How to start an IOP or PHP in Wichita Falls

Wichita Falls at a glance

Question	Wichita Falls's answer
State license	HHSC chemical dependency treatment facility license, per site (26 TAC 564)
Medicaid service area	MRSA West, including Wichita, Archer, Clay, Wilbarger, Young, Jack and Baylor counties
STAR plans	Superior HealthPlan, Wellpoint (FirstCare left Medicaid on August 31, 2026)
STAR+PLUS plans	Superior HealthPlan, Wellpoint
Local mental health authority	Helen Farabee Centers, for 19 counties from Wichita to Wise and Childress
OSAR	Abilene Recovery Council (HHSC Region 2), satellite office in Wichita Falls
Permits and certificate of occupancy	City of Wichita Falls Building Inspections Division, 1300 7th Street; the county outside city limits
Local watch-outs	Oklahoma residents' coverage, Wise County clients on Tarrant-area plans, Sheppard families on TRICARE, tornadoes and ice

Counties from HHSC's STAR+PLUS region-by-service-area appendix (revision 25-2); STAR plans from HHSC's MRSA West STAR comparison chart (October 1, 2026); STAR+PLUS from the managed care service areas map (revised August 2026). Check them before you apply.

The license is statewide

HHSC licenses Texas substance use programs as chemical dependency treatment facilities under Health and Safety Code chapter 464 and 26 TAC 564; Wichita Falls adds no treatment license. As of October 2026 the fee under 26 TAC 564.408 is $1,200 plus $125 for each additional site at a separate address. If services at a site stop for more than 60 days, HHSC retires that site's license unless you've asked for inactive status (26 TAC 564.406), which matters if a storm or a staffing gap closes you for weeks. The packet is in our CDTF license guide, the proof list in 26 TAC 564 in plain English, and the whole path in how to start an IOP or PHP in Texas.

Re-occupancy, permits and the certificate of occupancy

Most new programs lease an existing office or retail space. In Wichita Falls that starts with the Building Inspections Division's application for re-occupancy. What it asks for, and what it warns about:

• Former and proposed use. Say plainly what the space was and what it will be: "outpatient substance use disorder treatment, group and individual counseling, no overnight stay".
• A floor plan with room dimensions and a site plan showing parking and cross streets. Draw group rooms, offices, restrooms and any drug-testing room as they'll actually be used.
• An asbestos survey before any existing building material is disturbed. In an older building, budget for it before you plan to move a wall.
• Water connected before the inspection. The Building Department won't inspect without water service.
• No guarantees. The form says paying the fee doesn't guarantee the electricity will be reconnected or a certificate of occupancy issued. A changed use may trigger ADA compliance, and any remodeling may need a building permit.

If you're remodeling, the city's renovation checklist adds two points worth knowing: fire protection upgrades such as sprinklers or alarms may be required when a project changes the use or increases occupancy, and assembly, educational or institutional occupancies over 2,500 square feet need an engineer's or architect's seal. Wichita Falls's zoning is in its Zoning Ordinance (sections 1000 to 9999), including site plan review in section 7100. A build-out estimated at $50,000 or more must also be registered with TDLR for accessibility review and inspection (TDLR). Ask the city in writing before you sign:

1. Is an outpatient substance use treatment program allowed in this zoning district, and does it need a conditional use permit?
2. Can we use the re-occupancy application, or does our layout need a building permit?
3. What occupancy classification will you assign, and will our group-room headcount trigger sprinklers or alarms?
4. Do we need a sealed design for our square footage?

Burkburnett, Iowa Park and unincorporated Wichita County have their own rules. Lease with a contingency for the certificate of occupancy and the HHSC license; every site step is on our Texas IOP opening checklist.

Medicaid plans in MRSA West

After the HHSC license, enroll with TMHP, then credential with each plan. TMHP has said Medicaid SUD treatment may only be delivered in a licensed chemical dependency treatment facility (TMHP notice).

Program	Who it covers	Plans in MRSA West
STAR	Most children, pregnant women and some families	Superior, Wellpoint
STAR+PLUS	Adults with disabilities and adults 65 and older	Superior, Wellpoint
CHIP	Children in families above Medicaid income	Molina, Superior

• Two applications cover most adults. Superior and Wellpoint are in both STAR and STAR+PLUS. See our Superior HealthPlan and Wellpoint Texas guides; in the rural areas Wellpoint uses MultiPlan's Texas True Choice network.
• FirstCare is out. Baylor Scott & White and FirstCare ended Medicaid managed care on August 31, 2026, and FirstCare's MRSA West STAR plan code was end-dated (TMHP, July 17, 2026). Check every Medicaid card at intake.
• Helen Farabee's region spans two service areas. Wise County (Decatur, Bridgeport) is in Helen Farabee's 19 counties but in Medicaid's Tarrant service area, where the plans are different. A client from Decatur carries Fort Worth's plans; see our Fort Worth guide for that line-up. Check each member's county at intake.

