How to Start a K-12 Health Pathways Program
What is a Health Pathways Program?
How many times do we ask children what they’d like to be when they grow up? It’s a common adult question, and one that is inherently unfair. How many kids, or even young adults, are well-versed in the wide variety of career fields available to them? Within every field there are many professional positions that most of us haven’t even heard of. So how are kids supposed to learn about them?
For healthcare, one way kids can learn about the wide variety of available professions is through a K-12 Health Pathways program, such as the one we offer at Reach Out. Pathways programs are engineered to integrate with school schedules and curricula to provide opportunities for students to learn in multiple settings about different career fields.
“The key word is exposure,” notes Dr. Sherminah Davari, the Director of Reach Out’s Inland Health Professions Consortium, which oversees the Health Pathways programs. “The goal is to expose students to as many people, programs, and paths as possible so that when it is time for them to make decisions about their future, they have all the information they need to make informed choices.”
Most pathways programs begin in middle school, with sixth through eighth graders. The programs follow a continuum over seven to eight years, giving students plenty of time to explore their interests as they learn about the field from different perspectives.
Pathways Programs Offer Extensive Benefits
Given the shortage of healthcare workers in the Inland Empire, providing students with early exposure to the wealth of opportunities in this field is likely to help offset the shortage in the future. In a previous blog post, we discussed this shortage with experts who agreed that filling the pipeline early is the only way to combat the crisis we’re currently facing.
It’s been demonstrated that kids who are exposed to careers in the sciences early are more likely to choose careers in those fields. A study in the STEM Education journal notes that “exposure of students to STEM careers can enhance their interest in pursuing careers involving science, technology, engineering, and mathematics.”
Giving kids the opportunity to understand the full range of available health care careers early gives them more choices as they make decisions about their future through the high school years. This is especially important for kids from diverse backgrounds who may not feel “seen” in the current healthcare system and therefore hadn’t considered the field for themselves. Being exposed not just to a variety of potential careers, but also to a range of professionals within those jobs can change the landscape of what working in healthcare looks like.
What a Health Pathways Program Covers
Health Pathways programs, like those implemented by Reach Out across a spectrum of local schools and districts, include a range of informational activities and experiences geared toward introducing students to the healthcare field.
- Speakers: Reach Out focuses on bringing in a variety of speakers from diverse backgrounds and professional paths, recognizing the importance of students “seeing” themselves in the experts we bring in. Speakers often share their own journeys, and also discuss practical aspects of their chosen field such as educational requirements, income potential, and the pros and cons of their jobs.
- Site Visits: A good program will incorporate site visits to clinics and hospitals in order to offer a view beyond speakers and textbooks. Students get the chance for memorable, hands-on experiences in real settings, allowing them a first taste of fields they might be interested in. Site visits often lead students to pursue internships in places they’ve visited that have appealed to them.
- Internships: Most people understand the basic goal of an internship - to get a real hands-on immersion into something prior to making a full commitment. Reach Out offers a 40-hour internship, which students typically complete over winter or spring break.
“We’ve found that these internships have been really critical,” noted Miguel Olaez, Program Manager for the Inland Health Professions Consortium. “I’ve seen instances where students found that the thing they really thought they wanted to do wasn’t as interesting to them in reality as maybe, their third choice.” Internships are a way to avoid investing years into education and training only to learn that the career that looked good on paper wasn’t what someone really wanted.
Most students have the opportunity to participate in several internships over the years between middle school and graduation, giving them wide exposure to a variety of interesting career fields.
The benefit of schools working with a partner like Reach Out is that the organization has more than fifty years of experience in the community and can provide a wealth of connections in hospitals, clinics, public health departments and private offices to arrange placement for students based on individual interests.
- College Visits: Pathways programs also begin early helping students explore college programs that might serve their interests. With the guidance a program like Reach Out’s offers, students can learn what kinds of grades and scores they might need, and work on building extracurricular items that might make them more competitive when it’s time to apply.
