Today is a special day for us here at Webjunction. We also are providing a live stream of today's broadcast on Webjunction. A special welcome to all of those folks and to all of you on Twitter. We are using Twitter hashtags for today's event. Webjunction has a #wjwebinar that we use for all events and today we're using LBS4health. My name is Jennifer Peterson, and I'm here with Betha Gutsche logged in as WJ Support. We are thrilled to provide this opportunity for all of you. Webjunction looks forward to seeing you on Webjunction. We encourage you to join us for future events, but also want to make note that we have a monthy news letter that is a great way for you to stay connected to Webjunction. It will come to your email in box each month, and also our new libraries and health insurance area, which provides you with all of the information you need to stay up to date with this new work we're doing. On behalf of all of our state library partners, and IMLS, I welcome you to this Webjunction webinar. Welcome especially to all of you from our partner states. And we're going to go ahead and get started, and I'm going to actually have Susan introduce us. Welcome, Susan. >> Susan: Well, thank you very much, Jennifer. And good afternoon everyone. Well, good morning, good afternoon, we're all across the country. It's lunchtime here in Washington, D.C., but we are ready to have a great program with you today. It is a reprize of a presentation at the American library association annual meeting in Chicago. We are excited to share that with you and even provide updates, because honestly, we are moving very quickly and learning information every day to help share and prepare our libraries for October 1st and the health care roll out. I want to share with everybody, and think everybody on the call knows that libraries have a long history meeting consumer demand. A recent IMLS study showed an estimated 37% of library computer user, that's 28 million people a year, use those computers and seek assistance from librarians for health and wellness issues, including learning about medical conditions, finding health care providers, and assessing their health insurance options. As prominent providers of internet access and also digital literacy training and access for people who lack internet connections at home, we know that libraries can anticipate intensified demand for their services and information as our patrons look for health insurance, particularly regarding the affordable care act. IMLS has developed a great partnership with the centers for Medicaid and Medicare. That's the unit, the organization within the health and Human Services department responsible for the affordable care act roll out and we will work cooperatively with our partner there to make sure that libraries are aware of and able to connect patrons with information resources and community partners. With locations in nearly every community, libraries are a national place for the convergence of health information and health information navigators and assisters to help those who need to get information. We're also really excited to bring in the national network of libraries as medicine and operation and institution as this part of the national library of medicine to really help us as well and connect with our great network of health information providers that's in libraries and other organizations that is already existing. We want to help local libraries decide how best to serve their patrons in these efforts. IMLS is working with our great partner, OCLC Webjunction, and thank you for hosting our webinar today to support the efforts through its flagship public library program, Webjunction. The goal to ensure that librarians have the information and connections with local experts needed to connect their patrons to information about health insurance. And I would really like to re-enforce here that we are providing all our Library libraries, librarians, and library staff with information to really assist them in addressing the needs of the public, but ultimately, the Library's role in providing this information is really a local decision. We're here to provide you with great information, but really at the local level, that's where you have to decide your Library's priority for assisting all patrons and customers in getting this information. I think we will go on to an introduction of our great panel. We're excited to have some really wonderful speakers today. We have reassembled the same very effective group that was at ALA. I'll give brief introductionsintroductions. Jackie Garner, acting REEJ YOL director for the United States Department of Health and Human Services, region five, including the state of Illinois. Consortium administrator for Medicaid and children's health, centers for Medicaid and Medicare services. She and her team work in all 50 states and territories and throughout Jackie's career, she has worked in state government, not for profit sector, advocates to improve health status and access to care. Then we're going to hear from Webjunction's own Kendra Morgan, a senior program manager with Webjunction. Responsibilities include managing several grant programs with focus on digital literacy and digital inclusion. Previous experience includes providing training and technology support in libraries as part of the Bill and Melinda Gates foundation. We also have joining us Ruth Holst. Ruth is the associate director of the national network of Libraries of medicine. A 10-state Library network, and has done a lot of great work in our national network of library colleagues are getting great information together about the health care insurance options that we will share with you as well. Before moving to Chicago to take this position in 2002, she was a hospital librarian in Milwaukee for 32 years. She is a fellow and past president of the medical library association, and lead author on the first edition of the MAL guide to managing health care