Local Mental Health Authorities & Local Behavioral Health Authorities

Local Mental Health Authorities (LMHAs) and Local Behavioral Health Authorities (LBHAs) serve as the point of entry for publicly funded, privately funded, or unfunded mental health services for people who are assessed with mental illness in Texas.


  • Provide a full array of services and supports for people with mental illness.
  • Are responsible for admitting eligible people with Medicaid into assessed and most appropriate level of care based on completion of the Uniform Assessment.
  • Are responsible for admitting eligible people, when they have capacity, without Medicaid, into assessed and most appropriate level of care based on completion of the Uniform Assessment.
  • Are responsible for completing Preadmission Screening and Resident Review (PASRR) Evaluations, also known as a PE, for people suspected of having a serious mental illness seeking admission to a Medicaid-certified nursing facility.
  • Provide specialized services in the most appropriate setting for the people, including the nursing facility, who are PASRR positive and agree to receive the Mental Health Specialized Services.

LMHA/LBHA Specialized Services

LMHA/LBHA PASRR Specialized Services are provided via Texas Resiliency and Recovery when a person has been found to be PASRR positive for mental illness. Specialized Services are determined on a case-by-case basis. The number of services a person receives is based on the determined need when they’re admitted to an Adult Level of Care. While not every service will be helpful for every PASRR-positive person, there are a variety of services available. Some of these services include, but are not limited to:

  • Medication training and support services
  • Psychosocial rehabilitative services
  • Psychiatric diagnostic interview examination
  • Routine case management
  • Skills training and development
  • Supported employment
  • Supported housing
  • Other services provided via Texas Resiliency and Recovery.

To learn more about LMHA/LBHA PASRR Specialized Services, go to the Texas Resiliency and Recovery’s Utilization Management Guidelines and Manual webpage, and download the TRR Utilization Management Guidelines for Adults or TRR Utilization Management Guidelines for Children and Adolescents, as appropriate. These guidelines include details about Level of Care and a set of definitions for TRR-provided services for both age groups.


The PASRR forms page provides forms and information for the initial PASRR process.

PASRR Information and Additional Resources

Rules and Requirements

For all questions regarding PASRR, contact the HHSC PASR Unit at PASRR.Support@hhsc.state.tx.us.

PASRR Trainings on the HHS Learning Portal

The following online trainings will help you learn to navigate each step of the PASRR process and to better understand the responsibilities of the LMHA/LBHA staff when working with PASRR.

There are several web-based courses on the HHS PASRR training webpage.

Trainings pertinent to LMHA/LBHA staff include the following:

  • An Overview of the PASRR Process
  • PASRR PL1 and PE
  • PASRR Referring Entity Training

The Texas Medicaid & Healthcare Partnership LTC webpage includes Provider Education Training Materials, PASRR user guides and workflows.

Texas HHS Office of the Ombudsman

For more information for LMHAs and LBHAs regarding rules, training, resources, etc., go to: https://www.hhs.texas.gov/providers/behavioral-health-services-providers/local-mental-health-authorities