Connecticut Behavioral Health & Substance Use Licensing Guide

Licensing agency

Department of Public Health (DPH)Facility Licensing and Investigations Section (FLIS)

Substance use license

Private freestanding facility for substance abusive or dependent personsRegs. Conn. State Agencies 19a-495-570; nine service classes

Certificate of need

Required to establish a new facilityRun by DPH since July 1, 2026; filing fee $1,000 to $10,000

Opioid treatment

Chemical maintenance treatment licensePlus DEA, SAMHSA and DMHAS (State Opioid Treatment Authority) approval

Medicaid

HUSKY Health through the Connecticut Behavioral Health PartnershipCMAP enrollment, Carelon registration and, for SUD programs, ASAM certification

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

Who licenses behavioral health programs in Connecticut?

The Department of Public Health. DPH's Facility Licensing and Investigations Section licenses facilities for the care or treatment of substance abusive persons, psychiatric outpatient clinics for adults, mental health day treatment facilities, mental health residential living centers and mental health community residences. Its licensure processing unit handles initial licenses, renewals, changes of ownership and changes in services or beds.¹ State law defines a behavioral health facility as one that provides mental health services to adults, or substance use disorder services to people of any age, in an outpatient or residential setting.³

Other agencies: the Department of Children and Families (DCF) licenses children's programs, including outpatient psychiatric clinics for children and residential treatment, and a substance abuse treatment facility licensed by DCF does not also need a DPH license.^{5, 3} State-operated mental health and substance use facilities, with a few named exceptions, are not institutions that DPH licenses.³ The Department of Mental Health and Addiction Services (DMHAS) funds community addiction services through grants and contracts and houses the State Opioid Treatment Authority.^{10, 13} Since July 1, 2026, DPH's Health Systems Planning unit also runs the certificate of need (CON) program, which moved from the Office of Health Strategy.⁹

License types

A substance use facility license lists one or more of nine service classifications:²

• Residential: residential detoxification and evaluation; intensive treatment; intermediate and long-term treatment and rehabilitation; care and rehabilitation.
• Non-residential: ambulatory chemical detoxification; day or evening treatment (at least four hours a day); outpatient treatment.
• Medical: chemical maintenance treatment (the methadone license) and medical triage.

Mental health programs are licensed separately as psychiatric outpatient clinics for adults, day treatment or intermediate treatment facilities, residential living centers or community residences, each with its own section of the Public Health Code.^{1, 6} A provider with several sites can hold a multicare institution license, which can cover, among others, a psychiatric outpatient clinic for adults or a freestanding substance use facility that runs more than one facility or satellite unit under one licensee.³

Law and rules

No one may operate an institution without a DPH license under Conn. Gen. Stat. 19a-491; the definitions are in 19a-490 and licensing and ownership changes in 19a-493.³ Substance use facilities follow Regs. Conn. State Agencies 19a-495-570, last amended in 1999.² The mental health rules are 19a-495-550 (day treatment, intermediate treatment and adult psychiatric outpatient clinics), 19a-495-551 (residential living centers) and 19a-495-560 (community residences).⁶ CON rules are in chapter 368z, including 19a-630 and 19a-638.⁷

How to apply for a DPH facility license

1. Settle the certificate of needEstablishing a new mental health or substance abuse treatment facility needs CON approval, with a supplemental form for behavioral health. If you are unsure, file a determination request first. Nonprofits that contract with or are licensed by a state agency for the service are currently exempt.^{7, 8}
2. Clear the siteGet local zoning and building code approval and the local fire marshal's certificate. Tell DPH about new construction, expansions or conversions 60 days before work starts, and send construction plans for review.^{2, 3}
3. Request the applicationEmail DPH's licensure processing unit at DPH.FLISLPU@ct.gov to request and submit the application. DPH also posts ownership forms by entity type, a fire marshal certificate form, a sample certificate of insurance and an applicant attestation.¹
4. Include the required contentStatements of ownership and operation, public liability insurance, an organizational chart, the service classifications you want with a description of services, and staff names and titles.²
5. Inspection and licenseDPH issues an initial license after a scheduled inspection finds you meet the standards. The license is not transferable and lists the services, location and capacity.^{3, 2}

