Greetings from NCSS Executive Director Pam Flaherty

As we reflect on the past year, it is with great pleasure and gratitude that we present to you our 2023 Impact Report. This is a very special year for me as it marks my first full year as the Executive Director. At the National Center for START Services®, we are deeply committed to our mission of improving the lives of people with IDD and mental health needs and their systems of support. This report reflects the collective impact of NCSS’ program implementation, research, evaluation, training, and professional development delivered to START programs and START Network partners across the country.
Throughout all the challenges and uncertainties of 2023, START programs across the country demonstrated unwavering determination and resilience. Together we navigated unprecedented circumstances, adapted to new realities, and continued to serve our programs with compassion and innovation.
In this impact report you will find insights into our programs, initiatives, and accomplishments. We are proud to share our highlights and the milestones we achieved, the lives we touched, and the progress we made throughout the country advancing our mission to improve the wellbeing of people with IDD-MH, their families, and their systems of care. None of these achievements would have been possible without the dedication and hard work of every START team across the country. Without the commitment, creativity, and ingenuity of each program, we would not be successful in changing the culture of services provided to people with IDD-MH.
As we look ahead to the future, we remain committed to making a positive difference in the lives of the people and families we serve. With the strength of the START Network behind us, we are confident that we will continue to create lasting changes in all of our communities even as we anticipate the changing landscapes. Thank you for your ongoing support, trust and partnership. Together we are making a difference.
By the Numbers
At NCSS
- 77 START coordinators certified plus 15 certification renewals for a total of more than 550 certified coordinators
- 2 programs certified (CA Alta and CA East Bay) for a total of 13 certified programs
- 3 system evaluations were completed in Colorado (Boulder County), Delaware, and South Dakota, with 3 more in progress in Arizona, Louisiana, and Philadelphia.
Across the START Network
- 2,780 crisis calls resulting in 81% of people remaining in their community, up from 75% in 2022
- 3,579 people with IDD-MH served, up from 3,512 in 2022
- 72% of people served had a reduction in mental health symptoms, up from 70% in 2022
National Service Outcomes
Emergency Service Utilization

Distribution of Crisis Contacts

START Population
Age
Age Category |
Count |
Percentage |
Children |
946 |
26% |
Adults |
2633 |
74% |
Overall |
3579 |
100% |
Race/Ethnicity
Race |
Children |
Adults |
Overall |
American Indian/Alaskan Native |
1% |
1% |
1% |
Asian |
8% |
6% |
6% |
Black or African American |
19% |
19% |
19% |
Hispanic |
9% |
6% |
7% |
Middle Eastern |
1% |
< 1% |
< 1% |
Native Hawaiian/Pacific Islander |
< 1% |
< 1% |
< 1% |
White |
52% |
59% |
57% |
Two or more races |
6% |
5% |
6% |
Prefer not to answer |
2% |
3% |
3% |
Not identified |
1% |
1% |
1% |
Ethnicity |
Child |
Adult |
Overall |
Hispanic/Latino of any race |
26% |
18% |
20% |
Not of Hispanic origin |
70% |
78% |
76% |
Prefer not to answer |
4% |
4% |
4% |
START Network Expansion
Program Launches
NCSS provides ongoing, in-person, and virtual support in the form of START model tools, training, strategic planning, consultation, and technical assistance to START programs over a three to four-year implementation of the START model. This support occurs at all phases of implementation.
CA START Golden Gate - April 2023
CA START North Bay - June 2023
PA START Allegheny - July 2023
New Mexico START - August 2023
CA START Harbor - October 2023
CA START Redwood Coast - November 2023

PA START Allegheny Launch

CA START Harbor Launch
Training and Professional Development
2023 START National Training Institute (SNTI)

Participants of the 2023 SNTI colored in this poster from sponsor Debbie Lynn Coloring Posters.
Building Connections and Activating Strengths: Celebrating 35 Years of START
Austin, TX
After three years of virtual delivery due to COVID-19, the eighth SNTI was a chance to reconnect in the present and reflect on 35 years of history.
- 225 participants
- 28 geographic areas represented (26 states plus Canada and Washington, D.C.)
- 40 presenters
- 23 research posters
- Overall satisfaction 96%
"The aspects that were of most value to me were the topics that included lived experience perspectives, and perspectives from boots on the ground START team members who are doing the work, day in and day out.”
2023 START National Online Training Series (NOTS)
- 8 sessions for a total of 16 hours of training
- More than 1,800 recipients on the subscriber e-mail list
- 669 total attendees at the live Q&A events
- Overall satisfaction 97%
Applied Positive Psychology
Learning to Help People with IDD-MH Through Theory, Practice, & Technique
- Brand new live virtual course with Dan Tomasulo, PhD, TEP, MFA, MAPP
- Six weeks from October 4 to November 8 on Wednesdays 3:00-4:45 ET
- 62 participants
- Overall satisfaction 89%
"I really enjoyed the opportunity to listen and learn from Dan and be given the time to reflect and apply what I have learned both professionally and personally."
Professional Development Series
- Three virtual courses for Care Coordinators, Direct Support Professionals, and Mobile Crisis Responders.
- 725 participants combined across all three courses
- Total of 63 hours of instruction
- Participants reported more than 50% increase in self-rated abilities following each course
- Overall satisfaction 91.5%
Presentations and Publications

NCSS and START team members presented at the American Academy of Child & Adolescent Psychiatry (AACAP) 70th annual meeting in New York City on October 23-28, 2023. Dr. Jill Hinton (second from left) and Dr. Jen McLaren (third from left) were part of Institute 7: Excellence in Care for Individuals with Intellectual Developmental Disorder: Relevant Updates on Best Practices. Also pictured are Dr. Emaya Anbalagan (far left) and Dr. Katy Stratigos (far right).

NCSS team members presented a poster at the Association of University Centers on Disabilities (AUCD) conference on November 5-8 in Washington, D.C. The poster was entitled "Bridging the IDD-MH Training Gap: National Center for START Services Innovative Virtual Professional Development Courses" and was authored by Beth Grosso, MSW; Caitlyn Veenstra, EdD candidate; Sara Stanton, MA; and Micah Peace Urquilla, BA.

Joan Beasley and Andrea Caoili presented a poster entitled "Content Validity of the Person Experiences Interview Survey (PEIS)" at the 40th annual NADD Conference on December 13-15 in Nashville, TN.

Michelle Bagby of Tennessee START, Karen Weigle of NCSS, and Brian Tallant of Denver START attended the 40th annual NADD Conference and gave a presentation entitled "National and State Impacts of the Evidence-Based START Model for Community-Based Crisis Prevention and Intervention for Individuals with IDD-MH."
2023 Video
Our 2023 holiday video is a great way to reflect on a positive and productive year!