libraries. We will have our great speakers and then hopefully we will make sure that we have a bit of time for questions, and we'll also follow up, if we can't get to all of the questions after the webinar, we'll respond to you and of course you've heard all of this will be archived. Now I'm going to turn it over to my colleague, Jackie Garner. >> Jackie: Thank you. Good morning. Good afternoon everyone. I'm Jackie Garner. What I hope to accomplish today in the next 10, 12 minutes is to provide you with a high level, very general overview of the health insurance marketplace. So, let's get going here. And on our -- on the first slide here, ignore the number one, please. Formatting issue. We can't take it off. So, what is most important is that the health insurance marketplace is a new way to find and buy health insurance and apply for Medicaid and children's health insurance program, which we will talk a little bit about Medicaid and the CHIP program a little bit later. In the new marketplace, qualified health plans will be sold and run by private companies, and every qualified health plan will cover a core set of benefits. New and expanded programs will be directly linked. You will have an individual or family will have guaranteed coverage and renewability, regardless of preexisting conditions, such as cancer or diabetes. In addition, former things that perhaps were caused cost to be a little higher, sex and age, that will no longer be possible. So, beginning on October 1st of 2013, this fall, coming up in less than 70 days now, individuals and families can explore every qualified health plan in their state. They may even be eligible for lower premiums and out-of-pocket costs, and coverage can begin as soon as January 1st, 2014. We are going to talk about all of those things here. Through the -- on the second slide here, through the marketplace, again, individuals and families will be able to find out if they're eligible for the new premium tax credit, which you can choose to use to lower what you pay for your monthly health premium. Or other cost sharing reductions or even other health coverage programs, such as Medicaid and the children's health insurance program. On the marketplace, they will be able to enroll promptly and easily in that appropriate program. Keep in mind that the marketplace offers competition and choice, and insurance companies will compete for business on a level and transparent playing field driving down costs, which we are beginning to see in the state-based marketplaces that have been reporting on -- again on a very high level the rates that are coming in. On this next slide, I wanted to talk just a minute about qualified health plans and so you will understand because they are at the core of the marketplace so that you will understand what we mean by that term or as we often refer to them as QHPs. The qualified health plans, in effect, are certified at either the state and/or national level. And it really provides that level of quality assurance in order to be a qualified health plan under the affordable care act. The plan must also provide essential health benefits that are described in the law. And we will go over those in just a moment. The marketplace itself, in every state, will only offer qualified health plans and that could include stand-alone dental qualified health plans that cover pediatric dental essential health benefits. So important for children in our country. Each state has a benchmark plan that is the basis for what services a qualified health plan must cover. The exchange or the marketplace final rule requires a state's base benchmark plan that lacks pediatric dental or vision coverage to be supplemented with a pediatric vision or dental plan. So, in this next slide, we talk a little bit, and we're getting into the weeds here, but I just want to mention this because it is -- it is important to understand. Those of us who have insurance may understand what we mean by terms like oh, I have a gold plan or a silver plan or sometimes you will hear I have the Cadillac or something else plan. What that actuarial value really means, or it can be considered generally is a summary measure of health plan generositygenerosity. So, for example, if a plan has an actuarial value of 70% on average, an individual would be responsible for 30% of the cost of all covered benefits. However, you could be responsible for a higher or lower percentage of the total cost of covered services for the year if your health care needs and the terms of your insurance policy required it. But while premiums are not taking into account calculate this actuarial value, generally, and this is the core point here, generally plans with a higher actuarial value and more generous cost-sharing tend to have higher premiums. So, if an individual comes into your library and they're -- they go to the marketplace online, this may be some information that they will be looking at, and you can see here the bronze, silver, gold, and platinum levels. What the individual would pay generally, and what the plan would pay. So, I just wanted to give you that general piece of information. And also wanted to talk a little bit just so that you understand, about minimum essential benefit. They are things, such as emergency room services, preventive care, things that you would normally -- you and those of us that are fortunate enough to have insurance often have coverage for in our plan. And those must also be provided. On this slide entitled minimal essential benefits, we do point out that there will be a fee that an individual will pay in 2014. They will actually pay it in 2015, but the fee for 2014, if an individual does not enroll in insurance plan is one percent of their yearly income or $95 per person for the year, whichever is higher. The fee for uninsured children is $47.50 per child. The most a family would have to pay is $285. Now those amounts will go up after 2014, but it is important to remember