This paper is based on various Council for Advancement of Adult Literacy (CAAL) activities including in-depth review of six exemplary career ladder programs offered in various institutional settings: a union, a hospital, a community-based organization (CBO), and three community colleges in partnership with an array of medical centers. The programs are profiled in depth in this paper and the authors discuss their principle findings based on CAAL's research to date. The paper contains ideas and suggestions for institutions that may want to either create a new healthcare career program for low-skilled, disadvantaged workers or improve existing programs. (Contains 13 footnotes.)