- Soft Skills Training: While knowing where they might like to go is important, it’s equally critical to help students learn how to get themselves there. Reach Out includes mock interviews, resume advice, help with writing emails and making professional phone calls, and networking as part of the program.
“So many of these skills were lost during Covid and the years of Zoom classrooms,” Miguel notes. “So we really work on how to format emails differently than text messages and how to be professional in meetings and on the phone.”
- Conferences: Reach Out also puts on an annual one-day conference to bring students together to hear a selection of speakers and to talk one-on-one with representatives from hospitals and career fields they are interested in.
- Partner Network: The best pathways programs have a wide array of partnerships in place, which can be tapped in order to tailor truly individualized learning opportunities for each student, depending on their unique interests.
How Reach Out’s Health Pathways Programs Work
Reach Out’s programs vary because they are engineered to integrate directly into the needs of each school’s existing programs. We offer a diverse range of support and training, but the overall goal is to offer in-depth and honest exposure to potential career paths. We want students to have a comprehensive understanding of what is available to them, and also to understand the benefits and challenges of each path.
Though all programs are a bit different, they all offer:
- A Full Spectrum of Health Professions - Most students already know what doctors and nurses are. We expose them to the other health professions available to them as well. This includes behavioral health, public health, lab techs, physical therapy and more. Our speaker series, site visits, and internships expose students to the much broader field, so they can find an authentic career path for themselves.
- Inspirational, Honest Speakers - Our speakers are inspirational, but honest. On top of the excitement of their field, they also share their difficulties, the level of competition to enter the field, the challenges they’ve faced. The goal is to offer the complete perspective, since each choice will take commitment and perseverance. When students don’t get this type of exposure prior to making life-changing decisions, they can end up dissatisfied and disillusioned.
- Transparency into Earning Potential & Educational Requirements - We recognize that for some, earning potential is the most important factor, while for others, a less time-consuming training regimen might be the key. Exposing students to everything they need to know to make informed decisions is part of ensuring their choices will be good ones for them.
How Will Reach Out’s Program Integrate Into Your School?
The best thing about the Health Pathways programs Reach Out offers is that they are not a one-size-fits-all offering. Because every school and district is different, the program is built to accommodate flexibility and collaboration. Our mission is to align our program to each school’s needs, and we work as an integrated partner to achieve this.
One of the most important goals we have is to honor existing curricula and teaching time, so the pathways programs we implement are built to complement and extend existing curriculum. We work directly with teachers to find this balance, and build our programming into minimum day schedules and students’ off periods. As a general rule, schools will have some form of interaction with the pathways program manager from Reach Out every week.
Reach Out’s Health Pathways Program Takes the Burden off Schools
Reach Out has been running some form of the health pathways program for more than a decade. That experience means that we are able to seamlessly integrate into existing programs and serve a wide range of needs with our existing infrastructure and programs. By partnering with us, schools can save time, resources, and funds, and remove the burden to provide this comprehensive career education from teachers who likely don’t have time.
In most situations, teachers come to see Reach Out as an integrated partner, helping demonstrate the utility of the STEM skills they are teaching in their existing curriculum. We bolster this effort by helping students understand the practical applications of their classroom learning.
Because the program already exists, schools benefit from very little “ramp up” time. Once we gain an understanding of a particular school’s needs, we are able to implement immediately. The curriculum and programming already exist, and we can tap into our wide network of speakers and partners to deliver. Another benefit is that unlike programs spearheaded by one motivated staff member or teacher, Reach Out’s health pathways program isn’t reliant on a single individual. The program exists separately, which means if a staffing change occurs, the program can remain in place.
“We have so many connections with great partners, whether they’re potential employers, or colleges and universities. We have close relationships, so we can often just pick up the phone and call them directly to make connections for our students. That’s part of being an organization that’s been operating locally for 52 years.” - Dr. Shermineh Davari
How to Start a Health Pathways Program
- It starts with a conversation. If you are a teacher, an administrator, a school board member, or even a parent or student, we would love to talk to you about the potential for establishing a health pathways program for you. The discussion is really our first step, and will be very collaborative. The goal is for us to understand where the gaps and interest areas are in your school so that we can structure the program to meet those specific needs.
