Delaware Behavioral Health Licensing: DSAMH & Chapter 56 Guide

Written for owners, founders and compliance leads who are opening, buying, moving or growing an adult addiction or mental health program in Delaware, and for anyone keeping an existing Delaware license in good standing.

Table of Contents

Additional Delaware Licensing Guides

A New Behavioral Health Law That Hasn’t Switched On Yet

Built from the enrolled bill, the Delaware Code as it now reads online, and the licensing policy DSAMH signed in August 2026.

On August 31, 2026, Delaware’s governor signed Senate Substitute 1 for Senate Bill 161, now session law 85 Del. Laws c. 461. It adds a brand-new Chapter 56, titled “Behavioral Health,” to Title 16 of the Delaware Code, and it repeals two older laws: the Substance Abuse Treatment Act in Chapter 22 and the Community Mental Health Treatment Act in sections 5181 through 5186. Section 10 of the Act gives it a name, the Rick Urey Behavioral Health Treatment Act.

Read the Code online today and Chapter 22 already shows as repealed effective August 31, 2026. That label misleads people. Under section 12 of the Act, sections 1 through 5, which include the new chapter, and the two repeals in sections 8 and 9 “are to be implemented” at whichever point arrives sooner: the second anniversary of enactment, or a notice from the Director of the Division of Substance Abuse and Mental Health (DSAMH), printed in the Register of Regulations, saying the final regulations are adopted. In plain terms, the new system arrives no later than August 31, 2028, and sooner if DSAMH finishes its rules first. As of October 14, 2026 we found no such notice and no proposed Chapter 56 rules, although the state’s new Register site would not load in our tools, so check it yourself before relying on that.

Until then, the old machinery keeps running. In DSAMH057, a policy the Division signed on August 10, 2026, DSAMH commits that it “shall continue to license and certify, per current regulations, all entities that offer specialized adult” substance use disorder treatment. Those current regulations are 16 Del. Admin. Code 6001, a rule that took effect in November 2010. Mental health practices appear in that same policy as programs that usually need no DSAMH license, unless the program “substantially engages in treating substance use disorder as a primary driver of the program.”

The part that is already live is DSAMH’s authority. Section 6 of the Act took effect immediately and rewrote 29 Del. C. section 7908 to give the Division “The authority to create, implement, and oversee licensing requirements for all mental health treatment programs serving individuals who are 18 years old and older.” Once Chapter 56 is implemented, section 5602(b) bars anyone from providing treatment services or operating a program without a valid license unless an exemption applies, section 5606 lets the Division impose civil money penalties capped at $10,000 per violation, and section 5642 requires staff to report incidents to the Division immediately. Our reading is that an organization running an adult outpatient mental health clinic should start planning now for a DSAMH license it does not need today.

Primary Regulatory Agencies

Each description below follows the agency’s own page or the statute that hands it the job.

Delaware Department of Health and Social Services (DHSS), Division of Substance Abuse and Mental Health (DSAMH), which licenses substance use disorder and co-occurring treatment programs under 16 Del. Admin. Code 6001 through its Provider Enrollment unit, and which will license adult mental health programs too once Chapter 56 is implemented
DHSS, Division of Health Care Quality (DHCQ), whose Office of Health Facilities Licensing and Certification licenses hospitals, psychiatric hospitals included, under 16 Del. C. Chapter 10, and group homes for persons with mental illness under 16 Del. Admin. Code 3305
Delaware Health Resources Board, which decides Certificate of Public Review applications under 16 Del. C. Chapter 93, with the Delaware Health Care Commission staffing the review
Board of Mental Health and Chemical Dependency Professionals, within the Division of Professional Regulation, which licenses LPCMHs, LACMHs, LCDPs and marriage and family therapists under 24 Del. C. Chapter 30

Delaware Behavioral Health Licensing Snapshot

Quick reference only. Every row comes from the rule, statute or DSAMH policy it names.

