Oregon Behavioral Health & Substance Use Licensing Guide

Licensing agency

Oregon Health Authority (OHA)Its Behavioral Health Division oversees outpatient and residential programs

Outpatient programs

Certificate of approval (COA)OAR 309-008; first certificate up to 1 year, renewals up to 3

Residential programs

Residential license, renewed every 2 yearsOAR 415-012 for substance use; OAR 309-035 for mental health

Opioid treatment

COA plus a state opioid treatment authority letterOAR 415-020; new methadone clinics must sit 1,000 feet from schools

Accreditation

No deemed status in OHA rulesRequired for OTPs; CCOs may accept it in place of an OHA quality assessment

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

Who licenses behavioral health programs in Oregon?

The Oregon Health Authority. Its Behavioral Health Division certifies outpatient programs for up to three years and licenses residential programs every two years (adult foster homes every year), and may inspect without notice.¹ The rules still call the certifying unit the Health Systems Division.³

OHA also runs the Oregon Health Plan (OHP), the state Medicaid program, paying either through coordinated care organizations (CCOs) or directly as Open Card fee-for-service. A license or certificate does not by itself make a program eligible to bill OHP.^{1, 16}

Certificates and licenses

• Certificate of approval (COA): outpatient mental health, substance use and problem gambling services, community mental health programs, children's intensive treatment, civil commitment, opioid treatment and prison-based programs.²
• Residential substance use and problem gambling license: programs of up to 16 people, licensed under OAR 415-012 and run under the OAR 309-018 service rules. Withdrawal management programs are approved for ASAM levels 3.2-WM or 3.7-WM under OAR 415-050.¹
• Mental health residential license: residential treatment homes serve up to five people; residential treatment facilities and secure residential treatment facilities serve six to 16.^{1, 5}

Who needs a COA: any program paid under a contract with OHA, a CCO or another public body, or with other public funds. Others may seek one to qualify for commercial insurance payment. Practices made up only of licensed clinicians are exempt, and a COA never replaces a residential license.²

Law and rules

Certification procedures are in OAR 309-008 and outpatient standards in OAR 309-019.^{2, 3} Residential licensing is in OAR 415-012 for substance use and OAR 309-035 for mental health.^{4, 5} The statute behind both, ORS 443.400 to 443.455, covers residential care for drug or alcohol dependence as well as mental illness.⁶ Opioid treatment programs follow OAR 415-020 and ORS chapter 430.^{9, 8}

Measure 110 and HB 4002: Measure 110 (November 2020) decriminalized possessing small amounts of drugs and created a cannabis-tax grant program; SB 755 (2021) set up the Behavioral Health Resource Networks (BHRNs) it funds.¹² HB 4002 (chapter 70, Oregon Laws 2024) made possession a drug enforcement misdemeanor from September 1, 2024 and funded deflection programs. It also barred CCOs from requiring prior authorization for medication-assisted treatment, required adequate CCO addiction networks and created a certified community behavioral health clinic (CCBHC) program.¹³

How to apply for a certificate of approval

1. Contact OHAEmail LCApplications@oha.oregon.gov to start; OHA supplies the application forms and technical assistance.^{18, 2}
2. Build the applicationA service plan, an attestation of compliance, site descriptions, credentialing and seclusion and restraint policies, liability insurance and a code of conduct. Disclose owners of 5% or more, their license history and any substantiated abuse findings.²
3. Submit earlyFile at least six months before you want to be certified. One application can cover several sites if it documents each one.²
4. Desk reviewOHA audits the application within 60 days. If anything is missing or out of compliance, you have 14 calendar days to send an amended application.²
5. Initial certification reviewOHA reviews your records and sites, reports within 30 days and may require a plan of correction within 30 days. The first certificate lasts up to one year.²
6. Level of care approvalSubstance use programs also file ASAM level of care applications.²⁰

Renewals and changes: file at least six months before expiry; renewals last up to three years. New or moved sites and new service types need a written request 60 days ahead, and a new program director needs approval. A change in majority ownership voids the certificate. Closing takes 60 days' notice to OHA and 30 days' to clients.²

Residential licenses: new substance use residential applicants meet with OHA first, and each location needs its own application.⁴ For mental health residential programs, incomplete applications lapse after 60 days, and OHA inspects 90 to 120 days after first licensure, then at least every two years.⁵

Licensing fees

The residential fees are set by statute and repeated in the mental health residential rules.^{6, 5} The $600 fee covers only mental health providers certified solely for insurance payment; agencies with public contracts or residential licenses cannot use that route.⁷

How accreditation counts in Oregon

Deemed status: OHA's certification and residential rules have none. OHA does its own reviews, though it may do some or all of one as a desk review.^{2, 4}

Survey waivers: none from OHA, but accreditation helps with CCOs. Under ORS 430.637, OHA's quality assessment is for providers lacking a national accreditation that meets OHA standards. A CCO that does not accept your accreditation relies on OHA's assessment, and may require its own when none was done in the prior 36 months.⁸ OHA shares its review findings with CCOs and health plans for credentialing.²

Fee breaks: none; state fees are already low.⁶

Medicaid: OHP behavioral health providers need a current license, letter or certificate; no accreditor is named.¹⁷ Residential credentialing policies must follow national standards such as those of The Joint Commission, NCQA or URAC.⁴

Opioid treatment: an OTP must document accreditation by a SAMHSA-approved body.⁹ SAMHSA's approved bodies are CARF International, Social Current (formerly COA), The Joint Commission, the National Commission on Correctional Health Care and the Washington State Department of Health.¹¹

