Alternative sentencing program helps many begin road to recovery

The Clermont County Community Alternative Sentencing Center (CASC) helps people with addiction get treatment, support and services instead of just doing time in jail. In recent months, the innovative program has served more people than ever. Learn more about CASC in this interview with Karen Scherra, Executive Director, Clermont County Mental Health and Recovery Board.

Does CASC have the highest enrollment since its inception? If so, why?

Scherra: The men’s program has previously gone over the target of 25 individuals, so that census has been higher. Specifically, for the period Feb. 20, 2019-March 3, 2019, the census averaged 28.6 for men during those two weeks. The women’s program was designed for 12 participants and has historically been under that number. Recently, for the two weeks from Sept. 10, 2020-Sept. 24, 2020, the census averaged 14.9, the highest number of participants since that program opened in 2017. The combined census in recent months has reflected the highest total enrollment for the program.

The agencies involved with CASC don’t have a specific reason for the spikes in participation, but we think both the backload of cases due to COVID now before the Court and more word getting around about the benefits of the program have increased interest in it.

Although the program is offered as an alternative to jail, some individuals are not ready or not willing to engage in this level of treatment, which can affect the number of participants at any given time, despite referrals from the Court.

How successful has CASC been?

Scherra: The basic premise for CASC is to have people with an addiction spend time receiving treatment and other services/supports rather than just sit in jail. From that perspective, each person who goes to CASC reduces the number of inmates in the jail and is exposed to help with their addiction issues, which is a success. In terms of outcomes, we look at how many people complete the CASC program, how many are referred to treatment and begin treatment, how many get employment services and obtain a job/career, and how many have reoffended and are back in jail within a year. Here are some of those statistics from the 2019 Annual Report on CASC:

What contributes to that success?

Scherra: The program is voluntary, so the participants are at least somewhat motivated, and their days are filled with treatment services, as well as other activities like AA, Smart Recovery, exercise, yoga, religious groups, etc. provided by community groups (virtually during COVID). Their return to the community is planned for and discussed, they can start Medication Assisted Treatment (MAT) services while in CASC that continue when they are released, and there is a “warm handoff” to services in the community that helps with engagement. Perhaps most importantly, though, is the collaboration and commitment among the court, probation, and treatment that lays a foundation for making the program as good as it can be and to assure that the experience leads to success for the participants.

How unique is CASC in the state? Country?

Scherra: CASC is an outpatient treatment program which provides comprehensive behavioral health services to individuals who are referred by the Clermont County Municipal Court. The program is voluntary, and individuals referred to the program must have a substance use disorder.  As defined by the OAC 3793:2-1, the program provides structured programming that includes substance use disorder treatment with individual and group counseling, case management services, educational groups, employment readiness and retention services, peer recovery supports, and community recovery supports. In addition, medication assisted treatment, nursing services and psychiatric medical services are also available when appropriate.

In Ohio, there are several programs that call themselves Community Alternative Sentencing Centers, but only a couple who follow the model outlined in legislation. There are some similar programs throughout the country, but they all differ slightly. I think the uniqueness of CASC is the collaboration at the center of the program. The Board of County Commissioners, Clermont County Municipal Court, Clermont County Jail, Clermont County Municipal Court Adult Probation Department, Clermont County Mental Health & Recovery Board, and Greater Cincinnati Behavioral Health Services/Clermont Recovery Center work in partnership to support this innovative program.

How has CASC changed since its inception in 2015?

Scherra: We now have CASC for women, the services and activities provided have changed and expanded, and there is better coordination among the stakeholders in the program.

2019 was a year focused on collaboration, partnership, communication, training, team development and program enhancement. New leadership in January 2019 and new clinical supervision in July 2019 brought with it much opportunity for program enhancement. Efforts to engage in consistent dialogue and collaboration with key stakeholders provided essential feedback. A collaborative communication structure was established where CASC leadership and leadership from probation meet weekly to review current clients, address client issues/needs, and problem solve developing unit issues. In 2020, emphasis has been on maintaining the program during a pandemic, which has been successfully achieved.

