NC START, or North Carolina Systemic, Therapeutic Assessment, Respite and Treatment, are statewide community crisis support programs for individuals (ages 18 and above) with intellectual/developmental disabilities and complex behavioral or mental health needs. Crisis prevention and intervention services are provided through crisis response, clinical consultation, training and respite.

Frequently Asked Questions

Who is eligible for the NC START Program?

The NC START Program is exclusively available to serve adults (age 18 years and above) that have a diagnosis of Intellectual/Developmental Disability (I/DD) and challenging behaviors, often with a co-occurring mental illness.

What does the NC START program do?

The NC START program is divided into three regions (East, Central and West) and each region consists of a clinical team and a respite home. The clinical team (consisting of four START Coordinators) provides 24/7 crisis response and consultation, as well as on-going preventative cross-systems crisis prevention and intervention planning for eligible individuals. The crisis prevention component of NC START also involves working with the existing I/DD and mental health systems of care to provide technical assistance, consultation and support when working with individuals eligible for NC START. NC START also provides training and education on topics pertaining to care and treatment for individuals with I/DD, when requested and available.

The NC START clinical team will continue to work with referred individuals and their service/support system to reach sustained stabilization for the individual and their system of care, which generally takes one year from the start of the service. Within that time, the NC START team will work with the individual and their system of services and supports to systematically prepare for crises and reduce the frequency of restrictive interventions, hospital admissions and overall crisis events.

The NC START regional therapeutic respite homes each have two beds reserved for eligible individuals in crisis and two beds reserved for planned crisis prevention-eligible individuals* (4 beds total). START Coordinators are the conduit for access to all START services, including therapeutic respite.

*NC START planned therapeutic respite beds are only intended for eligible individuals living in unlicensed residential settings, such as family homes.

What is the difference between the NC START Clinical Teams and established/upcoming Mobile Crisis Management Teams and First Responder?

NC START DOES NOT REPLACE MOBILE CRISIS MANAGEMENT or FIRST RESPONDER. Although the START Coordinators are available for assistance/support/consultation at any time during a crisis response, the first responder and mobile crisis teams retain their roles and responsibilities. START Coordinators are intended to support, not replace, these functions.

An eligible individual will continue to access mobile crisis management via the established DMH/DD/SAS Crisis Service Protocol. Eligible individuals will still be required to “go through” their clinical homes/first responders (if applicable) prior to accessing Mobile Crisis services. The NC START program can be contacted at any point during a crisis situation and often works in tandem with Mobile Crisis teams.

For individuals previously known to an NC START region, their clinical home providers and/or natural supports may contact NC START at any time for information, consultation and assistance de-escalating individuals experiencing minor difficulties and/or crises. This assistance/availability of NC START clinical team staff is intended to help de-escalate situations before the level of need becomes “emergent” necessitating a mobile crisis intervention.

How do I refer an eligible individual to NC START?

Each NC START region has a central access number for information and referrals (located below FAQs).

Referrals to NC START for eligible individuals 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 referral. 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.

Referrals for eligible individuals not experiencing crises at the time of referral should be made during business hours to appropriate NC START team access number.  Referrals for eligible individuals experiencing crises at the time of referral may be made at any time of day/night (24/7/365) to the appropriate NC START team access number.

Contact Information


Asheville, Concord

START Respite

(888) 974-2937
RHA and Smoky Mountain

NC START (Central)


START Respite

(919) 865-8730, (800) 662-7119, x8730
Easter Seals UCP and Alliance Behavioral Healthcare


New Bern, Wilmington

START Respite
New Bern

(252) 571-9039

Page last modified: February 4, 2016