California Behavioral Health & Substance Use Licensing Guide

Lead agency

Department of Health Care Services (DHCS)Licensing and Certification Division

Residential SUD

DHCS license plus level of care designationDHCS 3.1, 3.2, 3.3 or 3.5, or an ASAM certification

Outpatient SUD

DHCS AOD certification (mandatory)Health and Safety Code 11832.2

Applications

DHCS Licensing and Certification Portal

2025 laws

AB 1037 and SB 83Combined licensure and incidental medical services application from DHCS by January 1, 2027

Who licenses behavioral health programs in California?

DHCS’s Licensing and Certification Division licenses, monitors and handles complaints for outpatient and residential substance use providers, narcotic treatment programs, DUI programs and residential mental health programs. It also licenses mental health rehabilitation centers, psychiatric health facilities and psychiatric residential treatment facilities, and approves facilities designated for 72-hour evaluation and treatment.¹

Other agencies license other settings: the California Department of Public Health licenses chemical dependency recovery hospitals, and the Department of Social Services licenses adult residential and social rehabilitation facilities.^{2, 3}

Licenses, certification and levels of care

Residential: a license plus a level of care

Licensed adult alcohol and other drug facilities must meet the ASAM criteria, which DHCS adopted as the minimum standard of care for licensed residential facilities. Each must hold at least one DHCS Level of Care Designation or a residential ASAM Level of Care Certification:⁴

• DHCS Level 3.1: Clinically managed low-intensity residential services
• DHCS Level 3.2: Clinically managed residential withdrawal management
• DHCS Level 3.3: Clinically managed population-specific high-intensity residential services
• DHCS Level 3.5: Clinically managed high-intensity residential services

You apply for a designation with form DHCS 4022, under Behavioral Health Information Notice 21-001. Designations stay provisional until DHCS completes an on-site or virtual compliance review. An ASAM residential certification, developed by ASAM in partnership with CARF, satisfies the requirement on its own.^{4, 5}

Outpatient: mandatory AOD certification

Under Health and Safety Code 11832.2(a), any business with a physical location in California that provides treatment, recovery, detoxification or medications for addiction treatment must obtain alcohol and other drug (AOD) certification from DHCS, unless exempt. Programs not already certified had to apply by January 1, 2024 and be certified by January 1, 2025.⁶

Exempt settings, which may still certify voluntarily, include residential facilities, DUI programs and narcotic treatment programs licensed by DHCS; clinics and health facilities licensed by the Department of Public Health; community care facilities licensed by the Department of Social Services; and county jails and correctional facilities.^{6, 7} Individual licensed practitioners working within their scope are not programs under the law, and DHCS level of care or ASAM designations are not required for certified outpatient programs.⁶

How to apply

1. Confirm which approval you needA residential license, outpatient certification or both, and whether an exemption applies.
2. Set up the Licensing and Certification PortalDHCS takes initial, level of care, amendment and renewal applications online and accepts electronic fee payment.¹
3. File the right formsOutpatient certification uses the Initial Application for Certification (DHCS 6040); amendments use DHCS 6042 and renewals DHCS 6043. Residential facilities add the level of care designation application (DHCS 4022) or an ASAM certification.^{7, 4}
4. Meet the certification standardsCertified programs must follow DHCS’s Certification for Alcohol and Other Drug Programs standards (revised February 2025). DHCS grants no waivers or variances.^{6, 7}
5. Complete DHCS’s reviewIncluding the compliance review that removes provisional status from residential level of care designations.⁴

DHCS publishes fees on its applications, forms and fees page; confirm the current amounts before you file. Questions go to the SUD Licensing and Certification Division at (916) 322-2911 or LCDquestions@dhcs.ca.gov.⁶

How accreditation counts in California

We found no rule that substitutes CARF or Joint Commission accreditation for DHCS licensing or certification. The certification that matters most in practice is ASAM Level of Care Certification, delivered with CARF, which can replace a DHCS level of care designation for residential facilities, though the license is still required.^{4, 5} Opioid treatment programs need accreditation from a SAMHSA-approved body, SAMHSA certification, state licensure and DEA registration.⁸

Other approvals and obligations

• Medi-Cal: enroll through DHCS’s PAVE portal, which covers Drug Medi-Cal clinics and SUD providers.⁹
• Website and intake disclosure: licensed facilities and certified programs must tell clients, on their website and intake paperwork, that they can check DHCS’s site for probation, suspension, revocation or violation notices, with a link to DHCS’s list.¹⁰
• Opioid treatment programs: SAMHSA certification and DEA registration.⁸

Recent changes

• AB 1037 (Chapter 569, Statutes of 2025; signed October 10, 2025). By January 1, 2027, DHCS must offer a combined application for alcohol and other drug facility licensure and incidental medical services. DHCS may not require admission agreements to demand abstinence or sobriety for admission or continued treatment, and licensees must prioritize keeping a client connected to treatment after a relapse. The law also widens access to opioid overdose reversal medication.¹¹
• SB 83 (signed October 6, 2025). DHCS must post an identification and summary of each violation it issues to licensed facilities and certified programs, and note on its list that certain recovery residence notices are not included. The existing website and intake disclosure requirement for providers stays in place.¹⁰
• DHCS certification standards were revised in February 2025 and took effect immediately.⁷

Confirm these with the agency

• Whether your program is exempt from mandatory certification, especially hospital- or clinic-based services.
• Which agency licenses each mental health program type you plan to run.
• Current fees and processing times.
• Incidental medical services approval for residential programs.
• County contracting requirements if you plan to serve Medi-Cal members through your county.

Sources

1. DHCS, Licensing and Certification Division. dhcs.ca.gov
2. California Department of Public Health, Chemical dependency recovery hospitals. cdph.ca.gov
3. California Department of Social Services, Adult care licensing. cdss.ca.gov
4. DHCS, Level of Care Designation. dhcs.ca.gov
5. CARF International, ASAM Level of Care Certification. carf.org
6. DHCS, AB 118 requirements: certification of alcohol and other drug programs. dhcs.ca.gov
7. DHCS, Program certification. dhcs.ca.gov
8. SAMHSA, Become an opioid treatment program. samhsa.gov
9. DHCS, PAVE provider enrollment portal. pave.dhcs.ca.gov
10. California Legislature, SB 83 (2025). leginfo.legislature.ca.gov
11. California Legislature, AB 1037 (2025), Chapter 569. leginfo.legislature.ca.gov

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