Renewals and changes: under the statute a license runs up to two years and renews biennially after an unscheduled inspection. Renewals go through the eLicense portal.^{3, 1} A change of ownership needs DPH approval in advance, with the application filed at least 120 days before the change.⁴ The rule also asks for 90 days' notice of a change in location or services.² A multicare institution adding a satellite or other location applies to DPH, which must decide within 45 days.⁴

Licensing fees

The CON tiers come from the CON program's form and fee page.⁸ The DPH fees are set in Conn. Gen. Stat. 19a-491.³ The CON process also requires a public notice in a local newspaper on three consecutive days, the last at least 20 and no more than 90 days before you file.⁸

How accreditation counts in Connecticut

Licensing: the substance use facility rule has no deemed-status or accreditation provision, so accreditation does not replace DPH licensing inspections.² At renewal, DPH may waive the inspection for an institution certified under Medicare or Medicaid, a waiver Public Act 25-96 extended to all institutions except nursing homes. That waiver turns on federal certification, not accreditation.⁴

Survey intervals: outpatient clinics accredited by a national body within the past 12 months may be inspected every four years instead of three, unless they have a violation that threatens patients.³

Fee breaks: the statutory fee schedule offers no discount for accreditation.³

Medicaid: for SUD programs under the 1115 demonstration, the state's guidance lists CON, DPH or DCF licensure and CMAP enrollment as the prerequisites for ASAM certification. It does not list accreditation.¹⁷

Opioid treatment: federal rules require accreditation within the first year of provisional certification. SAMHSA's approved bodies are CARF International, Social Current (formerly the Council on Accreditation), The Joint Commission, the National Commission on Correctional Health Care and the Washington State Department of Health.^{15, 16}

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

Opioid treatment programs

• State license: methadone programs are licensed for chemical maintenance treatment. The rule requires a Connecticut-licensed medical director, a licensed nurse during medication hours, a pharmacist supervising pharmacy services and access to a psychiatrist or psychologist.²
• Testing and exams: clients whose substance is not alcohol get a drug screen at admission and at least eight random tests in the first year of maintenance, then at least quarterly. DPH accepts waiver requests on the physical exam timelines.^{2, 20}
• State Opioid Treatment Authority: DMHAS's SOTA approves new OTPs for SAMHSA, usually after DPH and DEA approval, and tours the site and reviews schedules, staffing and dosing policies first. It can also monitor OTPs on site.¹³
• Mobile units: a multicare institution may run a mobile narcotic treatment program as an approved satellite.⁴ To bill Medicaid for it, the clinic uploads a DMHAS certification to its existing CMAP enrollment.¹³
• Federal steps: a state license and DEA registration come first. SAMHSA then grants one-year provisional certification, and the program must be accredited within that year.¹⁵

Other approvals you may need

• HUSKY Health (Medicaid): behavioral health benefits run through the Connecticut Behavioral Health Partnership of DSS, DCF and DMHAS, with Carelon Behavioral Health CT as the administrative services organization.¹⁸ Providers enroll in CMAP through Gainwell Technologies, which handles enrollment and claims, then request a Carelon ProviderConnect account for authorizations.¹⁹
• 1115 SUD certification: programs billing ASAM levels apply to Advanced Behavioral Health (ABH) once CON, licensure and CMAP enrollment are in place. Residential programs get a pre-certification site visit within 45 days, and certification letters list the ASAM levels approved.¹⁷
• Sober living homes: Connecticut does not license them. Homes certified by a NARR affiliate or another body DMHAS recognizes may report to DMHAS, provided they keep at least two doses of opioid antagonist on site and train residents when anyone has an opioid use disorder diagnosis. They must then report open beds weekly.¹⁰ DMHAS recognizes NARR through its affiliate the Connecticut Alliance of Recovery Residences (CTARR), the National Sober Living Association through New Life II, and NCORR. It lists certified homes but does not monitor or certify them.¹¹ Homes may not advertise treatment services or promise outcomes.¹⁰
• Fire code for sober homes: the State Fire Marshal treats them as residential, not institutional, occupancies. Homes with more than six residents get an annual inspection.¹²

