• Home/Hospital Referral Process for Mental Health Reasons

    Placement of Student on Home/Hospital Instruction for Mental Health Reasons – Contact the Home/Hospital Nurse Christine Proctor at (585) 254-1240 ext. 3432 or Chris.Proctor@rcsdk12.org

    Request for Home Hospital Teaching Services due to Medical Reasons Form

    Home/Hospital Extension Referral

    Referral forms can also be found in RCSD nursing offices.

    Please send referrals and forms for potential Home/Hospital students to the referral mailbox: hhinfo@rcsdk12.org or fax Home/Hospital Nurse Christine Proctor at (585) 324-9931.

    Per the NYS Commissioner's Regulations, Home/Hospital Instruction provides continuity of academic instruction in core subjects to students who are homebound or are unable to attend school for reasons including mental or emotional illness or disability as substantiated by a licensed physician. Medical students must be referred by a Medical Doctor (MD) to enter the Home/Hospital Program.

    The Medical Doctor (MD) note requires the medical diagnosis, length of time for the student to be in the Home/Hospital Program, and must be signed by a ­­Medical Doctor (MD). Parents or guardians may email the MD note to the referral mailbox: hhinfo@rcsdk12.org

    HIPAA-English Form

    A signed HIPAA must be completed and faxed to Home/Hospital Nurse Christine Proctor at (585) 324-9931. Christine Proctor can be reached at (585) 254-1240 ext. 4142 or Chris.Proctor@rcsdk12.org to ensure receipt.

    The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient's consent or knowledge.

    Mental Health-Medical Home Instruction Referral Form

    In addition to the Referral Process forms for Medical Reasons, the Home/Hospital Program has a specific referral form for requesting services for mental health reasons. Referrals should be made through the student’s Medical Doctor (MD).

    Once approved, students are placed in the Home/Hospital Program for three months at a time. After a case review and a consultation with the Home/Hospital Nurse Christine Proctor, the student’s Medical Doctor (MD) may extend the student’s time in the Home/Hospital Program an additional three months.