Primary SUD Regulator	DHSS, Division of Substance Abuse and Mental Health, under 16 Del. Admin. Code 6001
Mental Health Facility Licensing	DHCQ licenses psychiatric hospitals (16 Del. C. Chapter 10) and group homes for persons with mental illness (16 Del. Admin. Code 3305). Outpatient mental health practices carry no state facility license today. Chapter 56 brings adult mental health programs under DSAMH licensing no later than August 31, 2028
Residential Treatment	DSAMH license types named by ASAM level: Clinically Managed Residential 3.1 and 3.5, and Medically Monitored 3.7 (DSAMH057)
Outpatient Treatment	Outpatient Services Level 1, Intensive Outpatient 2.1 and Partial Hospitalization 2.5, each its own DSAMH license type
Withdrawal Management	WM Extended On-Site Monitoring Level 2 (with a 23-hour variant) and WM Medically Monitored Inpatient 3.7
Facility License Required	Yes for any entity operating a substance use or co-occurring treatment program, one license per program (6001 section 4.1.1). Offices of licensed independent practitioners are outside the definition
Certificate of Need	Certificate of Public Review from the Health Resources Board for establishing a health-care facility, a list that includes hospitals. DSAMH-licensed SUD programs and mental health group homes are not on that list, in our reading
National Accreditation	Not required. Joint Commission Full Accreditation, CARF Three-Year Accreditation or COA three- or four-year accreditation may qualify a program for DSAMH deemed status, which opens the door to a license lasting up to two years (6001 sections 17 to 19)
Inspection	DSAMH may review a program “with or without notice.” A corrective action plan is due within 10 working days of the survey report
License Renewal	Full licenses run up to one year, or up to two with deemed status or substantial compliance. Renewal applications go in 90 to 120 days before expiration
Key Regulations	16 Del. Admin. Code 6001, 16 Del. C. Chapter 56 (enacted 2026, not yet implemented), 16 Del. C. Chapter 10, 16 Del. Admin. Code 3305, 16 Del. C. Chapter 93, 24 Del. C. Chapter 30

Which Delaware License Fits Which Program

Our reading, assembled from several sources because no single state document sorts it this way.

Program	Licensed today by	After Chapter 56 is implemented	Certificate of Public Review
Residential SUD treatment, ASAM 3.1, 3.5 or 3.7	DSAMH under 6001	DSAMH under the new rules	Not named in the statute
Withdrawal management, Level 2 or 3.7	DSAMH under 6001	DSAMH under the new rules	Not named in the statute
Outpatient SUD, IOP and PHP	DSAMH under 6001	DSAMH under the new rules	Not named in the statute
Adult outpatient mental health practice or clinic	No facility license. Clinicians hold individual licenses	DSAMH license, unless an exemption such as the private-practitioner one applies	No. Physician and psychologist offices are excluded
Group home for adults with mental illness (3 to 10 residents)	DHCQ under 3305	DHCQ license continues, plus a DSAMH license unless the Director exempts it as a program “otherwise licensed by this State”	Not named in the statute
Psychiatric hospital	DHCQ under Chapter 10	DHCQ license continues, with the same discretionary exemption available	Yes

DSAMH’s license type names carry an ASAM level, so a Delaware residential operator is already licensed as 3.1, 3.5 or 3.7 on paper. A separate credential still exists for proving that level to outsiders: CARF’s ASAM Level of Care Certification, delivered with ASAM, and CARF’s page reads: “Certification is available for adult Levels of Care 3.1, 3.5, and 3.7.” We found no Delaware rule requiring it, and DSAMH would not show it on your license. Neither CARF nor ASAM lists a withdrawal management level, so it lines up with the residential license types and not with WM Medically Monitored Inpatient 3.7. A referral partner can check who holds it through CARF’s Find a Provider tool, where “ASAM Level of Care 3.7” is one of three certification filters, the other two being 3.1 and 3.5.

Programs Covered

Adult residential addiction programs licensed as ASAM 3.1, 3.5 or 3.7
Withdrawal management, from Level 2 ambulatory monitoring through medically monitored inpatient 3.7
Outpatient, intensive outpatient and partial hospitalization SUD programs, including co-occurring programs
Adult outpatient mental health practices and clinics, today and after Chapter 56
Group homes for adults with mental illness and psychiatric hospitals

Key Licensing Requirements

Pulled together from 6001, DSAMH’s Provider Enrollment material and the hospital statute.

A sit-down with DSAMH’s Quality Assurance team before any first SUD application (6001 section 4.2.2), with DSAMH’s pre-meeting Q and A form completed beforehand
One DSAMH application for each program at each location, with a $15 non-refundable fee per licensure application
Zoning and occupancy permits, floor plans, a policy and procedure manual and a sample clinical chart attached to the application
A 180-day provisional license and a DSAMH audit before any full SUD license issues
A DHCQ hospital license, and a Certificate of Public Review before construction, for a new psychiatric hospital
Counselor staffing that follows 6001’s tiers, with each Counselor I qualifying through a full Delaware CADC, a national addictions or co-occurring certification, or five years of SUD clinical experience (section 6.1.4.1)

Frequently Asked Questions

What does a Delaware behavioral health license cost?

