SYLVA, N.C. - In North Carolina, a check on your children's health can also provide them with food for thought - in the form of a new book.

Starting this year, the Reach Out and Read program has provided books to children in need by asking pediatricians to distribute them. The program's regional director, Callee Boulware, says it helps children develop early reading and critical-thinking skills, with the goal of children entering school with a larger vocabulary and stronger language skills.

"Books are expensive, and if it's going to be books or groceries, clearly it's going to be groceries. So, what we find is that an enormous number of children living in poverty really have no books in their home."

Reach Out and Read recently received a significant grant that will enable the program to add 20,000 children. It's also expanding into western North Carolina, thanks to an additional grant from the Sisters of Mercy Foundation.

Books are distributed to children from 6 months through age 5, during well-check visits to participating pediatricians. Doctors incorporate the books into the exam by observing child behavior and explaining to parents the importance of reading.

Reach Out and Read goes beyond reading, Boulware says, because it increases the amount of interaction between parents and children.

"A lot of young children don't get that talking face-to-face time like they need to get, and books are the perfect way to ease parents into that habit of sharing language with their child."

Research from the program has found that when families participate in Reach Out and Read, parents are four times more likely to read to their children, and that children score higher on vocabulary tests and school readiness assessments. Nationwide, 3.9 million children are served by Reach Out and Read.


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In the past four years, the way New Mexico children are taught to read has undergone a major shift. Following passage of a state law in 2019, the state's elementary teachers have received training in "structured literacy" and the science of reading.

Research shows kids learn to read when they are able to identify letters or combinations of letters and connect those letters to sounds. But teaching that skill is not always intuitive.

Severo Martinez, Literacy and Humanities director, said there are more than 500 elementary schools in the state, and the two-year training occurs while teachers continue working in the classroom.

"Teachers of any discipline, they're teaching literacy skills, still -- even if they're a math teacher, if they're a science teacher, if it's social studies -- if you can't read, you can't do any of the assignments in any of those classes," Martinez explained.

In addition to boosting the number of students achieving reading proficiency, the program aims to reduce the number of students who require special education services.

This school year, the Public Education Department launched a reading challenge -- encouraging students to become "Superhero Readers" and "level up" their reading scores. Martinez even wrote a book for students focusing on the rich cultural diversity and history of New Mexico. He hopes it will all combine to make them proud adults -- eager to make a positive contribution to the world.

"With the Level Up Reading Challenge, we want to motivate students and supporting them in understanding the 'why' it is so important to learn to read and write - because that's going to open up a world of possibilities for them into the future," Martinez continued.

To catch common disabilities that stall reading proficiency, Martinez says New Mexico now requires that first-grade students receive screenings for dyslexia by the 40th day of the school year. Starting this summer, the Public Education Department will also offer tutoring to make sure all students achieve reading competence.


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Arizona Superintendent of Public Education Tom Horne and the State Board of Education have rejected a move to enact a new ESA Voucher Handbook.

Proposed by the Arizona Department of Education, the handbook would have set safeguards to ensure responsible spending of taxpayer funds for what are known as Empowerment Scholarship Accounts. Instead, they stuck with last year's book.

Beth Lewis, director of Save Our Schools Arizona, said she's disappointed. She thinks Arizona voters now need to look to the Legislature and Gov. Katie Hobbs to prioritize accountability for the controversial ESAs. Lewis sees it as a missed opportunity to give taxpayers more transparency about the funds put into vouchers.

"There are all of these incredibly extravagant expenditures that are being approved," she said. "These laws weren't going to do a lot, but they were going to provide a bare minimum of accountability there."

Lewis said having rules in place would also have been helpful for parents using the vouchers to know what is allowed and what isn't. She's heard of instances of spending funds on waterpark tickets, TVs, Apple watches and expensive musical instruments.

In a letter to the State Board, state Sen. Jake Hoffman, R-Queen Creek, argued the handbook "overstepped" the Legislature, which "has not set any restrictions" on items that can be purchased with ESA vouchers.

Lewis contended that Arizona's public schools are good stewards of taxpayer funds, because when they make purchases, they're seen as investments for years to come.

"So, it's not just one child who owns that trombone forever," she said. "That is utilized, year over year. And that is just the perfect example of why public funds are pooled together for public schools, and why the voucher program really doesn't work when you put it under a microscope."

According to recent polling from Education Forward Arizona, most voters are concerned that teachers are underpaid and public schools are underfunded in the Grand Canyon State.

Lewis called Arizona's ESA voucher program a "complete black box," and contended the proposed safeguards were what she terms "common sense."

By Laura Aka for Working Nation.
Broadcast version by Danielle Smith for Tennessee News Service reporting for the WorkingNation-Public News Service Collaboration

We all witnessed the significant impact the pandemic had on frontline health care workers. One in five health care workers has left their job since 2020, according to one industry report. And the exodus is not over.

"Research suggests that up to 47% of health care workers plan to leave their positions by 2025. The U.S. is suffering from a significant health care worker shortage, and the data shows that this is going to have near-term and long-term effects on both patient care and hospital and physician performance," says Definitive Healthcare.

