Knox County, TN
Knox County Government
tennessee
Suburban | Population: 500,669Knox County, Tennessee’s third-most populous county, has faced a crisis of overdose and recidivism that far exceeds both state and national averages. In 2021, the county recorded an overdose death rate of 92 deaths per 100,000 people, with justice-involved individuals at particular risk. Forty-two of the fatal overdose victims had been arrested in the prior five years, and many died soon after release from jail. The three-year recidivism rate for felons released from jail stands at 66.9%, significantly higher than comparable counties in Tennessee. While misdemeanor-specific data is limited, the high felony recidivism suggests a similar risk among misdemeanor probationers, often linked to substance use and probation violations. These figures underscore the urgent need for a comprehensive, evidence-based response.
Before the implementation of the 2023 Comprehensive Opioid, Stimulant, and Substance Use project, Knox County lacked clear pathways for high-risk misdemeanor probation clients, many of whom were grappling with opioid use disorders and homelessness, to access treatment and services within the court system. Barriers such as long waitlists and disqualifying factors further complicate access to care. In response, Knox County launched the Intensive Case Management Program (ICMP), designed to forge robust linkages between the probation system and evidence-based community services.
“This program provides the structure, support, and accountability that many of those on probation need to turn their lives around. It helps them meet the court’s expectations and build a foundation for lasting success beyond the justice system.”
—chuck cerny, knox county general sessions court judge
Optimizing Referral Pathways
3
staff members trained on new risk assessment tool
The ICMP introduced a streamlined, validated risk assessment tool tailored to the misdemeanor probation population. This tool, which takes less time to administer and better reflects local needs, has enabled staff to assess most clients within two to three weeks, often after rapport has been established through prior interactions. As Jack Dennis, Probation Programs Coordinator, explains, the assessment tool was “developed specifically to match with community resources that we have here within our jurisdiction.” By aligning assessment questions with provider criteria, staff can efficiently determine eligibility before making referrals, ensuring clients are connected to appropriate services without delay.
Key Program Components
Evidence-Based Assessment
Three staff members have been trained on the new validated risk assessment tool, ensuring timely and accurate identification of client needs.
Case Management
Three new case managers have expanded access to substance use disorder (SUD) treatment, peer recovery support, and recovery housing. In the first six months (July–December 2024), 124 probation clients were connected to case management services.
Recovery Housing
The program provides up to $400 per person, per month for recovery housing. In the first six months, 20 individuals received financial assistance, removing a critical barrier to stability and long-term recovery.
Individualized Case Management
124
probation clients connected to case management services
Central to the program’s success is the emphasis on relationship-building. As Dennis notes, much of the case managers’ work “revolves around the prosocial interactions they're having with their clients.” To foster trust and engagement, case managers operate independently from probation officers, working in a separate space and reporting to a different supervisor. Program Director Richard Major underscores the intentionality of this approach: “There’s a definite separation.” This structure has yielded clear benefits, with participants reporting, “They tell me that they've never been this successful in probation.”
Key Achievements
Created clear treatment pathways for high-risk probation clients.
Increased pro-social support through peer mentoring and case management.
Removed access barriers to recovery housing.
Streamlined the assessment process for more timely and effective referrals.
Implemented evidence-based assessment tool to target the correct population of probationers
Collaborative Partners
City of Knoxville (All4Knox)
Justice System Partners
Knox County
Knox County General Sessions Court
Knox County Health Department (All4Knox)
Knox County Probation Department
Metro Drug Coalition
The McNabb Center
Alignment with National Priorities
Knox County’s approach reflects the urgent, decisive action required to address the scourge of illicit drug use and its devastating impact on communities. By focusing on reducing overdose fatalities, increasing access to evidence-based treatment, and removing barriers to recovery, the ICMP embodies the core principles of a comprehensive drug control strategy. The program’s emphasis on preventing drug use before it starts, providing treatment that leads to long-term recovery, and leveraging data to inform strategy aligns with the broader national imperative to secure communities, protect public health, and ensure that all Americans have the opportunity to lead healthy, productive lives.
Key Takeaways
By taking the time to understand the specific needs of its service population and tailoring solutions accordingly, Knox County has laid the groundwork for clients’ success on probation and beyond. Integrating case management and creating individualized treatment pathways, with less red tape and fewer financial barriers, has proven to reduce recidivism, save lives, and build a safer, healthier future for all.
Project Director
Richard Major, Magistrate
Knox County
richard.major@knoxcounty.org
865-215-2766
This project was supported by Grant No. 15PBJA23GK02258COAP awarded by the Bureau of Justice Assistance. The Bureau of Justice Assistance is a component of the Department of Justice's Office of Justice Programs, which also includes the Bureau of Justice Statistics, the National Institute of Justice, the Office of Juvenile Justice and Delinquency Prevention, the Office for Victims of Crime, and the SMART Office. Points of view or opinions in this document are those of the author and do not necessarily represent the official position or policies of the U.S. Department of Justice.