MONTREAL -- Nathalie Constantine has spent the last few days doing what many Montreal parents have been doing: trying to figure out how to balance her daughters’ education with her family’s health.

Her 82-year-old mother, Marianne, lives with them in Cote-Saint-Luc and has congestive heart failure.

Under the province's new back-to-school rules during COVID-19, Quebecers were told this week, there’s an option for kids to get remote schooling if they can prove there’s someone in their immediate family with serious health risks.

“If there's a medical issue then you can get a medical exemption from the doctor,” Constantine says.

So the family approached Marianne’s cardiologist for a medical note—only to be turned down.

"She said ‘Sorry, we’re not going to write the note,’” Constantine recalls. “The doctor feels uncomfortable writing the note.”

That means Constantine’s daughters will be back in class, unless their mother can figure out how to navigate the new system on a tight deadline. 

“Is it a medical profession’s decision not to cooperate?” she asked. “Is it this individual doctor that doesn’t feel comfortable? And here we are, as a society, we’re all in this together [but] it’s very disjointed.”

There have been scant details about how the exemption is supposed to work. On Monday, Quebec’s education minister said some students would be excused from in-person attendance.

If there’s someone with medical vulnerability at home “and a doctor has a paper to say, ‘Okay, this kid has some sickness related to COVID,’ he has a right to have learning from a distance,” Education Minister Jean-François Roberge said.

He added that the same rule would apply if family members in the same household had a higher risk.

But Quebec’s College of Physicians says it’s not sending out a directive to its doctors, meaning that yes, people like Constantine seem to be on their own.

“The College is not responsible for issuing or determining clinical directives justifying, for example, a quarantine, a work stoppage, or a preventive withdrawal,” the College of Physicians wrote in a statement to CTV News.

“In the context of the COVID-19 pandemic, this task falls to government authorities, more specifically to the Ministry of Health and Social Services and the Directorate of Public Health.”

The province says it came up with exemptions for children with chronic illnesses in May, and it’s working on updating them and sending them out to doctors in the coming days. 

Though asked by CTV about the criteria for exempting kids based on family members with chronic illness, rather than the children themselves, the health department didn’t address this question in its response.

It said that when it comes to kids, “generally speaking, the vast majority of children with chronic illness can return to class and wear a mask.”

Exempting children from in-class attendance will be reserved “for children with serious pathologies, and most of these children are already followed in specialized pediatricians.”

In the meantime, there’s just three weeks left until school begins, not allowing much time for families like Constantine’s to weigh their options.