Haw. Code R. § 11-148.1-5 - Application and documentation for substitute caregiver applicant

(a) A substitute caregiver applicant shall submit a written application on forms prescribed by the certifying agency.

(b) An application is not complete until the certifying agency receives a written application which contains all information and supporting documentation required by this chapter.

(c) Applicants may mail applications and supporting documents to the certifying agency; and

(d) Incomplete applications will not be processed by the certifying agency.

(e) The application shall include:

(1) A physician's statement regarding the applicant's ability to provide care to adults with I/DD;

(2) A signed consent form and all applicable processing fees so that the department or its designee can conduct a background check in accordance with section 11-148.1-44, which includes fingerprinting and employment history;

(3) Verification of the applicant's current tuberculosis clearance, in accordance with current department of health examination procedures and regulations, chapter 11164.2, HAR;

(4) Verification of the applicant's current certification in first aid and cardiopulmonary resuscitation;

(5) Verification of the applicant's license to practice as a registered nurse or licensed practical nurse; or certification to practice as a certified nurses aid, if applicable; and

(6) Any other requirements in accordance with departmental policy.

(f) An applicant may withdraw the application at any time during the application process by notifying the certifying agency in writing.

Notes

Haw. Code R. § 11-148.1-5

[Eff 8/2/2021] (Auth: HRS §§ 321-9, 321-11.2) (Imp: HRS §§ 321-11.2, 321-15.2, 846-2.7)