I understand that a women’s program was added in 2017. How has that been doing?

Scherra: The program for women was added in 2017 when CCMHRB received federal grant funds. The women’s program, designed for twelve women, has struggled at times with census numbers for a variety of reasons. Women are often more resistant to admitting their addiction issues and seeking treatment, don’t want the disconnection from heir children/families, and are often further along in their addiction when arrested. However, recent increases in the number of female participants seem to indicate that more women want help and are hearing about the positives associate with the CASC program.

How is CASC funded? How do levy funds support the program?

Scherra: CASC is funded by the Board of County Commissioners with services provided through Greater Cincinnati Behavioral Health Services. In 2015, GCB began managing the program and providing services to men. In the fall of 2017, the program was expanded to provide services to women through the federal Cures Act grant obtained by the Clermont County Mental Health & Recovery Board; funding was subsequently switched to the SOR grant that followed the Cures Act grant. A new SOR grant will begin this fall and will hopefully continue to provide the funds for the women’s program for at least the next two years.

What are the ages of those who complete the program?

Scherra: Adults 18 and over, range from 19-67. Average age is 37 for men and 34 for women.  64% of men and 82% of women are under 40.

For men admitted to the program in 2019, 61% had a primary diagnosis of Alcohol Use Disorder and 25% had a primary diagnosis of Opioid Use Disorder. For women admitted to the program, 30% had a primary diagnosis of Alcohol Use Disorder and 44% had a primary diagnosis of Opioid Use Disorder. This remains relatively consistent year to year. In 2019, 30% of men admitted to the program had a co-occurring mental health diagnosis. 59% of the women admitted to the program in 2019 had co-occurring mental health issues.

How long do people participate in the program? What does it consist of?

Scherra: Participants can be in the program for 5-90 days, depending on their offense and sentencing as determined by the judge. A majority of clients stay for less than 30 days.

Are there any success stories who might want to tell how CASC helped them?

Scherra: Brian B. participated in CASC for 30 days in the summer of 2019. During his time in the program, he made great strides in identifying triggers and developing coping strategies. Although he had one relapse early on, he was quickly able to get back on track by using the tools that he learned while in CASC. He engaged in aftercare services at Sojourner and also enrolled in the YWCA’s Transform program, which focuses on Intimate Partner Violence – he completed both of these services successfully. Brian celebrated one year of sobriety on Sept. 22, 2020. Within the past year, he has obtained full-time employment at a nursing facility as the Director of Maintenance, opened a consignment shop, founded and is now chair of his own AA meeting, and was recently married to his long-time partner (a relationship that he worked hard to mend). He remains motivated and has vowed to use his own story to help demonstrate to others the beauty of recovery.

Brittany M. served a total of 90 days in the CASC program. With the help of CASC, she realized she enjoyed being sober and wanted to fight for it. She chose to transition to additional inpatient treatment. The CASC staff was able to help her secure ongoing treatment and prepare her for her next step in her sobriety journey. Brittany went on to successfully complete inpatient treatment and transitioned to aftercare services at Clermont Recovery Center (CRC). She has since completed her treatment at CRC, has regained custody of her children, obtained full-time employment, owns her own trailer, has set healthy boundaries, and has been fully compliant with three separate Probation Officers. Brittany celebrated a year of sobriety in April 2020 and looks forward to continuing her sober lifestyle.

What recognition has CASC received? (Any honors, awards, etc.)

Scherra: CASC leadership, along with representatives from the Clermont County Mental Health and Recovery Board, Clermont County Municipal Court Probation, and the County Commissioners office have been invited to present on the CASC program several times, including twice at the special request of former Ohio Supreme Court Justice Eve Stratton.

A number of Ohio counties have sent teams to learn about the program, it has been visited by state and federal legislators, and has been the subject of TV interviews, including by CNN and a Spanish film company.