Welcome, everyone, to today's presentation on, on Health Happens in Libraries, supporting patron information needs, we thought this would be a great opportunity, after almost two months of the launch of both the Federal and the state health insurance exchanges to hear a bit about how libraries are responding to local needs that have been surfacing in their communities, so joining us today we have 
Susan Hildreth from the IMLS, and health happens in libraries is a grant that is funded through IMLS, and we are pleased to be working close with them on this project. 
We're also joined by Lynne Johnson from the centers for Medicaid and Medicare services who will be talking about what's been happening with healthcare.gov and giving us a few updates. 
And part of Lynne's team, we have Melissa moreno, answering questions at the end of the presentation today, during the Q&A session, and you will see in the chat box, we have tanisha brown, answering your questions on chat, that relate to Federal issues or questions about the website or, or general application issues, tarnisha has joined us in the past, and we are pleased to have her with us  
again, and we have two library representatives joining us today, we have Debbie Rzepczynski from the lake county public library, and we are very excited to see Debbie was an early adopter of the lids for help hashtag, and that was one of the ways we got connected with her, so if you are tweeting today, remember to use that hashtag. 
Use #libs4health, we would love to hear about that, and Jennifer Koehane, who I met through past projects that we have done here at Webjunction, as well as at the American library association conference, this year, where they were already ready to go and, and interested in how their community and how their organization could help to support patron needs around this request. 
So, to get started, I am going to turn it over to Susan Hildreth for a quick welcome. 
Susan. 
>> Well, good afternoon, everyone, and welcome to this Webinar. 
We're so glad that everybody is tuning in so close to our big holiday coming up with, with the crazy weather, at least on the east coast. 
So thanks so much for participating. 
And I would really like to acknowledge our terrific partners in this effort. 
Of course, Webjunction is a great partner, and as well as zero divide, that has brought a lot of information and knowledge about health and technology, and of course, our Federal partner, the centers for Medicare and Medicaid services. 
So, we're really happy to be able to check in with all of to see how things are going. 
And we know that we have had a little bit a challenging start. 
But, I think that it's really more important than ever to have libraries ready to help our customers in terms of their information needs. 
I wanted to make sure that everyone understands that your libraries's involvement in supporting health information is a very important service to the public, but it's also definitely a local decision. 
It's up to your library and your community to decide how this information is distributed and to what extent the library place a key role. 
And I also have had questions throughout this work, in terms of the concerns about, about the role of librarians in a providing information about the health insurance exchanges, and the affordable care act. 
So, we do not see librarians as health advocates or individuals who are helping people make their health decisions. 
They are not advising on these decisions. 
What we're really doing is to try to facilitate connections in our communities to help our customers understand the processes and all the information available, and in many cases, use our facilities to help to provide training opportunities for getting folks together with their navigators, or their community health centers. 
So, we're trying to use the power of libraries to help folks understand everything that they need to know to be able to navigate the affordable care act, and other health information, positively and safely. 
So, with that, I will turn it back over to Kendra. 
>> Thank you very much, Susan. 
>>> So we wanted to talk a bit about the health happens in libraries program here at Webjunction that we are doing in partnership with zero divide. 
And we want to make sure that you know about a few resources that are available, and one is the community of practice, that's available online for everyone. 
You can participate by reading articles. 
You are welcome to submit your own stories. 
And we'll talk a bit about that in a minute. 
But, what we have done is to actively collect ACA resources at the Federal and state level to share back with all of, and been collecting stories from, from libraries that are actively engaged in providing support, and a lot of times, that's through a local partnership that they have formed. 
And we're really looking for, for diverse set of examples of how libraries are working within their community to meet their needs. 
So, you will find some of these stories highlighted on the Health Happens in Libraries site, and we would be interested in hearing your stories. 
So, you see there are a few you questions up here. 
And you can email any of your stories or thoughts to content@webjunction.org putting in the Health Happens in Libraries in the subject line. 
But we would really like to hear about how your library has been involved in supporting patrons. 
What level of engagement do you have. 
Have you had a successful partnership. 
How have you seen patrons responding to the services that you've been offering. 
One of the strengths of Webjunction being able to share back stories, and through Webinars, such as today, we really look to being able to share back these stories, so that other libraries can either learn from them or look for opportunities that might be valuable in your own local community. 
So, with that, I am going to turn it over to our first presenter who is pinch-hitting today. 
A meeting came up so we have Lynne Johnson here from CMS, who will be talking about what's been happening at CMS and providing bit of an update. 
Welcome, Lynne. 
>> Thank you. 
And thank you for the opportunity to provide these important updates to the library community. 
And also, just want to thank all the libraries for their efforts in providing outreach and education and enrollment assistance to help ensure that consumers get access to our outreach education, and resulting in affordable health coverage. 
