Behavioral Health Consulting in Southern California and Across the State.
Saint Health Group works with behavioral health and substance use programs across California, including Los Angeles, Orange County, San Diego, the Inland Empire, the Bay Area, Sacramento and the Central Valley. We handle DHCS licensing and certification, county Medi-Cal and DMC-ODS contracting, Joint Commission accreditation, and the billing and operations behind a program that lasts.
Built for the California Regulatory Environment.
What We Have Built.
California Behavioral Health Regulation.
California has one of the most complex behavioral health regulatory frameworks in the country. The Department of Health Care Services (DHCS) licenses residential SUD treatment facilities, certifies SUD programs (mandatory since AB 118 in 2023 for any business entity with a California location providing SUD treatment, recovery, detoxification or medication for addiction treatment, unless exempt), and licenses mental health rehabilitation centers and psychiatric health facilities. Every licensed residential facility must also hold at least one DHCS level of care designation or a residential ASAM level of care certification. The Department of Social Services licenses social rehabilitation facilities and adolescent residential programs. Navigating which agency governs which program type is often the first significant challenge for new programs.
Medi-Cal SUD reimbursement in California runs through counties. Counties that have opted in to the Drug Medi-Cal Organized Delivery System (DMC-ODS) offer a full ASAM continuum; the rest offer the narrower State Plan Drug Medi-Cal benefit. Either way, provider participation requires DHCS Drug Medi-Cal certification and a contract with the applicable county. This means Medi-Cal SUD contracting in California is inherently local, each county has its own DMC-ODS structure, contracted services, and administrative requirements. Since July 1, 2023, DHCS has paid counties for specialty mental health and Drug Medi-Cal services on a fee schedule with CPT coding under CalAIM behavioral health payment reform, which is what county contracts and claims now follow.
California programs also operate within the largest commercial payer market in the country. Since SB 855 took effect for plan contracts issued, amended or renewed on or after January 1, 2021, health plans and insurers must cover medically necessary treatment of mental health and substance use disorders under the same terms as other medical conditions and base medical necessity on generally accepted standards of care. That rule is the lever in commercial authorizations and appeals, and programs that build both Medi-Cal and commercial payer infrastructure from the start are positioned for broader market access than those that prioritize one at the expense of the other.
Sober living is where new operators most often get the line wrong. DHCS does not license, certify or investigate sober living or transitional housing, but a home that provides 24-hour nonmedical recovery or treatment services, meaning detoxification, individual, group or educational sessions, treatment planning or incidental medical services, is a residential treatment facility and needs a DHCS license. Cities and counties can add their own permits, clearances and fees on top.
Where We Work in California.
California licenses at the state level and pays at the county level, so the practical difference between regions is which county agency holds the Medi-Cal contract and which managed care plans cover members. Kaiser Permanente is also a plan choice for some members in most of these counties.
Southern California
Los Angeles, Orange, San Diego, Riverside, San Bernardino, Ventura, Santa Barbara and Imperial counties
All eight counties run the Drug Medi-Cal Organized Delivery System, so a Medi-Cal substance use contract is a county contract with county-specific provider requirements. In Los Angeles County, Substance Abuse Prevention and Control runs the Drug Medi-Cal provider network and publishes its own contracting roadmap for new providers, while the Department of Mental Health is the county mental health plan. Orange County’s Health Care Agency, San Diego County Behavioral Health Services, Riverside University Health System and San Bernardino County’s Department of Behavioral Health hold both roles in their counties.
Medi-Cal managed care plans
L.A. Care and Health Net in Los Angeles; CalOptima Health in Orange County; Blue Shield Promise, Community Health Group and Molina in San Diego; Inland Empire Health Plan and Molina in Riverside and San Bernardino; Gold Coast Health Plan in Ventura; CenCal Health in Santa Barbara; Community Health Plan of Imperial Valley in Imperial County.
County agencies
LA County SAPC provider roadmap · LA County Department of Mental Health · Orange County Health Care Agency · San Diego County Behavioral Health Services · Riverside University Health System · San Bernardino County DBH · Ventura County Behavioral Health · Santa Barbara County Behavioral Wellness · Imperial County Behavioral Health Services
Bay Area
San Francisco, Alameda, Santa Clara, Contra Costa, San Mateo, Marin, Solano and Napa counties
All eight counties run the Drug Medi-Cal Organized Delivery System. Most have a locally organized Medi-Cal plan rather than a national carrier, and the commercial payer market is the densest in the state, so programs that build Medi-Cal and commercial contracting together from the start reach the widest market.
Medi-Cal managed care plans
San Francisco Health Plan and Anthem Blue Cross in San Francisco; Alameda Alliance for Health in Alameda; Santa Clara Family Health Plan and Anthem Blue Cross in Santa Clara; Partnership HealthPlan of California in Solano and Napa.
County agencies
San Francisco Department of Public Health · Alameda County Behavioral Health
Sacramento and the Central Valley
Sacramento, San Joaquin, Stanislaus, Merced, Fresno, Tulare and Kern counties
All seven counties run the Drug Medi-Cal Organized Delivery System. Medi-Cal managed care is a mix of national carriers and local plans, which means a program serving more than one valley county usually holds contracts with several plans for the same service.
