NYC parents grapple with limited learning for medically fragile students

Rodney Lee began looking for alternatives to in-person instruction for his daughter as soon as it became clear that New York City would not offer a remote option for families this year. Ten-year-old Priya suffers from a seizure disorder that could be exacerbated if she contracts the coronavirus.

Lee learned that his daughter would be an excellent candidate for “medically necessary instruction,” a revamped education department-run program that allows students to learn from home if they have health needs, including seizure disorders, that prevent them from safely returning to classrooms this school year.

But the Manhattan family soon learned that the program would only offer an hour a day of instruction, far less than what Priya received last school year when she opted for fully remote learning.

It left the family with a difficult choice: accept the possibility that she would slip behind her peers academically or risk the resurgence of a seizure disorder that has not flared up in three years but can leave her struggling to breathe.

The family decided the academic risks were too great.

“We had to make a really difficult decision to send her to school,” said Lee, noting that Priya’s school reported a positive COVID case just a couple days into the year, though his daughter was not a close contact. “Every day we pray, and we hope that she stays healthy.”

Families across the five boroughs are grappling with the same dilemma about whether the potential safety benefits outweigh the possible academic costs of the city’s program for medically necessary instruction that allows students to learn from home.

The program only guarantees five hours a week of instruction for elementary school students and 10 hours a week for middle and high schoolers, minimums that are set by state regulations. And while hundreds of families have applied for the program despite the limited hours, some are still waiting for instruction to begin weeks after the school year started as their applications are processed.

New York City Schools Chancellor Meisha Porter said in August that she expected between 3,000 and 5,000 students to participate this year. But so far, fewer than 500 families have applied, about 40 have been rejected, and roughly 300 are currently enrolled in the program, according to education department officials. With rolling admissions, enrollment is expected to grow throughout the fall.

“I think there’s a lot of interest and a lot of suspicion at the same time,” said Maggie Moroff, a special education policy expert at Advocates for Children, referring to the limited hours of instruction.

Revamping home instruction

City officials expanded access to home instruction by explicitly defining 20 different conditions that can quickly qualify students for the program with instruction expected to start within a day or two. The move aimed to cut through some red tape and has won some praise from advocates, who said that in previous years the program’s admission criteria were not always clear, and there were sometimes delays getting instruction started.

In a decision made just weeks before the school year started, the city changed the program’s pre-pandemic model of sending educators to meet with students in-person, to also allow for virtual instruction.

“Medically Necessary Instruction provides our immunocompromised students with high-quality education and support, and keeps them connected to their school communities,” education department spokesperson Sarah Casasnovas said in a statement. “Families may apply at any time, and students receive learning materials from their home school while their application is reviewed.”

Brooklyn mom Jennifer Goddard applied to the program on behalf of her 10-year-old son, August Huete, who she said has asthma and an overactive immune system. For the first several days of school, she used the workbooks provided by his school, P.S. 216, though it was a disorienting experience for her son to miss out on a more traditional start to the school year.

Now, August is receiving virtual instruction at home one-on-one for an hour a day, which has focused heavily on reading with only a couple sessions devoted to math so far. A recent math session introduced powers of 10, though some of the reading lessons have been less engaging, focusing on assessing August’s skill level, or devoting big chunks of the hour to reading a text.

“I think the teacher is doing the best he can,” she said. And despite the limited hours, she said home instruction wasn’t a hard choice. “I can find other ways to make up a loss of education,” she said, “I don’t have other ways to make up a loss of health.”

The family is filling in some of the gaps by providing supplemental social studies, art, science and physical education activities. Goddard is also paying out-of-pocket for online math classes through the website Outschool three times a week, which she expects will cost $500 through December. By then, she’s hoping August will have been vaccinated and can return to his classroom.

In the meantime, Goddard said she is hopeful the city considers moving more students like her son into online group sessions that are offered for more than one hour a day.

State officials said schools should consider providing more hours of instruction than the minimums established in state regulations.

Casasnovas, the city education department spokesperson, said the city plans to offer additional hours “in the coming weeks” to students who receive remote group instruction.

‘It’s medical home instruction or withdrawing entirely’

Other families are still waiting for their home instruction applications to be processed.

Erin Alexander said her efforts to apply to the program were delayed because her pediatrician’s office was slow to provide the application’s required letter explaining why her son needs to stay home. She formally applied Sept. 22, but has not yet heard whether her application will be approved.

Alexander, who lives in Brooklyn, acknowledged that her 6-year-old son’s case falls in a gray area. He doesn’t have a condition listed on the education department’s list of pre-approved illnesses, though officials have said that students with other medical issues may still be accepted. The 6-year-old boy was born 14 weeks early, and his lungs were underdeveloped, so he was immediately intubated and put on a ventilator, spending the first three months of his life in intensive care.

Her son has also struggled with other infections, becoming hospitalized after contracting RSV and pneumonia simultaneously just after beginning day care when he was 2 years old. The family worries a coronavirus infection, or even a regular cold, could have severe consequences. On top of that, she’s worried that her autistic son, who also has attention deficit hyperactivity disorder and struggles with transitions, will not do well in school if classes are disrupted by quarantines.

“It’s medical home instruction or withdrawing entirely,” she said, noting that he looked forward to his classes when they were remote last year. “That’s where our level of concern is.”

For now, Alexander remains in limbo. Even as they hope her son’s application to learn from home is approved, Alexander is not thrilled with the prospect of an hour or two a day of instruction.

If she’s denied a spot in the program, she said she’d likely homeschool him. (City officials said that it can take 7 to 10 days to process applications, which are reviewed by health department doctors or education department psychiatrists to determine if the medical need meets the city’s standards.)

So far, Alexander’s son hasn’t been receiving the constellation of therapies on his special education learning plan, and the school has not yet provided assignments for him while they wait for a decision from the city, though his teacher said she plans to provide workbooks and some digital materials soon.

The teacher offered to allow Alexander’s son to stop by for recess outside to connect with his classmates, a gesture Alexander said she deeply appreciates after more than a year of social isolation.

But whatever happens with her son’s application, she hopes it will be temporary. Asked when he would likely return to a classroom, she said it would be two weeks after his second shot. Children ages 5-11 could begin receiving shots later this fall, though the exact timeline is not clear.

“We’re not terrified of it,” she said of the vaccine. “Give it to him now.”

This article was originally posted on NYC parents grapple with limited learning for medically fragile students

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