that someone who pays the fee, who pays the fee will not have health insurance through the marketplace. So, after open enrollment ends on March 31st, 2014, people won't be able to get health coverage through the individual marketplace until the next annual enrollment period unless they have a special qualifying life event that is defined in the law, and that provides for a special enrollment period. Now, if they elect not to go into the marketplace and they do not have any other insurance and the IRS determines that they must pay this fee, they will pay that when they file their 2014 federal income tax return in 2015, and there -- thereafter. Routinely work with taxpayers who owe amounts and can't afford to pay. Prevents the IRS from liens or levies -- there are some exemptions in the law for reasons such as religious -- if you are a member of a federally recognized tribe. If you have no tax filing, or you had a short coverage gap in insurance, and that is defined in the law as less than three consecutive months. So, there are some exceptions, including a hardship exception in which -- again, think your patrons, this is probably a part of the Affordable Care Act, that they've heard something about and they may not understand it and they may be looking for information on this. Let's talk for a minute on this next slide about state marketplaces themselves. And the -- we have three different types of marketplaces as we go into our open enrollment period starting October 1st. The first is the state-based marketplace, which we have approximately 17 states that are working -- have been working for the last couple of years and they will operate their own marketplace. We, of course, will have under the law oversight of those marketplaces, and we are partnering very, very closely with the 17 states. They have been very, very busy building their IT systems, and they are now engaging in outreach and education. I'll tell you in a minute, later on here how you find out what kind of a state you are in. There is also a category of states where their market is referred to as a state partnership. And those are states that are trying to get to the place where they can operate their own state-based marketplace, but they need a little bit more time. So, they are taking on functions that typically include -- not always -- but typically include outreach and education. They'll be doing all of that themselves. We will help them if they need help. And plan oversight. Regardless of how a state structures its marketplace, the state department of insurance has oversight of the plans. And we work with the state department of insurance at the federal level. State partnership states are states that are in transition. They're building their marketplace. They are on their way. And the remainder states are states that either weren't far enough along, or elected to not operate their own marketplace, and they're going to participate in the federally facilitated marketplace. And there are a number of states who are, and we, at the federal government, provide all of the functions. We are very engaged in the marketplace, outreach, education, plan oversight. We are still even in the -- we call it the FFM, federal facilitated marketplace, working with the state department of insurance, and in all states, we are working closely with the state Medicaid agency, because Medicaid expansion was an option under the Affordable Care Act. Many states have elected to expand Medicaid, and more people will be eligible for Medicaid and the children's health insurance. And it is a little tricky. I will tell you how you know that and how you figure that out if you're not familiar with that. On this slide, it just basically talks about how -- who can operate a state-based marketplace under the law. And you can see here that it can be a not-for-profit entity, independent government agency, or existing state agency. Most states have opted for the existing state agency. Let's move along here. When can a person sign up for the marketplace? Well, you know, this date I hope is burned in your mind when you hang up on this call, beginning October 1st, 2013. And that will run through and end on March 31st, 2014. These are very -- this is a very important date. For the year 2015, for that benefit period and beyond, the annual open enrollment period will begin on October 15th, and end on December 7th, which should feel familiar to those of us who have insurance. That is somewhat similar to what many health plans do now. Next slide. I mentioned a special enrollment period, and I think that's important. Much like private insurance now, the marketplace does allow for special times when a person outside of that October 15th through December enrollment period, when they could enroll and recognizing that there are exceptional circumstances when that may need to happen, and the law allows for the secretary to make that discussion. So, really important slide here. How the marketplace itself works. And I suspect when your patrons come in, if they are comfortable on a computer, this is what they're trying to understand is how the marketplace itself works. And there are really four steps to using the marketplace. First they're going to go on and they're going to create an account. And there will be -- they will need to provide some basic information to get started like their name, address, email address. Actually, right now they can sign up for marketplace emails at HealthCare.gov and they can subscribe to alerts and we'll let you know how to do that. Beginning October -- and they can go on this web site now, right now, they can go on. We have been using it as an educational tool for people to get ready, for people to understand insurance. For many people, this is the first time they've been involved with insurance. The second step is actually applying starting October 1st. And they will -- if they are applying as a family, of course they'll need some information about their