Quick Setup

Enter your information once - it auto-populates all documents

Essential Information

This information will be used across all generated documents

Facility Location

Primary Contact

Programs to Offer

Mission & Vision

Application Packet Generator

Generate your complete DHCS application packet with one click

○ Setup Complete
○ AI Connected

Generate Complete Application Packet

Creates all required policies, procedures, and documents in one click. Documents are pre-filled with your facility information.

DHCS Forms (External)

These forms must be downloaded from DHCS and filled manually

Policies & Procedures

Auto-generated with your information

Program Documents

Program descriptions and schedules

Administrative Documents

Fee schedules, QA plans, etc.

AI Assistant (Optional)

Not Connected

Connect OpenAI to auto-generate professional content for your documents

Your API key is stored locally and never sent to our servers

Application Dashboard

California DHCS PHP/IOP Substance Abuse Treatment License

How to Use This Application

1

Start with Quick Setup

Enter your facility information in the Quick Setup section. This data automatically populates all documents - you only enter it once.

  • Fill in facility name, address, EIN, contact info
  • Select PHP and/or IOP programs
  • Choose treatment modalities and target populations
2

Generate Documents

Use the Document Generator in Quick Setup to create all required policies and documents with your facility info pre-filled.

  • Click "Generate All Policies" for one-click creation
  • Or generate individual documents as needed
  • All generated docs appear in the preview area
3

Fill Out Forms with the Wizard

Go to Form Wizard to complete DHCS application forms step-by-step with guided assistance.

  • Forms auto-fill with your Quick Setup data
  • Complete each step - validates required fields
  • Completed forms go to the signing queue
4

E-Sign Documents

Use the E-Sign section to electronically sign all completed forms.

  • Set up your signature (draw or type)
  • Click "Sign All Documents" to sign everything at once
  • Download signed packet with audit trail
5

Generate Full Proposal

Go to Proposal section to generate a complete, professional application packet.

  • Preview the full proposal with all sections
  • Download as text or print
  • Use DHCS Forms section for official form data
6

Track & Stay Compliant

Use Reminders to set up compliance deadlines and never miss a renewal.

  • Add standard compliance schedule with one click
  • Track staff credential expirations
  • Site visit preparation checklist included

Quick Actions

Overall Progress

0%
▤
0/15 Documents Ready
◎
0/5 Staff Verified
◇
0/20 Compliance Items
▬
90-120 Est. Days to License

Next Steps

  • Complete Facility Information
  • Define PHP/IOP Programs
  • Add Staff & Credentials
  • Upload Required Documents
  • Review Compliance Checklist

Key Dates

Application Start
Target Submission
Site Visit (Est.) TBD
License (Est.) TBD

DHCS Contact

Licensing & Certification Division

1500 Capitol Avenue, MS 2600
Sacramento, CA 95814

(916) 322-2911

SUD-Licensing@dhcs.ca.gov

DHCS Website →

Resources

DHCS 6002 DHCS 6040 SUD Toolkit Title 9 Regs DHCS Portal ASAM Criteria

Quick Navigation

Facility Information

Complete details about your treatment facility location and business

Business Information

Facility Address

Mailing Address (if different)

Primary Contact

Facility Details

Program Services

Define your PHP and IOP treatment programs aligned with ASAM criteria

Partial Hospitalization Program (PHP)

ASAM Level 2.5

DHCS Requirements for PHP

  • Minimum 20 hours/week of structured programming
  • 4-5 days per week attendance
  • 6+ hours per day of treatment services
  • Direct access to psychiatric, medical, and laboratory services
  • 24-hour crisis services availability

Intensive Outpatient Program (IOP)

ASAM Level 2.1

DHCS Requirements for IOP

  • Minimum 9 hours/week of structured programming
  • 3+ days per week attendance
  • 3+ hours per day of treatment services
  • Step-down from PHP or direct entry based on ASAM assessment
  • Coordination with primary care and other services

Staffing & Credentials

Track staff members and verify required credentials per Title 9 regulations

California Staffing Requirements (Title 9, CCR)

Program Director

Must have LPHA credentials OR CADC II with 3+ years supervisory experience

Clinical Supervisor

Licensed Professional (LCSW, LMFT, LPCC, or Psychologist) with 2+ years SUD experience

Counselors

Registered or Certified AOD counselors (CADC, CATC, RADT) or licensed clinicians

Staff Ratios

Minimum 1 counselor per 10 clients in group; 1:1 for individual sessions

Staff Roster

Name Role License/Cert Expiration Status Actions
No staff members added yet. Click "Add Staff Member" to begin.