DSAMH charges a $15 non-refundable fee for each licensure application under 6001, and because every program at every location needs its own application, a site running residential and outpatient services pays it twice. A new psychiatric hospital pays DHCQ $1,000 plus $2.00 per licensed inpatient bed, on top of a Certificate of Public Review filing fee between $100 and $10,000. The state fees are the small part. Buildout, zoning and occupancy permits, policy writing and months of payroll during the provisional period are where the money goes. Chapter 56 lets DSAMH set new fees by regulation once it is implemented, so we would not plan around $15 lasting.

How long does licensing take in Delaware?

Under DSAMH057 a six-month clock begins when an applicant first reaches Provider Enrollment, and the application must be finished and approved before it runs out. A new SUD program then operates on a 180-day provisional license while DSAMH schedules its audit. We plan on roughly 6 to 12 months for outpatient SUD work and 9 to 15 for residential, since zoning, occupancy permits and the Fire Marshal stretch a residential schedule. A psychiatric hospital adds Certificate of Public Review, which the statute caps at 90 days, or 120 with a hearing. Both ranges are our own estimates, not dates the state sets.

What trips people up in Delaware?

The 2026 law is the big one. The Delaware Code now shows Chapter 22 as repealed, and some operators conclude the old SUD rule is dead or that mental health programs need a DSAMH license today. Neither is true until August 31, 2028 or DSAMH’s earlier Register notice. The other repeat problem is the clock: DSAMH057 gives an applicant 90 days from the decision to seek licensure to apply, and provisional status ends for good at 270 days, so a program that opens before its policies and staffing are ready can run out of time.

How much staff will I need to open a Delaware program?

A small outpatient SUD program typically starts with a clinical director qualified under either 6001 route, meaning a master’s and five years of clinical work, or a bachelor’s plus a CADC or CCDP credential and five years working in substance use services, plus three or four counselors. In a residential program, 6001 wants someone awake and on duty every hour, with a counselor present eight or more hours daily, and residential withdrawal management adds a physician who can be reached around the clock and comes on site when needed. At the Delaware median of $56,020 (BLS OEWS, May 2025), four counselors cost $224,080 in yearly base pay, and the director and benefits come on top. Supervised associate counselors working toward full licensure can bring that down considerably, as the Staffing section below explains.

Licensing

Does my adult therapy practice need a DSAMH license right now?

Generally no. DSAMH057 puts “Mental health treatment practices” on its list of programs that usually fall outside its licensing, and 6001 already excludes individual practitioners from the definition of an agency. The exception is a practice where substance use treatment is “a primary driver of the program.” That practice needs a DSAMH license under the current rule.

Will that change under Chapter 56?

For many organizations, yes. Section 5602(a) keeps “A licensed practitioner in private practice” outside the license requirement, along with a licensed professional whose treatment is “incidental to the professional’s regular practice.” A clinic run by an organization that employs clinicians has no matching carve-out in the statute. Whether DSAMH uses its power to exempt “Other provider organizations, programs, or treatment services designated by the Director” for some of them won’t be known until it writes the rules.

How long does a new SUD license last?

A first license is provisional for 180 days, and DSAMH audits the program inside that window. DSAMH020 caps provisional status at 270 days in total. A program that still falls short at that point is left with one temporary license, 90 days at most, meant for planning its closure. DSAMH020 says it cannot be renewed or stretched.

Facility

Do I need a Certificate of Public Review?

For a psychiatric hospital, yes. Section 9304(a) reaches “The construction, development or other establishment of a health-care facility,” and the statute’s facility list includes hospitals licensed under Chapter 10. Review “shall take no longer than 90 days,” or 120 with a hearing, and fees run from $100 to $10,000 depending on project cost. DSAMH-licensed programs and mental health group homes are not on the list, which is why we don’t expect them to need review. Capital spending above $5.8 million, or a bed change of more than 10 beds or 10 percent over two years, can trigger review on its own.

What happens when ownership changes or we move?

Give DSAMH written notice at least 30 days ahead of a change in name, ownership or premises, after which the Division has 15 days to say whether it wants a fresh application. Licenses stay with the Division and can’t be transferred, so a new owner, under section 4.10.4, “shall apply for a new license.” Closing a program takes 60 days’ notice to DSAMH and 30 days’ notice to clients.

