Homebound instruction may be provided for students who are unable to attend school due to medical problems. It
is designed to serve students during the period of time they are physically and/or emotionally incapable of
attending school. It is a temporary alternative service to be provided only during specific periods of time when
students cannot attend school.
The goal of homebound instruction is to help the student maintain educational progress during the time they are
confined to home, hospital, or other convalescent center. Regular school attendance is an important factor in
learning and academic success. Unfortunately, during periods of homebound instruction, daily classroom activities
are not present. It is important parents and students understand that students placed on homebound instruction
may experience delays in grade advancement and graduation.
There are three (3) types of homebound/hospital instruction: homebound/hospital instruction for students with
exceptional educational needs (EEN), homebound/hospital instruction for non-EEN students, and homebound
services for certain pregnant students. The following procedures shall be used for all homebound/hospital
A. The student's parent/guardian will initiate the request for homebound/hospital instruction through completion
of a District-provided "Request for Homebound/Hospital Instruction" form. The completed "Request for
Homebound/Hospital Instruction" form shall be presented by the student's parent or guardian to the principal
or designee of the school where the student is enrolled.
B. Upon receiving the "Request for Homebound/Hospital Instruction" form, the principal/designee will provide a
"Physician's Statement" form (PI-2217) to the student's parent or guardian. In order for the District to consider
providing homebound/hospital instruction, a completed "Physician's Statement" PI-2217 form is required and
must be returned to the principal/designee of the school where the child is enrolled by the physician.
Additional information may be requested to substantiate the condition preventing the student from attending
school. The physician's statement is valid only for a maximum of 45 school days and all physician
statements expire at the end of the school year. Physician statements are requests for a homebound
program, not a mandate for services.
C. The principal/designee in the case of a non-EEN student, upon receiving both the request form and the
physician's statement, shall initiate a Section 504 of the Rehabilitation Act of 1973 referral to determine the
educational needs of the student and procedures for the carrying out of homebound/hospital instruction with
the individual student.
D. The principal/designee in the case of an EEN student shall forward both the request form and completed
physician's statement form to the supervisor of special education who will then proceed in accordance with
legal requirements and the District’s established multidisciplinary team procedures.
Under s. 115.85, Wisconsin Statutes each school district is responsible for the provision of special education
and related services to students with EEN who have not graduated from high school and who reside in the
school district. Special education includes instruction at home, in hospitals, institutions, and other settings.
The District has an obligation to provide special education and related services, if needed, even when a
student is unable to attend a school-based program. The Wisconsin Administrative Code PI 11.31(1) provides
for special education and related services for students with EEN in the home, a hospital, a sanitarium or
E. For an EEN student, the Individualized Education Program (IEP) committee must reconvene for placement in
homebound/hospital instruction. The written IEP must reflect placement, instructional changes and date of
return to regular school to match with medical statement.
The department reads s.118.15(3), Wisconsin Statutes, together with other State and Federal laws
mandating the provision of a free and appropriate education (FAPE), to mean that if an EEN student is unable
to attend his or her regular program, the full IEP does not have to be carried out for up to a thirty (30) day
period. Rather, the School District must provide the services in the student's IEP which the student can
tolerate. The District must document the student's current mental and physical limitations when determining
an appropriate program. Some instructional services may be provided through means other than direct
F. For all other requests for homebound programs, a homebound instructional team shall be convened by the
school administrator, school counselor or social worker, and the director of student services for the purpose
of evaluating and determining a student’s need for homebound instruction.
G. If the Homebound Instructional Team determines that homebound instruction is necessary, a homebound
instructional plan shall be developed with input from the student, parent/guardian, and the school district.
When a consensus within the team cannot be reached, the school decision takes priority. Details of the
plan shall include:
Anticipated beginning and ending dates of homebound instruction
Anticipated number of hours of homebound instruction per week
Identification of coursework to be completed during homebound instruction
Identification of coursework not available through homebound
Identification of coursework to be completed in addition to homebound instruction
Identification of coursework modifications and adjustments as needed
H. Decisions of Homebound Instructional Team may be appealed in writing by the parent/guardian to the
Director of Student Services within 5 school days. The Director of Student Services shall render a final
decision within 5 school days.
I. To initiate approved homebound programs, the principal or designee shall:
1. Survey building teaching staff to determine interest/availability for homebound instruction. This is
intended to determine if there are teachers in the building familiar with the curriculum and the student.
This is particularly important in the case of high school students enrolled in specialized courses such
as foreign language or advanced courses in a subject area.
2. If staff members from the student's school are not available for homebound instruction, the
principal/designee should contact the student services office to determine the availability of additional
3. Monitor the student's homebound/hospital instruction progress through periodic meetings with the
homebound/hospital instructor, the student's teachers, and/or communication with the student's
J. In all cases of homebound instruction:
1. A parent, guardian or other adult must be present in the residence when homebound instruction is
2. The student receiving homebound instruction must be prepared and available to meet with the instructor
at the scheduled times.
3. A suitable place for homebound instruction must be provided in the residence or the approved alternate
4. Any quarter, semester on or year grades to be given will be determined by the student's regular
classroom teacher(s) and/or special education teacher with input from the homebound instructor.
5. The homebound instructor will be required to maintain a log of instructional sessions, preparation time
and mileage to be administered through the student services office.
K. Homebound/hospital instruction is terminated and a student is returned to the assigned school if:
1. The 504 team or the IEP determines return to school placement is appropriate;
2. The attending physician determines the medical condition allows school attendance;
3. The medical request expires;
4. The instructor and the administrator of the program do not believe progress is being made with lessons
due to absences or other factors not related to the medical condition;
5. The parent selects to return their child to school.
L. The homebound teacher is responsible for submitting a summary grade report at the conclusion of
homebound services, or at a minimum at the end of each quarter/semester if services extend that long.
Grades for homebound services are maintained as part of the student permanent record card at their
A notice will be sent to the parent/guardian of the student and the assigned school when Homebound/
Hospital Instruction services are terminated or the request is denied. A copy of the summary grade and
attendance report should accompany this notice.
Homebound Instructional Plan
Beginning Date ________________________
Ending Date ___________________________
Note: the ending date should be no longer than 45 school days after the start date. For homebound instruction to
continue after 45 school days, an updated PI-2217 Physician Statement must be on file.
Number of instructional hours approved per week ______________
What courses will be covered as a part of the homebound instructional plan?
What courses is the student currently enrolled in that are not available through homebound?
What additional courses will the student be enrolled in outside of his/her homebound instruction program?
What types if any coursework modifications or adjustments are a necessary part of the student’s homebound
I understand and agree to comply with the Administrative Guidelines for Homebound/Hospital Instruction (AG 2412)
and the Homebound Instructional Plan.
Student Signature ____________________ Date __________
Parent Signature _____________________ Date __________