So today, we're about eight weeks into the implementation of the health insurance marketplace. 
And as you know, over the past few weeks, since implementation, we have had some issues with healthcare.gov. 
But, we are making measurable progress to improve the website. 
We're addressing both the software glitches and hardware upgrades, all of which will make a  meaningful difference in the consumer experience. 
We have also, also increased recent the system capacity. 
So, this will be part of an ongoing, hardware improvement process that will help keep the system stable with the growing volume of a number of interested consumers in comparing health care plans, and also in enrolling. 
Some of the examples of a few fixes we have improved, the response time going from sort of an  eight-second delay at launch to under one second now from the users, by eliminating glitches in executing some bug fixes in the software, where were driving the error rate on the pages down to under 1%. 
So, I hope that some of will, on the Webinar today seeing this improvement. 
We have added visual queues to plan and compare the screens to help consumers select the best plans. 
And we have we have worked to do this, but we know that we have some work to be done. 
But healthcare.gov is getting better. 
And the performance and user experience is improving. 
We committed to updating on our progress, and as we work to improve healthcare.gov, so, we have created a join the conversation that is a tech block page where he have provided the link to the health insurance tech blog where when there is an update or any changes to the website, you can go in and provide your feedback on your experience. 
While using healthcare.gov, and it's called, join the conversation. 
So, that's, that's a little bit on healthcare.gov in a nutshell, and the improvements. 
But I'm sure that if you look at the health insurance blog, you know, you will see the continued updates. 
In addition, to continued gathering feedback regarding enrollment, we are tracking, analyzing issues and experiences, during this time, and we feel as though your feedback is very important. 
the first we have a, a stakeholder feedback call. 
So far we have had two of those. 
And we push out key stakeholders and partners about a week before we have those calls. 
And we also provide updates on the calls, and then open it up for Q&A. 
And in addition, we have created a mailbox, and I have provided the link here. 
Marketplacecomment@cms.hhs.gov. 
You can send any issues you have related to open enrollment. 
This is not a place to get answers to questions or response to your issues, but this is where we collect all of this data, look for common issues and common trends. 
We analyze it, and we send it on to the component that can effect some change towards the positive, and towards resolution. 
And just to revisit a few things. 
There are several ways in which a consumer can apply for and enroll in the marketplace, and we have healthcare.gov. 
We have the marketplace help center, the 800 number. 
And there are the navigator, certified application assistance, counselors. 
And we also want to note that consumers can also apply by submitting a paper application, which they can download from, from the website. 
To add to that, the enrollment period for the Federal health care exchange has been extended until December 23rd. 
That's an extra eight days. 
For applying for health care coverage with the start date still being January 1. 
Even though it has been extended by eight days. 
Again, I want to review the many resources that are available for you. 
And the key stakeholders at CMS marketplace website, so if the trainings are still there, the overview of the marketplace, health insurance, marketplace 101, there are the presenter slides and speaker notes, and also training and the videos for download. 
The last link is the link where you can go in and order products and publications pertaining to marketplace. 
But, I would like to say, once a week, I check the, the warehouse for the stock that's on hand, and it continues to be depleted very fast. 
So, you know, if still want to go in and try, the order materials, there are also marketplace posters that you can order. 
You can also order the applications for your library. 
We have had quite a few of the applications on hand, also, in Spanish, too. 
And if we are out of, any publications, you can still download and print any from our website. 
And the last reminder, again, is about the champions for coverage. 
We do appreciate the opportunity to work with libraries and helping us get out the word about the marketplace. 
And if you are interested in signing up to become a champion for coverage, and promoting, you know, outreach education for the program, I have also included the champion link at the bottom of the screen. 
Right now, we have over 100 library champions that represent public, state, medical libraries, and as well as state library associations. 
And we're going to be looking into those numbers, about 100, the number so far to see what that translates to, and the reach, that the libraries are doing and, and in promoting the marketplace. 
That's it for me. 
>> Great. 
Thank you very much, Lynne. 
As a reminder to everyone, we do have two additional CMS representatives, tarnisha brown will be answering questions so feel free to do that, and then, step end of the session, Melissa Moreno will join us to answer your questions verbally. 
And as a second reminder, the CMS information and healthcare.gov is for the Federal marketplace. 
If you are part of a state exchange, you will want to make sure that you reference your state website to make sure that you have access to the latest resources and training materials that are specific to your state. 
Which is always a good, a good thing to have access to, to make sure that if there are training opportunities, for example, that might be specific to your state or region, and we encourage to do that, and another resource that we want to make sure that we mentioned that, Susan put into the chat was a national networks libraries medicine, who have been great in helping us to share information about 
what's happening in those regions throughout the country. 