Nashville, considered a major health care hub, has not been immune to worker shortages. To address its talent pipeline needs, Vanderbilt University Medical Center (VUMC) is collaborating with local education institutions - including high schools, community colleges, and state colleges - to create learning opportunities and fill open jobs.

Where the Shortages Are

Peggy Valentine, Ed.D., vice president of allied health education at VUMC, was brought on in 2021 to help address the organization's need for allied health workers. She says, "There were a lot of positions that were in high demand. You can't really run a hospital without these positions.

"I came on poring through these reports in terms of where the vacancies were located. We found that there were a number of professions where there were over a hundred vacancies, such as medical assistant, EMT/paramedics, pharmacy techs, medical laboratory scientists."

Valentine notes, "When you think of allied health, there are over 200 distinct disciplines, maybe more because it keeps growing. You combine them all together, it represents about 60% of the health care workforce.

"They include the technologists, people who work in the laboratory, people who work in x-ray, people who support the work of nurses, support the work of physicians.

"It may be in the operating room where you're a surgical assistant. It may be doing the CAT scan or the person who runs the machine for ultrasonography - just a very large group of professionals to support this important work," she explains.

Partnerships with local postsecondary institutions are instrumental to VUMC's efforts to grow its talent pipeline. "They already had these programs up and running. There's no need for us to reinvent the wheel."

Nashville State Community College

The first collaboration - launched in 2022 - was with Nashville State Community College (NSCC) with a focus on medical assistant training. The opportunity to learn central sterile processing through NSCC was added later.

"The first cohort of medical assistants was people who worked here at the medical center. Maybe they worked in dietary, delivering food trays, or they worked in environmental cleaning. We had people who worked in various positions who always wanted to go back to school but never had the resources to do so," says Valentine.

VUMC pays for their employees' tuition, books, uniforms, and supplies while they maintain their salaries and benefits, explains Valentine.

After the completion of the first cohort, she says the workforce opportunity was extended beyond employees of the medical center to the wider community, partnering with organizations like Grace Place Ministry and UpRise Nashville. Students from the community are given stipends to help offset the costs of expenses like transportation and childcare. As Valentine says, "Those kinds of things that people worry about."

Nashville is a good representation of what's happening in health care, nationwide, says Donna Whitehouse, dean of the School of Health Sciences at NSCC.

"The reason for the health care shortages - we have the baby boomer retiree exodus. We have the leftovers of COVID burnout that came along with the intensity of, not just the caseload, but just the depth of what caring meant at that point in time with the great loss of people."

Whitehouse says, "We are hearing from our alumni that the billable productivity requirements for rehabilitation professionals such as occupational and physical therapists have significantly increased over time.

"Productivity requirements, especially on our rehab side of things, used to be 80% to 85% of your work time was considered time with patients and then you had some time to do some paperwork. Now they're looking at 90% to 95% of that time to be billable and that's a quick pace in order to be able to get things completed."

She adds that other challenges include the cost and geographic location of educational opportunities, the need for more flexibility around work schedules, and having enough educators to teach the training.

"We have to really credit Vanderbilt with their open-mindedness and their creativity in addressing this workforce shortage," says Whitehouse.

"[VUMC is] also fronting scholarships for our surgical technology students [which requires a degree in order to earn the necessary credential]. Once those students have been accepted into our program, [VUMC is] helping fund any additional costs that they have so they can continue their education," she notes.

Whitehouse continues, "In this case, Tennessee residents who qualify for programs like Tennessee Promise or Tennessee Reconnect can attend school tuition-free. But we know that there are more costs to attend than just tuition, so Vanderbilt has stepped in.

"Vanderbilt has made, not just an investment in getting people on those ground-level positions and getting in those short-term training programs, but they are also investing in their long-term career towards a credential that requires a little bit more extra time and a little bit more extra education through an accredited program."

Whitehouse points out, "We've had over a hundred students who have completed the Vanderbilt-Nashville State MA program. Our first-time MA certification rates are well over 80%. That's the first-time test takers. We have a 100% certification rate, overall. Sometimes it takes more than one time, but we get it.

"Here's the kicker, of those people in that program, 90% have seen it all the way through. You're not going to see those numbers in a whole lot of places. Close to 95% of the people who have gone through the program and then gone to work are still at Vanderbilt."

Tennessee State University

"After COVID, there was a national shortage of respiratory therapists, and there still is," says Brenda K. Batts, D.H.A., director of the cardio-respiratory program, Tennessee State University (TSU).

She continues, "With that, Vanderbilt started a new initiative to recruit respiratory therapists. They started a scholarship program with Tennessee State University's cardio-respiratory program. Within that scholarship program, if [students] accept the scholarship, they have to commit to a time period to work at Vanderbilt for a year or more."

Batts says, sometimes, students have to leave the program, "One of the things we do know is that in the last year, many students at Tennessee State have financial hardships.

"When you have a scholarship that can help lift that heavy burden and help you complete that journey, it's so rewarding. We had 10 that applied to that scholarship program, and they accepted 10. All of them are ecstatic about working at Vanderbilt. Many of them wanted to work there anyway."

