Administrative Office of the Courts, Kentucky
The Setting
Kentucky has operated a statewide pretrial services program since 1976, when legislation established a uniform pretrial services department under the Administrative Office of the Courts. All 120 Kentucky counties have pretrial services, with coverage provided 24 hours a day, seven days a week through a centralized shift structure. Kentucky has three primary urban areas made up of counties near and around the cities of Louisville, Lexington, and Covington/Cincinnati. However, the vast majority of Kentucky's population live in rural counties throughout the state. Several of these counties rank among the most impoverished in the nation. The statewide model used ensures that rural communities receive the same pretrial services infrastructure as urban ones, eliminating the access gap that most rural programs in other states must solve independently.
The Challenge
Within a well-established statewide system, the challenge was introducing behavioral health services at the pretrial stage in a way that was voluntary, legally sound, and capable of reaching communities where treatment infrastructure was limited or absent. Mandating treatment at the pretrial stage conflicts with pretrial principles and produces worse outcomes than voluntary engagement. Convincing prosecutors and judges in rural communities to trust a new, voluntary model required a structured approach to both legal authority and community buy-in.
The Strategy
Kentucky’s Behavioral Health Conditional Dismissal Program (SB90) launched as a pilot program in 11 counties across both rural and urban areas. These locations were selected based on Supreme Court Justice jurisdictions. Letcher County, a rural Appalachian County, became the first site to go live, even prior to the program’s official launch date. As additional counties came online, it became evident that the program tends to be most successful in locations where there are not already similar competing programs or initiatives in place. The program identifies individuals at intake who meet eligibility criteria based on criminal history and the presence of a co-occurring behavioral health need. Eligible individuals are offered voluntary enrollment: they connect to case management or treatment within three days, receive up to $2,000 in barrier relief from opioid abatement funds, and have their case dismissed upon completion. Prosecutors who decline to enroll an eligible individual must provide documented reasons; but they also have the ability to refer non-pretrial eligible defendants into the program. Case navigators within the pretrial system facilitate enrollment and maintain contact throughout.
Starting in rural counties rather than urban ones was intentional. Community buy-in was stronger in smaller jurisdictions, and the demonstrated need for behavioral health infrastructure was more acute. As the pilot expanded, an unintended benefit emerged: the presence of the program in a rural county created demand that attracted new behavioral health providers. Counties that had one approved provider at program launch now have three, because the program created a market.
In year four, the program operates in 19 counties and is before the legislature for a four-year extension. A parallel pilot, the Swift, Certain, and Fair supervision model, is testing a graduated response to noncompliance at two sites, one urban and one rural, as a comparison. Pretrial services staff play a more significant role in both pilots than originally anticipated, having grown into the work rather than being assigned to it.
“Programs like this give people, especially in rural communities, a little bit more hope that they are not just stuck in generational poverty or substance use.”
— Statewide pretrial manager, Kentucky
What Made It Work
The statewide infrastructure eliminated the access problem that rural programs in other states face when trying to implement behavioral health services. Kentucky pretrial staff are already in every county, already conducting 24/7 interviews, and already connected to the judiciary. Adding a screening and navigator function to an existing workforce is operationally feasible in ways that it would not be for a stand-alone rural program trying to build from scratch.
The voluntary design of Senate Bill 90 is not incidental; it is the program's primary operating principle. Individuals can decline, can re-present at a future arrest and choose differently, and are never violated for choosing not to participate. That design reflects research on the effectiveness of voluntary versus mandated treatment at the pretrial stage and has been communicated consistently to prosecutors and judges throughout implementation.
Considerations for Replication
Statewide systems provide rural communities with infrastructure they cannot build independently. For states considering pretrial implementation or expansion, the Kentucky model demonstrates that a uniform statewide structure does not require uniformity of local approach. Counties implement the same framework in ways that reflect local conditions, judicial relationships, and provider availability.
Piloting behavioral health programming in rural communities first, rather than in urban centers where infrastructure already exists, builds a track record in the places that need it most and creates political support from legislators and stakeholders focused on rural service gaps.
For programs in other states without statewide infrastructure, the Senate Bill 90 model offers a framework that can be adapted at the county level: voluntary enrollment, connection to services within three days, barrier relief funding from opioid settlements, and dismissal upon completion. The legal authority and funding mechanisms will differ by state, but the operating logic is transferable.
In the summary brief
Meet behavioral health needs at the pretrial stage through relevant collaboration.
The Behavioral Health Conditional Dismissal Program, enacted through Senate Bill 90 and codified in state law, offers enrollment in a pathway that connects individuals to case management or treatment within three days of intake and provides up to $2,000 in barrier relief from opioid abatement funds. Buy-in has been strongest in rural jurisdictions, where behavioral health needs were most acute, and provider infrastructure has grown in rural counties as a direct result of the program’s presence. The pilot eventually scaled to 19 counties.
Also under Strategy 7
This project was supported by Grant No. 15PBJA-22-GK-03661-JAGT awarded by the Bureau of Justice Assistance. The Bureau of Justice Assistance is a component of the 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 Office of Sex Offender Sentencing, Monitoring, Apprehending, Registering, and Tracking. 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.