As well as many them have taken on partnerships with state library agencies, as well as local libraries. 
And they are a great resource to reach out to. 
So, the next part of the Webinar is going to move into hearing some specific examples from two libraries, and how they have been addressing their local patron concerns, and interests. 
So please join me in welcoming Debbie Rzepczynski from the lake county public library. 
Hi, Debbie. 
>> Hi, Kendra. 
Thank you very much. 
Just wanted to get started with kind giving a rough idea of where I'm coming from. 
This is my first year as being a system-wide trainer. 
And with this, the job was sort of just kind up in the air, I got to build it. 
And midway through the year, the, the ALA conference went on, and my director went, called me in and said we need to do something about this. 
So, in the past, before this, I've been a reference librarian. 
11 years there. 
11 years as an assistant manager, I've been a branch assistant manager, a clerk, and a page so I have kind of grown up here. 
We are located in northwest Indiana. 
About an hour southeast Chicago. 
And it's always kind of interesting that when you think lake county, Indiana, you think one of our largest cities, historically, has been Gary. 
So that's kind where we're coming from here. 
We are a library system in a county, but there are, actually, six other library systems in our county, so, we do share, we play nice together now, and, and but one of the things is that while we plan for, for programs and materials for our customers, we are also finding patrons from other library systems who happen into our library. 
And, and it's, it's -- we don't stop them, we encourage them to attend programs like this, and I think that now, finally, some of the other libraries in the county here are catching on in that, you know, that we need to get onboard with this because that's what I'm starting to hear now, is I'm getting calls from other library systems and say hey, what are you doing? 
So, we kind went for this in June, and I spent the month of July just kind, kind looking around to see what's going on with the affordable care act, and what exactly it is. 
So, I have got my file, my huge file. 
I watched the Webinars. 
I have watched the CMS training. 
Read a lot of, you know, kind of trying to teach myself all of this. 
And the goal was to have this all set up so that I can take what, the 900 some pages of the law, and train our branch managers, so that they can go back to their libraries, and our ten locations, and so that they could, you know, find someone who was looking for health care insurance for insurance information and point them in the right direction. 
And all along we thought of this as not so much are we going to help someone fill out their application. 
But rather, just like taxes. 
We're going to point them in the right direction, give them the tools to fill out the website information. 
Give them the flyers to find out more information about the ACA, so that was our goal. 
And it turned out to be -- it got bigger as we went. 
I should say. 
We did staff training. 
I did public programs after that, and all of our ten locations. 
We put together a website, and the website is for the staff, as much as it is for the public. 
Because it's nice for the staff to just have something that they can click on, and have some notes there to help them. 
More public programs are going on, and we just keep going with the public programs, as long as we get people in the seats, we're going to keep having the programs up for March. 
Now, my first meeting, the first training was supposed to just be our branch heads and supervisors. 
And in that meeting, they have kind of set my pace in what else we're going to do. 
Our library system has decided to absorb the cost of printing the applications. 
We had the, these, the draft applications printed early on, so people could get an idea. 
Clear, marked on top that they were drafts. 
And as soon as the, the, the other applications, the permanent applications came out, we made sure that we had links to those, and we had them all printed out for all of our branches. 
So, people could just pick them up. 
We figured it would be like FASA, where the kids are applying for college aid, that they would fill out the paper application, and then tackle the computer issues. 
The web page, has all of our local information, and that I was able to find with the help of our local newspaper as they ran -- I'm sorry. 
As they ran articles on the health clinics in the area who were training to be with navigators. 
And of course, the little giveaways, the bookmarks, they have our websites. 
That have our phone number. 
And as we kind figured out who the answer audience was, we figured out, we're not going to have to teach a lot of how to use the mouse classes. 
We're not going to have to teach how to use the internet. 
But, we probably would have to help people get an email address. 
So, those were the classes that we concentrated on. 
And, and some of our one-on-one instruction concentrates on the same thing, to get them started. 
We made sure that they had email, even if they were filling out the paper application to get information back, they could have it sent to them through email. 
So, the branch managers helped me to kind of focus on where our training should go. 
And, and they also looked for, how -- their question was, how should we, you know, limit ourselves when it comes to helping the patrons? 
And, and I brought it right back to tax season. 
And said that well, you don't sit down and start typing in someone's tax information if they cannot work the computer. 
And they are like no, we don't. 
But, you know, just things like, you know, don't sit when you are helping someone at the computer. 
Remain standing. 
So that they know that they are going to have to do the typing. 
And to not take the mouse from them. 
And this is all training that I learned eons ago with the gates' training when we got the gates computers how to best train someone else. 
, and and then the supervisors threw me for a loop, and they said wow, you did such a great job of putting 900 some pages into a couple of slides, can you come to our branch and can you train all the number service staff? 