- The next step is to identify funding sources. Most schools operate in a fee-for-service model, contracting Reach Out to deliver the programming and working with the school board to approve it. This may require receiving state or federal grant funding to subsidize the program. Sometimes, partners like Reach Out may receive grants directly from foundations, state, or the federal government, and be able to provide these programs directly to the school. Get in contact with us and we can discuss potential funding with you.
- Customizing the program is the next step. We’ll work with you closely to determine which programming pieces will best serve your needs, and also dive into the logistics of getting the program up and running in a way that complements your existing programs and schedule.
- The last step is to implement the program. This is the most exciting piece, since it’s where the students we all work to serve really see the benefit of the program. They’ll learn about real-life opportunities that can have a lasting impact on their future and on the health of the Inland Empire as a whole.
To learn more about establishing a K-12 health pathways program, please get in touch today.
The Health Workforce Crisis & Why the IE Needs More Health Pathway Programs in K-12 Schools
The Health Workforce Gap: A Mounting Crisis for the Inland Empire and Beyond
The world, the United States, and especially rural communities and communities of color such as California’s Inland Empire, are facing a health workforce shortage that is only expected to grow worse over the coming decade. While it’s easy to suggest fixes that seem simple (hire more nurses!), this issue is complex and woven through interconnected shortages and inequities that have impacts far beyond the obvious.
The Health Workforce Shortage is Dire
The shortage of qualified healthcare workers will look different in different settings.:
- It will mean that an overworked and exhausted nurse or aide might make a mistake, or simply offer a lower standard of care due to burnout.
- It will mean that patients will simply be unable to access specialty care in some geographic areas, or that the waits will be so lengthy that what began as a potentially simple issue might evolve into a life-threatening one.
- It will mean that the average mortality rate in the United States will rise as people simply lose access to basic medical care, shortening lifespans, increasing childhood mortality rates, and spiking deaths from chronic diseases for which treatment is life-prolonging.
What Roles are Most In-Demand in the Health Workforce?
There are shortages across the spectrum of healthcare, but what’s important to know is that healthcare encompasses a wide swath of careers beyond doctors and nurses. There is unprecedented demand for physical therapy aides, home health aides, pharmacy techs, phlebotomists, and medical assistants.
Staff Shortages and Overtime are Unsustainable
It isn’t hard to find evidence of the ongoing crisis in healthcare. This year saw strikes across the industry, with Kaiser Permanente nurses, ER technicians, and pharmacists participated in a three-day strike Oct. 4-6 that resulted in a 21% raise in wages over the next four years. CVS and Walgreens saw a similar walkout with working conditions cited as the cause. In fact, twenty-two separate healthcare strikes were reported this year in the United States, all of them citing staffing and concern for reduced patient care as the reasons.
In California, the situation is worse than in some other parts of the country. A recent report on CapRadio noted “the nation is facing a health care shortage decades in the making, and the situation in California is especially dire. Projections show the state could be short 44,000 registered nurses by 2030. Approximately 35% of physicians in the state are over 60 years old.“
What Caused the Inland Empire’s Health Workforce Shortage?
Geography is One Part of The Inland Empire’s Health Workforce Problem
The Inland Empire and California’s Central Valley both struggle to train and retain healthcare workers. According to Jeff Oxendine, MPH, MBA, who is a health executive, educator and consultant who founded and runs Health Career Connection (HCC), “The Inland Empire and the Central Valley are two of the fastest growing regions in California. And they are the two areas that have the lowest per capita health workforce. It’s also a challenge to recruit and retain people in these areas that reflect the diversity and language capabilities of these regions.”
Those born in these regions who ultimately pursue healthcare often leave to choose bigger cities like Los Angeles, San Diego, or California to practice. The other issue is that there are simply not as many medical schools and training programs in these regions to produce the workforce needed.
