Consent:

Aloha,

Hina Mauka specializes in treatment for diagnosed substance use disorders that include alcohol with an emphasis on behavioral health issues. In residential, Hina Mauka also provides services for high functioning individuals who have been diagnosed with co-occurring disorders (such as depression, PTSD, trauma, etc.), and limited co-morbidity physical health disorders. We treat the general population that primarily has addiction, as well as, low to moderate-risk, non-violent offenders. Also, we service a small number of people who are high functioning and have a psychiatric forensic case.

Hina Mauka has a continuum of care that includes a beautiful 48-bed residential, nestled in the Ko’olau mountains, day treatment, intensive outpatient, outpatient services, as well as, continuing care. We have family programs as well. Our primary treatment locations are Kaneohe and Waipahu. .

Please read the following carefully:

• Residential beds are generally full however admissions are done daily. A waitlist is managed by a case manager who will contact you once a bed becomes available. To be on the waitlist you must complete all the required documentation (Screening Information Packet) and provide whatever additional documentation that may be required by our doctors given your personal circumstances.
• Admittance to Hina Mauka programs requires a proper diagnosis according to DSM V and meet a designated placement set forth by the American Society of Addiction Medicine (ASAM) criteria for treatment.
• Hina Mauka has limited medical support services, which means that persons presenting for treatment must be properly detoxed and medically stable before admission. People in treatment must be able to self-medicate and self-monitor medical conditions. For residential, Hina Mauka is not a medical facility nor has the capability to administer qualified emergency responses. We provide basic first aid and call 911. For outpatient, patients work with their own physicians for proper medical care.
• First and foremost, Hina Mauka makes decisions based upon safety and functionality, whether the issue is behavioral, psychological or medical, and as such, reserves the right to not admit. Hina Mauka is an engaging, high functioning facility. If we are aware of other services that could fit your needs better than Hina Mauka, we refer to those services that we believe are more appropriate at this time.
• There is no wait list for day treatment or outpatient services

Hina Mauka encourages you to complete our application on our website or in person at our facility and to provide applicable medical and/or psychiatric health reports before admission.

Adult Treatment Application

Please read instruction sheet before completing forms. This packet is use to determine if you are eligible and appropriate for Hina Mauka services. Please follow the instruction sheet. Click to see moreClick to see less

ADAD Privacy Notice

This notice describes how medical and health information about you may be used and disclosed and how you can get access to this information. Click to see moreClick to see less

HIPAA Privacy Notice

Information regarding your health care, including payment for health care, is protected by federal law. Click to see moreClick to see less

Consent: Use for Legal Representatives

Please use this consent if you have a probation or parole officer, public defender, case manager or any other agency representative that may represent you. This for is specifically for Legal entities and non-provider agencies and individuals. Non-provider agency is defined as any agency that does not diagnose, evaluate, assess and treat clients. For further questions please call Hina Mauka for clarity.

Consent: Use for Treating Provider Entity/Agency

Please use this consent if you have a doctor, psychiatrist or any other health professional that is involved with providing care for you. This can be an agency or individuals.

Consent: Use for Relatives and Supporters

Please use this consent form if you have family, relatives or supporters that you would like Hina Mauka to disclose information to. The consent is limited to attendance and progress in treatment. It also allows Hina Mauka to offer other services relevant to the family members who may be interested in learning about their love ones treating condition.

Consent: Use for Health Insurance or Third Party payors

Please use this consent form if you have a medical or health insurance plan. This consent allows Hina Mauka to consult with your insurance plan for approval of services that may be rendered by Hina Mauka on your behalf. Insurance companies require us to seek approval prior to rendering services.

Consent: Applicant Consent to Authorize a Representative to Complete The Screening Application

Please use this consent if you are applying for treatment services for someone besides yourself. This consent allows Hina Mauka to conduct services with a applicant’s representative regarding treatment services.

What to Bring

If you are applying for residential treatment or are preparing for admission into residential treatment, please read this document. Click to see moreClick to see less