And with that, it was, um, I think that we trained 111 people at this point. 
So, we have trained all of our front line staff. 
Our reference librarians, our branch managers, our department managers. 
Everyone went to the training. 
Indiana is a Federal site, so we are depending on the Federal marketplace. 
So, that's where a lot of our information came from, and that's where I was able to get a lot of videos and whatnot. 
To help with that. 
This gives you an idea of the things that are on our website. 
It's, it's -- a lot of repeat of, of the web address, healthcare.gov. 
And then mostly, when our public programs are, and when our email classes are, I also had general overviews where I talked about, about the whole affordable care act, and it was just my, my staff training kind of reworked for the public. 
And, and applying in person was big thing. 
So, I played sure that we had the lists all the health clinics in the area. 
Who, who would offer the navigators, so that they could make appointments there. 
And of course, people came away with something when they attended the programs. 
So, we have the applications available for them. 
And our, our print shop printed up the, the pdf about the health insurance marketplace, and we made business cards that had our website on it, but also, healthcare.gov, along with the 800 number. 
So this is kind of -- was really cool because we had been thinking of this and doing this long before, you know, I learned about where we could order on CMS. 
And it's a good thing because with the CMS site, like Lynne had said, is that things go out of stock really, really quickly. 
So, just to go back and forth, and I make pointed looking every week or so, and seeing what's new, and I have gotten some nice handouts for people. 
One of them was on fraud. 
And that was big question people who were attending the workshops. 
So, that's kind of been, been handy to have. 
And as we go, we see people coming in to all of our programs, and I think that the biggest thing that they are looking at is, is they are trying to do the marketplace at home, or they might have an appointment with an, with a navigator, and they might find that they are getting so far only on the website. 
And they think, it's them. 
Well, the nice thing about bringing all these people together, and everybody exchanging stories, is they find out that, that no, really, it's not just. 
Other people are having the same issues. 
So, it's kind of reassures them that, that they are not making the mistake, and they are not the ones who can't figure it out. 
But, rather, I kind of encourage everyone to have patience. 
And try again. 
And I share some of the success stories that I have heard from the other programs that I have had. 
And, and everybody goes away with a better understanding of what they are doing. 
An idea that they can go back in and try the website again, and they will now know, because they used two of the videos that I found, that take step by step through the, the signup process with our fictional character William, and they kind of enjoy seeing in that, and seeing just how, how straightforward it does look, and for the people who have dabbled in the website, they are like  yeah, 
it did look like that. 
Yeah, it is kind of easy. 
I can do this. 
So, they go away with good feeling, and just today, I came into a nice email from, from one of the patrons, Paul, who says thank you for your session the other night in maryville. 
It was something I needed to do to kick myself in the bum to get myself on the journey to signing up for the Affordable Care Act. 
Thank you, Paul, so that's whether it's a about, helping to spread the word. 
However you can do it. 
However your library can afford to do it. 
We figured we would take the bull by the horns and make sure that we got in there beforehand, and started talking to people about this. 
And there is always more that can be done. 
I think that at this point, probably just more publicities we start having more programs planning for January and February. 
I am thinking ways that we can reach out to other partners, maybe some of the partners who wouldn't think of sending people to the library. 
But we would not have a problem sending our people to them. 
So, that is where, where we're going with this. 
>> Great, thank you very much, Debbie. 
I have a quick question, what have you been hearing from patrons? 
What types of questions has your library received from patrons regarding enrollment or ACA opportunities? 
>> I have had a number of different, one branch, I love it, they just kept track of every program, and usually, the biggest one was, was where do I go on the website? 
And it's like, gosh, I thought that was a given. 
But, other questions that I have had are from people who, the website didn't work. 
And they got in on the 800 number. 
And from that point on, they still haven't heard anything. 
Or people who have mailed their application in, but they are not hearing anything, and I have to just remind them at this point to, to have patience, because of the Government shutdown for one. 
That kind of delayed everything. 
And but, also, to get back on the 800 number and call again and see, you know, if somebody else can, you know, find their information out there so that they can continue. 
>> That's great. 
Thank you. 
>>> And can talk a bit about how you uncovered the population and insurance data for your county, and how that, that played into, into your decision to, it look at this as a library service? 
>> I'm thinking that, that we started with, with some of the, you know, the effects on Indiana. 
And I took it backwards from there. 
And I found the county information interesting. 
That, I believe, I found at CMS. 
And the, the division of the county where there is 100,000 person areas, so we have four PUMAs, there is 400,000 people here, and I found the breakdown of the number of uninsured in each area, and the uninsured in each area was kind of interesting because we have got our, you know, our northern section of lake county, which is more of the older established towns where there 
is a lot of flight to the southern part of the county. 