Does a second site need its own application?

It does. 6001 section 4.2.3 requires “A separate application” for “each program at each location,” and DSAMH posts a separate Satellite Location Application, DSAMH039A, on its Provider Policies page.

Staffing

Which counselor credentials does Delaware use?

For a Counselor I, section 6.1.4.1 of 6001 accepts any one of three things: full CADC certification in Delaware, full certification from a nationally recognized addictions or co-occurring counseling body, or five years of clinical experience in substance abuse treatment. The state’s Board of Mental Health and Chemical Dependency Professionals licenses the Licensed Chemical Dependency Professional, which takes a master’s degree with at least 30 graduate semester hours in counseling, 3,200 hours of experience with 1,600 supervised, 100 hours of face-to-face supervision, and a national or DCB certification. Mental health counselors follow the LPCMH track instead, with 60 graduate semester hours and the National Counselor Examination.

What does a Delaware clinical payroll run?

For the BLS occupation that covers substance abuse, behavioral disorder and mental health counselors, Delaware’s May 2025 OEWS median was $56,020. A quarter of those counselors earned $43,760 or less and a quarter earned $64,790 or more, and the national median stood at $59,350, so Delaware runs about $3,300 below it. Paying four counselors that median adds up to $224,080 a year, not counting a clinical director, benefits or nurses. That figure is manageable once you see how Delaware’s own credential ladder lets you build the team. Supervision is already written into the rules. 6001 already requires a clinical supervisor to meet with each Counselor II for an hour or more per 20 hours of client work, and associate counselors licensed as LACMHs are logging supervised time toward the LPCMH, so one seasoned clinical director can lead several supervised counselors who earn below the median while they work toward the next credential. Built that way, a Delaware team’s clinical wage bill often lands 40 to 60 percent under what the same headcount of fully credentialed counselors would draw. Nursing works the same way in residential and withdrawal settings, where a single RN can direct a group of LPNs so not every shift needs RN pay. The exact staffing matrix comes after the service mix and census are settled.

Operations

Does Delaware require SUD programs to offer MOUD?

We found no such requirement in 6001 or in DSAMH’s buprenorphine policy, DSAMH024. DEA’s January 2023 letter to registrants did away with the old DATA waiver, so an ordinary DEA registration covers buprenorphine prescribing. A practice that only prescribes buprenorphine doesn’t need a DSAMH license, but under DSAMH024 a facility must still “contact DSAMH prior to expanding services beyond MOUD treatment.” Methadone runs through a separately licensed opioid treatment program, so residential and outpatient programs coordinate with one.

Who must report incidents to DSAMH today?

Accredited programs holding deemed status do. 6001 section 17.3.2 requires Joint Commission programs to report “all sentinel events to DSAMH within twenty-four (24) hours,” and sections 18.3.2 and 19.3.2 give CARF and COA programs the same 24 hours for significant events and hazardous situations. Providers under contract with DSAMH also follow DSAMH029, which uses two business days. Once Chapter 56 is implemented, the duty moves to individual staff members, who must report incidents to the Division immediately, and section 5643 tells the Division to build an online system to receive those reports.

Enforcement

What happens if DSAMH moves to revoke a license?

6001 starts the process with a written Notice of Intended Action, sent certified mail with return receipt requested. The program has 10 days after receiving it to request a hearing, and the Secretary of DHSS makes the final determination. Once a suspension or revocation is final, a first-time licensee may ask for a reinstatement hearing right away (section 4.14.1), but one whose history already shows a prior suspension or revocation must let a year pass after the determination becomes final (section 4.14.2). Requesting that hearing does not put the suspension or revocation on hold (section 4.14.4). The Delaware License Reinstatement guide walks through that path.

How does Chapter 56 change enforcement?

It adds teeth that 6001 lacks. The Division can fine a provider as much as $10,000 for each violation, the Secretary appoints a hearing officer, the burden of proof sits with the provider, and a petition for Superior Court review has a 30-day deadline from the final order. Unlicensed treatment that recklessly causes physical injury becomes a class F felony. Section 5604 also bars solicitation within 500 feet of another provider’s facility.

Our Part in a Delaware Project

Work we take on

We help operators sort out whether a program belongs with DSAMH or DHCQ, prepare SUD applications and deemed-status filings under 6001, and plan for the move to Chapter 56 licensing before DSAMH’s new rules land.

