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Addiction Treatment Center Resources - Texas

Frequently Asked Questions


1. Which addiction treatment facilities are required to be licensed and what kind of services can they provide?

Any substance abuse facility which offers treatment services for chemical dependency requires a license, unless an exception applies. View More

2. Which facilities are exempt from licensure requirements?


Type of Provider


Faith-Based Chemical Dependency Programs.

These programs offer only nonmedical treatment and recovery methods such as prayer, moral guidance, spiritual counseling, and scriptural study.  View More



3. What does it mean to be ‘licensed’, ‘certified’, ‘registered’ or ‘accredited’ in this industry?

Licensing means that a particular type of facility or professional may only operate, or may only deliver services with the advance and continuous authorization (“license”) of a designated government agency to ensure protection of public health, safety, and welfare.  View More


4. Which body licenses drug rehabilitation facilities in the State of Texas?

The Texas Department of State Health Services Substance Abuse Facility Licensing Group licenses facilities in addition to providing registration procedures for faith-based programs. View More

5. What information must be provided in my initial application for licensure?

A written application must be submitted to the Department of State Health Services on the following form: View More

6.  How long does a licensing application usually take?

The Department will notify the applicant that the application is materially complete or specify the additional information required within 45 days of receipt of the application. View More

7. Does a license have to be renewed?

The license must be renewed using forms provided by the Department of State Health Services every two years from the date it was issued. View More

8.  What kinds of on-site audits or inspections will there be for licensure determination and how can I prepare?

The Department of State Health Services (DSHS) is entitled to enter and inspect a treatment facility or request materials without notice and at any reasonable time. View More

9.  What kinds of things could affect a license once granted?

Licenses may be denied, revoked, suspended or not renewed if the license-holder has a documented history of client abuse or neglect, or violates any Department of State Health Services (DSHS) rule. View More


10.  Does our facility have to be certified?

Certification for residential and outpatient programs is voluntary, but demonstrates that a higher level of quality has been attained than might be illustrated by licensing alone. View More

11. What are the practical benefits of certifying my facility?

Certification is a signal to potential clients, insurance companies, regulators and the public that a program aims to offer a responsible, safe, ... View More

12.  How do I apply for certification?

An online application is made to the Texas Recovery Oriented Housing Network (TROHN). The cost of certification is $200 + $10 per bed capacity, plus $50 for an onsite inspection. View More

13.  What should I do in preparation for the on-site compliance review?

Prior to the on-site visit, the Texas Recovery Oriented Housing Network (TROHN) will supply an inspection packet, this should be reviewed along with the certification standards, which are available here:  View More

14.   How often must I renew certification?

Certification is for one year, at which point it terminates automatically if it has not been renewed. View More

Zoning and Land Use

15.  What are the protections afforded to small group homes used for the purpose of residential drug rehabilitation? 

Any facility with six or fewer residents is exempt from local zoning and land use regulations (based on federal and state law) and is therefore not required to seek municipal approval to operate. View More

16.   Are there any proximity restrictions regulating how close treatment centers may be to each other? Can I open a residential treatment center right next to one that is already there?

There is no regulation preventing multiple facilities from operating in close proximity. However, many residential treatment facilities have faced objections and difficulties in various different locations across the state. View More

17. What kind of spaces can be used as treatment facilities?

In the case of residential programs, the provider must provide an appropriate, safe, clean, and well-maintained environment.  View More

Care, Treatment and Services

18.   How does a program decide if a client is suitable for the services they can provide?

Facilities have an obligation to provide adequate and appropriate services to their clients which must be delivered with objectivity, respect and integrity.  View More 

19.   What kind of health examinations are needed prior to admitting a client?

For detoxification programs, a physician must determine the appropriateness of the admission and authorize the admission.  View More 

20.  What client information should be collected during intake and what should we put in our admissions agreement?

Information to be included in the admissions agreement

The specific condition to be treated  View More 


21.  What should go in a treatment plan?

In collaboration with the client, and the client’s family where appropriate, a treatment plan should be developed which proposes services and support which meet the client’s needs identified at the admission assessment stage. View More 

22.  What are the Required Services That a Facility Must Provide to a Client?

Therapeutic Communities (Intensive Residential)

A minimum of 20 hours of services per week, which must include:  View More 


23.  Are facilities permitted to physically restrain an aggressive client?

Facilities have a responsibility not to admit a client who is beyond their ability to help, or whose behavior or symptoms exceed their ability to manage. View More

24. How should staff manage client medication?

The facility must develop written procedures for managing clients’ medication, which must include storage, administration, documentation, inventory, and disposal. View More

25. What rights are guaranteed to clients?

Clients rights must be respected and protected. Clients must be made aware of their rights upon admission, and sign to confirm they have received a copy of the Client Bill of Rights as follows: View More

26. What grounds are needed in order to dismiss a client from a program?

There are four types of discharge. Successful completion of program means that the client has met the goals of their recovery plan. View More

27. I need to discharge a client that relapsed, but am I at risk if he or she overdoses tonight and how can I protect myself?