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

Opioid treatment programs

• State approval: an OTP needs a letter of approval from Oregon's state opioid treatment authority (SOTA), a COA, compliance with OAR 415-020 and 42 CFR Parts 2 and 8, proof of accreditation and disclosure of 5% owners and lease holders.⁹
• Siting: ORS 430.590 bars opening a methadone clinic within 1,000 feet, in a straight line, of a school attended mainly by minors or a certified child care center; a violating clinic can be shut down as a nuisance. A county or local public health authority may waive the limit to remove unreasonable barriers to care.⁸ Methadone programs must document compliance, including when they relocate.⁴
• Medicare: by statute, OHA's approval rules must require OTPs to accept Medicare.⁸
• Mobile and medication units: need their own SOTA letter and COA, an affiliated Oregon OTP in good standing and yearly operational plans. Mobile units return home daily unless federally waived and may not cross state lines.⁹
• Federal steps: SAMHSA grants one-year provisional certification only after state and DEA approval; the program must be accredited within that year.¹⁰

Other approvals you may need

• Oregon Health Plan enrollment: organizations enroll for Open Card billing through OHA's MMIS portal with forms OHA 3972, 3974 and 3975, and revalidate at least every five years. CCOs credential separately.¹⁶
• Recovery residences: OHA does not license them, and its structured housing registration expressly excludes sober living and recovery homes.¹ HB 2239 (2025) would have limited OHA, CCO and county contracts to certified residences but never left Joint Ways and Means.¹⁴ MHACBO keeps a voluntary registry (18 homes, 216 beds in spring 2025).¹⁵
• BHRN grants: Measure 110 funds now flow through OHA's BHRN Program to grantees in every county for screening, peer support, harm reduction, low-barrier treatment and housing.¹²

Recent changes

• March 1, 2025: OAR 309-035 was broadly amended, then again on May 1, 2026; temporary rules for 2026 bills HB 4016, 4068, 4069 and 4115 run to November 25, 2026.^{5, 19}
• October 1, 2025: OHA adopted rules for certified community behavioral health clinics (OAR 309-009).¹⁹
• January 1, 2026: under SB 610 (2025), the Oversight and Accountability Council now advises OHA on BHRN funding rather than deciding it.^{12, 19}
• July 1, 2026: OAR 309-019-0125 now says that from July 1, 2027, board-registered associates serving Medicaid clients must work under an outpatient COA. OHA reports a surge in COA applications.^{3, 18}
• September 4, 2026: permanent certification rules for crisis stabilization centers (OAR 309-073).¹⁹
• October 1, 2026: a temporary rule, through March 29, 2027, lets DUII agencies be certified to hire screening specialists who lack individual certification.¹⁹
• July 1, 2027: substance use programs must be certified under ASAM Criteria 4th edition levels of care; earlier renewals keep current levels until then.²⁰

Confirm these with OHA

• Whether any fee applies to a standard certificate of approval, and the current residential substance use license fees.
• Current COA processing times, given the backlog OHA reports.
• The permanent versions of the 2026 temporary residential rules that expire November 25, 2026.
• When OHA expects your ASAM 4th edition level of care application.
• For OTPs: the methadone siting distance at your address, and whether your county or local public health authority would grant a waiver.
• Which CCOs accept your accreditation for credentialing.

Sources

1. Oregon Health Authority, Behavioral health licensing and certification. oregon.gov
2. Oregon Administrative Rules, OAR chapter 309, division 8, Certification of behavioral health treatment services. secure.sos.state.or.us
3. Oregon Administrative Rules, OAR chapter 309, division 19, Outpatient behavioral health services. secure.sos.state.or.us
4. Oregon Administrative Rules, OAR chapter 415, division 12, Licensure of residential substance use disorder and problem gambling programs. secure.sos.state.or.us
5. Oregon Administrative Rules, OAR chapter 309, division 35, Residential treatment facilities and homes. secure.sos.state.or.us
6. Oregon Revised Statutes, ORS chapter 443 (ORS 443.400, 443.415, 443.425). oregonlegislature.gov
7. Oregon Administrative Rules, OAR chapter 309, division 39, Approval of non-inpatient mental health treatment providers. secure.sos.state.or.us
8. Oregon Revised Statutes, ORS chapter 430 (ORS 430.358, 430.590, 430.637). oregonlegislature.gov
9. Oregon Administrative Rules, OAR chapter 415, division 20, Standards for outpatient opioid treatment programs. secure.sos.state.or.us
10. SAMHSA, Become an opioid treatment program. samhsa.gov
11. SAMHSA, Approved accreditation bodies. samhsa.gov
12. Oregon Health Authority, Behavioral Health Resource Network (BHRN) Program. oregon.gov
13. Oregon State Legislature, HB 4002 (2024), measure overview. olis.oregonlegislature.gov
14. Oregon State Legislature, HB 2239 (2025), measure overview. olis.oregonlegislature.gov
15. Oregon State Legislature, HB 2239 A staff measure summary (April 2025). apps.oregonlegislature.gov
16. Oregon Health Authority, Oregon Health Plan provider enrollment. oregon.gov
17. Oregon Administrative Rules, OAR 410-172-0610, Provider enrollment (Medicaid behavioral health). secure.sos.state.or.us
18. Oregon Health Authority, Billing changes for board-registered behavioral health associates. oregon.gov
19. Oregon Health Authority, Behavioral Health Division rule filings. oregon.gov
20. Oregon Health Authority, Moving to the fourth edition of The ASAM Criteria. oregon.gov

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