SmartCare & the National Pediatric Mental Health Care Access Program 7/8/2021

As an early adopter and provider of child psychiatric consultation to the pediatric community, SmartCare Behavioral Healthcare Consultation Services (SmartCare BHCS) has worked with the local pediatric community for more than one decade.  In 2020, the program has served nearly 1600 children and families and provided 550 consultations to 298 distinct primary care pediatric providers.   Created by San Diego County’s Behavioral Health Services and funded with Mental Health Services Act dollars, the project has also contributed to the national progression in developing, what are now called, Pediatric Mental Health Care Access (PMHCA) programs.

In FY 2016, the Work Force Development division of HRSA’s1 Maternal & Child Health Bureau awarded numerous PMHCA grants2, investing approximately $47 million; and, this year in the American Rescue Plan Act, they have funded another 32 implementation sites with expenditure of $14 million.

The purpose of the PMHCA grants is to educate and train the “nation’s future leaders” with the aim of dramatically expanding and improving the capacity of our country’s Primary Care Providers to address mental health, substance use and developmental disorders– earlier and more confidently.    Grant awards emphasize the development and implementation of inter-professional, family-centered, community-based, and culturally-competent systems of care, with experiences in” one life stage shaping health in later stages.

PMHCA projects are competitively awarded as five year grants to “states, political subdivision of states and Indian tribes or tribal organizations” subject to need and their submission of quality proposals.   Projects such as SmartCare BHCS are funded locally with either operational and/or private grant funding.

Like SmartCare, the PMHCA model of behavioral health integration uses tele-health as the core vehicle to provide consultation, training, and care coordination services for pediatric primary care providers.  The goal is to achieve “timely detection, assessment, treatment, and referral of children and adolescents with behavioral health problems” as a function of the primary care clinic.

The PMHCA Program has identified the following priorities:

  • Develop regional networks of multidisciplinary mental health teams to consult with Primary Care Providers
  • Train and support Primary Care Providers in their efforts to provide or facilitate  behavioral health care
  • Improve access to clinical consultations, treatment and referral for Parents/Families,  “especially those living in rural and other underserved areas”.

The SmartCare-BHCS program staff have been and remain privileged to have the support of the San Diego pediatric community and the County of San Diego’s Behavioral Health Services in promoting integrated behavioral care locally.  Our newsletter reaches more than 550 recipients, we provide weekly tele-presentations for providers and families, work in association with child-serving community agencies and interface with the county’s diverse and widely dispersed patient and provider community.

We have been eager to promote PHQ-9 (depression), SCARED (anxiety), Vanderbilt (ADHD), ASQ (Autism) screening tools and have supported the development and implementation of care for new moms experiencing post-natal depression.   We continue to help our PCP partners with decisions as to when and how to prescribe psychotropic medications and when not to do so.

We also continue to provide tele-video child psychiatric consultations for youth and their families in collaboration with numerous clinics across the County.

Through our Family Support Services phone line, SmartCare staff seek to clarify the psychosocial issues contributing to the presenting behavioral health concerns.   We provide these parents with psycho-education resources, links to relevant advocacy groups, and referral options and inform PCPs of our findings and recommendations

We additionally provide support to the independent initiatives in behavioral health integration begun by the highly respected local provider groups: Children’s Primary Care Medical Group and Children’s Healthcare Medical Group.

Finally, we are now in the process of rolling out our ACEs Resiliency service for children and families that score as at-risk on the ACEs-PEARLS screening tools.  Referred families will be offered guidance about helping their children cope with and progress developmentally in spite of their past trauma and current stressors.

Thank you for caring and collaborating with the SmartCare team now and into the future as we extend our efforts in support of San Diego’s children and their families.

References & Footnotes:

  • Health Resources & Service Administration
  • Title V of the Social Security Act, the Autism CARES Act, and the 21st Century CURES Act)
  • Pediatric Mental Health Care Access Program:



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