Repeat offender bookings dropped by 61% at Sanpete County Jail. Here's how

At Sanpete County Jail, recidivism — where individuals are resent to jail after release for repeating criminal behavior — dropped by 61% in 18 months, thanks to a program that connects inmates dealing with substance use disorders with a community health worker.

The program was created by the Intermountain Health Community Health Team through federal grants from the Rural Communities Opioid Response Program. After conducting a needs assessment of rural Utah, they employed Cheryl Swapp, a community health worker, to work with the Sanpete County Jail in 2022.

Before the program, inmates with substance use disorders had little support at the Sanpete County Jail, with no one trained in offering them resources or treatment. The most the jail could offer was to look up phone numbers if an inmate had a specific treatment center they were interested in.

Now, Swapp works directly with those inmates. As soon as they’re booked, she’s brought in to do an assessment of their situation and needs, then recommends treatment.

For those who are incarcerated for an extended period of time, the program offers telehealth visits with a nurse inside the jail once a month, which can open individuals up to further treatment.

“If they show interest, we can do a one-on-one intake right here in the jail, so the second they leave jail, they have their MAT [medication-assisted treatment] ready,” Swapp said. “A lot of them will relapse within the first 72 hours, so that MAT treatment helps them, just one more resource that they have.”

They’ve also begun offering more classes inside the jail such as parenting and anger management so those who have court-mandated classes can finish them before release.

As inmates get ready to leave, Swapp then helps them form a plan to ensure they have the greatest chance of recovery.

“Make sure they have food, clothing, a good place to go," she said. "If they need classes, dentist appointments, doctor's appointments — a lot of things that they need, that they just aren’t sure how to get.”

That plan often includes connecting inmates with rehab or recovery centers, sometimes even as a replacement for incarceration — finding where they want to go, setting up intakes, getting transportation, and ensuring they can afford the treatment.

“Folks are immediately entering treatment when they leave jail,” said Sarah Diefendorf, community health director at Intermountain Health. “I think that's part of why we're seeing this dramatic reduction in recidivism, because folks are leaving with a plan, they're enrolled immediately.”

Because Sanpete County is rural and many areas lack providers who are trained to work with substance use disorders, the program also allows people to get treatment through telehealth. This provides more options, as well as a way to avoid the shame or stigma that can surround substance use disorder and treatment.

“Many folks described not wanting their truck to be seen in a parking lot at the clinic because everyone knows what car you drive and they know it’s you,” Diefendorf said. “So [telehealth] provides a more accessible means of treatment and a less stigmatizing one in smaller communities, when that sometimes can be hard to seek treatment.”

Another way the program seeks to fight stigma is by connecting these individuals to the community with monthly activities called “Sanpete Area Fun Events,” or “SAFE events.” These activities, ranging from bowling to aquarium visits to picnics, are open not only to those involved with the program, but anyone in the community.

“We do that very intentionally so that individuals who are on their recovery journey can hang out and get to know other folks in the community,” Diefendorf said. “And I think this is important so that community members who don't have a history of substance use or incarceration can connect with folks that do and get to know each other as community members.”

Diefendorf believes these events can also help with prevention of substance use disorder by providing everyone in the community safe, welcoming events and people to engage with.

“If we’re only focusing on [treatment], we can miss a lot of important work, and I think these events really help address that as well,” Diefendorf said.

Community involvement on the back side has also been an important part of making the program successful.

“I work super close with the counseling center, the sheriff, LDS church leaders, Catholic church leaders, and just the whole community works together for it,” Swapp said.

“We need as many people at the table as possible to work to change the course,” Diefendorf added. “And I think this program can really has really highlighted the power of that community collaboration to really affect change in a positive way.”

In the 18 months before Swapp was hired, Sanpete County Jail had 599 repeat offender bookings. In the 18 months after she was hired, there were 236. That’s a 61% reduction in recidivism.

The impact isn’t only in statistics, though. Swapp shared several stories of how the program changed the lives of inmates and their loved ones. One woman said her son, who had been arrested regularly, hadn’t used drugs or been arrested in six months.

“There’s this other girl that checks in ... and she is actually getting custody of her kids back again after like 11 years,” Swapp said, tearing up. “She actually has a relationship with her kids. And it’s stories like that, you know? We are making a difference, and it’s just by caring. A lot of times, what they need is just somebody to check on them and tell them that they can do it.”

The Intermountain Health Community Health Team and Swapp were all honored for their work earlier this year at an event in Washington D.C. for individuals and groups who’ve received federal grant money for opioid use.

Of the hundreds of groups in attendance, they were one of six selected to present, and were voted first place by the audience for their work.

Eventually, the grant funds that created this program will run out, but Swapp, Diefendorf, and the rest of their team have already made strides in making sure the program stays alive.

“Cheryl’s job is funded once this grant period ends by the county,” Diefendorf said. “That was a huge win for everyone involved.”

They’ve also used some grant funds to buy a trailer filled with supplies they can use to keep up the safe events, such as softball gear and fire pits.

The team also hopes not just to keep the program alive, but to expand and improve it. Currently, Swapp only works weekdays, which means people booked on the weekends can fall through the cracks, and she’s looking for ways to remedy that.

She also hopes to set up a mobile truck to provide hygiene kits and Narcan, a medicine that can reverse opioid overdoses, to the community, and to eventually get transitional housing in the area.

Diefendorf and the rest of the Intermountain Health Community Health Team are also currently applying for additional grants to replicate this program in other parts of Utah and in Montana.

“I think in many ways, this is just the beginning of this work in a really, really exciting way,” Diefendorf said.