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Caring for the Whole Child

First Choice Pediatrics brings behavioral health consultants on board to fulfill the mental health needs of patients.

When it comes to providing mental health care to the pediatric population, there can be many obstacles, from months-long waits for appointments to the general stigma that oftentimes accompanies this type of care.

At First Choice Pediatrics, a new pilot program bringing primary care behavioral health to its eight Orange County offices is looking to recreate the wheel on mental health care for children.

“We define ourselves as a primary care home,” Chelimer Miro says, “and what that means is that we’re trying to provide holistic care to our patients—physical care, mental health care.”

Miro is a licensed mental health counselor who serves as the enterprise mental health program manager at First Choice Pediatrics, and she is leading the charge with the new primary care behavioral health services, which are funded through an Orange County government grant.

And she’s happy to report that it’s working. Within two weeks of the program’s inception, the team of behavioral health consultants has seen near-full schedules. There is clearly a need for this type of care, and Miro is happy to see First Choice Pediatrics able to fulfill it.

“We need to make sure Orange County residents know that we are providing these types of services with the hope that soon this will provide the model for Florida overall,” Miro says.

“This is our passion,” she continues, “and in the blink of an eye, we’re going to have data to support more physicians.”


Serving the whole child

First Choice Pediatrics is now part of the Pediatric Associates family, which has long been offering comprehensive health care services to Florida families. Since its 1955 founding, the private primary care pediatric practice has grown to include 93 offices in Florida and more than 500 providers across the state.

Most recently, this growth has included the new mental health care services at the Orange County offices.

According to Miro, primary care behavioral health is a model of care that enables licensed mental health providers to serve alongside pediatricians. These consultants—called behavioral health consultants at First Choice Pediatrics—work with providers on any mental health issue or problem.

Mental health providers working as part of a pediatric care team is a new level of care in Florida.

“It’s not like you go to a mental health provider and you’re receiving an hour session every week,” Miro says. “The advantage of integrated primary care behavioral health services lies in providing patients with timely, problem-focused interventions within their medical home as soon as concerns are identified by their pediatrician.”

The behavioral health consultants continue monitoring patients on a weekly basis after this initial consultation, provide short-term services for them and help connect them to further services they may need.

“We are not a subspecialty service,” Miro says. “Behavioral consultants are part of the care team within the primary-care setting.”

The program utilizes the Modular Approach to Therapy for Children with anxiety, depression, trauma or conduct problems—or MATCH-ADTC—psychotherapy modality of services. As an evidence-based treatment program, MATCH-ADTC can be tailored to best treat each individual child.

“We build a care plan for everyone,” Miro says. “So let’s say the child has developmental delays. We’re thinking this child needs [applied behavioral analysis] therapy because they have the criteria for autism, just to name one diagnosis. If that’s the case … we’re going to start developing a care plan to connect the child with all services they will need in the community, and the care plan will also include interventions that will help manage some of the symptoms like tantrums or defiant behavior.”


A plan in place, right away

When children are not receiving mental health services they need because of a long wait for an appointment, symptoms can escalate. In fact, according to Miro, 30-50% of these referrals never make it to the first appointment.

At First Choice Pediatrics, this new care program keeps that from happening since children receive services right away.

“Prevention is our focus, to make sure that kids are receiving services as soon as they are experiencing their symptoms,” Miro says. “[It usually takes] three to six months with a referral to get to the specialist—at that point symptoms can exacerbate when left untreated. We’re trying to prevent that.”

Even though the program is in its infancy, having only launched with grant funding a few weeks ago, the response has been “amazing,” according to Miro. The therapists are almost fully booked, however, each therapist has room to see four new patients every day.

“Parents are expressing concerns to the pediatrician, and we are promptly formulating a care plan on the same day. It’s amazing,” Miro says.

These plans also incorporate the parents, helping them learn how best to work with their child and have control over the services being provided. This is part of the MATCH-ADTC modality of care—parents are involved with any and all sessions they want to be involved with.

“We are basically training them so they can become coaches for their kids,” Miro says. “From the beginning we are telling them what we’re doing. These are the interventions and this is the purpose. These are the stages of treatment. And you are going to be involved.”


First Choice Pediatrics
Multiple locations
(407) 249-1234