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Texas

Navigating Behavioral Health and Substance Use Disorder Facility Licensing in Texas: 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 Texas’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 Texas

  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 Texas but it’s important to check!
  3. Get your documents and processes in order
    Compile the documents required for your Texas application. You’ll definitely need:
  • Organizational formation documents
  • Staffing plans
  • Facility floor plans/ building documents (in some cases, Texas requires your inspection is completed by a licensed architect)
  • Relevant policies and procedures
  1. Once you finalize your application, submit it to the state
  • Mental Health Facilities (Residential): Submit to HHSC Regulatory Services Division – Behavioral Health Licensing
  • Substance Use Disorder Facilities (Detox, Residential, PHP, IOP): Submit to HHSC – Health Facility Licensing 
  • See below for more information on these agencies
  1. Prepare for Inspection
    Depending on the service and level of care you decide, Texas may have a virtual meeting or might want to come on-site for an inspection. Make sure your facility is in good shape and your leadership is prepared!

OR

After your application is reviewed, HHSC will schedule a pre-licensure inspection of your facility. This includes reviewing safety protocols, physical layout, staffing, emergency preparedness, and program readiness. Make sure your space is operational and aligns with all submitted documentation.

  1. 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 Texas

 

Licensing for Substance Use Disorder (SUD) Facilities

Substance use disorder treatment facilities in Texas are licensed by the Texas Health and Human Services Commission (HHSC), specifically through the Substance Use Disorder (SUD) Licensing Unit.

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

  • Qualified staffing
  • Therapeutic programming
  • Patient care standards
  • Emergency preparedness
  • Compliance with HHSC’s rules under Texas Administrative Code (TAC), Title 26, Chapter 564

Detox and Residential Treatment:
Detox programs in Texas must be licensed under specific SUD treatment categories and must comply with HHSC 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 HHSC regulations
  • Program-specific policies and procedures under Chapter 564 TAC

 

Licensing for Mental Health Facilities

Mental Health PHP and IOP programs that do not provide inpatient, overnight or court-ordered services do not require a state facility license. 

Residential and inpatient mental health facilities in Texas are licensed by the HHSC Regulatory Services Division – Behavioral Health Licensing.

Residential Treatment Facilities in Mental Health:

Facilities providing residential mental health services must be licensed by HHSC and are required to meet state standards for:

  • 24/7 care in a structured environment
  • Therapeutic services
  • Staffing qualifications
  • Patient safety
  • Quality care
  • Compliance with HHSC Behavioral Health Licensing regulations under TAC Title 26, Part 1

 

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