Repercussions of the Covid-19 Pandemic on the Health Workforce
There is no denying the devastating consequences that 2020’s pandemic wrought on those in the healthcare field. Burnout was a very real issue, leading to more healthcare workers leaving the field than at any time in recent memory. The lack of full-time nursing staff led to an increase in competition for traveling nurses, and hospitals without deep pockets or attractive locations could simply not compete with the bonuses and high weekly salaries being offered in other places.
Reimbursement Declines Exacerbate the Problem
Cliff Daniels, Senior VP / Chief Strategy & Integration Officer at USC Arcadia hospital and the current board chairman for Reach Out noted, “While our costs are rising for hospitals at 12-15% per year, our reimbursement rate rises at maybe zero to two percent per year. You can visualize that graph. It’s unsustainable.”
Reimbursement is the payment that a hospital, healthcare provider, diagnostic facility, or other healthcare provider receives from insurance plans for providing service. The 1997 Balanced Budget Act (BBA) kicked off an enormous shift in the way Medicare reimbursed healthcare.
Though the topic of healthcare reimbursement is extremely complex, some studies suggest that “the BBA may have exacerbated the nursing shortage, because nurse workload increased at high and medium Medicare pressure hospitals and, thus, likely increased nurse dissatisfaction and burnout. The BBA may have resulted in slower growth of nurse wages, and existing nurses were unlikely to be compensated for the additional workload. In addition, slower growth in wages makes the field less attractive to new entrants and may have accelerated the use of temporary nurses in hospital settings.”
Balancing Short & Long-Term Solutions to the Health Workforce Shortage
One of the ways the state of California has found to incentivize health workers to stay is by offering various incentives. Jeff says, “Now the state is investing hundreds of millions of dollars to get people into the pathway to go into those professions and with loan repayment, with scholarships, those kinds of things, but it’s still a drop in the bucket compared to what the immediate and long-term needs are.” And while reimbursement for school and scholarships certainly work, the funding available isn’t bottomless and these programs ultimately increase the cost of care. At some point, we’ll need a longer-term solution.
The Future Lies in Training for the Health Workforce
Jeff notes that the two greatest factors influencing where a physician chooses to practice are: where he/she is from, and where he/she does residency. It makes sense then that building more residency programs in underserved areas would help, since this would allow retention of locals who understand the culture and community where they train.
An additional strategy is to secure more scholarships to fund healthcare education within underrepresented populations. Jeff points out that it’s difficult for those without significant resources to enter healthcare because of the schooling required and the cost associated. This clearly disfavors those from lower income backgrounds, and contributes to the lack of representation many populations see in their healthcare providers.
That said, there are numerous areas of healthcare that don’t require the years of education or the cost associated with becoming a doctor. Unfortunately, many people who might enter the health workforce in one of these areas aren’t aware that these jobs and the need to fill them exist.
The Long-Term Solution to the Health Workforce Crisis
The most sustainable and effective solution to the workforce shortage is to begin filling the pipeline earlier. Cliff and Jeff agree that critical exposure to the variety of potential health care careers must occur in middle school.
Jeff explains, “I’ve assessed these programs for over 20 years now, and the best ones include a combination of academic support and helping with things like study skills and notetaking to help students be successful. Having health career exposure that includes work-based learning, internships, or project work or shadowing” can lead to interest in health careers.
Why K-12 Health Pathway Programs Work
Jeff and Cliff both talk about the benefits of funneling middle school students into what they call Health Pathways programs, like the work-based learning program and Moving in New Directions program Reach Out offers. It’s been demonstrated that kids who are exposed to careers in the sciences early are more likely to choose careers in those fields. A study in the STEM Education journal notes that:
“exposure of students to STEM careers can enhance their interest in pursuing careers involving science, technology, engineering, and mathematics.”
Giving kids the opportunity to understand the full range of available health care careers early gives them more choices as they make decisions about their future through the high school years. This is especially important for kids from diverse backgrounds who may not feel “seen” in the current healthcare system and therefore hadn’t considered the field for themselves. Being exposed not just to a variety of potential careers, but also to a range of professionals within those jobs can change the landscape of what working in healthcare looks like.
