North Carolina is experiencing some of the worst effects of the opioid epidemic, with 8 residents dying from opioid overdoses every day in 2020. Between 2000 and 2020, the state lost over 28,000 residents to opioid overdose. More people die in North Carolina from opioid overdoses than they do in car crashes. Highlighting the state’s issue with poly drug use, three quarters of overdose deaths in North Carolina involve multiple drugs. 

While North Carolina has some drawbacks as a home for your addiction treatment center, including CON laws that limit the number of providers allowed to open in the state, it also has a real need for providers, especially in more rural areas. 

Read on for more information about what it takes to open an addiction treatment center in North Carolina. 

Does My Addiction Treatment Center Need to be Licensed in North Carolina? 

Probably. 

The North Carolina Division of Health Service Regulation (NCDHHS) oversees the Mental Health Licensure and Certification Section (MHLCS). The MHLCS administers the state’s licensing program. 

According to North Carolina General Statute 122C-3(14)b.:

b. A "licensable facility", which is a facility that provides services to individuals who are mentally ill, developmentally disabled, or substance abusers for one or more minors or for two or more adults. These services shall be day services offered to the same individual for a period of three hours or more during a 24‑hour period, or residential services provided for 24 consecutive hours or more. Facilities for individuals who are substance abusers include chemical dependency facilities.

According to the same set of state statutes, there are some exceptions to the rule. You may not need to get a license if your facility: 

• Is just a private office practice composed of physicians and psychologists 

• Only provides care to fewer than three people at a time 

• Is a nonprofit organization based in 12-step, self-help, peer role modeling and self-governing approach

• Only provides services to inmates 

• Receives no federal or State funding and is an exempt religious organization 

• Is a permanent group home 

North Carolina Offers a New Provider Orientation for People Looking to Open Addiction Treatment Centers in the State

New Provider Orientation reviews the requirements for licensure in a three hour session. Reservations are required. Orientations take place in Raleigh, Gastonia or Asheville. You can register by completing this form and returning to the training organization via email. 

If You Want to Take Medicaid, State or County Addiction Treatment Payments in North Carolina, You’ll Need to Contact Your LME/MCO

You’ll want to touch base with your Local Management Entity/Managed Care Organization (LME/MCO) if you are interested in participating in any Medicaid or state/county funded addiction treatment programs. Do this before you begin the process of applying for certification to verify with the LME/MCO that there is a need for services in your target area and that they will allow your application to be considered. 

After you’ve obtained your certification with the state, you may apply for a license for your program with your LME/MCO. The LME/MCO you’ll want to contact depends on your location in North Carolina. You can find your appropriate LME/MCO on this handy map-based directory. 

Be Aware That North Carolina is a CON State

If you’re opening a residential treatment facility in North Carolina, you’ll need to obtain a Certificate of Need (CON) before you apply for your DHSR mental health license. North Carolina is one of 35 states in the country that administers a CON program. The state government passed the “CON law” in order to reduce the number of superfluous - and potentially fraudulent - providers in the state. 

You can obtain your CON from the “CON Section,” a division of Health Service Regulation with the state. You can find their contact information here. In states that have CON laws, we generally see over 40% fewer substance abuse treatment centers in that state. Be aware that CON programs can be a stumbling block for new providers. 

The Addiction Treatment Licensure Application in North Carolina is Pretty Standard, As Are the Fees

The actual application packet for addiction treatment center licensure in North Carolina is 16 pages long. It includes typical attachments and requirements like zoning compliance documentation, floor plans, organization information and information on the level of care you expect to provide at your facility. North Carolina’s application is slightly unusual in that it requires photos of the interior and exterior of all buildings and written driving directions from Raleigh, specifically. 

For residential facilities with fewer than 6 beds, the base fee is $350. For residential facilities with 7 beds or more, the base fee is $525 plus a “per bed fee” of $19. Non-residential facilities have a base fee of $265.  

If You’re Opening an Addiction Treatment Center in North Carolina, We Can Help 

Behave Health is committed to making it easier - and more profitable - to operate evidence-based, results-focused addiction treatment centers. 

Our all-in-one app puts clinical, administration, staff, admissions, alumni, residents, treatment plans, billing, insurance authorizations and more - all at your fingertips. 

Get your organization off to a strong start from the beginning. Don’t let disorganization and chaos stifle your business’ potential.

Get your free trial started today and see why more addiction treatment centers prefer Behave Health.

Need help with certification? Behave Health can also help direct you to the right resources for help with Licensing or Accreditation by either The Joint Commission or CARF.  Make sure you mention this to your product specialist after you start your free trial!