The process is in our Texas Medicaid credentialing guide, and every area is in Texas Medicaid health plans by service area. For commercial plans, start with insurance contracts for treatment centers; our credentialing service files and follows each application.

Clients from Oklahoma and the region

• Oklahoma coverage is its own question. Lawton and southern Oklahoma are close enough that some clients will cross the Red River for care. A Texas Medicaid contract doesn't cover Oklahoma Medicaid members, and an Oklahoma resident's employer plan may route behavioral health through a network you aren't in. Verify benefits before admission; our sister site's VOB checklist lists what to ask, and behavioral health carve-outs explains the hidden-network problem.
• Telehealth follows the client's location. 26 TAC 564.911 sets Texas's rules for counseling by electronic means, with identity checks and consent. It doesn't license your Texas staff to treat a client sitting in Oklahoma; check Oklahoma's rules before any remote session with a client there. Our virtual IOP guide covers the payer side.
• Schedule for the drive. Helen Farabee's region reaches west to Childress and Dickens counties. Evening tracks and a transportation question at intake keep attendance up; see our IOP schedule templates.
• Plan for severe weather. Tornadoes and ice storms close roads. Write who decides to close and how clients hear about it into your emergency plan; Comply's hazard vulnerability analysis guide walks through it.

Sheppard, TRICARE and veterans

• Sheppard Air Force Base's mental health clinic takes walk-ins and self-referrals as well as medical and command referrals, and prioritizes appointments: active-duty members first, then active-duty family members in TRICARE Prime, then others as space allows (Sheppard TRICARE). Retirees and many family members are therefore likely to need civilian care.
• TRICARE needs accreditation. Texas has been in TRICARE's West region, run by TriWest, since January 1, 2025, and TRICARE pays an IOP or PHP only under a participation agreement that requires accreditation (TRICARE Policy Manual). See TRICARE IOP and PHP certification and accreditation for new programs.
• The VA clinic is run from Oklahoma City. The Wichita Falls VA Clinic on Central Freeway belongs to the VA Oklahoma City Health Care System and offers mental health care, including addiction treatment (VA). Community care referrals come through the VA's Community Care Network, separate from TRICARE; see our VA Community Care guide.

Hiring in Wichita Falls

HHSC checks hiring practices under 26 TAC 564.601; the roles it expects are in IOP staffing requirements in Texas.

• Verify licenses at the source. LCDCs and counselor interns through HHSC's LCDC program; LPCs, LMFTs, LCSWs and psychologists through the Behavioral Health Executive Council. Clinicians who also hold an Oklahoma license still need a Texas one to practice here. Check the OIG exclusion list for every hire.
• Midwestern State University in Wichita Falls offers a Clinical Mental Health Counseling M.A. that earned CACREP accreditation in 2020, in hybrid and online formats (MSU Texas). Its students need practicum sites, and its graduates need supervised hours toward the LPC; see hiring and supervising associates.

The local landscape

Earn referrals with quick assessments and honest updates. Paying or giving anything of value for referrals is illegal under the Texas Patient Solicitation Act and EKRA (patient brokering laws, explained). We never arrange referrals.

• Helen Farabee Centers, headquartered in Wichita Falls, is the local mental health authority for Archer, Baylor, Childress, Clay, Cottle, Dickens, Foard, Hardeman, Haskell, Jack, King, Knox, Montague, Stonewall, Throckmorton, Wichita, Wilbarger, Wise and Young counties (HHSC LMHA directory). Agree on crisis hand-offs and where you'll send people you can't serve.
• OSAR. Abilene Recovery Council provides Region 2's Outreach, Screening, Assessment and Referral from Abilene, with a satellite office in Wichita Falls (HHSC OSAR page). Decide whether you'll take state-funded clients.
• North Texas State Hospital has campuses in Wichita Falls and Vernon, serving adults, children and adolescents, including forensic patients, and the state is building a 200-bed replacement for the Wichita Falls campus (Office of the Governor). Patients leaving a state hospital usually return through their local authority, so a program that wants to serve that step down works with Helen Farabee on the hand-off.
• Hospitals and courts. The city's general and psychiatric hospitals discharge patients who need a step down; case managers want your levels of care, accepted plans and assessment times. Specialty courts operate under Government Code chapter 123, and reports go only with written consent under 42 CFR Part 2. Legal outreach is in how to market a treatment center.

