How Buncombe County's START teams work and the results staff say they've seen

Rebecca Smith described START as "sobriety treatment and recovery teams," an evidence-based model embedded inside county child-welfare work to serve cases where parental substance use co-occurs with child maltreatment.

"STAR is sobriety treatment and recovery teams," Smith said, explaining the program pairs a social worker with a family mentor in each START dyad. She said Buncombe County currently has five dyads supervised by two supervisors and that the model emphasizes early, intensive contact: transport to treatment for the first appointments, weekly random drug screening, and frequent case contact in the first 90 days.

Staff cited both national-scale research and local outcome measures. Smith cited national evidence that "50 percent of children are less likely to enter out of home placement" under START models, and she reported a local foster-care census drop "from about 380 children in 2017 to 270" today. She added the county became the nation's second certified START site in 2022 and was recertified in 2025, and that UNC Chapel Hill is now supporting data collection and evaluation.

The presenters described START's philosophy as changing agency culture toward compassion and recovery, and emphasized family mentors' lived experience as a core tool for engagement. "They talk in their language, and it...works," Smith said, describing mentors' ability to engage parents who initially resist services.

County staff did not claim the total reductions in foster-care population are solely the result of START; Smith said she would "attribute a huge portion" of the change to START while acknowledging multiple factors affect the census.