A More Diverse Health Workforce Means Better Care
“California is facing a health workforce crisis. There are not enough health workers to meet the needs of its increasingly diverse, growing, and aging population, and the situation is worsening. Shortages exist across professions and geographies, with sizeable urban and rural underserved populations. Additionally, although the state population is becoming increasingly diverse, the current health workforce doesn’t reflect these demographic shifts. For example, in 2019, 39% of Californians identified as Latinx, but only 14% of medical school matriculants and 6% of active patient care physicians in California were Latinx.” (Source: CA Healthcare Foundation)
Recruiting early and from traditionally underrepresented populations and regions makes sense in other ways too. There is an increasing focus in hospitals on cultural competency, something many healthcare organizations are paying consultants to train. If the makeup of the health workforce more closely matched the population served, there is a potential for better cultural competency without the need to bring in outside consultants to train this.
Keys to a Successful Health Pathways Program in K-12 Schools
As organizations like Reach Out partner with healthcare organizations and work to counter the effects of the health workforce shortage, one of the critical aspects of curriculum planning will be based on an honest evaluation of current needs. As Dr. Shermineh Davari, Director for Reach Out’s Inland Health Profession Consortium points out, “We need to be innovative and consider what it is now that students actually need. We collect both qualitative and quantitative data through our learning and evaluation department in order to adapt to current needs and provide the best training and services possible.”
Pathways programs must be directly connected to the organizations they feed in order to ensure that their programs are providing training that prepares participants for the evolving requirements of various health professions.
The Pipeline Cannot Leak
The entire goal of exposing children as early as elementary and middle school to the variety of health care professions is to capture their interest early and then build on that interest as they grow in order to hopefully help them enter the workforce. That means that having a fantastic middle school program isn’t enough. Once a student moves on to high school, the program must be there to continue to support the student’s interest and meet their needs in terms of curriculum and preparation.
Ideally, this begins with a program like Reach Out’s work-based learning program, which exposes children in middle school and high school to health careers. In college, programs like those offered by Health Career Connection, Jeff Oxendine’s non-profit, expose students to networking opportunities, internships, and training that lead directly to entrance into healthcare fields. When programs like these are supported in diverse communities, they lead directly to a more diverse health workforce.
“Part of why I focus on health workforce and diversity issues is because everybody wins,” Jeff says. “The health organizations get the qualified diverse employees they need, and people get education, which leads to all kinds of other benefits. It’s an economic development solution.”
Health Pathways Programs Can Solve the Health Workforce Issue
Jeff points out that there is no need to reinvent the wheel when it comes to working to build a good health pathway program into schools. Teachers and administrators are burdened enough without having to try to figure out how to create these programs. Instead, he suggests districts partner with existing and proven programs like Reach Out’s work-based learning program.
“Reach Out is trying in every way we can to provide opportunities and resources for students,” Dr. Davari notes. “Through hands-on direct services for high school students and teachers, providing internships, side visits, bringing in career speakers, and offering coaching, we strive to create hands-on experiences to help bring exposure to health care careers.”
Reach Out also offers training for Community Health Workers, a career field that Jeff and Cliff agree is gaining in both demand and impact, and is an excellent opportunity for someone entrenched in their community who really wants to make a difference.
Bringing in a health pathways program is something all school districts in the state of California should be considering to help provide diverse opportunities for their student populations and to help offset the dire health workforce shortage the state is facing.
For more information about how Reach Out can help build a health pathways program at your school, contact us.
The Transformative Role of Community Health Workers
Bridging Gaps in Healthcare Access
Community Health Workers (CHWs) are increasingly essential in providing comprehensive healthcare support in various communities. Their work spans educational outreach, healthcare advocacy, and specialized healthcare programs.
