Miriam Castaneda rubbed her husband's extended forearm with her thumb. She searched for a vein. Once she spotted one, she slowly punctured his skin with the needle in her other hand.

Luis Angel Garibay, her husband, winced.

Blood slowly coursed out of him through a catheter and trickled into a small plastic tube.

“OK. Now turn your hand over. I have to do one on the other side,” she said in Spanish.

“What? That wasn’t part of the deal!” Garibay said, laughing and slowly turning his hand over for another draw of blood.

Right now, this is just for practice. But in about a month, Castaneda and her classmates in the Step Forward Program in West Dallas will be licensed patient care technicians. Most know it’ll be better than being underemployed or being stuck in a job that doesn’t pay enough. And, they’ll be able to carry out other skills at hospitals, such as transporting patients and taking electrocardiography scans.

For many of them, working full time at local hospitals or clinics while putting their newly learned skills to use will be the start of a new path. It'll be a second chance at futures they may have missed out on because some dropped out of high school, had children as teenagers or didn’t go to college for some other reason.

Luis Garibay has his blood drawn by wife Miriam Castaneda, a patient care technician student, at West Dallas Community Church in Dallas. (Carly Geraci / Special Contributor)

The Step Forward program, housed by area nonprofit Serve West Dallas, puts qualifying young adults in Dallas who don’t have a direct path to better-paying jobs through a free, six-month medical training program that prepares them for entry-level jobs at hospitals and clinics.

Castaneda, a 26-year-old mother of four, didn’t finish high school. She dropped out as a sophomore after getting pregnant. She doesn’t have much support from her parents, who have always been more focused on work rather than education.

She’s worked in restaurants and currently works at a call center, where her pay has been stagnant. Other jobs she’s applied for ask for more education than her GED and more work experience. This has limited where she can find employment.

Castaneda said she’s ready to move on to something better — for her sake and for her family.

“It’s gonna mean something to my kids because I’ll be the first one from my family to have a career,” Castaneda said.

Nazareth Vidal, Serve West Dallas' director of operations, often works out of an office at West Dallas Community Church, where the classes are held. A white board with the words “Broken crayons still color” written on it hangs in the office.

Vidal said the young adults who enroll in the program are often looking for something better than what they’re doing.

“All these kids know what they want. They just never had the opportunity to have someone guide them,” Vidal said.

Student Asael Codiz draws blood from Miguel Valdez at West Dallas Community Church in Dallas. (Carly Geraci / Special Contributor)

Since the program's first cohort started training in May 2017, 60 young adults have completed it. Twenty-two have been hired and 17 have remained employed at least six months. The next class will graduate in March.

Vidal works closely with students. She tries to make sure they show up for class and on time. She checks in to make sure they’re doing their work. She even volunteers to help them with hands-on training, like letting students draw her blood.

The biggest struggle they face after finishing the program, she said, is finding the drive to stay the course on their own.

“Once they’re out of here, it’s up to them to wake up on time, find that motivation to be at work and not just do it one day but do it every day,” Vidal said. “Right now they’re held accountable by me, but they need to hold themselves accountable.”

Asael Codiz, 28, has a wife and a 1-year-old son. For him, the quick, six-month training is what was most attractive because he has a family to support. His wife is a stay-at-home mom and he drives for a ride-sharing service.

Codiz graduated from high school and worked various jobs including construction. He even completed a lumber industry certification. But Codiz never felt like he was getting ahead in the jobs he held.

Student Asael Codiz draws blood from Miguel Valdez at West Dallas Community Church in Dallas. (Carly Geraci / Special Contributor)

His parents, immigrants from Chihuahua, Mexico, supported him where they could, but they don't have more than a middle-school education and weren’t able to provide much guidance when it came to higher education.

“I felt like I was stuck. It was not fulfilling my dreams of being successful in life,” Codiz said.

Codiz, whose father is a Christian minister, saw an opportunity when he heard about Step Forward, thanks to a radio ad about a career he always dreamed of as a kid: being a doctor.

“Being a kid, you would always see [doctors] in the white coats. It caught my attention. The majority of doctors are in it to help others more than anything,” Codiz said. “When God came to Earth, he came to help others. His message was to care more for others than to care for yourself.”

Scott Hanson, Serve West Dallas’ executive director, said the training program was born from conversations between groups like Baylor Scott & White, Dallas County Community College District, Dallas ISD and a few others that wanted to find a way to develop the city’s young adult workforce.

A 2015 report commissioned by JPMorgan Chase found that there were almost 33,000 entry-level medical industry job openings in Dallas-Fort Worth.

Concern about high turnover rates in entry-level positions at hospitals, like patient care technicians, Hanson said, was one of the primary reasons for focusing the program on health-care training.

Student Jocelyn Marquez draws blood from Asael Codiz at West Dallas Community Church in Dallas. (Carly Geraci / Special Contributor)

Hanson and the other partners developed a plan, and Serve West Dallas was awarded a $375,000 contract from the city of Dallas' Office of Economic Development. The money helps pay for equipment, supplies, program staff, financial aid stipends and training. That contract runs out in November, and Hanson's goal is to try to secure new funding to keep the initiative going.

But it’s not enough just to provide the technical training, Hanson said, because many of the young adults who sign up have had traumas or life experiences that may hinder their professional development.

“We take it a step further. We’re dealing with all the issues that they bring with them to the job that will keep them from holding that job,” Hanson said. “Businesses today are dealing with outdated management practices because they aren’t in touch with the population that they’re hiring.”

After participants finish the program, case managers stay in touch with them and try to guide them to the next step, which may include more school or getting more certifications. The post-program mentoring is intended to make sure that those who get hired stay employed and keep searching for more opportunities.

Castaneda has her sights set on a career as a registered nurse, but first she wants to improve her English-speaking skills. Still, she said, she sees this as a second chance to make something else of her life and to be able to help support her family better.

“It’s never too late,” Castaneda said.