The Sobriety Treatment and Recovery Team (START) program of the Buncombe County Department of Social Services was recently recognized with the i2i Center for Integrative Health’s Quality Commitment Award.
i2i’s Executive Director Mary Hooper explained, “The purpose of the Innovation Awards is to recognize innovation in services and programming to increase integrated, whole person approaches to care. This was the first year for the award program, and the Quality Commitment award was developed to recognize an organization that demonstrates commitment to improvement in the quality of service delivery by demonstrating improved treatment and outcomes that result in measurable improvements in the lives of the individuals served.”
The Buncombe County START program is based on the START Kentucky Model and considered a Promising Practice. START is a child welfare program for families with co-occurring substance use and child maltreatment delivered in an integrated manner with local addiction treatment services. START pairs Child Protective Services (CPS) workers trained in family engagement with FPS Family Mentors (Peer Support Specialists, who are in long term recovery and have had their own child protective services case as part of their life experience) and a FPS Coordinator using a system-of-care and team decision-making approach with families, treatment providers, and the courts. Essential elements of the START model include quick entry into START services to safely maintain child placement in the home when possible, and rapid access to intensive addiction/mental health assessment and treatment. Each START CPS worker-mentor has a capped caseload, allowing the team to work intensively with families, engaging them in individualized wrap-around services, and identifying natural supports to increase child safety, permanency, and parental sobriety and capacity.
The goals of Sobriety Treatment and Recovery Teams (START) are to ensure child safety, keeping children in the home with the parent when safe and possible, achieve parental sobriety, improve parental capacity to care for children, parental engagement in essential life tasks, reduce repeat maltreatment and re-entry into out-of-home care, and expand behavioral health system quality of care and service capacity as needed to effectively serve families with parental substance use and child maltreatment issues.
Some promising outcomes of the program that began in August of 2017 are that 30 families have been served and since June of 2018 the program has:
· Graduated 15 families, with children safely maintained or returned to their home by case closure with parent(s) having achieved case goals and in active recovery.
· 6 START families that successfully graduated since June had two parents that had a substance use disorder and at case closure, both parents graduated in active recovery (21 parents have graduated).
· Average days between START services started and CCA: 1.9 days
· Over 88% of START families had completed a clinical assessment and had at least 4 appointments in Substance Use treatment/or accessed inpatient treatment within 30 days of working with the START team.
· 2 Successful START graduates so far, have voluntarily motioned cases back in to court to regain custody of children they had lost custody of prior to their START case.
· So far none of the successful START graduates, whose cases closed have an incident of repeat maltreatment.

