RHA Health Services - NC Start



NC START: North Carolina Systemic Therapeutic Assessment Resources Treatment

The NC START program provides prevention and intervention services to individuals with intellectual/developmental disabilities and complex behavioral needs through crisis response, training, consultation, and education. The goal is to create a support network that is able to respond to crisis needs at the community level. Providing community-based, person-centered supports that enable an individual to remain in their home or community placement is the first priority.

The NC START Philosophy

Services are most effective when everyone involved in care and treatment actively participates in treatment planning and service decisions. (The whole is greater than the sum of its parts.)

Individual Outcomes

  • Maintain stable community residence
  • Access and engage resources
  • Decrease crises
  • Decrease behavioral health symptoms
  • Improve the quality of life
  • Decrease state facility and hospital utilization
  • Increase community integration

Community Outcomes

  • Increase expertise in Mental Health/Intellectual and/or Developmental Disability service delivery
  • Implement and maintain community collaboratives
  • Utilization of community resources
  • Increase natural resources
  • Decrease state facility and hospital utilization

NC START is a nationally certified program through the Center for START Services at the Institute on Disability/University of New Hampshire. NC START, based on the Massachusetts START model, represents a collaboration between the Center for START Services, the North Carolina Division of MH/DD/SAS, MCOs, providers and families.

Role of NC START Team

  • Provide on-going consultation to providers and/or families
  • Provide support and technical assistance to Mobile Crisis Teams
  • Create and maintain linkages and relationships with community partners
  • Coordinate support meetings and cross systems crisis plans for individuals
  • Provide training and technical assistance to community partners

Why use NC START?

RHA’s START program helps reduce high-cost Emergency Department and Inpatient Hospitalization, while improving overall wellness and community participation.

NC START services work in conjunction with all other services including community-based services (ACTT, CST, Care Coordination, Innovation Services, Mobile Crisis Management, School Systems, Day
Treatment, etc.). Driven by a person’s needs, NC START offers proactive, clinically-based consultation and
training for crisis prevention and intervention.

Services Available

Crisis Support Continuum
• Psychological, behavioral support and crisis consultation to the treatment team and primary service providers
• Psychiatric consultation to the treatment team and primary service providers
• Facilitate communication across intellectual/developmental disability, mental health, community and family networks

Clinical Support – Assessment & Treatment Planning
• Conduct functional behavioral assessment to gather information for plan
• Develop prevention and intervention plan involving parents, caregivers, and/or providers
• Facilitate emergency meetings among service providers, treatment and crisis teams, and families
Training and Consultation
• Provide training to providers, families and other community partners
• Provide on-going consultation as needed to maintain  community placement

• Access and link families and providers to community
services and supports
• Work with care coordinator as service provider on
planning for future needs
• Maintain relationships with community partners to enhance ability of the community to respond to crisis

START Resource Center
Each NC START region operates a 4 bed therapeutic home called a Resource Center for individuals 18 years and older. Beds in these homes are triaged by the NC START clinical teams for individuals in the highest need and can be utilized for planned or emergency stays.

START Therapeutic Coaching (STC)
Each region also offers START Therapeutic Coaching to individuals enrolled in NC START. This program offers coaching techniques in the community (home, schools, day programs, etc.). The program is available to systems deemed eligible through the NC START clinical team.

NC START receives referrals from multiple sources. START provides lifespan services, available to individuals age 6 years and older. Individuals must have a documented intellectual/developmental disability and a co-occurring mental health diagnosis OR a complex behavioral health challenge.

For Eligible Individuals Age 6 – 20 Years:
Referrals must be made by contacting the MCO Access Line. Once the MCO receives the referral, a clinical team will review the referral and take the necessary steps to get it to the appropriate NC START region.

For Eligible Individuals Age 21 Years and Older:
Referrals can be made by anyone known to the individual with an understanding of the individual’s current status and treatment, support and behavioral history and the applicable legal consent for a referral directly to NC START using the appropriate region’s 24-hour access line. Referral sources often include the following individuals/groups: Individuals themselves, Parents and other natural supports, Legal guardians, MCO staff, Care Coordinators, Mobile Crisis team staff, Clinical Home provider staff, hospital staff (inpatient and emergency), Community Mental Health provider staff, etc.

NC START services are intended for individuals who experience multiple crises that put themselves or others at risk in the community. While a person does not need to be in active crisis to receive NC START services, individuals that benefit most from the service are vulnerable to experiencing psychiatric hospitalizations, regular removal from residential settings, and/or interactions with law enforcement.


WEST TEAM (888) 974-2937

Serving the 37 counties of Western North Carolina.  RHA’s START team can come to you.

CENTRAL TEAM (Easter Seals Program) 800-662-7119 ext. 8730

Serving the 25 counties of Central North Carolina

EAST TEAM (888) 962-3782

Serving the 38 counties of Eastern North Carolina.  RHA’s START team can come to you.

Training & Education

Find clinical educational opportunities in your region for more information.

RHA NC START Training Schedule


NC START East Advisory Council

Translate »