Michigan Drug and Alcohol Inpatient Treatment Licensing

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.

Apply through: Michigan State Licensing System (MI-SLS) | Questions: LARA Non-Long Term Care State Licensing Section, LARA-BCHS-NLTCSLS@michigan.gov, 1-833-757-7308

Residential substance use disorder treatment in Michigan is licensed by the Department of Licensing and Regulatory Affairs (LARA), Bureau of Community and Health Systems (BCHS), Non-Long Term Care State Licensing Section, under Part 62 of the Public Health Code (MCL 333.6230 to 333.6251), with revised rules that took effect June 3, 2026.

Residential and Withdrawal Management Are Separate Categories on One License

LARA issues a single Substance Use Disorder Program license, and the license itself names the service categories the program is authorized to provide. Under the rules in force since June 3, 2026, R 325.1303(6)(d) allows three of them: methadone, residential, and residential withdrawal management. A residential program is a staffed residential setting where treatment or rehabilitation services happen onsite. Residential withdrawal management is its own category, run as either clinically managed or medically monitored withdrawal management, and it carries extra requirements in R 325.1388, including a medical director and a review of each recipient by a physician, PA or APRN at admission and every 72 hours. A facility with detox beds next to its residential beds should expect both categories on its license. Outpatient is not among the three.

Nothing on the license sorts residential care by ASAM level. LARA authorizes “residential,” full stop, so the license won’t tell a payer whether your house runs at Level 3.1, 3.5 or 3.7. If you want that level documented somewhere a referral source can check, look at CARF’s ASAM Level of Care Certification. ASAM runs the program jointly with CARF, and it certifies adult residential Levels 3.1, 3.5 and 3.7. We saw no withdrawal management level in ASAM’s description of the certification, which is why we treat it as a fit for Michigan’s residential category rather than residential withdrawal management. That pairing is our own interpretation, not something LARA has said. LARA’s license may never mention it, but a payer can look the program up in CARF’s provider search under the certification filter for its level.

No Certificate of Need for SUD Residential Programs

Michigan’s Certificate of Need law, Part 222 of the Public Health Code, applies to the health facilities listed in MCL 333.22205: hospitals, psychiatric hospitals and psychiatric units, nursing homes and hospital long-term care units, freestanding surgical outpatient facilities, and HMOs. A substance use disorder program licensed by LARA under Part 62 isn’t on that list, so our reading is that a freestanding residential SUD program doesn’t need a CON. MDHHS administers CON review, and its psychiatric bed standards (CON-205, effective January 29, 2026) treat a psychiatric hospital or unit as a covered facility. That only comes into play if your plans include psychiatric beds or a hospital setting.

Medication for Opioid Use Disorder in a Residential Setting

Methadone is a separate license category in Michigan (R 325.1303(6)(d)), apart from the residential authorization this guide covers, so a residential program without it has to send clients who need methadone to a licensed methadone program. R 325.1331(2)(c) also expects your policies to facilitate access to medication-assisted treatment when a recipient wants it, and in our view a written coordination agreement is the clearest way to show that. Naming the specific partner holds up better than a general referral statement. In the Detroit area, for example, Premier Services of Michigan operates an opioid treatment program in Dearborn Heights under the name CMS, listed by CARF with a three-year accreditation. Buprenorphine is simpler. DEA told registrants in January 2023 that a DATA-Waiver is no longer required and that buprenorphine prescriptions “only require a standard DEA registration number,” though state law still applies. For naltrexone, SAMHSA says any practitioner licensed to prescribe medications can prescribe and administer it.

Can a Michigan Residential License Carry Ketamine?

LARA’s SUD rules don’t mention ketamine, and we haven’t seen LARA address it. The conclusions here are our reading of the rules and statutes cited, so put the plan to the Non-Long Term Care section before you start.

Probably yes, and Michigan’s category list is the reason. Since June 3, 2026 a license authorizes only methadone, residential or residential withdrawal management (R 325.1303(6)(d)), and none of those is a medication category. Giving ketamine to a resident for co-occurring depression or PTSD doesn’t change which category the program holds, so in our view it isn’t the kind of “addition or deletion of service levels” that R 325.1303(1) sends back through an application. What the rules do control is how medication is handled. R 325.1393(3) says medication must be “administered by or under the supervision of personnel” who are qualified and trained, R 325.1365 requires controlled substance and medication records, R 325.1375 calls for secured storage, and R 325.1393 gives the recipient the right to refuse treatment and to have a medication’s benefits, side effects and risks “fully explained” in language they understand. Write ketamine into the consent the admissions policy already requires under R 325.1331(2)(d).

The residential rule itself, R 325.1385, carries no medical staffing requirement, which matters for monitoring. A medically monitored withdrawal management program, by contrast, must have a physician (or another clinician the rule lists) onsite during all hours of operation and a medical director (R 325.1388). A building holding both categories is better placed to watch a resident through the hours after a dose than a residential-only house that relies on a visiting prescriber.