The order of work in Wichita Falls

Step	Wichita Falls detail	Typical time in our roadmap
1. Program model and budget	Levels of care, evening tracks, Oklahoma and TRICARE decisions. Run the break-even calculator.	1–2 months
2. Site search	Zoning and conditional use; asbestos survey for older buildings	about 30 days
3. Lease with a contingency	Out if the certificate of occupancy or license fails; free rent for the build-out	about 3 weeks
4. Re-occupancy application or building permit	Floor plan, site plan, water on; sealed design if required; TDLR registration if $50,000 or more	about 6 weeks
5. Inspections and certificate of occupancy	Fire protection sign-off; keep copies for HHSC	about 3 weeks
6. HHSC license and inspection	The statewide process	about 2–3 months
7. Facility contracts	TMHP, then Superior and Wellpoint, plus commercial plans	about 90 days each
8. Accreditation, then TRICARE	Survey once you have clients and charts; then TriWest	after opening

The times are the planning figures in our own launch roadmap, not promises. On that roadmap the first admission comes about 6 months after kickoff. Costs are in how much it costs to start an IOP.

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Questions

Which Medicaid plans serve Wichita Falls?

Wichita County is in MRSA West. Superior and Wellpoint are the STAR and STAR+PLUS plans, and Molina and Superior carry CHIP. FirstCare left Texas Medicaid on August 31, 2026.

Who is the local mental health authority in Wichita Falls?

Helen Farabee Centers, for Wichita and 18 other North Texas counties. Region 2's OSAR is Abilene Recovery Council, which has a satellite office in Wichita Falls.

What does Wichita Falls need before I can open in an existing building?

An application for re-occupancy with the former and proposed use, a dimensioned floor plan and a site plan, an asbestos survey before you disturb building materials, and water service on before the inspection. Remodeling needs a building permit, and a change of use can trigger fire protection and ADA work.

Can a Wichita Falls IOP serve clients from Oklahoma?

In person, yes, if you verify their coverage first: a Texas Medicaid contract doesn't cover Oklahoma Medicaid members. By telehealth, the client's location matters, so check Oklahoma's licensing rules before treating a client who is in Oklahoma.

How long does it take to open an IOP in Wichita Falls?

Plan on nine to twelve months to a full caseload of insured clients. The building, the HHSC license and the facility contracts happen mostly in order; start the plan applications as soon as the license arrives.

Other Texas cities: Abilene (the same OSAR region and Medicaid plans), Amarillo, Fort Worth, Dallas, and every city on opening a program in Texas, by city.

Cima Consulting isn't a law or accounting firm. HHSC, the City of Wichita Falls and each health plan make their own decisions; we don't guarantee approvals, rates or dates. We aren't affiliated with any health plan, hospital or agency named here.

Sources

• HHSC, STAR comparison chart, MRSA West (October 1, 2026): hhs.texas.gov; Managed Care Service Areas map (revised August 2026): hhs.texas.gov; STAR+PLUS appendix XXXVIII, region by service area (revision 25-2): fhb.hhs.texas.gov
• TMHP, Baylor Scott & White and FirstCare health plans will end participation in Texas Medicaid managed care (July 17, 2026): tmhp.com
• City of Wichita Falls, application for re-occupancy: wichitafallstx.gov; renovation checklist (January 2025): wichitafallstx.gov; Zoning Ordinance: ecode360.com; TDLR, Architectural Barriers at a glance: tdlr.texas.gov
• HHSC, local mental health authority directory: resources.hhs.texas.gov; OSAR: hhs.texas.gov; Office of the Governor, new North Texas State Hospital in Wichita Falls: gov.texas.gov
• Sheppard TRICARE, mental health: tricare.mil; TRICARE Policy Manual, IOP participation agreement: manuals.health.mil; VA, Wichita Falls VA Clinic: va.gov
• Midwestern State University, Clinical Mental Health Counseling accreditation (August 2020): msutexas.edu; HHSC LCDC program: hhs.texas.gov; BHEC: bhec.texas.gov; OIG exclusions: oig.hhs.gov
• Texas Health and Safety Code chapter 464: statutes.capitol.texas.gov; 26 TAC 564.406 and 564.408: 564.406, 564.408; TMHP SUD notice: tmhp.com
• Texas Occupations Code chapter 102: statutes.capitol.texas.gov; EKRA: law.cornell.edu; Government Code chapter 123: statutes.capitol.texas.gov; 42 CFR Part 2: ecfr.gov