The Charleston County Public Library offers more than just books. With more than 19 locations along South Carolina’s Atlantic Ocean coastline, the facilities have become a hub of resources for area residents.
There are sewing machines, cooking classes and free birth control, made available through partnerships with local organizations. A branch on Edisto Island, a 1,800-person community on the southern edge of the county, hosts health fairs to make up for a lack of infrastructure.
“A lot of people come to the library. It’s a trusted place in the community, sort of a neutral ground. And I think being that trusted place in the community, we can use that as leverage to reach people with their healthcare needs,” said Ren Ruggiero, who was hired by the library through grant funding to serve the county’s rural regions.
Ruggiero is a community health worker: someone who may be tapped to fill health literacy gaps, create public health projects or help patients navigate available services. She launched a telehealth program connecting rural residents with clinicians at the Medical University of South Carolina in Charleston and supplies the library’s three rural branches with free take-home kits to test for sexually transmitted infections. She is also developing seminars on how to manage diabetes.
The grant covering Ruggiero’s salary and programming costs is running dry. The library will pay on an interim basis, but leadership is trying to find another long-term funding source. This is a common problem among community health workers, Ruggiero said. One-time grants often pay for the work, making it hard to sustain in the long term. Though community health workers have been lauded by insurers, providers and policy experts as a way to close disparity gaps, reduce healthcare costs and improve outcomes among vulnerable patients, their deployment throughout the United States has been limited and inconsistent.
With Medicaid redeterminations restarting for the first time in two-and-a-half years, many stakeholders believe community health workers will be critical in helping the estimated 15 million individuals who will no longer qualify for public health plans sign up for other coverage. A growing number of states are using their Medicaid programs to more consistently fund the workforce. But the workers’ nebulous role in the healthcare system can present reimbursement challenges, leaving some states hesitant to directly pay for their services.