Behavioral health and justice system stakeholders across Texas have spent more than a decade searching for strategies to divert publicly intoxicated people from emergency medical assistance or justice involvement to community-based care. In 2018, Travis County began an innovative program to address this need by collaborating with the City of Austin on the Sobering Center. Six years after opening its doors, the center has won over stakeholders as a safe place for immediate sobriety care and an entry point for long-term recovery services.
The idea of a sobering center in Austin first came through discussions in 2013 between law enforcement, city and council officials, and other stakeholders. Three years later, Austin and Travis County officials signed the articles of corporation for the Sobering Center to be a local government corporation. Through an intergovernmental agreement, the city and county both fund the Sobering Center’s building costs and operations.
The Sobering Center Board includes a variety of stakeholders who are appointed by the county Commissioners Court and City Council. Board members include representatives from the Austin Police Department (APD), Austin-Travis County Emergency Medical Services (EMS), the City Council, health care professionals and other stakeholders to foster innovation and collaboration between organizations.
Modeled after the Houston Sobering Center, the Sobering Center offers both immediate and brief interventions for jail diversion. Through collaboration between APD and EMS, officers and medical professionals have the option to divert people to the Sobering Center instead of taking them to jail.
If someone is picked up by APD with a chief complaint of public intoxication, or if EMS deems an individual publicly intoxicated and medically stable, they can coordinate an intake with Sobering Center staff. This referral relationship is unique to Travis County due to the medic-to-medic rule, which allows EMS or paramedics to transfer patients to an equal or higher medical authority.
APD, EMS and the City of Austin Community Court and Integral Care are among over 70 partner agencies that can refer people to the Sobering Center. Services provided at the center — including any EMS transportation to the facility — are voluntary and free. There are no disqualifications based on criminal history or lack of medical insurance.
Anyone receiving services at the center must be 18 or older, show signs of drug or alcohol intoxication, and be medically stable without the need for emergency medical intervention.
Sobering Center Development and Communications Director Ashlyn Branscum said the stages of care at the center are “like a funnel.” At intake, paramedics or EMTs on staff perform medical assessments, and staff counselors perform a behavioral assessment. Once someone goes through intake, they are offered a spot in a dorm to sleep. Anyone using alcohol will stay for an average of 6-8 hours, while those on stimulants typically stay between 24 to 48 hours.
After waking up, the person goes through a substance audit and meets with a counselor to discuss a safety plan around substance use. Then they are free to leave the center.
Anyone seeking higher levels of care can enroll in the Holdover Program. Within five days, Sobering Center staff refer individuals to inpatient treatment, sober living facilities or other psychiatric services, depending on the need. But Branscum said this group tends to be a fraction of the general client population.
“Most people are not opting into that process or don’t need that level of care,” she said. “Those who do funnel into our Holdover Program tend to be repeat clients.”
The Holdover Program has seen a high rate of success. Of the 200 people at the Sobering Center who sought higher levels of care in 2023, 92% of them were connected to treatment through the program.
The service model of a sobering center has proved to be beneficial to city and county resources. Through the Houston Sobering Center, Harris County saw a 95% decrease in public intoxication jail admissions from 2013 to 2017.[1] This decrease freed up valuable resources for Harris County jails while expanding the capacity of county and state hospital emergency services.
The benefits are also apparent at the Austin Sobering Center. Since 2018, 6,092 people have been diverted to the Sobering Center instead of jail.[2] Of those people, around 95% said they were satisfied with their stay. The Sobering Center’s staff are credited for this satisfaction rate.
“For many folks with chronic substance abuse behaviors, this is one of the first places that they have been able to receive dignity in care,” Branscum said.
A continuing goal at the Sobering Center is to build trust with its service model. Six years into the project, over 70% of referrals to the Sobering Center continue to come from Austin and Travis County law enforcement.
Most challenges the Sobering Center team faces involve things beyond their control. For clients, the stigma around substance use and public intoxication continue to act as barriers for seeking treatment. Programmatically, the Sobering Center team must work creatively to offer harm reduction services for people using contaminated substances.
Looking forward, Travis County officials approved renovating the second floor of the Sobering Center building. This larger space will allow the team to expand the Holdover Program and provide more opportunities to serve the community.
[1] Suzanne V. Jarvis, Leonard Kincaid, Arlo F. Weltge, Mike Lee, and Scott F. Basinger, 2019:
Public Intoxication: Sobering Centers as an Alternative to Incarceration, Houston, 2010–2017
American Journal of Public Health 109, 597_599, https://doi.org/10.2105/AJPH.2018.304907
[2] Sobering Center Website- Impact https://soberingcenter.org/impact/
Additional Resources
Deflection and the Deflection Pathways Fact Sheet. Legislative Analysis and Public Policy Association, 2023.
Behavioral Health Diversion Interventions: Moving from Individual Programs to a Systems-Wide Strategy. The Council of State Governments Justice Center, 2019.
Expanding First Response: A Toolkit for Community Responder Programs. The Council of State Governments Justice Center, 2019.
In the News
Austin-Travis County Sobering Center set to expand. KVUE, December 2023.
New Sobering Center gives intoxicated people an alternative to jail or the hospital. KUT News, August 2018.