District Nominee – Palomar Health

In 1933, the Escondido Community Hospital opened under the leadership of two community health workers – a nurse and a dietician. From that grassroots, community-led effort, Palomar Health has grown to become the largest public healthcare district in the state of California and one of the seven largest in the United States. Palomar Health operates two community hospitals, a skilled nursing facility, a state-of-the-art Rehabilitation Institute, Cancer Institute, and is beginning construction of a new Behavioral Health Institute that will serve the increasing behavioral health needs of patients across the lifespan. Palomar Health is home to North San Diego County’s only designated trauma center, serving the residents of North San Diego and South Riverside.

As a public healthcare district, Palomar Health is committed to equity in healthcare and in our workforce which we demonstrate through community-driven wellness initiatives, health education and training programs, and unreimbursed medical care services to ensure our most vulnerable members of the community are served with the highest level of dignity and care. Through this innovative multi-year initiative, Palomar Health is taking a foundational role as a community healthcare district, working collaboratively with the educational community, to address workforce shortages and to prepare qualified employees who are culturally representative of the communities they will serve. Palomar Health intends to demonstrate that youth from marginalized communities - when provided access to opportunities, the conditions necessary to succeed, and support systems to help build personal capacity - can achieve rewarding careers in healthcare and economic mobility for themselves and their families.

Determining the Need

In early 2000, there was an industry-wide shortage of trained nurses which lead to dangerously overworked nurses and underserved communities. In response to that critical shortage, Palomar Health created a training program that essentially served as a pipeline for nurses to acquire experience and obtain long-term employment. Today, the Pathmaker Internship Program has grown to include over 50 hospital departments and specialties. Interns choose to serve in multiple departments through this immersive internship program, including medical interpreting. Palomar Health is providing hands-on, culturally-relevant experience to high school and college-level students from diverse backgrounds to explore healthcare careers through applied learning while gaining extensive training alongside peers and medical professionals as they pursue their education and prepare to enter the healthcare workforce.

Nearly 25 years later, the healthcare industry is once again facing a critical shortage of skilled healthcare workers to meet the healthcare needs of our communities. With the anticipated opening of the Palomar Behavioral Health Institute slated for late 2025, it is our imperative to increase the number of trained allied health professionals who specialize in mental and behavioral health.

Innovative Approach to Workforce Development and Replicating the Model

As a long-standing community healthcare provider committed to addressing the needs of the people, Palomar Health is leading an innovative multi-year initiative to ensure youth from marginalized communities are aware of and have access to high-quality healthcare career training programs, increase the completion of healthcare training programs by reducing barriers, and ensuring youth secure jobs that offer livable wages, career progression, and pathways to economic mobility. This initiative is creating a more diverse, culturally competent, high-quality workforce by developing educational and career pathways in partnership with local school districts who are graduating an emerging workforce that is culturally representative of their communities.

Palomar Health Pathways Program is a collaborative initiative that includes the state’s largest public healthcare district, multiple North San Diego County school districts, and funding from a leading philanthropic organization with the goal to deliver high-quality education, training, internship and employment opportunities within healthcare organizations that are committed to professional development and career advancement for youth from historically marginalized communities. Grant funding was generously provided by the Prebys Foundation and is paying for tuition and all costs associated with program completion and certification for 150 overburdened youth over the multi-year year initiative. Additionally, grant funding provides the comprehensive supports necessary to address non-academic barriers to completion such as childcare, transportation costs, technology needs, or other emergency needs that may impede success for the overburdened youth.

California has a robust network of healthcare districts and local adult education providers. As the most responsive form of local government, California Healthcare Districts have a unique opportunity to leverage high-quality adult education programs in their local communities to strengthen or develop Career Technical Education (CTE) pathways for the allied health careers that are tailored to meet the needs of the local community. California adult education programs support adults 18 years and older to meet their educational, work, and life goals, and to ultimately be contributing, productive members of their local economy and communities. Tuition costs throughout California adult education programs are the most affordable educational pathway for young adults. Additionally, the State of California has recognized the need for high-quality CTE programs to prepare youth who may not pursue a traditional 4-year college. Significant funding is available to strengthen and develop CTE pathways that lead to certification and family-sustaining career opportunities.

