Purpose/Objectives: Educating families about the multi-faceted benefits of early childhood literacy while providing age-appropriate books is an evidence-based intervention that correlates strongly with the kindergarten readiness and the future academic success of young children (1). “Reach out and Read” (RoR) is a well-validated program for literacy promotion in the primary care setting. However, early childhood literacy promotion to date has not been systematically implemented in the ER setting. Long before the COVID-19 pandemic and the associated school-closings, many children fell through the cracks of literacy education. This was especially true of children with irregular well-child care and frequent non-urgent ER visits. The Covid-19 pandemic only deepened these disparities in access. Our project sought to focus on these marginalized populations and address disparities in access to early childhood literacy. Design/Methods: We designed and implemented a novel expansion of the “Reach out and Read” toolkit to the acute care setting of two freestanding pediatric hospital emergency rooms in Akron and Youngstown, Ohio. To ensure longevity and sustainability, we partnered with the Akron Children’s Hospital Foundation, ACH Reach out and Read, and the Kids’ Book Bank of Cleveland. We implemented a dual-focused, literacy promotion program leveraging the validated ROR curriculum combined with new enrollment in the Ohio Governor’s Imagination Library. We paired targeting families for counseling on developmentally appropriate reading techniques and distributing age-appropriate books with the families’ direct enrollment in the Ohio Governor’s Imagination Library. Our program was implemented in winter 2020-2021 to address challenges in access to literacy with school and library closings during the Covid-19 pandemic. We plan to continue indefinitely beyond school reopenings. Results: 451 families and counting have been enrolled in the Ohio Governor’s Imagination Library during their pediatric ER visits since our screening and recruitment program launched in February 2021. Conclusion/Discussion: Educating families about the educational benefits of early childhood literacy while providing age-appropriate books has long been known to be an impactful intervention for the academic success of young children. Targeting families seeking care in the ER- often for non-urgent medical concerns- offers another clinical setting for this focused intervention.