# COMAR Title 13A — State Board of Education

## Subtitle 03 — General Instructional Programs

### Chapter 05 — Administration of Home and Hospital Teaching for Students

**Authority:** Education Article, §§2-205, 6-704, 7-101, 7-301, and 8-403, Annotated Code of Maryland

**Administrative History:** Effective date: July 4, 1994 (21:13 Md. R. 1158)

**Administrative History:** Regulation .01C, E amended effective February 16, 2015 (42:3 Md. R. 317)

**Administrative History:** Regulation .02B amended effective May 1, 2023 (50:8 Md. R. 339)

**Administrative History:** Regulation .03 amended effective February 16, 2015 (42:3 Md. R. 317)

**Administrative History:** Regulation .03A amended effective May 1, 2023 (50:8 Md. R. 339)

**Administrative History:** Regulation .03B amended effective June 3, 1996 (23:11 Md. R. 810)

**Administrative History:** Regulation .04 amended effective February 16, 2015 (42:3 Md. R. 317)

**Administrative History:** Regulation .04A amended effective May 1, 2023 (50:8 Md. R. 339)

**Administrative History:** Regulation .05 repealed effective February 16, 2015 (42:3 Md. R. 317)

#### Regulation .01 Scope.

*COMAR 13A.03.05.01*

A. These regulations, which establish a minimum requirement, apply to the provision of instructional services to public school students who are unable to participate in their school of enrollment due to a physical or emotional condition.

B. In implementing these regulations, all school systems shall comply with the Individuals with Disabilities Education Act, Americans with Disabilities Act, and §504 of the Rehabilitation Act of 1973, as appropriate.

C. Concurrent delivery of instructional services and enrollment in a public school shall be provided for a student whose physical or emotional condition requires the student to be absent from school on an intermittent basis. These conditions include, but are not limited to, kidney failure, cancer, asthma, cystic fibrosis, sickle cell anemia, depression, and bipolar disorder.

D. Instructional services shall be provided to an identified student with disabilities in accordance with federal and State special education law and regulations, including COMAR 13A.05.01. The student and parents shall be involved in the process and are entitled to all rights and due process procedures included within these laws and regulations.

E. Excluded from these regulations are the home-based programs operated through the Office for Children and the Maryland Infants and Toddlers Program for the birth through 2-year-old disabled population and Home Instruction under COMAR 13A.10.01.

#### Regulation .02 Definitions.

*COMAR 13A.03.05.02*

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

  (1) “Local school system” means the public school system in which the student is enrolled, or for an identified student with disabilities, the public school system that has responsibility for the education of the student.

  (2) “Nurse practitioner” means a nationally board certified, advance practice nurse with a master’s or doctorate degree who, by reason of certification under COMAR 10.27.07, may practice in Maryland as a nurse practitioner under the terms of that chapter or, if out-of-State, as a nurse practitioner in the state in which services are provided.

  (3) “Psychiatric mental health nurse practitioner” means an advanced practice registered nurse, possessing a master’s or doctorate degree, who, by reason of national certification under COMAR 10.27.12, is recognized as being trained and certified to diagnose and treat individuals who have mental health needs and substance abuse issues.

  (4) “Therapeutic treatment center” means any day or residential facility, licensed by a unit of State government, providing treatment for medical, physical, or emotional conditions including drug or alcohol dependency, or both.

#### Regulation .03 Responsibility of Local School Systems.

*COMAR 13A.03.05.03*

A. Nature.

  (1) Each local school system shall make instructional services available to students who are unable to participate in their school of enrollment for those reasons set forth in this chapter. In making instructional services available, local school systems shall consult with any of the following as deemed necessary:

    (a) Parent;

    (b) Guardian;

    (c) Student;

    (d) Psychologist;

    (e) Physician;

    (f) Psychiatrist; and

    (g) Nurse practitioner.

  (2) Instructional services, as outlined in this chapter, shall be available to all students during convalescence or treatment time in a medical institution, or therapeutic treatment center, and at the student's place of residence, or all of these.

B. Service Delivery.

  (1) Each local school system shall:

    (a) Determine the manner in which instructional services shall be delivered to a student;

    (b) Develop safety procedures, including training, to ensure an appropriately supervised safe environment for teachers and students; and

    (c) Develop a review process to resolve any disagreement that arises in the implementation of this chapter.

  (2) Instructional services as outlined in this chapter shall be delivered by an individual possessing a minimum of a bachelor’s degree from an institution of higher education as defined in COMAR 13A.12.01.02B. This requirement does not apply to an individual who has demonstrated satisfactory performance as a home and hospital teacher in a local school system before July 1, 2001.

C. Delivery Options. The local school system may:

  (1) Provide directly instructional services to a student;

  (2) Contract with private providers to deliver instructional services;

  (3) Contract with other local school systems to provide instructional services; or

  (4) Combine any of the delivery options described in §C(1)—(3) of this regulation.

D. Attendance and Time of Instruction.

  (1) A local school system shall either maintain a student on the regular school roll and count the student as present, except when a student is not available for the scheduled instructional service, in which event the student is counted absent, or establish a school for record-keeping purposes called a home and hospital school with a local school number. In the latter event, a student identified for home and hospital teaching shall be withdrawn from the roll of the school the student attends and transferred to the roll of the home and hospital school. The student shall be counted as present, except when the student is not available for the scheduled instructional service. In this instance, the student is counted absent.

  (2) The length of instruction for students in a full-day program is a minimum of 6 hours a week.

  (3) The length of instruction for students in half-day programs is a minimum of 3 hours a week.

  (4) A local school system shall determine the need for service and begin instruction as soon as possible, but not later than 10 school calendar days following the:

    (a) Notification to the local school system of the inability of the student to attend the school of enrollment; and

    (b) Receipt of the verification of the need for services as provided in Regulation .04 of this chapter.

#### Regulation .04 Verification Procedures.

*COMAR 13A.03.05.04*

A. The local school system shall determine initial service need through verification of the physical condition, including drug and alcohol dependency, by a licensed physician or certified nurse practitioner, or verification of emotional condition by a certified school psychologist, licensed psychologist,  licensed psychiatrist, or licensed psychiatric mental health nurse practitioner.

B. The student’s parent or guardian shall submit a statement from a practitioner designated in §A of this regulation verifying that the current physical or emotional condition prevents the student from participating in the students school of enrollment.

C. Continuation of Service Need.

  (1) Continuation of service need is subject to review and determination by the local school system and requires reverification of the physical or emotional condition in the manner set forth in §§A and B of this regulation.

  (2) Except as provided in §C(3) of this regulation, service need shall be reverified as follows:

    (a) 60 calendar days after the initial determination of eligibility and every 60 days thereafter; or

    (b) Sooner at the request of the parent, guardian, or local school system.

  (3) Service need shall be reverified annually for students who receive concurrent delivery of instructional services pursuant to Regulation .01C of this chapter.