WHO: Aubree Rosenberg

JOB: Community Outreach Recovery Specialist

INITIATIVE: Coordinating Care for Individuals with Substance Use Disorders

POPULATION: All adults enrolled in the Allegheny County, Pennsylvania Medicaid managed care program, who present to one of four local hospitals with alcohol or drug use identified.

KEY FEATURES: Hospital-based intervention that uses people in recovery to build rapport and coordinate aftercare treatment with individuals identified with substance use disorders in the emergency department or upon inpatient admission.

Less than five years ago, Aubree Rosenberg had something few people in their 20s have: a living will. She was presented with the document by her father after being discharged from the hospital following a suicide attempt. Having spent years in and out of treatment facilities, battling multiple mental health diagnoses and addiction to alcohol, benzodiazepines, and opiates, Rosenberg, who is now 26 years old, describes the moment as having changed her life: “For my father to do that was a huge wake-up call, because my parents were enablers, and to see them give up…something lit in me that said, ‘Wow my dad is just saying I’m going to die and there’s nothing he can do about it.’ Which is the truth.”

After becoming sober, she felt called to work with people who struggled with co-occurring mental health and substance use disorders. She became a Community Outreach Recovery Specialist (CORS) at Community Care Behavioral Health, a behavioral health managed care organization. A CORS is someone with lived experience who is in stable substance use recovery and trained to help people with substance use needs connect to treatment and navigate the complex health care system. This position is part of the Coordinating Care for Individuals with Substance Use Disorders initiative in Allegheny County, Pennsylvania. This project operates out of four hospitals in the greater Pittsburgh area and serves Medicaid beneficiaries who might benefit from peer support to connect with substance use disorder treatment and recovery services.

New Faces of The Complex Care Workforce

In communities across the nation, complex care management teams are deploying “non-traditional” health care workers — including individuals with lived experience or skills that transcend the traditional bounds of health care — to better connect with high-risk patients. The New Faces of the Complex Care Workforce series showcases how these workers are helping in innovative ways to address the needs of adult Medicaid beneficiaries with complex health and social needs.

After meeting a person for the first time, usually at their hospital bedside following an overdose or medical emergency, Rosenberg works with hospital social workers to develop a recovery plan and connect the person to community services prior to discharge. If the person agrees to continue working with her, she starts working on a variety of activities tailored to the person’s needs.

This could include accompanying them to appointments; connecting them to substance use disorder treatment, mental health services, or recovery support groups; or working to get them admitted to a residential treatment center.

“If I can give patients that little sense of encouragement and power, advocate for them to be heard at the hospital or an inpatient appointment, then we’re already in the first step of maintenance. We’re taking action in our lives.”

Aubree Rosenberg, Community Outreach Recovery Specialist, Community Care Behavioral Health

Rosenberg works with people ranging in age from 18 to 82, with most of her clients in their mid-20s to 30s. The majority, she notes, battle opioid or alcohol use disorders. “About 90 percent remind me of myself back then,” she notes — sick, frustrated, and uncertain where to begin with sobriety. But rather than being disappointed when a person relapses or overdoses and returns to the emergency department, Rosenberg is patient and comforting. Drawing from a toolbox of techniques including motivational interviewing, as well as her own experiences, Rosenberg takes a strengths-based approach. “I would say [to a person]: ‘Thank goodness you made it back… I’m very proud of you, that you made the decision to come back.’ I didn’t get that, back when I was a patient myself.”

Today, Rosenberg is five years sober and happily married with two young boys. In August 2018, she will start working on a social work degree, and in the future, plans to continue working with people as a mental health and addictions counselor. “Helping people who are experiencing the same things as I did helps me emotionally, physically and spiritually. It aids my own recovery more than they’ll ever know.”

Additional Resources

Case Study | Southwestern Pennsylvania: Peers Help People with Substance Use Disorders Move Toward Recovery – Provides information about how Allegheny County, Pennsylvania is successfully using people in recovery to build rapport and coordinate outpatient treatment for individuals identified with substance use disorders. July 2018

Author: Mariel Gingrich, MPH