So, they are losing population. 
And then we also have our southern parts of the county, where it might be more wealthier collection people. 
In areas, but, the statistics on who was uninsured, almost the same. 
>> Ok. 
And mentioned during your presentation about connecting with navigators, can you talk about how that worked in your community, and what that relationship has been? 
>> We have a couple of health clinics who are -- I went to them first. 
And, and they were just still getting trained. 
And they were just like oh, please, don't call us, we're still in training. 
And so, as we, you know, hear and we check back with them, they are like ok, you can call now. 
We'll make appointments for people. 
So, that's the word that I pass on. 
So that they can connect to them that way. 
And I did have a couple of, of sisters show up to one of reply programs where they had started their own website. 
And they are, actually, insurance salespersons. 
With a website that kind of brings in affordable health care, all those right words, and they wanted to come partner with us. 
And it was like, I don't think so. 
I wished them well but I kind of pointed them in other directions, where they might be welcomed. 
>> And you will find for everyone listening, there is a link that was just posted for local help at healthcare.gov where you can find navigators and assisters in your area. 
That you might be able to partner with to do programs at the library. 
And, and these are all people who have, with the navigators have received funding to do some of this training, and others who have gone through training that, that has certified them as assistance counselors. 
We also had a question from Linda eagleton about whether, if we could get access to the video created. 
>> Oh, it was not a creation of mine. 
I would have to look for the link. 
It was from either health and human services or from CMS. 
But I will look for that, and I will send it out. 
>> Perfect. 
And we'll make sure that we include that link, as well, and thank you very much, and again if, anyone else has questions, make sure to put those in chat, and we'll follow up with Debbie at the end of the session. 
>>> Now we would like to welcome Jennifer Koehane from the Connecticut library consortium, who will talk a bit about the work that's been happening with their organization. 
Welcome, Jennifer. 
>> Hi, Kendra, and thank you very much. 
Connecticut is one of the states that does have an exchange, and has been a leader in the insurance marketplace, so we were in a different situation with what Debbie explained. 
But, we still had similar issues, and we still had rocky starts, and we still had libraries with a lot of questions. 
The Connecticut library consortium, we are a statewide library consortium, for, for all types of libraries. 
And we, basically, try to make things easier for our members. 
We try to make things easier, and more affordable, and more efficient. 
So when we saw what was happening, with, with the incoming issue, related to the affordable care  act, and we knew that we had to sort take charge on that and, and one of the other things that, that I should talk about, is that, that before I came to, to the Connecticut library consortium, which were done a year ago, I had been heading up a business resource center in Connecticut, so I had 
dealt with a lot of the unemployed, and that's how Kendra and I had worked together on a project for project compass in serving the, the unemployed and those seeking employment. 
So, we knew a lot about what happens when there is significant social change, and there is changes in people's lifestyle. 
And how that brings people into the libraries for help. 
So, one of the things that we do really well at Connecticut library consortium is listen. 
And we were hearing a lot of discussion and, and concern from our members about, about what they saw was the big coming storm, which was a lot of concern about the numbers people that they expected, the lack of information, and things like that. 
And so, one of the things that we wanted to talk about, and really figure out is, you know, answer these questions about could they get, could they really count on getting help, and how could they get incredible speakers, as Debbie alluded to. 
There are a lot of people helpful in the community, but that did not mean that they were the best people, the unbiased people to bring into your community. 
And more than anything else we really wanted to eliminate the stress that our, that our members were feeling by bringing in more information. 
What we ended up developing as our goals was that we were going to focus on two areas, which would be, to quickly supply facts and training, and we also wanted to help our members save time and energy, and I think that someone put this in the chat about reducing the clutter. 
That because we were in a marketplace in Connecticut that we were going to try to create resources that were very customized to the Connecticut marketplace, and although there were wide range great resources out there, that we felt that it was really going to be important to create customized tools and training for our members to make sure that, that we could help them create handouts. 
We did not want everyone back at their libraries having to create their own tools. 
That if we could find out from everyone what they wanted, we could help develop that. 
And that we also felt like if we were to put resources up, we wanted to make sure that they were arranged by patron type and subject. 
I had a lot of experience being at a reference desk, and I could imagine fast forwarding to this fall what it would be like to handle the question from the, you know, 7th grader about World War II and asking for the books about it, quickly followed by the next person who wants to help them to sign up for their health insurance. 
And what kinds like difficulty that would cause and how quickly you would need to be able to access information because you would be jumping from things to things. 
The other thing that we really wanted to do was to help our members find incredible partners, and other major points, we were hearing this was going to be a real shift for librarians, and that instead in other cases where we really found ourselves like Debbie said, sitting next to people in cases, sometimes helping them out, that we really shouldn't be doing that. 