Licenses That Follow the Drug

Ketamine is Schedule III federally (21 CFR 1308.13(c)(7)), and Michigan wants a state controlled substance license on top of DEA registration. MCL 333.7303 requires one from anyone who prescribes or dispenses a controlled substance in the state, and “a separate license is required at each principal place of business or professional practice.” Prescribers must also be registered with MAPS, Michigan’s prescription monitoring system, before prescribing or dispensing any schedule 2 to 5 drug, and must pull a MAPS report before issuing a prescription for more than a 3-day supply (MCL 333.7303a). A single dose given in the building won’t usually reach that trigger, and the statute’s exception for drugs administered on site applies only in licensed hospitals and freestanding surgical outpatient facilities.

Nurse practitioners can’t carry a ketamine series alone in Michigan. Under MCL 333.17211a (2016 PA 499), an APRN prescribes schedule 2 to 5 controlled substances only “as a delegated act of a physician.” We did not find a Michigan Board of Nursing statement on RNs giving ketamine, so the delegation and the program’s own protocol define the nurse’s role. For Spravato, the program site has to be certified in the Spravato REMS and observe each patient for at least two hours after dosing, per the FDA medication guide.

Choosing Residents

Ketamine has no FDA approval for any substance use disorder. It isn’t MOUD and can’t stand in for the methadone, buprenorphine or naltrexone access R 325.1331(2)(c) expects. Timing matters as much as diagnosis. In the first days after withdrawal a resident is too unsettled for anyone to read a response, so we would wait until the stay has steadied and the depressive or trauma symptoms have plainly held on despite the usual medications. Someone whose use history includes ketamine, PCP or other dissociatives is a poor fit.

Owning the Outpatient Clinic That Finishes the Series

A residential stay is a sensible place to begin because staff see the resident around the clock. Finishing the series after discharge means a stand-alone outpatient ketamine clinic, and Michigan takes corporate practice seriously. The Attorney General concluded in OAG No. 5676 (April 8, 1980) that a corporation for osteopathic services with a lay shareholder could not be formed solely under the Business Corporation Act and had to be organized under the Professional Service Corporations Act, and a later LARA order denying a declaratory ruling request quotes MCL 450.1281(1) (“A corporation must incorporate as a professional corporation”) and adds that “each shareholder of a professional corporation must be a licensed person.” The usual answer is a physician-owned professional corporation that contracts with a management services company for nonclinical work. For how the PC and the management company fit together, see the ketamine section of Michigan Drug and Alcohol Outpatient Treatment Licensing.

Before the residential program and the clinic trade referrals, have counsel look at the federal Eliminating Kickbacks in Recovery Act. 18 U.S.C. § 220 punishes paying or receiving anything of value for referrals to a recovery home or a licensed SUD clinical treatment facility, with fines up to $200,000 and up to 10 years in prison per occurrence, and a LARA-licensed residential program fits that definition.

Staffing a Residential Program

The rules set a floor. R 325.1385 requires a residential program to employ a full-time licensed counselor, LMSW, licensed psychologist or LMFT, keeps any one counselor’s caseload at 20 recipients or fewer (10 for a limited certified counselor), and calls for at least one trained staff member onsite during all hours of operation. Every licensee also designates a program director responsible for the whole operation (R 325.1347). Most operators we work with add a clinical director, typically a CAADC, plus enough credentialed staff to match the population’s acuity. BLS puts the statewide median for Michigan’s substance abuse, behavioral disorder, and mental health counselors at $61,960 a year (OEWS, May 2024), a bit higher than the roughly $59,350 national median, so a residential program with a clinical director, several counselors, and 24-hour direct-care staff commonly runs well past $420,000 a year in payroll before nursing coverage. That number is meant for budgeting, and it gets easier to carry once you see how Michigan’s counselor credentials are tiered. MCBAP offers the CADC to applicants from a high school diploma up and reserves the CAADC for those with a master’s degree or higher, and MCBAP lets someone still earning a credential work on a Development Plan in the meantime. Many residential programs lean on that, filling a good share of counseling roles with CADC holders and Development Plan staff supervised by a CAADC clinical director, which trims payroll and gives junior staff a way up. They also pair an RN with several LPNs for medical oversight rather than staffing every shift with a registered nurse. Census and level of care decide the final staffing matrix.

How to Submit Your LARA Application

LARA’s Non-Long Term Care licensing page routes licenses, changes, and renewals through the Michigan State Licensing System (MI-SLS), and it says instructions, requirements, and fees are completed inside that system. The rules only say an application goes on the department’s most recent applicable form (R 325.1303(1)). We haven’t found a separate SUD application form number published on LARA’s current pages, so work from what MI-SLS presents rather than an older PDF. Questions go to the Non-Long Term Care State Licensing Section at LARA-BCHS-NLTCSLS@michigan.gov or 1-833-757-7308.