family, including income, household size, and a little bit more. But it is -- when I talk about the application in a minute, you will see that we have worked very, very hard to make it as seamless and simple as is possible. So, once they go on, and they have started the application, they will then be looking at qualified health plans. And they will be able -- what we're really committed to here at CMS is an apples to apples comparison. It really was developed much like if you shop on Amazon or -- perhaps you use a travel web site, and then you kind of know what we're talking about. You will be able to compare all of your choices, and assistance will be available through a number of community-based organizations, as well as a toll free hotline. But once they pick a plan, then they will complete, hopefully they should be able to complete the enrollment process. Focusing on the application, I want to make sure that you know that it is available electronically and on paper. I know libraries provide a lot of paper, for example, tax forms and things. We are really, really hoping that most individuals, if they are capable or with assistance from community resources, again, that they will be able to complete the application electronically. It is more efficient and I think we're just hoping that that is what they do and what we're encouraging them to do. Paper applications are certainly available in both English and Spanish. We've worked very hard to streamline the application process so that no matter what an individual may be applying for or may be eligible for, if they end up that they are eligible for tax premium credits or cost sharing or even Medicaid or the children's health insurance program, they will be directed right there. We like to say there is no wrong door. That -- it's one stop shopping and streamlined. Just a reminder, a little bit about the advanced premium tax credit. And you can see here, I'm not going to through them all in the interest of time, as to what the numbers are, but I think it's important to -- for you to keep in mind that the congressional budget office estimated that when the affordable care act is fully phased in, the premium tax credit will help 20 million Americans afford health insurance. I think that's the words of encouragement that we're trying to help people understand is that they may be eligible for some help that they aren't even aware of. And I've mentioned that the streamlining and links with Medicaid and CHIP, a very important part of the marketplace and one that should make it much easier for people to enroll in. And of -- of importance also is that we have launched a toll free call center through CMS that went live in June. It is there for the federally-facilitated marketplace and the state partnerships. The states who are operating their own marketplace, will have a call center also, and most of them, I believe, are -- have launched. And when you go to HealthCare.gov, you can get the link to all of those call centers. Again, one stop. Everybody goes to HealthCare.gov and it will take you to your state and then to any -- all of the information that you need about your state. I wanted to just say one thing on this slide. I reference shop employers, shop is the small business health options program. You may have heard something about. And there is a marketplace for employers, again, on HealthCare.gov, and we've been conducting conference calls and responding to small employers requests. And it is a whole separate seminar. And I -- but when you see the word SHOP, it is the small business marketplace that the affordable care act provided for as a means to make it possible for small employers to find affordable insurance for their employees. The next slide, probably one thing you have heard about is the navigator program. And navigators in federally facilitated and state partnership marketplaces are organizations that are being awarded grants to assist with enrollment. And there will be two navigators in every state. And those grants are being reviewed right now and will be awarded in August. There was a lot of interest in the navigator program, and a lot of statewide collaboratives came together and really worked to be able to provide this. Just want to note that under the law, the navigators must be certif certified, whether they go through our federal training or a state-based marketplace training, and they are individuals that I really believe -- individual organizations that you will want to know. There are other types of assistance that will be available through the marketplace. The department of health and Human Services just announced awards to community health centers, who will be working to help with enrollment. We have certified application counselors who currently work in hospitals and all sorts of clinics that will help, and, of course, agents and brokers are also a part of this. So, next page. Most important page probably of this entire presentation. HealthCare.gov. It is here that individuals will be able to identify their options for health insurance. This web site as you know seen on the slide, also available in Spanish. It is accessible for those with visual disabilities. I hope you will spend some time exploring it and getting to know it. It really will -- it is the source that we are using for all -- all of our information. It's the most important, HealthCare.gov, most important thing to take away here today. This last slide is a look ahead of what we can expect happening in August and through January 1. I hope that helps. That concludes my presentation. And thank you very much. >> Thank you so much, Jackie. This is Kendra Morgan. I'm going to remind everyone thank you for your questions, the chat is fantastic. We love seeing all of your questions and comments both Jessica, Amy from CMS -- actually responding to questions. You will see their responses in the chat. We have a little bit of time at the end to do some Q & A and any questions