Medi-Cal managed care plans
Anthem Blue Cross, Health Net and Molina in Sacramento; Health Plan of San Joaquin and Health Net in San Joaquin and Stanislaus; Central California Alliance for Health in Merced; CalViva Health and Anthem Blue Cross in Fresno; Anthem Blue Cross and Health Net in Tulare; Kern Family Health Care and Anthem Blue Cross in Kern.
County agencies
Central Coast
Monterey, Santa Cruz, San Benito, San Luis Obispo and Santa Barbara counties
All five counties run the Drug Medi-Cal Organized Delivery System, and each has a single local Medi-Cal plan, which keeps managed care contracting simple and makes the county agency the main relationship.
Medi-Cal managed care plans
Central California Alliance for Health in Monterey and Santa Cruz; CenCal Health in San Luis Obispo and Santa Barbara.
County agencies
San Luis Obispo County Behavioral Health · Santa Barbara County Behavioral Wellness
Recent rule changes in California
- DHCS seeks feedback by November 3 on ending the PSC-35 requirement for county plansCalifornia Department of Health Care Services · Week of October 22, 2026
- BHIN 26-032 moves county plans to the IP-CANS for all youth from January 1, 2027California Department of Health Care Services and California Department of Social Services · Week of October 22, 2026
- Medi-Cal members with unsatisfactory immigration status move to fee for service in 2027California Department of Health Care Services · Week of October 22, 2026
Frequently Asked Questions.
What licenses are required to operate a behavioral health program in California?
The licensing requirements in California depend on the program type. Substance use disorder residential programs require licensing from the Department of Health Care Services (DHCS). Outpatient SUD programs require DHCS certification: since AB 118 took effect on July 10, 2023, any business entity with a physical location in California that provides SUD treatment, recovery, detoxification or medication for addiction treatment services must hold DHCS alcohol and other drug certification under Health and Safety Code 11832.2, unless it falls under an exemption. DHCS also licenses mental health rehabilitation centers and psychiatric health facilities. Social rehabilitation facilities, which provide nonmedical residential care for adults recovering from mental illness, are licensed by the Department of Social Services, and adolescent residential SUD programs are licensed by that department as residential facilities for children.
Do you work with programs in Southern California?
Yes. Saint Health Group takes on programs anywhere in California, including Los Angeles, Orange County, San Diego, the Inland Empire and Ventura County. The work is the same as elsewhere: DHCS licensing and certification, county Drug Medi-Cal contracting, accreditation, credentialing and billing. The county pieces are built around the agency that holds the contract where you are: Substance Abuse Prevention and Control and the Department of Mental Health in Los Angeles County, the Health Care Agency in Orange County, Behavioral Health Services in San Diego County, and Riverside University Health System and the Department of Behavioral Health in the Inland Empire.
How does Medi-Cal reimbursement work for behavioral health in California?
Medi-Cal behavioral health is split three ways. Specialty mental health services for people with more serious conditions run through the county mental health plan. Other mental health care runs through the Medi-Cal managed care plans, which differ by county: L.A. Care and Health Net in Los Angeles, CalOptima Health in Orange County, and Inland Empire Health Plan in Riverside and San Bernardino, for example. Substance use treatment runs through the county under the Drug Medi-Cal Organized Delivery System, which every Southern California county and most Bay Area and Central Valley counties have adopted; a provider needs DHCS Drug Medi-Cal certification and a contract with each county it serves. Since July 1, 2023, DHCS has paid counties for specialty mental health and Drug Medi-Cal services on a fee schedule with CPT coding under CalAIM behavioral health payment reform.
Is Joint Commission accreditation required to contract with Medi-Cal or commercial payers in California?
Accreditation requirements vary by payer and county. Some commercial payers require Joint Commission or CARF accreditation as a condition of network participation. DMC-ODS county contracts may or may not require accreditation depending on the county and the service type. Programs planning to contract with multiple payers should check accreditation requirements against their target network early in the planning process.
Do sober living homes in California need a license?
Not as such. DHCS does not license, certify or investigate complaints about sober living or transitional housing, and a home that is only an alcohol and drug free living arrangement needs no DHCS license, though cities and counties may require their own permits, clearances, business taxes or fees. The line is services: a home that provides 24-hour nonmedical residential recovery or treatment services, meaning detoxification, individual or group sessions, educational sessions, treatment planning or incidental medical services, is a residential treatment facility and must hold a DHCS license.
Can you help a California program if your core experience is in Oregon?
Yes. The core consulting work, operational infrastructure, revenue cycle, accreditation preparation, payer contracting strategy, translates across states. For state-specific licensing and regulatory navigation, we identify where California's framework differs from Oregon and build the engagement accordingly. For complex California-specific regulatory questions, we also engage with California-licensed advisors where appropriate.
Ready to Build in California?
Schedule a consultation with Saint Health. We assess your program across licensing, compliance, payer contracting, and revenue, and identify where to build first.
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