That there were going to be other people more qualified and trained to do that, and this was going to be a shift in our impulses, and that we needed to help people feel confident that they knew who to send people to so that they could move on. 
The last thing that we felt was really important was the fact that, that the affordable care act had many pieces and, and the enrollment period for the marketplace or the exchange was one piece of it. 
And in Connecticut, only 10% of the Connecticut residents are eligible for insurance through access health C.T., which is our marketplace, and we flew that libraries, particular public -- we knew they would see the population and they would have a whole wide spectrum of questions, and that not all those questions would be answered by just a, looking at the exchange piece of the affordable care act. 
We had a lucky circumstance. 
We had a partner approach us, the universal health care foundation Connecticut, who came to us with a fairly traditional request, which was they wanted to find venues to do a Film discussion around health care. 
What happened was, through working with them, through researching them, we found out that we had really good partner that, that enabled us to do something that Debbie talked about, and we did not have to go and do the research ourselves. 
We found partner who could help do it for us. 
And so, we found partner who was involved in research and policy-making and health care in Connecticut for ten years. 
And they had connections to the speakers and resources. 
And they were also, once we started talking to them, they were going out and doing training for the public. 
So we turned to them and said, hey, do you think that you could create customized training for librarians? 
And they were willing to do it. 
So, we sat down with them, and worked to create focus group of librarians across the state, and went through their training, and really critiqued it. 
Some of the things that were really fun to work with them on, like librarians wanted documented sources, so that pushed us to get the real data, and they also -- they really refined their  training. 
So, it worked out quite well. 
The other piece that we wanted to do was we still wanted to work on the community engagement piece, which was going to be to use -- there is a, a documentary Film called escape fire. 
And we intended to use that as early as this fall, as a Film with a, a facilitated discussion after it to bring the context of, health care down to a local level, and maybe spur some community  engagement into, into what health care reform means at, you know, in each town or community. 
So, what's happened so far, right now, beginning in September, actually, mid August until, until today, we have offered nine workshops for librarians over 260 were trained, and we offered that in nine different locations around the state geographically. 
We particularly concentrated on the areas where we knew that there was a higher percentage of residents that were going to be needing or were eligible for enrollment in the access health C.T. or the marketplace. 
Our partner has been really great at helping us find incredible speakers. 
They have vet speakers, they have their own, and they have booked -- I had here that they booked about 12 public programs. 
It's, actually, 20, and they have got another 17 already booked in libraries around the state. 
In addition, we have got some libraries that have asked our partner to come and give the same  training that they gave to libraries in a region to staff at those libraries, so we have got about four more those. 
And on our website, we have reproducible resources and handouts that are, that the universal foundation helped us to discrete, and they created in some cases that are really sort of just a  handout with the facts arranged by patron type, age, and kinds of questions. 
And those are always changing. 
We have one about social security, and the affordable care act. 
And we have ones for different types, of patrons and different aspects of the affordable care act, and that's constant changing. 
We have gotten great feedback from our participating libraries, who suggested how we should arrange our resource and is what kinds of things that we needed, and remembering that our goal was that we did not want the libraries to have to go back and create these tools themselves. 
We knew if one library found a need, that if we could create it on behalf of all the libraries, most of them would be able to use it. 
And one of the things that was a great outcome of the partnership, is that our libraries were able to connect with the assisters and the navigators in the region early on. 
And that was, actually, a win-win because the assisters and navigators have a certain amount of people they are supposed to be connecting with, and they were struggling to find ways to connect with, with the public, and so, of course, connecting with libraries early on, being able to host enrollment events, and, or many libraries are, actually, connecting to have the assisters be based out of 
the libraries, one or two days a week, or having enrollment sessions once a week, or once a month, at the library. 
And that made it much easier for our members who are handling questions at the reference desk to be able to sort of point to the assister that was parked at a table or in a conference room down the, the hall, and say, you know, we have got that person who can help you. 
Or we have gotten an enrollment session next week. 
Why don't sign up for it then. 
And so, we found people were really, found that piece of it helpful. 
And our escape fire Film and discussion program, it, actually, has taken bit of a wrinkle. 
There is two things that have happened. 
First all, we had unexpected response from libraries wanting to host the Film discussion. 
We had about 40 libraries sign up initially to do this. 
The second piece that happened was, I attended the harwood institute's training related to the American library association's promise of library's transforming communities, and some of the community engagement tools. 
And we think that escape fire Film and discussion programs are going to be really significant way for our members to assume a leadership role in community engagement. 
They can invite their communities to come in and talk about health care at the local level. 
Beyond this enrollment period, talking about it as an ongoing issue. 
It certainly is on everyone's mind. 
And so, we're working on that to, to launch in the spring of 2014. 