that we don't get to, we will try to follow up with all of the presenters to get those recorded in the archive as well at the end of the session. A little heads up there. So, again, my name is Kendra Morgan. I am part of the team here working on the eHealth program at Webjunction. A little bit about our organization for those of you who may be new to Webjunction, our mission is to connect people to knowledge through library cooperation and we've been very fortunate to work very closely with IMLS on a number of library programs that help to ensure that libraries have the support and resources they need to lead and engage their communities in a vibrant future. One of the core things that we also understand is that we are really conduits for information and service models, and those of you on the front lines of the libraries across the country really undertake a challenge and put -- are the real change in your communities. We thank you for being here today to learn a little bit more about some of the options for helping to support patron needs in your communities. Many of the programs that Webjunction has been involved with have been related to public access technology, which is now a core library service. And recently, we've had the opportunity to work with libraries and their communities in what we look at as meaningful use of digital information. Connecting to family and friends, education, work force, access to health information, are really at the top of 21st century needs and skills. This includes the broader scope of digital inclusion, which looks at the importance of access to broad band internet to build these skills and connections to information. Just one example of a meaningful youth program that we have worked on recently was three years worth of project compass, an IMLS-funded grant. Participants in the project compass training, staff at state libraries and front line public library staff throughout the country. During the evaluation of that program, participants reported over 3,000 new partnerships were formed to augment work force recovery programs and efforts and at least 5,900 new or enhanced skill-building activities, outreach, other services were being undertaken as a result of project compass. We hope to build on that program as we move into looking at some of the concerns and importance of getting accurate health care information. So, this program is part of a cooperative agreement with IMLS, and the project started on July 1st. We're not even a month in at this point. There is so much interest and enthusiasm. This has been one of the most popular webinars to date and we're looking forward to bringing you more information in the coming months. This work will involve the public and state libraries in the collection of resources and materials that can help library staff with patrons who have questions about the ACA. We want to reiterate what Susan mentioned at the beginning, libraries need to make their own decisions about how to respond for requests for information related to ACA and how they want to support the enrollment process, if that's something that they can do. And really to help prepare libraries for that anticipated increased demand for information. Our partner in this work is ZeroDivide. For over 15 years, ZeroDivide has supported the use of technology in underserved communities to improve outcomes in areas such as health, education, civic engagement, work force. Their team will specifically serve as eHealth subject matter experts and the development of tools and resources that can be used by state and local libraries to determine how they would best like to engage in community needs around these issues, particularly with the launch of the health insurance marketplace. We had a great couple of days of meetings with their team and we are excited about the work ahead. Our group is going to engage directly with the chief officers of state library organizations to ensure that state and local public libraries are engaged as we launch that national program. And to help support this work, we've launched a new section on Webjunction related to eHealth and this program and will use the space for ongoing updates and new resources and information. I'll talk more about that in a second. Overall, this program aims to help libraries improve public library health services by increasing staff capacity to respond to patron requests for health and information and assistance. So, as a result of the work that we do over the next year, we anticipate that eligible individuals will successfully access information that they seek about the health insurance enrollment process, with support from their public library when they seek it. So, we know that libraries are encouraged to utilize the information and content that will be developed over the open enrollment period and beyond. We know that October 1st is right on the horizon. And what we're going to be doing over the course of this program is to collect your questions, collect your information about how we can best support some of your needs and questions in the development of new resources over the course of the year. As much as possible, we're hoping to inform libraries of and connect everyone to resources that are existing for the ACA by October 1st and customizing those materials moving forward. And so there are already a lot of really great resources available on HealthCare.gov that we've been pointing people to and we expect to be able to repurpose those with a specific library angle. I'm sure many of you have already signed up under Webjunction's get involved page. That is probably how some of you heard about the webinar. Because this project may have resources and webinar opportunities that become quickly available, and not in time for some of our regular communications like Crossroads, we're encouraging people to sign up on the "get involved" page and request to receive updates directly about this program. Feel free to encourage