Ohio Behavioral Health & Substance Use Licensing Guide

Regulator

Ohio Department of Behavioral Health (DBH)Renamed from OhioMHAS by HB 96 (2025)

Treatment providers

Community behavioral health services (CBHS) certificationOAC 5122-24 to 5122-29; core chapters replaced August 1, 2026

Applications

LACTS online systemFull certification lasts up to three years

Opioid treatment

OTP license under ORC 5119.37CBHS certification comes first

Accreditation

Required for services with national standardsCARF, The Joint Commission or COA; deemed status no longer exists

Licensing or accrediting a program here? Book a free consultation or call 561-396-0813.

Who regulates behavioral health providers in Ohio?

The Department of Behavioral Health. HB 96, the 2025 budget bill, renamed OhioMHAS as DBH, and laws, rules and contracts that use the old name now refer to DBH.¹ It certifies or licenses more than 2,400 providers, from community treatment agencies to OTPs, psychiatric hospitals and residential facilities.²

Certification is mandatory. Since October 3, 2023, every community behavioral health services provider must be certified, except Ohio-licensed professionals working within their own scope of practice and individuals working for an accredited hospital outpatient clinic.³

Certification and license types

• CBHS certification for mental health and addiction services, including SUD residential and withdrawal management, driver intervention programs and peer-run organizations.² Residential and withdrawal management certificates are site-specific.⁴
• Opioid treatment program (OTP) license, for providers that already hold CBHS certification.²
• Residential facility licenses: Class 1 adds mental health services and needs CBHS certification first; Class 2 offers personal care; Class 3 offers room and board for five or more adults with mental illness.^{5, 2}
• Recovery housing certification, under emergency rules since August 10, 2026.⁶

Law and rules

Certification falls under ORC 5119.36 and OAC 5122-24 to 5122-29, whose Chapters 5122-24 to 5122-28 were replaced on August 1, 2026.^{7, 4, 8} Residential facilities fall under ORC 5119.34 and OAC 5122-30, OTPs under ORC 5119.37 and OAC 5122-40, and recovery housing under ORC 5119.39 onward and OAC 5122-31.^{5, 9, 10, 11, 12, 6}

How to apply for CBHS certification

1. Start accreditationServices with national standards need at least provisional or conditional accreditation before DBH issues interim certification.⁴
2. Secure an Ohio siteOwn or lease at least one physical site in Ohio; drop-in co-working space and libraries do not count.⁴
3. Collect inspectionsBuilding or occupancy approval, a fire inspection from the last 12 months and any water, boiler, elevator or food service approvals.⁴
4. Apply in LACTSList each service and its accreditation status, disclose adverse actions from the past three years, and add accreditation reports and the fee.^{4, 2}
5. Interim, then full certificationDBH notifies the local ADAMHS board and must visit for any unaccredited service. Interim certification lasts 180 days and can be extended once; for accredited providers DBH aims to issue full certification within 30 days.⁴

Renewals and sales: renew at least 120 days before expiration. Certificates do not transfer to a buyer, and ownership changes need 30 days’ notice.⁴

Licensing fees

A third plan of correction adds a $250 resubmission fee and each later one $500.⁴ Other fees come from their own rules.^{9, 11, 6}

How accreditation counts in Ohio

It is required. New providers have needed accreditation for each service DBH says has national standards since October 3, 2023, and existing providers since their first renewal on or after October 1, 2025. The law names The Joint Commission, CARF and COA, and accreditation is optional for prevention services.^{7, 3}

No more deemed status. The 2019 rules treated accreditation as a choice that earned deemed status.^{13, 3} Now DBH accepts accreditation as evidence of compliance and can certify accredited services without further review. The survey must cover every service you want certified, and Ohio’s incident reporting rule still applies.^{7, 14} Accredited services also skip the $200 per-service fee and the mandatory site visit.⁴

Medicaid: agency billing for community behavioral health services rests on DBH certification, so the accreditation requirement reaches Medicaid too.^{15, 7}

Getting accredited? See our CARF accreditation consultants and Joint Commission consultants, available nationwide.