We got some fantastic publicity for librarians in Connecticut, and we are having really happy because we made librarians look really splatter and highlighted the fact that we were trusted resources. 
So anyone who read the article had no question as to why people were going to the library, and it shed light on a situation that we all know about. 
Which is that when, as we said, the public trusts us and they come to us, and, you know, a lot of times people don't realize that. 
And lastly, one of the best things that's happened is we really have found new library advocate or partner. 
As you could see from the quote from the universal health care foundation, it was a win-win partnership, and that, that they all of a sudden have access to, to the public, in a way that they never had before. 
And they have us to help them to navigate, interpret and, and help them in working with the public, and they have refined their training significantly based on the training experience that we had, and the different feedback that they have gotten from librarians. 
What's next for us? 
Is that, that our state is, is one of the states that, that has been, has received Federal funding to, to create a state innovation model for recreating health care in the state, and libraries not been at the table, but I was invited to be part a focus group and the discussion, and one of the issues that came up is the lack of public participation in the process. 
I believe that in the future, public libraries and libraries in Connecticut and, and our patrons are going to be more involved in providing feedback, and in maybe public forums about this innovation model, and I think that prior to this relationship, we would not have been at the table. 
It would have been more difficult for us to be invited. 
And finally, at our statewide conference, we think that there is still, will be a lot of interest in health care, even though our conference is in April, so we're planning an update program then. 
>> Well, you have definitely been busy, Jennifer. 
So, one of the clear strengths of the relationship, and the work that you've been doing has been this partnership with the universal health care foundation. 
What recommendations would you have for libraries who might be approaching new partners who are interested, and I think that we had a comment that, that people, their local Flagstaff gators were concerned about library Cyber security issues, but how would, or how did you position the library as a strong partner in this opportunity? 
>> Well, there is two pieces to it, Kendra. 
I think the first piece is that the idea of how do you find a partner. 
And one of the things is, this was scary to go with a partner that was a bit of an unknown, and we had to do our research and feel comfortable that they were unbiased. 
So I think that you really have to spend time and know who the players are in your community to be able to sort through. 
I think that we're qualified to do that, as librarians, and I think that the local resources and organizations, the way that we curate our collections, you know, is something to think about, and that's the approach. 
But it was scary to think that we were deviating from the known, which was only going with our market and reaching out to somebody that had a bigger view and, and might have a bias. 
And, and it's not to say that our partner is not completely unbiased. 
But, we recognized up front where they do have an agenda, and we pushed them to all of the materials that they worked with us to be neutral, and to be fact based. 
The second piece that I think that you asked about was about, about libraries working in their community, and I guess it's really a, a very similar to what I just said on finding a larger  partner. 
I think that you really have to know who they are, and when in doubt, I think that it's good to pick up the phone and know who the other folks are, and, and ask, what do you know about that person? 
Or go and visit and see who the presenters are. 
And listen to how they present themselves. 
I think that now, like, you know, with Debbie's training and with all the resources that are out there, I'm intrigue. 
I think that there are ways to see what presentations are out there so you can pick and choose and make sure that you don't have that local -- it might be a local business person who has very clear agenda. 
In our state one of the things that we found out early on was that people were certified. 
And there was a certification program, process, so that's what was important, so we could see, you know, identify people who are certified to be able to talk about this and help people. 
>> Great. 
Thank you. 
So again, we reached the Q&A portion of the session, so we're going to, and we have a few questions that have come up for the team at CMS, so I am going to ask Melissa to go ahead and unmute, and we'll pose those questions. 
And do feel free to keep your comments and resource sharing in the chat box. 
It's been great to see what has been happening in other locations around the country, so do, if you have links, feel free to put those in the chat, as well. 
If you have an answer to someone's question, feel free to post that. 
Melissa, we have a few requests to clarify a couple of points, and one is the extended deadline for registration for people who want to be covered by January 1st. 
Can you please reiterate that date? 
>> Sure. 
The date has been extended by eight days. 
So, where it was the cut-off was, was December 15th. 
This year is now December 23rd. 
And that would be for all of those that would want their effective date to be January 1st of 2014. 
>> And that is true for both -- any state in both the Federal or state-based marketplace, is that correct? 
>> That would be correct. 
>> Perfect. 
And by what point in March, we know that people don't have to be signed up for January 1st coverage. 
But, by what point in March do they need to sign up to avoid any penalties or, or what would the impact be if people don't apply by the March deadline? 
>> Ok. 
Well, my understanding is that if they sign up by the last day March, their effective date would be the first day of the second following month. 
So you are looking at may 1st. 
And as far as they sign up, meaning that they have made their, submitted their application and paid their premium, and their coverage is effective, and they do so by the end of March, then they would avoid any type of, of potential fee. 