people to sign up at your library and participate in the ongoing conversation. And we really want it hear from you about what you need. So, one of the things that we would like to hear as we move forward is does your library already have plans in place to support ACA? We were at Susan mentioned, this is a lot of similar information to what we talked about at the American Library association conference. Stories about how libraries were partnering with local organizations to disseminate information and if you're doing that, we would love to hear how your library already has plans in place. What resources would your library like to see to support those information needs? And we expect that some of these answers will come as you hear more questions from patrons. It may turn out that you're in an area that doesn't get many questions. You may not have a population that is as interested or engaged, and so we would like to know as you hear from people what we can do to help support those needs. If there are any local or statewide partners that you would recommend to others to look at. We heard from one library that they were working with their local hospital to offer sessions on ACA needs. That's an example of the types of partners that we would love to be able to highlight and focus. And so we will be pursuing this work actively over the next few weeks as we all move towards October 1st. Remember, this is a one-year program for us and we look to be able to bring you things on an ongoing basis moving forward with the program. And with that, I'm going to turn this over to Ruth Holst from the National Network of Libraries of Medicine. >> Thank you, I'm Ruth Holst, representative from the National Network of Libraries of Medicine today. I know you are eager to get to the Q & A. I will try to get through my slides as quickly as I can. For those of you who don't know about the National Network of Libraries of Medicine, our mission is to advance the progress of medicine and for the -- and to improve public health in two ways. One by providing U.S. professionals with access to good information and the other is by improving the public access to good information. The national network has eight regions. You will see on this map how the country is divided into those eight regions. Each RML -- we refer to the network as the often referred to it as the regional medical library network, because that is the original name for it. Some people still call it that. If I slip into using RML as an acronym, you will know that I'm still referring to the National Network of Libraries of Medicine. Each RML office provides a variety of services, including training for librarians and health professionals about resources, spreading the word about NNLM resources, funding opportunities for members who want to provide outreach. We provide advice and training about the use of new and emerging technologies to improve access, and we provide assistance to members who participate in the DOCLINE program of the network. This slide is included to remind everyone that public libraries are an important part of the national network. In fact, of the more than 6,000 members, public libraries comprise nearly 20% of the network. The phrase health insurance literacy is increasingly being used to recognize that consumers have serious difficulties understanding and using health insurance. These health insurance difficulties take a toll on consumer's health and financial well being and they have cost implications for health plans and the nation. A health insurance literacy expert roundtable sponsored by the consumers union, university of Maryland, American institutes of research was held in November 2011, and this is the definition they came up with for health insurance literacy. It's the knowledge, ability, and confidence to find and evaluate information about health plans, to select the best plan for your family and to use the plan once you are enrolled. Help is on the way in the form of the national network of libraries of medicine. CMS has developed some outstanding resources to help the public. In addition to that, the National Network of Libraries of Medicine works with all types of libraries providing a variety of services. The services of the regional offices may vary somewhat, but the network members -- but network members should expect to begin hearing from their regional medical libraries with announcements about what each of the regions is doing. During a call with some of my colleagues this week, I found that many of them are already in the process of contacting the state librarians in each of their states to offer to collaborate. I think this will be a key link for each of our regions and you heard Kendra mention the importance of the chief library officer in each of the states. The other kinds of activities that I'm hearing about from the regions are that many of them plan to do a web page related to health insurance literacy and the Affordable Care Act and many of them are planning to do webinars on the Affordable Care Act as part of the monthly webinar series. When I did this presentation at ALA, one of the questions from the audience was about funding from the network related to ACA. My advice would be that you should check the web site for your regional office to see what kinds of small project awards might be available. Many of the regions have outreach project awards. They have technology improvement awards, and sometimes they have exhibit awards for exhibiting at professional meetings. All of these -- many of these smaller awards could be adapted to possibly help you if you are looking for funding for a small project related to health insurance literacy. We know that libraries will become the hub in many communities and we are hoping to be part of helping people find that information. The network staff will not be able to provide advice for the public or for librarians about the law, but we plan -- we expect to be part of