Skip to main content
Rural Health Information Hub

Rural Libraries and Health Cooperative Agreement

  • Need: To increase access to healthcare and social services in rural South Carolina via library systems.
  • Intervention: Pilot sites are hiring social workers and community health workers to provide consultations, case management, and referrals.
  • Results: One library screens an average of 215 residents a month, and another library's programming reached over 800 female patrons.


The Rural Libraries and Health Cooperative Agreement program in South Carolina provides funding to participating libraries to bring in community health workers, social workers, and telehealth. The funded projects aim to increase access to a variety of services, including behavioral health, health screenings, and reproductive health with the ultimate goal of connecting community members to appropriate services for consistent and sustained preventive care and treatment. The program began with five pilot projects in October 2020 and added four more sites in March 2022 through a grant with the South Carolina Department of Health and Environmental Control (SC DHEC).

Through an established relationship with SC DHEC, the South Carolina Center for Rural and Primary Healthcare released a Request for Application for Libraries and Health Community Health Engagement Mini-Grants in July 2022. Libraries and community groups were encouraged to submit proposals that promote healthy communities and address COVID-19-related informational and care needs. Requested budgets could be up to $5,000. Three organizations successfully implemented local projects that support community health, and these programs were completed in March 2023.

Services offered

Eight of the nine pilot sites are located in rural counties:

  • Abbeville County: hiring a health liaison to formalize partnerships with a local medical center and church and oversee a telehealth partnership with an internet company
  • Calhoun County: hiring a full-time social worker to make referrals, provide case management, and develop a crisis management plan for the library
  • Kershaw County: embeds a social worker to provide case management and connect library patrons to healthcare providers
  • Lee County: collaborates with a local Federally Qualified Health Center (FQHC) to incorporate a community health worker to connect high-risk underserved community members to healthcare providers
  • Marlboro County: collaborates with a local FQHC to incorporate a community health worker to address health and social needs
  • Oconee County: embeds a licensed social worker to provide case management and assistance with housing and childcare referrals
  • Orangeburg County: embeds a social worker, called a Library Resource Associate, to address social determinants of health and connect patrons to healthcare and other services
  • Union County: hired a social worker as part of the library's budget

The ninth, Charleston County, connected women to health promotion and disease prevention resources, including women in the rural communities Hollywood, McClellanville, and Edisto Island. This pilot has ended.

The following counties received mini-grants. All but three counties are rural:

  • Williamsburg, Orangeburg, Fairfield, Saluda, Richland, and Greenville Counties: installing six Little Free Libraries with resources such as materials related to general consumer health, developmental disabilities, and childhood trauma
  • Barnwell County: embedding a physical activity and literacy boosting project, which places illustrated children's books and health information along a walking route
  • Charleston County: offering community fridges that provide access to free fruits and vegetables


Highlights include:

  • The Calhoun County Public Library and the South Carolina State University social work program are piloting an internship program offering undergraduate students field learning experiences in a rural public library.
  • The Charleston County Public Library System reached over 800 women in the rural Lowcountry.
  • The Kershaw County Public Library expanded their resource room to include non-perishable food, essential hygiene products, and access to health resources and equipment like blood pressure cuffs and scales.
  • The Lee County Public Library screens an average of 215 residents a month.
  • The Marlboro County Public Library's staff underwent training to become benefit counselors and referral liaisons to address social determinants of health and connect patrons to social services within the county.
  • The Oconee County Public Library hired a Spanish-language translator and is now hosting events and providing resources in both Spanish and English to better serve Spanish-speaking families and patrons.
  • Health liaisons made over 690 referrals to health and social services between October 1, 2020, and September 30, 2022.


  • Recruiting and initial hiring of some health liaisons for the library sites
  • Establishing a new workflow to integrate the new health liaison into the library's operations
  • Marketing and promoting the services of the community health hubs in the library to community members
  • Establishing infrastructure to integrate telehealth services in the library sites
  • Standardizing reporting for multiple sites and types of programs/models of implementation and health outcomes based on community needs


  • Work with a partner from a library system and other trusted community partners and stakeholders to inform program structure and establish together how they will lead and participate throughout the program from conception to delivery.
  • Be flexible in design and implementation to meet the needs of community and library capacity.
  • Use a standardized screening and referral tool to help with coordinating services and assessing impact.

Contact Information

Alanti M. Price, MPH, Program Manager
SC Center for Rural and Primary Healthcare
Libraries & Health

Community and faith-based initiatives
Community health workers
Health disparities
Human services
Population health
Social determinants of health

States served
South Carolina

Date added
May 26, 2022

Date updated or reviewed
July 24, 2024

Suggested citation: Rural Health Information Hub, 2024. Rural Libraries and Health Cooperative Agreement [online]. Rural Health Information Hub. Available at: [Accessed 25 July 2024]

Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.