>> Ok. 
Looking at -- we have had a question about assessing plan and pricing options. 
Is there a way for individuals to assess their cost before going through the application process, and we'll say this is specific to those in the Federal exchange. 
>> Ok. 
Now, I am going to preface that, I believe, this is my understanding, and I am going to have tarnisha standing by to pick up if I misstate. 
But at first, when healthcare.gov launched, there was no -- it was changed, such that there was no functionality to do that without creating an account, and going through the process. 
But, my understanding now is that you will be able to go in and shop and look at your regional  plans, plans in your service area and the pricing, as an initial step, if you want to explore. 
>> Ok. 
Great. 
Jennifer has posted into the chat a link to getting an estimate. 
And there is a calculator available that is linked from healthcare.gov. 
>> Great, thank you. 
>> Ok. 
My list of notes here. 
So one of the questions that came up, and this is a bit -- this deviates about questions in the  past, and that is the option to have coverage, so if you are part of a city or a county, and they would get their coverage through, through those Government bodies, and but, we would like to hear a bit about employer requirements, maybe for those libraries that 
are independent. 
Can you talk a bit about what it looks like for, for a business or an organization to ensure their staff? 
>> Well, I think that most people who have been following along, in the news, will hear that there's been a delay on the program am I am trying to rejoin the meeting here, so, basically, you know, they can kind of maintain as is for the time being. 
At least for the first year or two, they will not have much in the way of changes as far as the requirements to offer, you know, they are one of the independents listed, if they have been or if they decide not to. 
The penalties that they would have looked at. 
Before the change or delay. 
Would not be effective. 
>> Ok, great, thank you. 
So, that's coming through, so besides seeing planned features, from vera, for bronze, silver or gold platinum plans, is there a way for someone interesting to see the list of participating doctors in a particular plan? 
>> Ok. 
So, if you are in looking at a particular plan, they do have links to their networks. 
>> Ok. 
>> So you can look at doctors, you can also look up prescription medications on their covered list, and so forth like you would in the plan finder on the Medicare side of the house. 
>> Great. 
This relates a bit back to what Jennifer was talking about, but, what types of consumer assistance qualifications should libraries look for in potential partners? 
What would you recommend? 
>> Ok, I'm sorry, could you repeat the question? 
>> When we think about, about navigators and certified assistant counselors, are there any particular qualifications that libraries need to look for in potential partners within their states? 
>> Well, I think Jennifer and Debbie did an outstanding job in talking about their outreach efforts. 
And I just want to recognize them for that. 
But, you know, really, it is a matter of looking at the folks who probably are already working in some capacity in your area, helping people. 
Whether it's a community center or official worker or what have you, if they already have existing roles to assist people to get them pointed in the right direction, even if it's as far as resources and their local community, then they are tracked on that type of a connecter role, if you will. 
So they might be someone that could easily understand the protocols as far as privacy, and where your boundaries lie, and also understanding the terminology, and the roles to help people in the community get connected to the right resources. 
>> Great. 
Thank you. 
So, another question, and from Kim -- what are libraries doing in regards to concerns, and I would think this is any organization, about patrons and privacy. 
I will say from our perspective, here at Webjunction, and our partners at zero divide, we're looking at pulling together resources that relate to privacy and best practices that are recommended across the spectrum of personal information that patrons may be leaving on public computers, so we'll share that, and you will find that on our website. 
Liz has just included that link. 
Is there anything else that you would recommend people do to inform themselves about issues around privacy and the ACA? 
>> Well, they can go to healthcare.gov and look up privacy related topics. 
They are in, there is an abundance of resources, blogs and so forth about the topic on healthcare.gov, as well as on marketplace, and CMS.gov, the materials and resources concerning health literacy and all sorts of related topics, including privacy can be found there. 
Not to mention under the training tab, under marketplace, CMS, you have all the training content for the certified application counselors, and navigators, and there are sections in there that that, speak to, to privacy so if you want in addition to what you are going to post here with Webjunction, you can certainly check out those sites to enhance your knowledge. 
>> Great. 
Thank you very much. 
And that brings us to the top our hour. 
And we want to thank all our presentedders for sharing their experiences and their resources and for those who included links and stories in the chat, we really appreciate that, and we will pull those and add them to the resources that are on the Webjunction. 
As a reminder, you can get to the health happens in libraries website by putting in, in that URL, http://oc.lc/ehealth, and you can also subscribe to our monthly newsletter. 
And visit us any time for free at Webjunction.org. 
All the materials related to this project will continue to be freely available, and we look forward are to continuing to share the library experience and helping libraries to learn from each other through these Webinars, and we thank you all for your contributions, and hope you have a great holiday week. 
Thank you very much.