NC START, or North Carolina Systemic, Therapeutic Assessment, Resources and Treatment, is a set of statewide community crisis support programs for individuals (ages 6 and above) with intellectual/developmental disabilities and complex behavioral or mental health needs. Crisis prevention and intervention services are provided through crisis planning, crisis response, clinical consultation and training.

Frequently Asked Questions

Who is eligible for the NC START Program?

The NC START Program is exclusively available to serve individuals (age 6 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 Resource Center. The clinical team provides 24/7 crisis response to individuals currently served by NC START and consultation, as well as on-going preventative cross-systems crisis prevention and intervention planning. 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 community and family 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 START recipients 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 Resource Centers each operate homes with four beds for use by START recipients in that region who are over 18 year of age and may benefit from therapeutic stays.  NC START also offers a Therapeutic Coaching service for individuals ages 6-20 years old in the residence of the individual.  The Resource Center and Therapeutic Coaching are offered on an as-needed basis when START coordinators triage an individual’s need with the clinical team to ensure this would be an appropriate service.

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 listed below.

For eligible individuals age 6-20 years old:  Referrals must be made by contacting the Alliance Access Line.  Once Alliance receives the referral, a clinical team will review the referral and will take the necessary steps to get it to the appropriate NC START region.  NC START clinical teams will NOT accept referrals for this age group from anyone except the MCO.

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 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.

Contact Information


Asheville, Concord

(888) 974-2937
RHA and Vaya

NC START (Central)


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


New Bern, Wilmington

(888) 962-3782
Referrals: (252) 571-9039