ability.
Home/Hospital TeachersPrimary Responsibilities
- The role of the Home/Hospital teacher is to provide the most appropriate academic accommodations for the student and to act as the liaison between the family and the school and to help the student remain current with their academic program, including courses needed for graduation.
- The HH teacher should immediately contact the parent/guardian to establish dates and times for visits.
- Provide instruction and course assignments for all classes.
- Maintain communication with the regular classroom teachers on student progress. A weekly progress report is encouraged.
- The HCPSD pays $25 per visit
- Beginning with the date of enrollment in the H/H program, the H/H Teacher meets with the student for individualized instruction a minimum of 2 visits per 5 days of instruction beginning with the date of placement; each meeting/visit must provide a minimum of 1-hour of instruction. Please do not use calendar weeks to calculate/schedule visits. Begin with the 1st day of placement and provide 2 1-hour visits for every consecutive 5 days of instruction.
- HH visits should not be made on days that school is cancelled unless you are behind on visits and at the discretion of the parent/guardian.
- HH visits can and should be made on NTI days if weather/conditions permit. NTI days are regular instruction days and visits must be made after regular school hours.
- HH visits should not be made on holidays or long breaks such as Christmas Vacation and Spring Break
- HH visits can/should only be made on a weekend out of necessity such as make-ups, testing periods, HH teacher or student illness, etc. at the discretion of the parent/guardian.
- To calculate the # of visits that should be made within the HH period - # of instructional days / by 2.5. Again, Please do not schedule or count visits based on calendar weeks. Remember that 2 visits should be made for every 5 instructional days.
- If visits have NOT been made for a week, make-ups can be done for that week for a total of (2) two visits. Anything beyond a week will either 1.) be counted as an absence if the HH teacher tried to make the visit but was unable to due to the parent(s) & student being unavailable to meet with or 2.) excused due to the HH teacher not making the visit(s) which was no fault of the student. Note that our regulation states that make-up visits must be made within the next five instructional days.
- The regular classroom teacher must be contacted immediately to develop an academic plan for the projected period of time the student will be out of school to meet the instructional needs and abilities of the student. Upon being provided with completed assignments by the HH teacher, the regular classroom teacher will grade assignments AND enter the grades into Infinite Campus. HH teachers or guidance counselors should not provide or enter grades. The regular classroom teacher can request that you assist with this process, but please document this agreement. Please make every effort to collect and return assignments to the regular classroom teacher as quickly as possible. It is very important that grades posted to IC are accurate and reflective of what the student has/has not completed while on the HH program.
- Assignments can only be provided within the HH service window. If there are excused absences that occurred just prior to this period, you are more than welcome to gather those assignments and help the HH student with them.
- Timesheets, the Visitation & Planning Schedule AND the Program Form must be turned in by the 10th and 25th of each month in order to process payment and document visits. At times payroll ends early and you may want to submit your paperwork a few days prior to the 10th and 25th. Please submit copies of the Program Form each time and provide the original at the conclusion of HH services. Note that any visit turned in 30 calendar days beyond the visit/service date will not be paid. If paperwork has to be returned for corrections, the days included to get it back to the Central Office for processing will be counted in the 30 days.
- Multiple students cannot be added to individual Timesheets. Please provide a separate Timesheet and Visitation and Planning Schedule form per student.
- Please make sure that the Timesheets, Visitation and Planning Schedules and Program Form are turned in together and the dates & times of your visits match exactly.
- Please do not send copies of your paperwork for payment except for the Program Form mentioned above. Timesheets and the Visitation and Planning Schedule must be originals.
- Your ID Number must appear at the bottom of the Timesheet in order for it to be processed for payment.
- Please have the parent/guardian sign the Visitation and Planning Schedule each time you make a visit. Do not have them sign in advance.
- Please use a blue colored pen when completing paperwork as it helps to distinguish original documents from copies.
- Please do not write notes such as make-up visits, NTI Days, etc. on any of the forms you turn in for processing. Send additional correspondence or explanations on a separate sheet of paper.
If you are interested in becoming a Home/Hospital teacher please contact Scott Pace, H/H Director at 606-574-4330 x2047 / email@example.com!
Classroom TeachersProviding work/assignments typically means:
- Copies of all necessary texts, unless the student already has his/her own.
- A brief list of units/chapters/assessments (not necessarily daily lesson plans).
- Copies of handouts/worksheets
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If you have additional questions, we will be happy to help!
- Home/Hospital Guidelines (702 KAR 7:150) (Parents & Students)
- Application for Home/Hospital Instruction (Parents & Medical Professionals)
- Sample Paperwork (Timesheet, Visitation & Planning Schedule, Program Form, Calendar)
- Home Visit Time Sheet (Home/Hospital Teachers) .XLSX-Excel, .PDF
- Home/Hospital Visitation & Planning Schedule (Home/Hospital Teachers)
- Home/Hospital Program Form (Home/Hospital Teachers)
- School Calendar (Home/Hospital Teachers - Use to Track Visits)