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California

Navigating Behavioral Health and Substance Use Disorder Facility Licensing in California: A Step-by-Step Guide

 

You can’t start a compliant and successful mental health or substance use treatment program without first ensuring you are adhering to the state’s licensing requirements. Whether you’re seeking to open an outpatient facility (providing outpatient, intensive outpatient/ IOP, or partial hospitalization/ PHP) or a residential facility (detox/ withdrawal management, high intensity or low intensity residential) navigating California’s regulatory landscape can be complex and time-consuming.

At Arrow Consulting, we specialize in guiding providers through every stage of the licensing process – ensuring your facility meets all regulatory standards and is fully prepared to deliver high-quality, legally compliant care.

 

Step-by-Step Guide to Getting Licensed in California

  1. Decide what service you want to provide and which license you’ll need
    Decide whether your facility will provide mental health services or substance use disorder services. This decision determines the regulations you must follow and guides your application process.
  2. Review the regulations for the service you’ll provide
    Consult the appropriate licensing agency’s website to understand the current regulations and requirements (see below about which licensing agency if right for your program). It’s also important to see if there are any barriers to getting licensed (like the Determination of Need process in Massachusetts or the Certificate of Need process in Connecticut). Historically this has not been relevant in California but it’s important to check!
  3. Get your documents and processes in order
    Compile the documents required for your California application. You’ll definitely need:
  • Organizational formation documents
  • Staffing plans
  • Facility floor plans/ building documents 
  • Relevant policies and procedures
  1. Once you finalize your application, submit it to the state
  • Mental Health Facilities (Residential, PHP, IOP): Submit to California Department of Social Services (Community Care Licensing Division) or the local county behavioral health department, depending on your service type and funding source.
  • Substance Use Disorder Facilities (Detox, Residential, PHP, IOP): Submit to California Department of Health Care Services (DHCS), Licensing and Certification Division.
  • See below for more information on these agencies.
  1. Prepare for Inspection
    California licensing agencies typically conduct on-site inspections to ensure compliance with health, safety, and program standards. Make sure your facility is in good shape and your leadership is prepared!
  2. Make any corrections and start providing services
    You may need to make some revisions to policies or other items as discussed with the state. Once you have completed your plan of correction, you will be issued your license and may commence providing services to your community.

 

Understanding Behavioral Health Facility Licensing Requirements in California

 

Licensing for Substance Use Disorder (SUD) Facilities

Substance use disorder treatment facilities in California are licensed by the California Department of Health Care Services (DHCS).

PHP and IOP for SUD:
PHP and IOP programs for substance use disorder treatment must provide structured, intensive services and comply with California requirements for:

  • Qualified staffing
  • Therapeutic programming
  • Patient care standards
  • Emergency preparedness

Detox and Residential Treatment:
Detox programs in California are also licensed by the DHCS and must meet state standards for:

  • Medically supervised withdrawal management
  • On-site licensed professionals (e.g., physicians and nurses)
  • Patient safety and clinical oversight
  • Staffing qualifications
  • Facility operations and compliance with DHCS regulations

Additional Step – Medi-Cal Certification

If your facility intends to serve Medi-Cal beneficiaries, you must also obtain Medi-Cal certification from DHCS after licensing. This process verifies that your program meets federal Medicaid requirements, including:

  • Compliance with Centers for Medicare & Medicaid Services (CMS) standards
  • Billing and documentation systems that meet Medi-Cal requirements
  • Additional staff training related to Medi-Cal service delivery and reporting

Medi-Cal certification is separate from licensing and must be completed before you can bill Medi-Cal for SUD services.



Licensing for Mental Health Facilities

Mental health facilities in California are overseen by the California Department of Social Services (CDSS), Community Care Licensing Division (CCLD) or the California Department of Health Care Services (DHCS), depending on the type of services provided and the facility’s structure. Residential facilities that serve adults or children with mental health needs often operate under specific licensing categories and may require additional program certification through the local county behavioral health department.

PHP and IOP for Mental Health:
Mental health PHP and IOP programs must meet state standards for:

  • Therapeutic services
  • Staffing qualifications
  • Patient safety
  • Quality care

Residential Treatment Facilities in Mental Health:

Facilities providing residential mental health services must be licensed by the appropriate state agency (often CDSS or DHCS) and meet standards for:

  • 24/7 care in a structured environment
  • Therapeutic services
  • Staffing qualifications
  • Patient safety
  • Quality care




Let Arrow Consulting handle the entire process for you – ensuring a smooth, compliant, and efficient licensing experience.