Buncombe County Behavioral Health & Justice Collaborative

Buncombe County’s Behavioral Health and Justice Collaborative (which formed in 2021) continued to meet regularly througout 2022 to assess the County’s crisis response service array. In 2022 the group began examining data and service utilization trends and soliciting feedback from community members and organizations, in order to engage in strategic planning to identify and priority rank the identified models and initiatives for local implementation. Throughout most of 2022, the group utilized meeting time to work on strategic planning and recommendations for opioid settlement funding, including various sub-committees focused on establishing a robust research narrative on root causes, and development of goals, strategies, and performance measures. In 2023, the group will pivot slightly to refocus on behavioral health and crisis strategic planning and recommendations for future initiatives.

* Proposed/Upcoming initiative: 911 Nurse Triage line (tentatively FY25)

CARE Team

The Buncombe CARE Team continued to meet regularly in 2022 to strategize with community members, providers, and those with lived experience around substance use and harm reduction initiatives in Buncombe County. A new leadership advisory group was formed in the Fall of 2022 to further support the CARE Team’s strategic planning and initiatives, some of the focus areas include: prevention education, outreach, media/awareness, and policy change with a focus on safe, evidence-based recovery housing. In early 2023, CARE Team leadership and HHS staff will be facilitating a lunch and learn event for Buncombe County employees on available harm reduction services, provide access to free reversal kits, and train on how to administer Naloxone in the event of an overdose.

National Alliance to End Homelessness: Within Reach Ending Unsheltered Homelessness in the Asheville-Buncombe Continuum of Care (COC)

The City of Asheville, Buncombe County, and Dogwood Health Trust contracted with the National Alliance to End Homelessness to assess Buncombe County’s community needs related to housing and to develop a formal report with recommendations to support ongoing work within Buncombe County to end houselessness.

The specific recommendations outlined in the report included:

• Improve system governance
• Implement an encampment resolution policy
• Build street outreach capacity
• Increase crisis response capacity
• Implement system improvements to the coordinated entry system (data systems)
• Create a high-utilizer targeted initiative
• Promote a housing surge for unsheltered people
• Implement moving on strategies (for those phasing out of supporting housing services)

Buncombe County State of Housing Insecurity & Houselessness (National Alliance to End Homelessness, 2022)

• The National Alliance to End Homelessness report identified that in January 2022, there were 637 individuals experiencing houselessness during the designated day for the Point In Time (PIT) count, which is a 16% increase from 2020. 
• There has been a 21% increase in overall houselessness in Buncombe County from 2020 to 2021.
• Of those experiencing houselessness in Buncombe County during the January 2022 PIT count, 24% were Black/African American (Black/African American’s make up 6% of the Buncombe County population), which indicates that Black/African American Buncombe County residents disproportionately experience houselessness compared to White residents.
• More broadly, there were 17,000 Buncombe County renters/households that were cost burdened in 2022, meaning that the household pays more than 30% of their total income towards housing – cost burdened households are more vulnerable to falling into houselessness.
• Rental costs in Asheville have increased by more than 40% since the start of the COVID-19 pandemic.
• The County-wide rental vacancy rate is less than 4% and City-wide rental subsidy rate is less than 3%, meaning that locating rental housing, particularly affordable, income-based rental housing, is nearly impossible.
• There are currently not enough emergency shelter beds to adequately support the community’s need for safe shelter (there were 293 year-round beds available – but only 105 of those beds are available to non-veteran adults who are single)

Buncombe County is set to receive $16 million over a period of 18 years through the Opioid Litigation Settlement. Communities will be able to use these dollars to help attain outcomes for residents through treatment, recovery, harm reduction, and other life-saving programs and services. Last year, Buncombe County personnel worked with a concentrated team of professionals and community members with proximate experience to opioid and substance use-related harm in our community to create a list of short-term spending priorities, while also beginning the process of exploring longer term strategic approaches to capitalize on this unique funding opportunity.

Short-term priorities that were identified through this community engagement process included support for Buncombe County’s Community’s Paramedicine teams, Syringe Service Program (including enhanced community collaboration to broadly distribute Narcan throughout the county), medication assisted treatment (MAT), and re-entry programs through the Justice Resource Center. Seeking to look further ahead, a strategic planning process launched in September of 2022 engaged multidisciplinary stakeholders to conduct root cause analysis, identify key indicators for monitoring & evaluation planning, and conduct community outreach including surveying efforts to hear from residents across the County, those actively receiving care in treatment facilities, as well as from currently incarcerated individuals inside the Buncombe County Detention Facility. This planning cycle is nearing completion as County administrators prepare to bring recommendations for funding priorities for Fiscal Years 2024-2026 to the Board of Commissioners consideration in March 2023.

Buncombe County Sheriff’s Office Co-Responder Program

During the summer, Buncombe County Sheriff’s Office piloted a program in partnership with the Community Paramedic Program which paired mental health professionals with police officers to respond to calls of potential mental health crises and or substance use related calls. The goal of the program is to prioritize connecting individuals with the appropriate resources and care. During the pilot program the Co-Responder Team were able to assist with 191 calls in which no arrests were made.