Home or Hospital Educational Services

Occasionally, your student may be ill and unable to attend school for an extended period of time.  If your student will be absent for 14 days or more for medical reasons, he may be entitled to educational services.  Massachusetts regulations provide that: “Upon receipt of a physician’s written order verifying that any student … must remain at home or in a hospital on a day or overnight basis, or any combination of both, for medical reasons and for a period of not less than fourteen school days in any school year, the principal shall arrange for provision of educational services in the home or hospital.” 603 CMR 28.03(3)(c).

The Department of Elementary and Secondary Education provides a form for physicians to use to request home or hospital educational services (Form 28/R, available on the DESE website).  Use of the form is not required.  However,  any statement from your physician in support of home or hospital educational services MUST contain the following: the date the student was admitted to a hospital or was confined to home; the medical reason(s) for the confinement (with some specificity); the expected duration of the student’s hospitalization or home confinement (>13 days? >60 days?); and what medical needs the school should consider in planning the home or hospital education services.

Further, to ensure sufficiency, this additional information should be included: the student’s diagnosis (related to the absence from school); the length of time the student has been under the physician’s care; when the student was last seen by the physician; an explanation of the medical condition that prevents the student from attending school; an indication if the condition is serious and/or chronic; and, if applicable, a discussion of how the student’s medical condition affects his educational performance (e.g., strength, vitality, or alertness is significantly limited and affects access to the educational environment).

Because school districts often deny requests for home-hospital educational services based on the insufficiency of physicians’ statements, it is important to explain to your student’s doctor what information must be included.

Special Education Eligibility and the DSM-5

Last week, I wrote about the new DSM-5. Although it is wise to make sure your student has an updated diagnosis, changes to the classification of the DSM-5 will not affect your student’s eligibility for special education services in Massachusetts. In July 2013, the Massachusetts Department of Elementary and Secondary Education (DESE) issued Technical Assistance Advisory SPED 2014-1 in response to the new changes in the DSM-5.  The DESE reminded schools that eligibility for special education services is an educational decision, not a medical decision and that eligibility for special education does not require a school to make a medical diagnosis.  In light of the fact that schools often receive reports from professionals who use the DSM to diagnose students, the DESE recognized that a change in diagnosis or a failure to qualify under the DSM-5 for a condition previously diagnosed under the DSM-IV could be confusing for school personnel.  Accordingly, the DESE advised schools that “changes in the DSM-5 diagnostic categories do not alter a student’s current eligibility status or IEP nor does it change any of the federal or state laws or regulations related to the determination of special education eligibility or services.”

The New DSM-5

The Diagnostic and Statistical Manual of Mental Disorders, known as the DSM, is the publication that mental health professionals use to diagnose patients.  The DSM was revised last year after a great deal of discussion, and the current version, the 5th edition, is known as the DSM-5.  One of the most controversial changes made in the DSM-5 was the elimination of diagnoses of Asperger’s Syndrome and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS).  Many people formerly diagnosed with Asperger’s or PDD-NOS will now fit under the new definition of Autism Spectrum Disorder (ASD).  Those that don’t may fall under a new diagnosis called Social Communication Disorder. The DSM-5 also combined learning disorders of reading, writing, and math into one general category, and changed the way that ADD is diagnosed and classified.  If your student has a diagnosis under the DSM-IV, the best practice would be to ask your clinician to revise the diagnosis so that it is consistent with the DSM-5.

Summer!

Summer is a great time to let kids de-stress! But it is also a good time to arrange for private evaluations. Many good private evaluators have a lighter load during the summer and wait times for appointments are correspondingly shorter. If you have been considering consulting a private evaluator, there is no time like the present. Getting the testing done now means that you can have an updated report ready to give to your school (if you choose to do so) in the fall.

Moving?

What happens to your child’s IEP when you move to another school district? It depends to some extent on whether you are moving within state or out of state. But, in all instances, the receiving school district is required to provide your child with services “comparable” to the services she was receiving pursuant to her IEP in your old school district. These services must be provided immediately and continuously until the new IEP team convenes and a new IEP is in place. Rules concerning what happens when a child has been placed in a special education school and the family moves are more complex, particularly concerning the financial responsibilities of the sending and receiving school districts. These rules can vary state to state and may add another layer of complexity to an out-of-state move.

“The art of teaching is the art of assisting discovery.”

Mark Van Doren

Follow Us!