Apply now: DHCS Mental Health Licensing and Certification (DHCS 1813 for an MHRC, DHCS 1814 for a PHF) | Questions: MHLC@dhcs.ca.gov
California licenses two genuinely different 24-hour mental health facility types through the same branch of the Department of Health Care Services (DHCS) that licenses residential SUD treatment, but under separate rule books. Picking the wrong one, or assuming one works like the other, is the first real decision point.
Two Facility Types, One Branch, Different Rule Books
Built from DHCS’s published structure for both facility types. A Mental Health Rehabilitation Center (MHRC) is a 24-hour, non-acute program providing intensive support and rehabilitative services to adults 18 and older who would otherwise need placement in a state hospital or another mental health facility. MHRCs are licensed under California Code of Regulations, Title 9, Division 1, Chapter 3.5 (sections 781.00 through 788.14), and the application is DHCS 1813.
A Psychiatric Health Facility (PHF) is acute inpatient psychiatric care, licensed under Title 22, Division 5, Chapter 9’s health facility standards, with its plan of operation requirements set out in Welfare and Institutions Code section 4080(e)(1). The application is DHCS 1814. A third, narrower category, Psychiatric Residential Treatment Facilities (PRTF), serves a different population and runs through a separate application track at PRTF@dhcs.ca.gov, not covered in depth here.
The Plan of Operation Has to Clear Your County First
The county step comes first, and it’s the one most often left too late. Before DHCS will review either an MHRC or a PHF application, the local behavioral health director has to approve the facility’s plan of operation. This isn’t a courtesy step you can circle back to. It’s a real local gate that sits ahead of the state review, and operators who treat it as paperwork to clean up later lose real time waiting for county sign-off they should have started pursuing months earlier.
Annual Versus Biennial Inspections, and They’re Genuinely Different
MHRC and PHF inspections run on different clocks. Under Welfare and Institutions Code section 5675(b), DHCS conducts at least one annual on-site inspection of a licensed MHRC. PHFs are inspected on a longer, biennial cycle under the same statutory framework in ordinary circumstances. DHCS has suspended or adjusted that normal cadence during declared emergencies before, so confirm the current inspection posture directly with the Mental Health Licensing and Certification Branch rather than assuming the standard cycle always applies.
A Genuinely New Door for Severe Substance Use Disorder Admissions
SB 1238 opened this door recently, and older guidance doesn’t mention it. Under SB 1238 and DHCS’s own 2026 guidance, a PHF or MHRC can now apply for DHCS approval to admit individuals diagnosed solely with a severe substance use disorder, a population previously outside either facility type’s core mental-health focus. To qualify, the facility has to offer medication-assisted treatment directly on site or through a documented agreement with a physician or opioid treatment program, maintain SUD-specific policies and procedures with documented staff training on them, and, for an MHRC, hold an ASAM level of care certification where applicable. A facility’s admitted population and its license category aren’t quite as fixed as they used to be, and this is worth building into a growth plan rather than assuming the original license locks you out of this population permanently.
Ketamine and Spravato in a California PHF or MHRC
An interpretation built from the PHF and MHRC rule sets described above, California’s CURES statute and the Spravato REMS. DHCS hasn’t published ketamine guidance for either facility type.
The two facility types answer this differently. A PHF is a licensed health facility providing acute inpatient psychiatric care, with physician coverage and licensed nursing already required, so ketamine or Spravato can come in through its medical staff and pharmacy procedures like any other medication protocol. An MHRC is non-acute and rehabilitative, built around Mental Health Rehabilitation Specialists rather than an acute medical team. Nothing reviewed for this page clearly authorizes infusions there, so an MHRC should get the Mental Health Licensing and Certification Branch’s answer in writing before planning on it, and many will find a partnership with an outside clinic simpler.
A PHF admission puts a patient’s first ketamine sessions under a psychiatrist’s daily review and nursing coverage around the clock, which helps the patient and gives the next prescriber something solid to work from. PHF stays often run a week or two, so the outpatient prescriber who will continue the series is lined up when the first session is ordered.