helping guide librarians towards the best resources. Whenever possible, we will be copresenting with people such as the navigators and other certified people that you heard mentioned today to provide assistance with the law. The national network has many ways of disseminating information. You see those mentioned on this slide, blogs, web pages, etc. And an important resource of the national library of medicine is the medline plus. Web site for patients and their families and friends. National library of medicine part of the national institutes of health, part of the department of health and Human Services. Medline plus -- MedlinePlus, the site receives over 10 million unique visitors each month. Well, approximately -- and approximately 70 million page views each month. It contains a wealth of authoritative reliable consumer-level health information in a variety of formats. MedlinePlus provides full functionality in English and Spanish and select information in over 40 additional languages. There are not advertisements on MedlinePlus and everything has been vetted and meets strict quality guidelines. Here are some of the numbers to give you an at a glance view of the volume of what's provided on MedlinePlus. Everything from an encyclopedia, drug information, herb, supplemental information, medical dictionary, anatomy and surgery videos, etc., etc. MedlinePlus also has 951 topic pages covering a variety of health and wellness topics. On the screen you see five topics closely related to the topic that we're talking about today. Going to any of these health pages, health topic pages will bring you to a wealth of resources and near the top of any of the health topic pages, you can sign up to receive alerts. This is another way for you to find out what information has been added to the MedlinePlus health topic pages. An overlooked resource that many of you may not know about is the rural assistance center. This is an online library service. There are four librarians as part of the Rural Assistance Center, and they are helping communities and stakeholders across the United States access a full range of programs, funding, and research that will enable them to provide quality services to rural residents. Emphasis here is rural. And you see the web link on this page for accessing the Rural Assistance Center. And this is what their home page looks like. The Rural Assistance Center also also has topic guides, health reform, Affordable Care Act, linked off their page. This is another good resource for you to know about. I will finish up by saying you can join the network by going to the URL, clicking on the information that is found on your screen and we hope that if you are not already a member of the network in your region, that you will join us, and I thank you for inviting me today and for giving me this opportunity to talk a little bit about the National Network of Libraries of Medicine. Now I will turn this back over to Kendra. >> Kendra: Thank you so much, Ruth. It's great to hear about the work starting with NLM and I know there is more to come as we move closer to the launch. I see through chat that people are very interested in posters, bookmarks and flyers ASAP. Thank you for your comments and questions that have come through chat. We will spend a few minutes talking to our panelists and most of the questions did come through for CMS and Jackie Garner and her team. I will pose a few questions to Jackie that have come up that I think we would really like to reiterate and make sure that we touch on again. Jackie, can you talk a bit more about the similarities and differences between the federal marketplace and the state marketplace and how libraries can identify if their state has its own marketplace? >> Jackie: Yes, absolutely. I saw those questions, too. To be very clear, HealthCare.gov has the drop-down where you can go to your state and then you will -- if the state is the state-based marketplace or a state partnership, you will go to their web page. And that will be -- that will be clear. And it is important to keep in mind that all marketplaces operate under the same set of federal rules. The functions that they perform, the services they provide are all going to be the same. It's simply a matter of who is doing that, either the state government or the federal government. I saw questions in there about -- in the chat room about -- I think there was a question about navigators in all states. And, yes, regardless, there will be two navigator organizations in all states. Please keep in mind that navigators are not the only -- will not be the only groups providing assistance. There are other in-person assisters, as we're calling them. We expect -- we know that agents and brokers are encouraged under the ACA to participate and they certainly are stepping up. They, in fact, have -- are developing their additional resources to help with that. The plans themselves are helping with outreach. The federally-qualified health centers, or you may know them as community health centers have been funded to reach out because they already do a lot of this work, and so they will have people helping, and we here at CMS are working with our partners that we have had since the days of part D. Some of you will remember, you were very helpful when part D expanded. It is a little similar, although this is a much larger effort. The libraries stepped up and helped in part D. And many of those groups at the community level -- I loved the suggestion I saw in the chat room about these webinars would be great to do on a state level or a local level, and I think in time, everybody will get there. But this was our -- our first effort to provide a general overview. I hope that helps answer the question. >> Yes, thank you so much. Another thing that came up and I want to be sure that we reiterate are the enrollment options. A lot were concerned about email address. You did mention that that is definitely not a requirement. People