Understanding the DHCS Licensing Process

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DHCS licensing is one of many forms of licensure required for behavioral health service providers in the state of California. Learn about the process for completing the DHCS licensing process.

What is the DHCS?

The DHCS is a California agency that oversees services for its 15.4 million Medi-Cal recipients. Medi-Cal is the healthcare safety net provided for millions of low-income and disabled residents of California. Therefore, the DHCS services about one-third of California who are on Medi-Cal.

DHCS administers a wide range of programs for the state, some of which are federal programs. Among these programs are those that provide mental health and addiction recovery services. For this reason, someone operating a behavioral health facility in CA will need to obtain DHCS licensing.

Understanding ASAM and Level of Care (LOC) Designations

The American Society of Addiction Medication (ASAM) created criteria as guidelines for residential treatment programs. The different levels exist on a continuum from lowest to highest intensity of treatment services.

DHCS has integrated the ASAM criteria into the following clinically managed LOC:

DHCS Level 3.1. Low-intensity residential services.
DHCS Level 3.2. Residential withdrawal management.
DHCS Level 3.3. Population-specific high-intensity residential services.
DHCS Level 3.5. High-intensity residential services

The provider will designate the correct LOC for the behavioral health facility when submitting the application. Selecting the correct DHCS level is very important when applying for the DHCS license.

What is the DHCS Licensing Process?

If you are opening a behavioral healthcare center in the state of California you will need to secure a DHCS license. About one-third of the state is on Medi-Cal, which is under the prevue of the DHCS. To be able to serve these patients, you must be DHCS licensed.

The DHCS licensing process takes about a year to complete, so it is wise to start this process early on. Here are the basic steps of the process:

Pre-Application Process. There are several steps to complete before submitting an application for a DHCS license. They include:

- Review the fee schedule. Know what the fees are so you can be prepared.
- Select your site. This includes an address, floor plans, zoning, water access, and fire clearances.
- Learn which zoning documents and fire clearances are required. Zoning clearance is needed for outpatient, as well as residential centers with more than six beds. A fire clearance is needed for both outpatient and residential centers.
- Submit a staffing plan. No need to have already hired the staff, just provide a plan.
Decide if you are applying for DHCS LOC or ASAM LOC certification.

Initial Application. Complete the Initial Treatment Provider Application. In most cases, the application process takes 120 days, once the DHCS reviews it and determines it is complete. You must also submit supporting documents, such as the staffing plan and zoning documents. The fire clearance will be handled directly through the DHCS and the local fire authority. The application fee is due at the time you submit your application.

DHCS LOC Designation Application. This LOC Designation Application must be submitted at the same time as the Initial Treatment Provider Application. If you are applying for multiple sites, you must submit a separate LOC application for each. There is no additional fee for this LOC application. The following items must be included in the application for LOC:

Facility staffing plan.
Detailed monthly program staff schedule.
Weekly activities schedule.
Detailed weekly program activities schedule.
The program’s LOC assessment for residents.

Compliance Review. After both applications have been deemed complete, the DHCS will perform an initial on-site compliance review of the treatment center. The purpose of the visit is to ensure that the program adheres to Title 9, Chapter 5, California Code of Regulations, and/or Alcohol and/or Drug Certification Standards. The site review includes:

Entrance conference.
Inspection of the treatment center.
Review of personnel files.
Review of the mock client file.
Staff interviews.
Review of operations and personnel manuals.
Exit conference.

At a later date, after the treatment center is fully operational, another site inspection will be performed. During this visit, the following items will be reviewed:

Medication review.
Documentation review.
Group activity monitoring.
Staff and resident interviews.

Medi-Cal Enrollment. Before you can provide treatment services for clients on Medi-Cal, your center must be enrolled and have a contract. This is arranged directly with your county through the Provider Application and Validation for Enrollment (PAVE). This allows you to be reimbursed for services rendered to clients under Medi-Cal.

How to Avoid Missteps in the DHCS Licensing Process

It is plain to see that the process for DHCS Licensing is intensive. There are many boxes to check in completing multiple documents prior to being licensed. To avoid making time-consuming errors, follow these tips:

It is important to take care to check and recheck that all documents are correct and complete. To ensure that you have not made any errors, be sure to all enough time for reviewing the documents before submitting them.
Be responsive to the DHCS if they reach out to you. They contact you when they need more information or if they have found an omission or error. The sooner you return the call or email, the sooner you are back on track.
Gather the documents and materials needed early on in the process. This saves you a lot of time when you are ready to submit the applications.
Make sure you are up-to-date on the licensing, certification, and training requirements for all staff members. Once hired, each staff member must have TB testing and be CPR certified.
Check with your local city to make sure there are no zoning ordinances that prevent your site from operating. Your treatment center may need to have a conditional use permit. Zoning clearance is not required if there are fewer than six beds.

Circa Behavioral Healthcare Solutions Consultants Guide the DHCS Licensing Process

If you are preparing to open a behavioral health center, you are probably spinning multiple plates. To simplify your workload, consider hiring a consultant who can relieve you of this cumbersome process. Circa Behavioral Healthcare Solutions is ready and able to assist you with the DHCS licensing process. Call them today at (888) 458-6619.