The 24 Hour Recertification Competency Course consists of six (6) hours of in-classroom training and eighteen (18) hours of basic nursing skills evaluation. DOH worked with DHS, DCCA, and long term care providers to develop a state-approved CNA training program as mandated by federal law for those nurse aides working in Medicare and Medicaid (M/M) certified nursing facilities. A system was created to assess the competency level of all CNAs currently working in M/M certified nursing facilities to meet the new state standards and to ensure there is reciprocity for those Hawaii CNAs wishing to relocate to other states, which was not available previously. In order to renew your certification, you must have worked for pay performing nursing, nursing related services and/or direct patient care, under the supervision of a Licensed or Registered nurse, for at least 12 hours during the last 24 month certification period. Recertification forms should not be submitted more than 30 days before your current certification expiration period.