The discharge of a client must be handled carefully given the risks if a client suffers negative health consequences following discharge. View More

28. How can a facility prepare clients for discharge?

In order to ensure a safe discharge and continuity of services, the client, or the person responsible for the client, and the counselor should develop an individualized written discharge plan, which must be updated as the client makes progress through treatment. View More


29. How must clients’ privacy be protected?

Client confidentiality is an important issue covered by both federal and state laws. These laws set forth specific requirements regarding how and when patient information may be shared and the protections that must be in place ... View More

Governance and Staffing

30. What kind of governance structure should a substance abuse facility have?

If the facility is incorporated then it needs a governing body with legal authority to operate in the State of Texas. View More

31. What are the staffing requirements for different types of services?


All Types of Treatment Services

Direct care staff must be awake and on site during all hours of program operation. View More


32.  Can a program employ its own clients?

Clients may not be hired or utilized to fill staff positions until at least two years after they have been discharged from the facility. View More


33. How should I respond to clients who are unable to pay the required deductibles? Can I waive a program participant’s financial responsibility?

Clients seeking drug and alcohol rehabilitative services often face financial difficulties, whether as a result of the consequences of their addiction or as a result of the expense of multiple, prior failed treatment programs.  View More

34. What are the key issues insurers raise to demand recoupment of fees from substance abuse treatment programs?

Insurers may demand recoupment of fees based on any defect in the billing claim or supporting documentation and/or based on any noncompliance with federal or state laws.  View More


35. What marketing practices are prohibited?

The most widespread prohibited marketing practices in addiction treatment appear to revolve around inappropriate inducements and inaccurate marketing claims. View More

36. What are the limits of gift giving to potential referral sources?

State and federal regulators prohibit the exchange of items of value to induce referrals so the exchange of any item of value, whether it is cash or in kind, must be carefully monitored. View More

37.  What kind of benefits can I offer existing or new clients?

Facilities should avoid giving gifts to clients or referral sources based on anti-kickback statutes which prohibit patient brokering. View More

Sober Living Environments


38.  What is a sober home?

A recovery residence is an alcohol and drug-free environment inhabited by individuals who are attempting to maintain their recovery from substance abuse disorders. View More

39. Do we need a license to open a sober home?

Licenses are not required to operate sober-living homes, so long as they provide... View More

40.  Are there any consequences to being ‘unlicensed’?

Because there is no regulatory oversight, some have complained that many sober living homes are maintained in poor,... View More

41. What kinds of services can a sober home offer?

Alcohol and drug-free houses (sober-living environments) typically provide a living environment to enable residents to organize activities... View More


42. How can we demonstrate to our clients that we are offering a high quality living environment?

A Sober home can elect to demonstrate voluntarily that it meets minimum quality standards. Several states (including Texas) have formally adopted an optional certification process for sober living facilities. View More

43.  Does a sober home have to obtain certification in order to operate?

The law protects small groups of individuals who choose to live together in peer-supportive environments... View More

44.  How do I apply for certification and what is the process?

An online application is made to the Texas Recovery Oriented Housing Network. The cost of certification is $200 + $10 per bed capacity, plus $50 for an onsite inspection. View More

45.  What should I do in preparation for the on-site compliance review?

Prior to the on-site visit, Texas Recovery Oriented Housing Network will supply an inspection packet, this should be reviewed along with the certification standards. View More

46.   How often must I renew certification?

Certification is for one year, at which point it terminates automatically if it has not been renewed. View More

Zoning and Land Use

47. What are the protections afforded by federal law to small group homes used for the purpose of residential drug rehabilitation?

A facility with six or fewer people is exempt from zoning and land use regulations based on federal and state law, ... View More

48.  Can local governments put special restrictions on sober living residences?

Sober homes in some communities have found growing efforts to regulate them by local ordinance, including registration requirements, concentration (spacing) limits, and other requirements.  View More

49.  What other aspects should I consider before choosing a location for our sober home?

In siting a sober home, attention should be paid to potential hostility from neighbors.  View More

Resident’s Rights and Responsibilities

50.   What would our obligations to residents be?

The sober living home operation must ensure that the premises remain safe...  View More

51.   What kind of agreement should we ask our residents to sign?

The agreement should include a pledge from the tenant to live by the house rules... View More

52.   Can we insist on drug tests and searches?

No, sober homes do not have the right to impose testing... View More

53.   Can a sober home bill insurance for required and/or random drug testing?

Sober homes sometimes rely on the drug screening which takes place... View More

54.  Can we make residents’ obligations contractually enforceable?

If the rules are contained in the tenancy agreement as conditions of residence, and the resident agrees to them upon accepting the tenancy, then they are enforceable. View More

Governance and Staffing

55.  What kind of ownership and staffing structures are common with these types of residential arrangements?

A sober housing facility may be structured as a nonprofit corporation, a for-profit corporation, limited liability company, partnership, or a sole owner arrangement. View More

56.  Are there any other organizations which could help us?

Substance Abuse and Mental Health Services Administration (SAMHSA)

http://www.samhsa.gov/  View More

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