Palomar Health employees have personally stepped up to help address workforce development and long-term staffing needs and have chosen to serve as instructors for the local adult education programs which has strengthened the partnership between Palomar Health and the educational partners.

Community Stakeholder Involvement

Educational Partners

As the largest adult education consortia in San Diego County, the Education to Career Network (ETCN) of North San Diego County is comprised of six member districts including five adult education schools and Palomar College. ETCN provides classes in a variety of industry areas, including hands-on learning opportunities, career technical training, and certification programs to prepare all students for the workforce and/or higher education. For this initiative, Palomar Health Pathways Program has partnered with Escondido Adult School, Poway Adult School and Vista Adult School, which all currently offer multiple allied health career training and certification pathways, including Nursing Assistant, Medical Assistant, Pharmacy Technician and Phlebotomy. The three leading adult schools are the educational training partners for this innovative initiative. Additionally, multiple high schools across the region are graduating thousands of students in the 2024 and 2025 graduating classes, with significant populations of overburdened youth. The school districts are serving as both the educational training providers through the adult schools, and also the referral sources for outreach and enrollment through their high school campuses. Graduating seniors have been able to seamlessly continue their education at their local adult school and pursue an allied health career pathway in a familiar environment, close to home, with the additional supports needed to help them succeed.

Outreach and Enrollment Partners

Palomar Health is a referral source for outreach and enrollment through both our client population and our own employees. Since 2013, Palomar Health has operated a highly successful home visiting program that provides services to low-income, at-risk families in North County to promote positive parenting, enhance child health and development, and prevent child abuse and neglect. Funded through First 5 San Diego, the First 5 First Steps (F5FS) Family Support program serves low-income families, pregnant and parenting teens, immigrant/refugee families, and military families. Parents enrolled in F5FS experience excessive physical, emotional and psychological pressure beyond what is considered normal or healthy for their age due to circumstances including living in poverty, becoming a teen or young parent, being an immigrant or refugee, or the pressures of military service. Several parents enrolled in the F5FS program were enrolled in our first cohort of students for the different career pathways. Additionally, many students have been referred into the Palomar Health Pathways Program that are family members of Palomar Health and Palomar Health Medical Group employees.

Employment Partners

Palomar Health and Palomar Health Medical Group are both internship and employer partners. With nearly 5,000 employees across both organizations, Palomar Health is one of the largest healthcare employers in the North San Diego County region, operating two community hospitals, a skilled nursing facility, a state-of-the-art Rehabilitation Institute, Cancer Institute, and beginning construction of a new Behavioral Health Institute. Palomar Health Medical Group is the network of doctors, nurses and allied health professionals who care for our community across 23 locations. This initiative is providing internship and employment opportunities for 150 emerging allied health professionals throughout our hospitals, skilled nursing facility, rehabilitation center, and networks of care with anticipation for increased employment opportunities in late 2025 when the Palomar Behavioral Health Institute is expected to open.

Outcomes, Milestones and Achievements

Palomar Health Pathways Program is an innovative and collaborative project with projected outcomes based on enrollment and completion rates provided by the Education to Career Network for their 2022-2023 Medical Programs. Total enrollment across all programs at all three sites was 434 enrollments with an average certificated completion rate of 85%. The Medical Assistant Clinical pathway demonstrated the most success with a 100% certificated completion rate.

With six months into this multi-year initiative, we have received applications from nearly 150 students. There are currently 40 students enrolled in the multiple career pathways and five students who have successfully completed a program and are awaiting certification. Based on current and projected outcomes, the Palomar Health Pathways Program is on target to exceed the anticipated 75 students per year.