Required Documents

Track all documents needed for DHCS certification application

DHCS Application Forms

Facility Documents

Policies & Procedures

Staff Documentation

Additional Requirements

Compliance Checklist

Ensure readiness for DHCS site visit and certification

0% Complete

Application Timeline

Track milestones from application to certification

Proposal Generator

Generate a comprehensive program proposal document

Generate Documents

Create formatted documents from your entered data:

Document Preview

Click a button above to generate a document preview.

DHCS Application Forms

Pre-filled form data ready to transfer to official DHCS forms

How to use: The data below is pre-filled from your Quick Setup. Copy each section to the corresponding field on the official DHCS PDF forms.

DHCS 6002 - Initial Treatment Provider Application

Open PDF ↗

DHCS 6040 - Initial Application for Certification

Open PDF ↗

DHCS 6005 - Disclosure Statement

Open PDF ↗

Client Intake Forms (Generated)

Ready-to-use intake forms pre-filled with your facility information

Client Intake Assessment
Consent for Treatment
Release of Information (42 CFR Part 2)
Financial Agreement
Client Rights Acknowledgment
Emergency Contact Form
Treatment Plan Template
Progress Note Template
Discharge Summary Template

Staff & HR Forms (Generated)

Job Description - Program Director
Job Description - Clinical Supervisor
Job Description - Counselor
Organizational Chart
Staff Training Log
Incident Report Form
Supervision Log

Compliance Reminders

Track deadlines, renewals, and required reviews

0 Urgent (< 30 days)
0 Upcoming (30-90 days)
0 Scheduled (90+ days)

Add Compliance Reminder

California DHCS Compliance Requirements

Auto-populate all compliance deadlines based on California Code of Regulations Title 9, Title 22, and DHCS licensing requirements.

Licensing & Certification
  • License Renewal (2-year cycle) - CCR Title 9 §10505
  • Certification Renewal (Annual)
  • Business License (Annual)
Staff Training (Annual)
  • HIPAA Privacy & Security - 45 CFR 164.530
  • 42 CFR Part 2 Confidentiality
  • Cultural Competency - CCR Title 9 §10125
  • Sexual Harassment Prevention - CA Gov Code §12950.1
  • Mandated Reporter - CA Penal Code §11165.7
  • Bloodborne Pathogens - Cal/OSHA 8 CCR 5193
Quality Assurance - CCR Title 9 §10341
  • Monthly Chart Audits
  • Quarterly QA Committee Meetings
  • Annual Program Evaluation
  • 90-Day Treatment Plan Reviews
Fire & Safety
  • Quarterly Fire Drills - CCR Title 22
  • Annual Fire Extinguisher Inspection
  • Monthly Safety Walk-Throughs
  • Monthly AED Inspection
Policy Reviews (Annual)
  • 14 Required Policies per CCR Title 9
  • Staggered throughout year

Quick Add: Custom Schedule

Or manually select which reminders to add:

All Reminders

Type Description Due Date Status Actions
No reminders set. Add reminders above to track compliance deadlines.

Staff Credentials Tracker

Auto-populated from your staffing data. Expiring credentials will trigger reminders.

Add staff members in the Staffing section to track credentials here.

Site Visit Preparation Checklist

Use this checklist before your DHCS site visit

Interactive Form Wizard

Fill out forms step-by-step with guided assistance

Select a Form to Complete

Completed Forms

Forms you've filled out are ready for e-signature

No forms completed yet. Select a form above to get started.

Electronic Signatures

Sign all documents with legally-binding electronic signatures

Signature Setup

Create your signature profiles for signing documents

Primary Signer (Owner/Director)

Not Set

Clinical Supervisor

Not Set

Documents Ready for Signature

Complete forms in the Form Wizard to add them to the signing queue.

Signed Documents

No documents signed yet.

Signature Audit Trail

Complete record of all electronic signatures for legal compliance

Document Signer Date/Time IP Address Status
No signatures recorded yet.