Two California details apply inside the PHF. Health and Safety Code § 11165.4 normally requires a CURES check the first time a patient is ordered or administered a Schedule II through IV drug, but it exempts patients while they’re admitted to a licensed health facility, which moves that check to whichever outpatient prescriber continues the series. A PHF offering Spravato registers with the REMS program and watches each patient for two hours afterward.
Staffing a California Mental Health Facility
Staffing splits sharply by facility type. A PHF needs physician-level psychiatric coverage and licensed nursing staff appropriate to acute care, not an optional add-on the way it might be at a lower level of care. An MHRC needs a Program Director meeting Title 9’s specific criteria, plus direct care staff classified as Mental Health Rehabilitation Specialists under the same regulations. California doesn’t license mental health clinicians the way it certifies SUD counselors through bodies like CCAPP; instead, clinical staff typically hold individual licenses through the Board of Behavioral Sciences (Licensed Clinical Social Workers, Licensed Marriage and Family Therapists, Licensed Professional Clinical Counselors) or the Board of Psychology.
California’s substance abuse, behavioral disorder, and mental health counselors earn a median of $59,250 a year statewide (BLS OEWS, May 2025), with the top 10 percent above $111,080. That’s the counselor-level figure, and PHF-level staffing runs well past it once physician and round-the-clock nursing coverage enter the budget. Many MHRCs build their direct-care team around a fully licensed Program Director supervising Mental Health Rehabilitation Specialist-classified staff who may still be working toward independent licensure, which keeps a meaningful share of payroll below an all-independently-licensed roster. PHFs typically contract psychiatric coverage through a medical group rather than carrying full-time psychiatrists on staff, and lean on an RN-heavy nursing structure with LVN support for the rest of coverage.
How to Submit Your DHCS Application
Submit DHCS 1813 for an MHRC or DHCS 1814 for a PHF, along with a detailed plan of operation and the applicable licensing fee, once your local behavioral health director has approved that plan of operation. Applications and ongoing correspondence go to the Mental Health Licensing and Certification Branch at MHLC@dhcs.ca.gov.
What Delays California Mental Health Facility Applications
Three delays show up in these applications over and over. The most common delay is treating the local behavioral health director’s plan-of-operation approval as a formality rather than a genuine prerequisite that has to clear before DHCS will even begin its own review. The second is applying for the wrong category, an MHRC for a population that actually needs PHF-level acute psychiatric care, or the reverse. The third is assuming severe-SUD admission is automatically available without actually pursuing DHCS’s specific approval process for it.
Frequently Asked Questions
What’s the difference between a Mental Health Rehabilitation Center and a Psychiatric Health Facility in California?
An MHRC is 24-hour, non-acute rehabilitative care for adults who would otherwise need a state hospital placement, licensed under Title 9. A PHF is acute inpatient psychiatric care, licensed under Title 22’s health facility standards with a Welfare and Institutions Code plan of operation. They’re reviewed by the same DHCS branch but under different rule sets.
Does a California PHF or MHRC need separate approval to admit someone with a substance use disorder?
Yes, and the option is recent. Under SB 1238 and DHCS’s 2026 guidance, a PHF or MHRC can apply for approval to admit individuals diagnosed solely with a severe substance use disorder, provided it offers MAT directly or through a documented agreement and maintains SUD-specific policies and training.
How often does DHCS inspect a licensed MHRC or PHF?
They differ by facility type. MHRCs get at least one annual on-site inspection under Welfare and Institutions Code section 5675(b). PHFs are inspected on a biennial cycle in ordinary circumstances, though DHCS has adjusted that cadence during declared emergencies before.
Sorting out whether your California program needs an MHRC or PHF license? Reach out here.
Author: A. Ant, CADC-II, Licensing & Accreditation Expert
Disclaimer: This content is provided for general informational purposes only and should not be construed as legal, regulatory, or licensing advice. Requirements change frequently. Consult qualified professionals for guidance specific to your situation.
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