Reach Out trains and employs CHWs throughout the Inland Empire, and hopes to see these critical healthcare workers utilized more widely across the potential spectrum of applications. This post will consider:
- Who are community health workers?
- The critical importance of trust and cultural literacy for CHWs
- The spectrum of a CHWs work
- Who is a good fit and how is a CHW trained?
Who Are Community Health Workers?
According to Dr. Shermineh Davari, Director of Reach Out’s Inland Health Profession Consortium Department (IHPC), CHWs are individuals trained to assist their communities with a variety of healthcare issues. Dr. Davari's department, for instance, runs various programs such as work-based learning and mental health advocacy, with a special focus on Community Health Workers. “The goal is to find gaps and remove barriers to provide more equitable access to resources and services within our communities," she explains.
Mayra Mixco, a physician trained in El Salvador, is a program manager at Reach Out focused on the CHW initiatives there. “Community Health Workers inform communities about healthcare issues, help schedule various appointments, and focus on culturally appropriate outreach. They seek to connect as trusted community members, working in community spaces, including churches, consulates, and schools.”
Trust Comes with Cultural Literacy for CHWs
The cornerstone of effective healthcare provision by CHWs is trust. These workers share a cultural, linguistic, and social background with the communities they serve, which makes their role exceptionally vital. From providing healthcare education to serving as navigators and advocates, the CHW’s responsibilities are diverse. After specialized training, they are equipped to provide more equitable and inclusive services.
This trust allows CHWs to battle common myths and misconceptions about conditions and treatments that may exist in certain cultural communities. Mayra quoted a situation where she discovered that some community members believe that the diabetes treatment medication would make them go blind – when that is a risk of the disease itself. “The CHW knows our community, knows our culture, what we believe in, and what we do not believe in. They can actually come, get comfortable, and educate during a casual conversation, dispelling myths and misconceptions as they help access resources.”
The Spectrum of Work: What Do CHWs Do?
The scope of a Community Health Worker's focus can be expansive, varying by setting, healthcare system, and community. They might assist a diabetic patient in understanding their medication and monitoring blood sugar levels. They may also aid in appointment scheduling and running regular tests.
CHWs go by various names, including health navigators and case managers. No matter the title, their focus remains on providing personalized, culturally sensitive healthcare support.
Who is a Good Fit for a Role as a CHW?
Typically, CHWs begin as individuals already recognized by their communities as trustworthy and proactive—people identified as "doers," "seekers," or "advocates." Mayra emphasizes that those who undergo training to become CHWs already possess a foundational skill set, which gets refined and directed through the program.
Reach Out's Training Programs
Reach Out (and many other organizations) actively train CHWs. We offer an 80-hour training program that not only covers health-related topics but also includes development of interpersonal and communication skills. Following the training, CHWs must complete 40 hours of field experience to get hands-on practice in the community, something Reach Out helps to facilitate.
New Funding Opportunities and Specialization
Funding is now being directed towards expanding the focus of CHWs to areas such as substance misuse. Dr. Davari and Mayra both emphasize that CHWs could play an essential role in de-stigmatizing substance misuse treatment and assisting individuals in recovery. The aim is to adopt a holistic approach, addressing not just the issue of substance misuse but also the factors that may be contributing to it.
Understanding Social Determinants of Health
CHWs are trained to be aware of the broader social determinants that impact health, including socioeconomic status, sexuality, and housing conditions. This knowledge allows them to provide services tailored to individual needs rather than taking a "one size fits all" approach.
The Future of CHWs
Public health departments are increasingly recognizing the importance of CHWs, especially as their services become medically reimbursable. CHWs can assist busy healthcare providers by taking the time to understand patients’ cultural and lifestyle nuances, such as food habits, thus enabling better healthcare outcomes.
CHWs and Reach Out are shaping the future of community healthcare in the Inland Empire by offering a blend of education, trust, and cultural understanding. As this role evolves, their contributions promise to make healthcare more equitable and accessible for everyone – a mission Reach Out shares.
If you’re interested in learning more about Reach Out’s CHW training, learn more here and sign up!