New Orleans Human Services Authority: Behavioral Health and Support

The New Orleans Human Services Authority (NOHSA) is the local governance body responsible for planning, funding, and overseeing behavioral health and developmental disability services across Orleans Parish. It operates as a local governing entity under Louisiana's network of Human Services Districts and Authorities, connecting residents to mental health treatment, substance use disorder programs, and supports for individuals with developmental disabilities. Understanding how NOHSA functions — and where its authority begins and ends — is essential for residents, providers, and policymakers navigating the city's public behavioral health infrastructure.

Definition and scope

NOHSA is established under Louisiana Revised Statutes Title 28, which governs the statewide network of Human Services Districts and Authorities. The Authority serves as the local management entity for behavioral health services in Orleans Parish, operating under a framework set by the Louisiana Department of Health (LDH) and the Louisiana Behavioral Health Partnership (LBHP).

The three primary service domains NOHSA oversees are:

1. Mental health services — crisis intervention, outpatient psychiatric care, case management, and community support programs
2. Substance use disorder treatment — prevention, detoxification, outpatient counseling, and recovery support services
3. Developmental disability supports — coordination of waiver services, respite care, residential supports, and employment assistance for individuals with intellectual and developmental disabilities

NOHSA does not directly employ the clinicians who deliver most services. Instead, it contracts with a network of community-based providers, monitors service quality, and administers Medicaid and state general fund dollars allocated through LDH. This managed care coordination role distinguishes NOHSA from a direct-service clinical agency.

Scope, coverage, and limitations: NOHSA's geographic jurisdiction is Orleans Parish. It does not govern behavioral health services in Jefferson, St. Tammany, St. Bernard, or St. Charles parishes — each of which falls under a separate Human Services Authority or District established under Title 28. State-level policy for Louisiana's Medicaid behavioral health carve-out is set by LDH and the Louisiana Department of Children and Family Services, not by NOHSA. Federal oversight of Medicaid funding flows through the Centers for Medicare and Medicaid Services (CMS), which sets conditions of participation that apply statewide and are not within NOHSA's authority to waive or modify.

How it works

NOHSA is governed by a Board of Directors whose members are appointed through a process defined in Louisiana statute. The Board sets policy, approves the operating budget, and provides oversight of contracted provider performance. Day-to-day administration is handled by an executive director accountable to the Board.

The operational funding model operates in three layers:

1. Medicaid reimbursement — the largest revenue source, flowing through Louisiana's 1915(b)/(c) waiver programs and the state plan for behavioral health services
2. State general fund appropriations — annual allocations from LDH to NOHSA for services not fully covered by Medicaid
3. Federal block grants — the Substance Abuse Prevention and Treatment (SAPT) Block Grant and the Community Mental Health Services (CMHS) Block Grant, administered federally by the Substance Abuse and Mental Health Services Administration (SAMHSA), passed through Louisiana to NOHSA

Service access typically begins with a single point of entry: a resident contacts NOHSA or a contracted provider for an intake assessment. The assessment determines eligibility, acuity level, and the appropriate level of care under the American Society of Addiction Medicine (ASAM) criteria for substance use disorders or equivalent clinical tools for mental health needs.

For developmental disability services, access is governed by the Supports Waiver and the Residential Options Waiver (ROW) administered through the Louisiana Office for Citizens with Developmental Disabilities (OCDD), a separate state office. NOHSA coordinates locally but does not administer waiver slots — that authority rests with OCDD at the state level.

Common scenarios

Residents and families interact with NOHSA's system in distinct ways depending on need:

Crisis mental health situations: A resident experiencing acute psychiatric distress may be connected to a mobile crisis team contracted through NOHSA, or to a crisis stabilization unit. These services operate under the Louisiana Crisis Response System framework, which requires NOHSA to maintain 24-hour crisis access points in the parish.

Outpatient substance use treatment: An individual seeking outpatient counseling for alcohol or opioid use disorder would typically be screened at a contracted community behavioral health center. NOHSA-funded programs must follow SAMHSA's evidence-based treatment criteria, including access to medication-assisted treatment (MAT) such as buprenorphine or methadone where clinically appropriate.

Developmental disability waiver navigation: A family seeking home- and community-based services for a child or adult with an intellectual disability contacts NOHSA's developmental disability coordinator, who facilitates connection to OCDD's waiver enrollment process. Wait times for waiver slots are determined by OCDD's statewide prioritization list, which NOHSA cannot override.

Post-incarceration reentry: Individuals leaving Orleans Parish Criminal District Court jurisdiction — covered separately at Orleans Parish Criminal District Court — or the Orleans Parish jail may be connected to NOHSA-funded reentry behavioral health programs designed to reduce recidivism through continuity of psychiatric and substance use care.

The distinction between acute inpatient psychiatric care (handled by licensed hospitals under LDH hospital licensing rules) and community-based behavioral health services (contracted and monitored by NOHSA) is the most operationally significant boundary in the system. NOHSA does not govern hospital inpatient psychiatric units; it governs the community-level continuum.

Decision boundaries

Understanding what NOHSA decides — versus what is decided at the state or federal level — prevents misrouted service requests and policy advocacy.

NOHSA decides:
- Which providers receive contracts to deliver behavioral health services in Orleans Parish
- How local outreach and prevention resources are allocated across neighborhoods
- Whether a contracted provider is in compliance with performance standards
- How state and federal funds are distributed among competing service priorities within the parish

NOHSA does not decide:
- Medicaid eligibility (determined by LDH's Bureau of Health Services Financing)
- The total dollar amount of state general fund appropriations to NOHSA (set by the Louisiana Legislature)
- Waiver slot availability for developmental disability services (set by OCDD statewide)
- Licensing and certification of individual behavioral health clinicians (regulated by the Louisiana State Board of Social Work Examiners, the Louisiana Licensed Professional Counselors Board of Examiners, and the Louisiana State Board of Medical Examiners, respectively)
- Involuntary commitment procedures, which follow Louisiana's Physician Emergency Certificate (PEC) and Coroner's Emergency Certificate (CEC) process under Louisiana Revised Statutes Title 28, §53

The boundary between NOHSA's authority and that of the New Orleans Health Department is functionally distinct: the Health Department focuses on public health programs, communicable disease response, and clinical health services at city-operated facilities, while NOHSA focuses specifically on behavioral health and developmental disability service system management. Both entities coordinate with state agencies but operate under separate statutory mandates.

Residents and providers looking for a broader orientation to how agencies in Orleans Parish connect to each other can consult the New Orleans Metro Authority index, which maps the full civic infrastructure of the region.

References

• Louisiana Revised Statutes Title 28 — Mental Health Law
• Louisiana Department of Health (LDH)
• Louisiana Office for Citizens with Developmental Disabilities (OCDD)
• Substance Abuse and Mental Health Services Administration (SAMHSA)
• Centers for Medicare and Medicaid Services (CMS)
• Louisiana Behavioral Health Partnership (LBHP) — LDH Overview
• SAMHSA Block Grants Program