Special Education: Absences due to Medical Illness Policy

As described under 603 CMR 28.03(3) (c), if the Lowell Middlesex Academy Charter School (LMACS) receives a physician’s written order stating that a student must remain at home or in a hospital due to a medical illness and for a period of not less than 14 school days in any school year, the principal shall arrange for provision of educational services in the home or hospital. Such services shall be provided with sufficient frequency to allow the student to continue his or her education as long as it is determined the student can safely be expected to do school work during the hospitalization/medical illness. The goal of such services is to provide necessary instruction to allow the student to keep up in their courses of study and minimize any educated loss. The principal shall coordinate such services with the Administrator for Special Education for eligible students. Furthermore, the district procedures ensure that these educational services are not considered special education unless the student has been determined eligible for such services, and the services include services on the student’s IEP. The student’s physician must complete a Department of Elementary and Secondary Education form, “Physician’s Affirmation of Need for Temporary Home or Hospital Education for Medically Necessary Reasons and submit it to the principal or other appropriate program administrator at LMACS. Educational services must begin without undue delay after the school district receives written notice form the student’s physician that services are necessary. 

If, in the judgment of a student’s physician, a student with an IEP is likely to remain at home, in a hospital, or in a pediatric nursing home for medical reasons and for more than 60 days in any school year, the Administrator of Special Education is required, without undue delay, to convene a Team meeting to consider evaluation needs. And, if appropriate, to amend the existing IEP or develop a new IEP to the student’s unique circumstances (603 CMR 28.04(4).) It is recommended that the Administrator of Special Education convene the Team meeting within 10 school days after the school district is notified in writing by the student’s physician that the student is likely to remain at home or in the hospital for more than 60 days. 

Instructional services are provided on an individual basis and should be determined in the best interests of the student and in consideration of the medical circumstances of the student. All aspects of a student’s needs are considered, including any current IEP services, Section 504 plans and instructional accommodations, as well as the student’s general education services. These services may be provided and are not limited to the following:

  • Providing the services directly to the student using district employees;
  • Contracting with the hospital to provide the needed services;
  • Contracting with another school district to provide the services; or 
  • Contracting with another agency to provide the services.

School districts should determine the number of instructional hours per day or per week based on the educational and medical needs of the individual student. School districts may not preset the number of instructional hours per week provided to students who must remain at home or in the hospital; the decision must be individualized. Based on the student’s medical status, the student’s physician may determine that the number of instructional hours should be reduced. In addition, the amount of instructional time deemed necessary by a district may be guided by the instructional approach used in a one-to-one home or hospital setting as compared to the instructional approach normally implemented in the student’s school-based program. However, such a reduction in instructional time must be based on the educational benefit received by the student given the reduced teacher-student ratio. Service delivery, including the time of day the services are to be delivered, should be determined in the best interests of the student and in consideration of the medical circumstances of the student.

While teacher certification requirements apply to the person who is providing this instruction, the person does not have to be certified in all subject areas. The teacher providing these educational services coordinates the instructional content, approach and student progress with the student’s teachers at school. In addition, special education and/or related services provided in a home or hospital setting must be delivered, or closely supervised, by staff, which is appropriately licensed to deliver such services.

All decisions related to this policy are made with input from parents with the student’s health and safety as the primary concern and are ongoing.