The license fee is $500 a year, a figure MCL 333.6237 sets until October 1, 2027. Residential and residential withdrawal management applicants get a prelicensure survey, and LARA is to decide within 3 months after the application is complete, then come back for a post-licensure survey within 3 months of issuing the license (R 325.1303(5) and (7)). A standard license lasts no more than a year. R 325.1305(3) puts renewal before August 1. On the billing side, the Non-Long Term Care page says annual renewal notices show up inside MI-SLS during the second quarter, payment is due no later than July 31, and any license still unrenewed by September 1 is closed with a notice sent. That page also says a provider’s non-renewal by September 1 isn’t treated as a department refusal to renew. The rules add their own backstop: under R 325.1305(5), a license not renewed within 30 days after it expires must be closed, and that closure can’t be appealed.

Accreditation and the Three-Year Survey

National accreditation isn’t a condition of the Michigan SUD license. Where it pays off is the survey cycle. LARA has to visit each licensed program at least once every 3 years (MCL 333.6238(2)), and an accredited program can ask to have that visit waived. The statute requires the department to grant the waiver when the accrediting body is one LARA accepts and the accreditation report is less than 3 years old with no sign of substantial noncompliance. R 325.1309 adds the calendar: LARA publishes next year’s survey list by October 1, waiver requests are due November 1, and a denial can’t be appealed. The rule says LARA keeps a list of approved accrediting bodies, but it doesn’t name them, and we couldn’t locate the list online. The residential programs we work with in Michigan carry CARF, Joint Commission or COA (Council on Accreditation) accreditation, so those are the three we’d plan around. That is our own experience, not a LARA statement, so ask the Non-Long Term Care section to confirm your accreditor is on the list before counting on a waiver.

What Delays Michigan Residential Applications

In our experience the most common holdup is a policy manual still written to the pre-June 2026 rules, for instance one that describes outpatient as a licensed service. The rules expect policies to be reviewed and updated every three years or sooner when needed (R 325.1331(1)), and a rule revision of this size is a clear reason to update them. Another is applying for the wrong category, such as asking for residential alone when the building also runs withdrawal management beds, since each category has its own requirements.

Frequently Asked Questions

Confirming your policies reflect Michigan’s June 2026 rule revision for a residential program? Reach out here.

Sources

• LARA, Substance Use Disorder Administrative Rules, R 325.1301 to R 325.1399 (eff. June 3, 2026): SUD Administrative Rules (PDF) (checked October 9, 2026)
• LARA, BCHS: Non-Long Term Care State Licensing (checked October 8, 2026)
• Michigan Public Health Code, Part 62, MCL 333.6230 to 333.6251: Substance Use Disorder Services Programs (PDF) (checked October 8, 2026)
• Michigan Public Health Code, Part 222, MCL 333.22205: Certificate of Need (PDF) (checked October 8, 2026)
• MDHHS, CON-205: CON Review Standards for Psychiatric Beds and Services (PDF) (checked October 8, 2026)
• DEA Diversion Control Division: Dear Registrant letter on elimination of the DATA-Waiver, January 12, 2023 (PDF) (checked October 8, 2026)
• SAMHSA: Naltrexone (checked October 8, 2026)
• CARF: Premier Services of Michigan LLC, CMS Dearborn Heights provider listing (checked October 8, 2026)
• MCBAP: MCBAP Certifications (CADC, CAADC, Development Plan) (checked October 8, 2026)
• CARF: ASAM Level of Care Certification (checked October 8, 2026)
• ASAM: Level of Care Certification (checked October 8, 2026)
• CARF: Find a Provider (Certification filter) (checked October 8, 2026)
• eCFR, 21 CFR 1308.13(c)(7): ketamine as a Schedule III depressant (checked October 9, 2026)
• U.S. FDA: Spravato prescribing information and Medication Guide, REMS and two-hour monitoring (checked October 9, 2026)
• 18 U.S.C. § 220, via Cornell LII: Illegal remunerations for referrals to recovery homes, clinical treatment facilities, and laboratories (checked October 9, 2026)
• Public Health Code, MCL 333.7303: Controlled substance license, separate license for each place of practice (checked October 9, 2026)
• Public Health Code, MCL 333.7303a: MAPS registration and report review (checked October 9, 2026)
• LARA, MAPS: Laws and regulations (checked October 9, 2026)
• 2016 PA 499, MCL 333.17211a: APRN prescribing, schedule 2 to 5 as a delegated act (checked October 9, 2026)
• Michigan Attorney General, OAG No. 5676 (April 8, 1980): Corporations providing osteopathic services (checked October 9, 2026)
• LARA, declaratory ruling on learned professions and MCL 450.1281 to 450.1289: Learned profession order (PDF) (checked October 9, 2026)