While thousands of librarians met in Philadelphia for a convention and the announcement of prestigious literary awards this week, there was another topic trending: the Affordable Care Act. Libraries across the country have been trying, in varying degrees, to meet a growing demand for health insurance information.
At one end is the Free Library of Philadelphia where library coordinator Nani Manion has started running twice-a-week enrollment clinics at Parkway Central's technology lab. Manion is one of 33 librarians in the city who have completed the five-hour training to be certified as an application counselor.
On a recent morning, Alfred Di Martini stopped in after having problems going through the government website on his own.
"I came in here and saw the flyer, and the person at the front desk told me about it," he said, plopping down in front of a computer. A librarian sits next to him, on hand to assist as he searches for options for his wife and the caregiver of his 95-year-old mother, both uninsured.
Another man, uninsured and in need of physical therapy for a past injury, comes in to browse insurance options.
At least through March, 11 library locations will be taking individual sign-up appointments or hosting these walk-in sessions.
"It started off slow post-holiday and because of the weather," said Manion. But the pace has picked up; one day last week, six people showed up for help. That might not seem like a lot, but the process for some individuals took nearly two hours. "I could have used more assistance."
The added service also means some give-and-take with other library programs. While Manion conducts sessions, another computer class is on hold.
Last summer, the Free Library's director, Siobhan Reardon, issued a system-wide request for librarians who were interested in taking the training.
"Our role here in library land has been changing rapid fire," said Reardon, who was surprised to learn from a recent pew study that more than one third of people are coming to the Philly library for health information, spurring the concept of this latest effort. "The trail into getting insurance is not a neatly designed trail, and so there's nothing better than a librarian to help navigate."
Libraries as key sources for health information
Libraries often serve a role well beyond that of book caretaker — from providing early childhood education to employment assistance to computer literacy skills. The economic downturn heightened the demand for those expanding services, but health information has long been a recurring theme.
The Institute of Museum and Library Services estimates 28 million people sought health information from libraries in one year. A 2012 Pew report found one in three adults visiting the Free Library obtained health information.
"So we know people are going to the library and we want to make sure librarians know about community resources and websites that they need to give them accurate information," said Mamie Bittner, director of government affairs for IMLS, who was in Philadelphia for the conference where the Newbery and Caldecott award-winning books were announced.
As that excitement was going on, Bittner and a handful of other librarians from Texas to Idaho to Northeast Pennsylvania were brainstorming about ways to help their patrons navigate the process of signing up for health coverage.
Last summer, IMLS issued a $286,104 grant to craft webinars geared toward librarians. More than 1,000 have participated since that launched, Bittner said.
"There are pressures on libraries," she said. "They are stressed in many ways, but meeting the high-priority information needs of their community, that is their job."
And responding to health needs is nothing new, Bittner said. Libraries were active in assisting seniors with the launch of Medicare Part D, for example.
Varying approaches and levels of involvement
Libraries "are assuming a variety of roles" in relation to the Affordable Care Act, Bittner said, though not all are going as far as the Free Library in Philadelphia. "Other staff are just being ready, so that they know where the websites are and can help people find them," she said.
In Delaware, state librarian Annie Norman, said they've been thirsty for useful, accurate information so they can best assist patrons.
"We saw such an influx of people needing job assistance, that when this big health care initiative was coming in, we thought they're going to be coming in!" she said. As many as "35,000 people could be on our doorstep with questions, so we wanted to be prepared to help them."
The system first turned to the state, which is running the health care marketplace in partnership with the federal government. Libraries in Delaware have since hosted more than three dozen public events. Navigators, or federally certified application assistors, have used library space to meet with people and help them enroll. Libraries like those in Delaware also have computers with solid, protected Internet connections, which may come in handy for those lacking places to enroll online elsewhere.
While they haven't seen the influx of people they had initially expected, Norman said they're also tracking the questions — 300 so far — that people have, so they can better respond to insurance questions in the future.
"Since this is new, we're laying the foundation for years to come," says Cathay Keough, with Delaware's Division of Libraries and Reference Services.
Approaches also vary from library to library and community to community. In Atlantic City, the free library has a history of being active in responding to community events. Superstorm Sandy is one example.
"We were very prepared to help the community with stuff like that because they see us as a place to help with that information," said Julie Senack, head of information and community education services at the Atlantic City Free Public Library.
When Sandy struck, she said, they tracked down resources and distributed that information in fliers around town. The library also became a FEMA base, with people applying for assistance inside. Now, she said, the library is applying those lessons to the Affordable Care Act rollout.
"Like with FEMA, the first thing we did with the Affordable Care Act was learn," Senack said. "We don't have to understand everything, we just need to understand how to get correct and accurate information and reach out to people who do know, and have them in our orbit."
That orbit isn't too big. A main health clinic, staffed with navigators, sits on the same street.
This story is part of a partnership with NPR, WHYY and Kaiser Health News.
This story has been updated. A correction was made to reflect the grant was given by the Institute of Museum and Library Services and not the Centers for Medicare and Medicaid.
This audio and web copy of this story was again updated for the February 7 episode of The Pulse.