Recent changes

• 2025: DMHAS began aligning OTP practice with the revised 42 CFR Part 8, including dropping the one-year opioid use history requirement.¹⁴ Public Act 25-96 broadened the renewal inspection waiver for Medicare- or Medicaid-certified institutions.⁴
• October 16, 2025: DPH invited substance use facilities to seek eLicense waivers of the physical exam timelines, for example when a recent hospital exam exists.²⁰
• November 14, 2025: the State Fire Marshal issued guidance classifying sober living homes by size and occupancy.¹²
• July 1, 2026: PA 26-68 eliminated the Office of Health Strategy and moved the CON program to DPH. The act also extends the CON exemption for some mental health bed increases to June 30, 2027.^{22, 9}
• October 1, 2026: DPH may impose civil penalties of up to $5,000 a day for operating a facility without a required license, which is also generally a class C misdemeanor.²¹
• July 1, 2027: a new CON process starts, with decisions by a panel of the DPH and DSS commissioners and the OPM secretary. It adds an exemption for state-operated or nonprofit providers that only offer behavioral health or SUD treatment, and drops the broader nonprofit state-contract exemption and the mental health bed-increase exemption.²²

Confirm these with DPH

• The license fee, if any, for substance use facilities and adult psychiatric outpatient clinics, which the statute does not list.
• Whether your license runs one year, as the 1999 rule says, or two years, as the statute says.
• Whether your project needs a CON, especially for for-profit applicants and projects filed after July 1, 2027.
• Current CON forms and fees now that DPH runs the program; some pages still carry Office of Health Strategy branding.
• For OTPs: CON status, the SOTA site review and how Connecticut applies the revised federal rules.
• Which programs serving minors need a DCF license instead of a DPH license.

Sources

1. Connecticut DPH, Facility licensing (FLIS). portal.ct.gov
2. Regulations of Connecticut State Agencies, Sec. 19a-495-570, Private freestanding facilities for substance abusive or dependent persons. eregulations.ct.gov
3. Connecticut General Statutes, Chapter 368v, Health care institutions (Secs. 19a-490, 19a-491, 19a-493). cga.ct.gov
4. Connecticut General Statutes, 2026 Supplement, Chapter 368v (Sec. 19a-493 as amended by PA 25-96). cga.ct.gov
5. Connecticut DAS, Uniform licensing application: regulations. portal.ct.gov
6. Regulations of Connecticut State Agencies, Secs. 19a-495-550 to 19a-495-571. portal.ct.gov
7. Connecticut General Statutes, Chapter 368z, Health systems planning (Secs. 19a-630, 19a-638). cga.ct.gov
8. Connecticut certificate of need program, CON forms and fees. portal.ct.gov
9. Connecticut certificate of need program, Certificate of need. portal.ct.gov
10. Connecticut General Statutes, Chapter 319j, Addiction services (Secs. 17a-675, 17a-716). cga.ct.gov
11. Connecticut DMHAS, Certified sober living homes. portal.ct.gov
12. Connecticut Office of the State Fire Marshal, General Information Notice 25-02, Sober living homes. portal.ct.gov
13. Connecticut DMHAS, Mobile opioid treatment programs (State Opioid Treatment Authority, January 2024). portal.ct.gov
14. Connecticut DMHAS, Opioid treatment programs: where we are in 2025. portal.ct.gov
15. SAMHSA, Become an opioid treatment program. samhsa.gov
16. SAMHSA, Approved accreditation bodies. samhsa.gov
17. Connecticut DSS, 1115 SUD demonstration certification application guidance. portal.ct.gov
18. Connecticut DMHAS, CT Behavioral Health Partnership. portal.ct.gov
19. Connecticut Behavioral Health Partnership, Welcome new providers. providers.ctbhp.com
20. Connecticut DPH, Blast Fax 2025-20, Waivers for Sec. 19a-495-570 physical examinations. portal.ct.gov
21. Connecticut Office of Legislative Research, 2026 acts affecting health professions and institutions (2026-R-0080). cga.ct.gov
22. Connecticut Office of Legislative Research, Public act summary, PA 26-68. cga.ct.gov

This guide summarizes Connecticut statutes, regulations and DPH, DMHAS and DSS pages as of the date above. It is general information, not legal advice. Requirements change; confirm with DPH before you apply.