Opioid treatment programs

• Prerequisites: CBHS certification for general services, SUD case management and crisis intervention; SAMHSA certification; a Category III terminal distributor license from the Ohio Board of Pharmacy; and a DEA-approved security system. Renewals also need OTP accreditation from a SAMHSA-approved body.¹¹
• 500-foot rule: a new OTP cannot sit within 500 feet of a school, licensed child day-care center or DBH-regulated child-serving agency without a support letter from each.¹⁰
• Good standing: the provider and its owners and principals need three clean years at other OTP sites; HB 96 added subsidiaries.^{10, 1}
• Term: two years, or one with compliance concerns; DBH inspects at least every two years.¹⁰
• Federal steps: SAMHSA provisional certification lasts up to a year while you earn accreditation and needs state and DEA approval first.¹⁶

Other approvals and duties

• Residential facilities: fire and building inspections and a DBH visit before occupancy; renewals are due 90 days early.⁹
• Recovery housing referrals: since January 1, 2025, community addiction and mental health providers may refer clients only to residences on DBH’s registry, and must keep referral records.¹⁷

Recent changes

• HB 96 (2025): renamed the department, extended adverse-action reporting and OTP good-standing checks to subsidiaries and let DBH certify CCBHCs if funded.¹ The amended licensing statutes took effect September 30, 2025.⁷
• August 1, 2026: new certification rules and fee schedule.⁴
• August 10, 2026: Executive Order 2026-03D let DBH certify recovery housing, which grew from 356 houses in 2022 to over 1,700.¹⁸ The emergency rules require accreditation, background checks and an on-site inspection, and certification lasts two years.⁶ DBH says existing operators need not reapply immediately.¹⁹
• HB 58 would write state recovery housing certification into law. It passed the House on February 25, 2026 and sits in a Senate committee.²⁰

Confirm these with DBH

• Which of your services DBH treats as having national accreditation standards; this sets the per-service fee and site visit.
• This fiscal year’s OTP license fee, and whether the residential facility fee applies again at renewal.
• Whether DBH has started certifying CCBHCs.
• For recovery housing: when accredited residences must apply to DBH, and whether permanent rules or HB 58 change the emergency rules.

Sources

1. Ohio Legislative Service Commission, H.B. 96 final analysis: Department of Behavioral Health. lsc.ohio.gov
2. Ohio DBH, Types of licenses and certificates. dbh.ohio.gov
3. Ohio DBH, Statutory changes SFY 2024. dbh.ohio.gov
4. Ohio Admin. Code, Chapter 5122-25, Certification procedures. codes.ohio.gov
5. Ohio Rev. Code 5119.34, Residential facilities. codes.ohio.gov
6. Ohio Admin. Code, Chapter 5122-31, Recovery housing residences (emergency rules). codes.ohio.gov
7. Ohio Rev. Code 5119.36, Certification of services and supports. codes.ohio.gov
8. Ohio Admin. Code, Chapter 5122-26, Provider operations. codes.ohio.gov
9. Ohio Admin. Code 5122-30-04, Residential facility licensure application. codes.ohio.gov
10. Ohio Rev. Code 5119.37, Opioid treatment programs. codes.ohio.gov
11. Ohio Admin. Code, Chapter 5122-40, Opioid treatment programs. codes.ohio.gov
12. Ohio Rev. Code 5119.39, Recovery housing. codes.ohio.gov
13. Ohio Admin. Code 5122-25-04, Certification procedure for deemed status (2019 version). codes.ohio.gov
14. Ohio DBH, National accreditation. dbh.ohio.gov
15. Ohio Admin. Code 5160-27-01, Eligible provider of community behavioral health services. codes.ohio.gov
16. SAMHSA, Become an opioid treatment program. samhsa.gov
17. Ohio DBH, Recovery housing statewide registry. dbh.ohio.gov
18. Office of the Governor, Executive order on recovery housing (August 10, 2026). governor.ohio.gov
19. Ohio DBH, Recovery housing frequently asked questions. dbh.ohio.gov
20. Ohio Legislature, House Bill 58 status (136th General Assembly). legislature.ohio.gov

This guide summarizes Ohio statutes, rules and DBH pages as of the date above. It is general information, not legal advice. Requirements change; confirm with DBH before you apply.