Dominique Felton started using drugs at 13 years old. In her 20s, she escalated to selling drugs to maintain her habit. When she was incarcerated, she had 10 warrants out for her arrest.
In the Sanpete County Jail in rural central Utah, her life would turn around thanks to the work of Cheryl Swapp and Intermountain's Community Health team.
The project started back in 2020 when Intermountain’s Community Health team received a Health Resources and Services Administration (HRSA) Rural Communities Opioid Response Program (RCORP) Planning Grant to conduct a robust needs assessment in Central Utah.
The needs assessment identified a critical need to support prevention, treatment, and recovery efforts for individuals with opioid use disorder in the six-county region. In 2021, Intermountain Health received two HRSA Rural Communities Opioid Response Program (RCORP) grants: Implementation III and the Psychostimulant Support Grant, totaling $1.5 million dollars in funding.
“We combined strong community collaborations with Intermountain resources to apply for the federal grants that have allowed us to do this work and make a positive impact on the livelihood and well-being of many in this rural community,” says Sarah Diefendorf, community health director and government grants leader for Intermountain.
With that funding, Intermountain hired Cheryl, a community health worker employed by the Sanpete County Sheriff’s Office in July 2022.
Cheryl works with individuals with substance and opioid use disorders in the Sanpete County Jail. She conducts substance and opioid use screenings and offers Moral Reconation Therapy (MRT) and peer support classes for individuals in the criminal justice system and those exiting from the jail. MRT is a cognitive-behavioral therapy that helps people change their thought processes and decision-making to reduce the likelihood of re-offending or returning to substance abuse.
“Cheryl kept in contact with a rehab [facility] that I wanted to go to and made sure they had a bed for me,” Dominique says. Dominique is a year sober, employed, and reconnected with her children. “Without her, I wouldn’t be where I am today,” she says.
In the 18 months before Cheryl was hired, Sanpete County had 599 repeat offender bookings. In the 18 months since a community health worker was hired in the jail, there have been 236 repeat offender bookings, representing a 61% reduction in recidivism.
This huge reduction in recidivism means that the rate of repeat offender bookings in Sanpete County Jail is now only 22%. The reduction rate is highly significant, considering that the average reduction in recidivism in Utah is about 45%, while the Sanpete County Jail initially had a rate of 56%.
The Intermountain Community Health team collects and analyzes robust data related to each grant project. This allows the team to determine which new projects are making an impact. Importantly, this type of data collection is necessary to help community partners decide, alongside Intermountain Health, if a program can be sustained after a grant ends.
At Sanpete County Jail, the data told a clear story: The community health worker was making an impact. The tangible benefits demonstrated through this data collection led Sanpete County Jail to agree to fund the Community Health Worker position after the grant ended in August 2024.
Furthermore, the State Department of Corrections is considering implementing this model in prisons and is piloting a program at the Northern Utah Correctional Facility. This work has garnered significant media attention in Utah, culminating in a site visit in November at the Sanpete County Jail by members of the Utah State House of Representatives and Community Health worker policy leaders.
“This work embodies one of our core values as an organization: that we are partners in health,” Sarah said. “We would not see the success we celebrate today with our work on opioid use in Central Utah without the strong support and collaboration with our community partners and project officers at HRSA. This funding gave us the opportunity to build a new program to respond to a community need together.
“Most importantly, we were able both show a clear impact and work with Sanpete County Jail to sustain the work after the grant ended,” Sarah said. “That’s the biggest win in the world of grants—when we receive federal dollars to try something innovative and new, it works, and we can keep the work going once the grant ends.”
In addition, the Community Health team used lessons learned from this work in Central Utah to secure additional grant funds to replicate this program in Washington County and Weber County.
Intermountain Health was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $1.5 million with zero percentage financed with non-governmental sources.