Home and Hospital Instruction in Massachusetts: A Guide for Families and Districts
Updated: 7 hours ago
When a student in Massachusetts can't attend school for medical reasons, the district doesn't stop being responsible for their education. Massachusetts regulations require public schools to provide temporary educational services at home, in a hospital, or both. This guide explains who qualifies, what paperwork is needed, and what families and districts can expect.
What the law says
The rule is in the state's special education regulations at 603 CMR 28.03(3)(c), but it applies to all public school students, not only those with IEPs. When a physician gives the school a written order stating that a student must remain at home or in a hospital, on a day or overnight basis or any combination of both, for medical reasons for at least 14 school days in a school year, the principal must arrange for educational services in that setting.
According to the Department of Elementary and Secondary Education (DESE), the purpose is to give a student the opportunity to make educational progress even when a physician determines they are physically unable to attend school.
Who qualifies
Students enrolled in a public school, or placed by their public school district in a private setting.
Students whose physician certifies they must stay home or in a hospital for at least 14 school days.
Students with chronic illnesses whose shorter absences add up, or are expected to add up, to at least 14 school days over the school year. These recurring absences count too, as long as the physician documents the medical need.
Students absent for mental health reasons, such as a psychiatric hospitalization or a period of recovery at home, when the medical need is documented.
The physician's form
DESE publishes a standard form, the Physician's Affirmation of Need for Temporary Home or Hospital Education (Form 28R/3). Many districts accept an equivalent signed statement. Either way, the physician should include:
The date the student was admitted to the hospital or began staying home.
The medical reasons the student can't attend school.
How long the student is expected to be out.
Any medical needs the district should consider when planning instruction.
Wording matters. Hearing officers have found that a note merely recommending home tutoring is not enough. The statement needs to say clearly that the student must remain home or in the hospital for medical reasons for at least 14 school days, or on a recurring basis adding up to 14 days.
How quickly services should start
DESE's guidance says home and hospital services must begin without undue delay once the district receives the physician's written notice. In practice, families usually send the form to the school principal or the district's student services office, which then arranges a teacher and a schedule.
Some districts use a separate physician form for students expected to be out for more than 60 days, so ask your district which form applies if the absence is likely to be long.
Students with IEPs or 504 plans
Home or hospital instruction doesn't replace a student's IEP or 504 plan. If a student already has one, the instruction should account for their goals and accommodations, and the student's Team may need to meet to adjust services while they're out. Families should raise this with the Team as soon as the absence begins.
A checklist for families
Ask your child's doctor to complete DESE Form 28R/3 or a signed equivalent.
Make sure it states the student must stay home or in the hospital for at least 14 school days, or on a recurring basis adding up to 14.
Send it to the school principal or student services office, and keep a copy.
If your child has an IEP or 504 plan, ask whether the Team needs to meet.
Share any medical limits, such as session length or best times of day, so instruction can be planned around treatment.
For districts: staffing home and hospital instruction
The hardest part for most districts isn't the paperwork. It's finding a qualified teacher who can start quickly, follow the student's curriculum, and work around medical schedules. Einstein Tutoring partners with Massachusetts districts and treatment facilities to provide in-person home and hospital instruction, with most students placed within 3 days. You can find answers to common questions on our homebound instruction FAQ.
This article is general information, not legal advice. For the full rules, see DESE's Question and Answer Guide on home and hospital services, and check your district's own procedures.
Looking for another state? See our homebound instruction rules by state for guides covering every Northeast state.
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