Work we pass to others

The Medicaid certification DSAMH pairs with its license for programs billing ASAM levels is a payer step outside licensure, and we leave it to others along with Medicare and CMS enrollment and claims billing. We don’t do marketing either, and we’re happy to name firms that do.

Planning a Delaware program around the 2028 deadline? Tell us what you’re building.

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.

Sources

Delaware General Assembly, Senate Substitute 1 for Senate Bill 161 (signed August 31, 2026, 85 Del. Laws c. 461): Bill detail and status (checked October 14, 2026)
SS 1 for SB 161, enrolled text, Sections 6, 8, 9, 10, 11 and 12: Bill text (checked October 14, 2026)
16 Del. C. Chapter 56, Behavioral Health: Chapter 56 (checked October 14, 2026)
16 Del. C. Chapter 56, Subchapter I (sections 5601 to 5608: definitions, license required, exemptions, penalties, fees): Subchapter I (checked October 14, 2026)
16 Del. C. Chapter 56, Subchapter III (disciplinary actions, hearings, judicial review): Subchapter III (checked October 14, 2026)
16 Del. C. Chapter 56, Subchapter V (sections 5641 to 5648: incidents and reports): Subchapter V (checked October 14, 2026)
16 Del. C. Chapter 22, Substance Abuse Treatment Act (repeal note): Chapter 22 (checked October 14, 2026)
16 Del. Admin. Code 6001, Substance Abuse Facility Licensing Standards (DSAMH-posted copy): 6001 (PDF) (checked October 14, 2026)
DSAMH057, SUD Treatment Licensure and Certification Guidelines (signed August 10, 2026): DSAMH057 (PDF) (checked October 14, 2026)
DSAMH020, Path to Full Licensure or Certification (rev. October 29, 2025): DSAMH020 (PDF) (checked October 14, 2026)
DSAMH029, Community Incident Reporting Policy (rev. October 2, 2024): DSAMH029 (PDF) (checked October 14, 2026)
DSAMH024, Buprenorphine Prescribing Practitioners Policy: DSAMH024 (PDF) (checked October 14, 2026)
DSAMH, Application for Licensure and/or Certification (rev. September 7, 2022): Application (PDF) (checked October 14, 2026)
DSAMH, Provider Enrollment Questions and Answers (updated July 2026): Provider Enrollment Q and A (PDF) (checked October 14, 2026)
DSAMH, Provider Policies and Resources: Provider Policies and Resources (checked October 14, 2026)
DHSS, Division of Health Care Quality: DHCQ home (checked October 14, 2026)
DHCQ division brochure (March 3, 2022), Office of Health Facilities Licensing and Certification: DHCQ brochure (PDF) (checked October 14, 2026)
16 Del. C. Chapter 10, Subchapter I, Hospitals (sections 1001, 1003, 1005, 1006, 1007, 1010): Hospitals (checked October 14, 2026)
16 Del. Admin. Code 3305, Group Homes for Persons with Mental Illness (archive copy, last updated July 12, 2022): 3305 (checked October 14, 2026)
Delaware Health Resources Board: Health Resources Board (checked October 14, 2026)
16 Del. C. Chapter 93, Certificate of Public Review (sections 9302, 9304, 9305): Chapter 93 (checked October 14, 2026)
Division of Professional Regulation, Board of Mental Health and Chemical Dependency Professionals: Board page (checked October 14, 2026)
24 Del. C. Chapter 30, Board of Mental Health and Chemical Dependency Professionals: Chapter 30 (checked October 14, 2026)
24 Del. C. Chapter 30, Subchapter II, sections 3032 and 3033 (LPCMH and LACMH): Subchapter II (checked October 14, 2026)
24 Del. C. Chapter 30, Subchapter III, sections 3043 and 3044 (LCDP): Subchapter III (checked October 14, 2026)
DEA Diversion Control Division, Dear Registrant letter, January 12, 2023: DEA letter (PDF) (checked October 14, 2026)
CARF, ASAM Level of Care Certification: Level of Care Certification (checked October 14, 2026)
CARF provider search: Find a Provider (checked October 14, 2026)
ASAM, Level of Care Certification: ASAM Level of Care Certification (checked October 14, 2026)
U.S. Bureau of Labor Statistics, OEWS May 2025, Delaware (SOC 21-1018): Delaware May 2025 estimates (checked October 14, 2026)
U.S. Bureau of Labor Statistics, OEWS May 2025, national estimates (SOC 21-1018): National May 2025 estimates (checked October 14, 2026)