DCBHA Membership 2026
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This form is for organizations applying for new or renewal membership as DCBHA member agency full voting members.

According to the District of Columbia Behavioral Health Association Bylaws, "A “member agency” is a provider of behavioral health services and which:

1.  Focuses on serving under-served residents of the District of Columbia;

2.  Is a privately operated entity not owned by the D.C. government;

3. Pledges, by its membership, its acceptance of the mission, purposes and goals of the D.C. Behavioral Health Association; and

4.  Pays annual dues according to a formula established by the Board of Directors, in a timely manner."

This form is not for hospital affiliate membership, insurance affiliate membership, or corporate partners. Other forms are available for hospital affiliate and insurance affiliate members. Please email Mark.LeVota@DCBehavioralHealth.org for information about corporate partnership opportunities.

Please provide your organization's name *
Please provide the first and last name of your organization's primary contact. This individual is authorized to vote or otherwise take official action for your organization in DCBHA membership official business matters.
Primary Contact First Name *
Primary Contact Last Name *
Primary Contact Email *
This must be an email address assigned to a specific individual and not a generic email address like business@abc.com or admin@xyz.org.
Primary Contact Title *
For example, Chief Executive Officer, Vice President, Director of Behavioral Health, etc.
Primary Contact Business Phone Number *
Please provide the name of your organization's secondary contact. This individual is authorized to vote or otherwise take official action for your organization in DCBHA membership official business matters.
Secondary Contact First Name *
Secondary Contact Last Name *
Secondary Contact Email
 *
This must be an email address assigned to a specific individual and not a generic email address like business@abc.com or admin@xyz.org.
Secondary Contact Title *
For example, Chief Executive Officer, Vice President, Director of Behavioral Health, etc.
Secondary Contact Business Phone Number *
Please provide the current physical street address of your organization's principal place of business in the District.
Street Address - Line 1 *
Street Address - Line 2 *
City
Should be Washington
State
Postal Abbreviation - Should be DC
Zip Code *
Ward
Please provide your organization's federal tax identification EIN number. *
Please provide first and last names and unique email addresses for anyone else your organization wants to add to DCBHA's calendar invitations and email distribution lists by emailing Mark.LeVota@DCBehavioralHealth.org.
New members or members that need to make updates, please provide your organization's full legal name or DC-registered D/B/A (if different from above), mailing address (if different from street address), year of incorporation, for-profit or non-profit status, and DC CBE status. Again, renewing members only need to provide any updates. New or renewing members can also send this information directly to Mark.LeVota@DCBehavioralHealth.org.
How many people did your organization provide DC behavioral health services in the past year (January 2025 - December 2025, or most recent 12 month data available)? *
DCBHA dues are based on an organization's DC behavioral health direct service budget. DC direct behavioral health services include, but are not limited to: DBH-Certified MHRS, ASARS (including MAT), or ASTEP services, DBH CRF (Residential) services, DBH direct service contracts, Free Standing Mental Health Clinics, Professional Mental Health or Addiction Treatment Services (including those provided in physician practice groups or FQHCs) , including services reimbursed through Commercial Insurance / Private Pay, Medicaid / MCO, and DC Healthcare Alliance. All hospital services are included in hospital affiliate membership.
What is your organization's DC behavioral health budget for 2026, to the nearest $500,000? Under $500,000, round to the nearest $100,000. Do not include a dollar sign. *
Please select the dues range for your organization's DC behavioral health budget for 2026. *
Middle Management Academy
For 2026, the District of Columbia Behavioral Health Association in May is hosting a session of the National Council for Mental Wellbeing's Middle Management Academy. Each DCBHA member organization that has paid its dues by March 31, 2026 will also have one space reserved, for an additional $900, for an individual from the member organization to participate in Middle Management Academy. Please feel free to browse a sample agenda from 2025 to gain a sense of what topics are covered, though DCBHA has requested a few customizations in addition to the National Council's routine 2026 course updates. Sessions will be conducted virtually on Tuesdays in May, generally as a four hour block; specific schedule details forthcoming. Neither DCBHA nor the National Council will offer Continuing Education credits for this session of Middle Management Academy.
Does your organization want DCBHA to hold a slot for a staff member from your organization to participate in DCBHA's hosted May session Middle Management Academy? *
Middle Management Academy Participant First Name *
Please enter N/A if not applicable
Middle Management Academy Participant Last Name *
Please enter N/A if not applicable
Middle Management Academy Participant Title *
For example, Chief Executive Officer, Vice President, Director of Behavioral Health, etc. Please enter N/A if not applicable
Middle Management Academy Participant Email
This must be an email address assigned to a specific individual and not a generic email address like business@abc.com or admin@xyz.org. Please enter na@abc.com if not applicable
Please provide any additional information that might be helpful regarding your organization's interest in Middle Management Academy. Please share if your organization would be interested in additional participant slots if they become available, or please identify any barriers to participation that DCBHA might want to consider in future planning. DCBHA is working with Deaf Reach and the National Council to review provision of interpretation services. Please advise if availability of interpretation services, or lack thereof, would change your organization's decision to send a staff member to Middle Management Academy.
An invoice will be emailed to your primary contact and secondary contact. If the invoice should be sent to someone other than the primary and secondary contacts, please provide the first name, last name, and email address of anyone who should receive a copy of the invoice.
DCBHA prefers payment by business check to avoid credit card merchant processing fees. If your organization strongly prefers to pay by credit card, please write to Mark.LeVota@DCBehavioralHealth.org to arrange an electronic invoice through Paypal.
2026 member dues payments are due no later than March 31, 2026. Organizations that complete this form after April 1, 2026 will receive an invoice requesting payment within 30 days of the date the form is submitted or processed, whichever is later. Certain membership benefits may not be available after March 31, 2026 until payment is received.

DCBHA is prepared to accept a first payment of half the balance due by March 31, 2026 and the remaining balance due by June 30, 2026 for any organizations that prefer to have additional time to pay. If your organization will be unable to pay in full by March 31, 2026, please write to Mark.LeVota@DCBehavioralHealth.org to discuss a payment installment plan. Request for additional time to pay will not disrupt participation in Middle Management Academy so long as half of the organization's dues plus the $900 Middle Management Academy registration fee are paid by March 31, 2026.
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