According to the Bureau of Labor Statistics, "Employment of respiratory therapists is projected to grow 13% from 2022 to 2032, much faster than the average for all occupations. About 8,600 openings for respiratory therapists are projected each year, on average, over the decade."

Batts says it is crucial to create awareness about the role of the respiratory therapist. "Some respiratory programs have a problem with recruiting people.

"I think people are misinformed because they think, 'Oh, you have to have go to school forever.' No ma'am. We need to identify the two ways that you can enter our profession.

"There's a two-year program that feeds into the four-year program. You can have a two-year degree, but Vanderbilt will invest in you to go back and get the four-year degree."

In addition to the Vanderbilt collaboration, Batts says outreach in the community is important, including afterschool programs. She says, "The Martha O'Bryan Center is one of the largest nonprofit organizations in the middle Tennessee area. We take our respiratory therapy students, who have to do a total of 80 hours of service work over two semesters.

"The respiratory therapy students become teachers of those young people. We showcase our profession, and we take all the tools with us - the mannequins, the intubation of procedures."

Pearl-Cohn High School

Similar to Batts, Tyler Welch, academy coach of the Academy of Health Science and Personal Care at Pearl-Cohn High School, says, "It comes down to exposure. Young people have a hard time, I think, seeing where they fit in the big picture."

"It's actually from their life experiences," says Welch. "When they go to the emergency room or when they go to the doctor's office, everyone they interact with has scrubs on.

"I started realizing they were generalizing - a nurse. When you start looking at, 'Well, I want to become a nurse,' the pathway to be a nurse can be more difficult than some of the [alternative] pathways to become a nurse. I started realizing these certification stacks are what actually can lead to, ultimately, being a nurse. When we say medical assistant certification, they don't really know what that is. But we say, 'Hey, it's a path to nurse.'"

Welch notes that Vanderbilt has visited the high school giving students the opportunity to explore different jobs including - the already-mentioned medical assistant, HR positions, nurse practitioner, traveling nurse, and surgery techs.

By the time students complete high school, they have OSHA and CPR certifications. Additionally, when they finish the medical assisting coursework and an appropriate clinical internship, students may sit for the Certified Clinical Medical Assistant (CCMA) exam. Welch says the Academy has recently implemented a program to teach professional and employability skills.

He offers an observation, "I feel like it's really hard to go from high school to the job. I feel like that's a big jump. I could be wrong, but that's what I feel like. We need to get that postsecondary piece. We have to find a model that really keeps them into it."

Welch says, "To hear what Vanderbilt is doing with Nashville State - if we could learn to build that bridge, 'Hey, prefer our students if they're prepared and ready.' Let's build that bridge where it is.

Changing Family Trees

Welch notes, "We all see that there's a problem and we have to figure out a way to solve that. In the medical field, there's some postsecondary schooling, skills work and it's a long game. Nowadays everything is a sprint, instant gratification so there has to be some other teaching going on than just this is the skeletal system. We have to do our part to prepare the kids so then they can be in that environment to take hold of the opportunities that are there.

"I just feel like that pathway is ready to really explode and do what it's supposed to do."

Tennessee State University's Batts says about the stakeholder collaboration, "It's a partnership within a community - coming together to address the needs of our community."

She continues, "I try to make a difference in my community and that's what drove me to do the different aspects of [my own] education. I wanted to learn more about how to fix a problem that kept me up at times - kids with asthma, people down from COPD, and health disparities.

"A lot of the students come from those same communities. So, they're already vested in it."

Nashville State Community College's Whitehouse says, "If we take advantage of these opportunities to ladder up, it's endless what we can do. And it's just a matter of making the connection.

"I want to talk about helping people connect to these opportunities because we need them. We have seats available. We need people to come in to provide health care services in a variety of different ways. We can get you connected and into a program that is going to put you on that path for success," says Whitehouse. "Not only put you on a path for success, but we know connecting workers to high-wage jobs then changes family trees, right?"

She adds, "Think about times in your own life when people have invested in you and the fact that when someone invested in you, they thought you mattered. That feeling of mattering to someone else is motivation to continue to move forward. And that's exactly what this opportunity is."

Lastly, VUMC's Valentine notes not everyone can go to college right now, "It has been very important to reach young people to let them know that if you don't go to college, there are other options - short-term training programs until you figure out what you want to do.

"Sometimes the work experience you gain at one level can help you at your next level. And courses you take may transfer into that next level. With high school students, it's very important to let them know, 'If you don't go to college, it's not the end of the world. You can go later, but there's some things you can do short-term when you can still earn a decent income until you figure out the path forward.'"

Valentine continues, "They may be the first one in their family to reach this level. It opens up the doors of opportunities for them and generations to come because the children will look at their parents and say, 'Wow, if mommy could do this then I can go back to school and do this too.' It also moves the needle in terms of having a more diverse workforce. We're moving the needle in terms of ridding our communities of health disparities.

"We're setting the examples for the next generation that's coming behind us. And to me, it's the most important work that we can do for our communities."


Laura Aka wrote this article for WorkingNation.



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