will be able to print out and complete forms online as well as to call in for support in many languages. I was very impressed with the number of languages in support that is going to be available. >> Yes, that's true. Over 150 languages will be -- we have a line where we will be able to connect people in over 150 languages. So -- and I just want to remind people that they can -- people can enroll online, yes. As I said, we are encouraging that. The ACA and other laws over the last five years have invested a lot of money in rebuilding state IT systems for eligibility and enrollment, as well as everything we've done at the federal level. I think we all know with the -- with -- hoping to enroll 7 million people in the next eight months, it will be -- the process will work much more efficiently if we are dealing with in electronic systems. That said, we fully expect and understand that we will be and we are required under the law to accept paper applications, and people can also enroll over the phone. The call center will be able to walk someone through the enrollment process and the call center will be able to enroll people. >> Kendra: Great. Thank you. One more question about the privacy guidelines and recommendations for public professional supporting enrollment. People who maybe are not certified assisters or part of a navigator organization. Can you talk a little bit about that? >> Jackie: Well, much like we did in part D, we understand that someone providing enrollment assistance is -- they cannot under the law, they cannot work for a plan, they cannot be paid by a third party such as a plan. We expect them to be both transparent and have no vested interest in which plan the individual enrolls in other than getting -- helping the individual make that selection themselves. Oh, I understand that people are worried about privacy and confidentiality, and I just want to remind them that -- the assisters, the people providing that enrollment assistance, will not actually be hitting the enroll button or making the selection for anyone, unless, of course, there is a legally authorized representative involved. >> Kendra: Great, and that's something, and I want to confirm to people, we know that is a very important issue in libraries. As we look to build out resources, we will provide additional information around that question, as well as anything else today. Again, your local library, local decision, we want to reiterate that across the board. So you can take these conversations and have them with your staff, and decide the Library's best approach. Finally, can you talk one more time about the navigators in each state and how that program will roll out? >> Jackie: Sure, the grants are under review right now. There was a lot of interest, as I'm sure you can all imagine. A lot of interest. And so we're in the final stages of reviewing them right now. We expect to make announcements by mid-August. They will immediately go through their training. And should be on the ground shortly there after and begin the work. I will say they have -- obviously in each state, there is a lot of interest. I think when people understand a little bit more about the navigators, you'll understand -- you'll begin to develop relationships with them. And really that interest in learning more about what's going on in the state. That will help meet that need for people. >> Kendra: Great. Thank you so much, Jackie. We have gotten close to the end of our hour. I want to reiterate that this webinar is archived. You can feel free to forward it to your colleague, anyone else who's interested. A few comments from Susan Hildreth before we close the session. Susan, go ahead and unmute yourself. >> Susan: Yes, ma'am. Here I am. I want to thank all of our partners who are working with us to get this information to our librarians and library staff throughout the country. I want to really reiterate a theme that I think I've heard today and I've also seen in this chat channel, which is absolutely fascinating. And that is I think IMLS's interest in bringing all of these partners together is to make sure that our libraries on the ground have the best information they can about the health insurance marketplace, but not necessarily -- but certainly in no way need to be experts on these topics. We want to make sure that you at your local library or at your state know the resources in your community or in your state and can offer up the library possibly as a place where you can bring navigators together with people. We really want to try to leverage the fact that we know folks are going to come to us for information and we want to help you all be prepared to share information with the public, really primarily about how to get the resources they need. So, I just really want to try to reiterate that I don't think that librarians or library staff have to be experts in the health insurance marketplace. What we want to be able to do is readily get our patrons connected with the resources that we need are on the ground all around our communities and states. And I just want to try to reiterate that. That's really our ultimate goal in getting all of our partners together and providing the most timely and useful information that we can to all of you. So, I'd like to thank everybody for participating and also thank Kendra and Jennifer and Webjunction for making sure that this -- I think went off in a very technologically comfortable fashion. >> Thank you so much, Susan. Thank you so much to Jackie and to Ruth and to all of the continued work that's going to be going into this project. We look forward to providing you with the archive later today. A special thank you to those who were Guinea pigs for the livestream broadcast and Twitter. It was great to see folks chiming in there. We will keep you posted and look forward to continue to working on this with you, and thank you for all of the great work that you're doing in your libraries. Have a great day.