Objectives To provide descriptive information on behavioral health (BH) productivity and billing practices within a pediatric primary care setting. Methods This retrospective investigation reviewed 30 months of electronic medical records and financial data. Results The percent of BH provider time spent in direct patient care (productivity) was 35.28% overall, with a slightly higher quarterly average (M  =  36.42%; SD  =  6.46%). In the 646.75 hr BH providers spent in the primary care setting, $52,050.00 was charged for BH services delivered ($80.48 hourly average). Conclusions BH productivity and billing within pediatric primary care were suboptimal and likely multifactorially derived. To promote integrated primary care sustainability, the authors recommend three future aims: improve BH productivity, demonstrate the value-added contributions of BH services within primary care, and advocate for BH-supporting health care reform.

Background Autism spectrum disorder is a heterogenous neurodevelopmental condition accompanied by a variety of associated features. Case reports suggest one such associated feature, food selectivity, increases risk for nutritional deficiencies; however, little attention has been given to prevent and treat nutritional deficiencies in youth with autism spectrum disorder. Method Single case report. Results This single case report presents a child with autism spectrum disorder and food selectivity difficulties that resulted in severe vitamin C deficiency. Although eventually corrected, the nutritional deficiency was debilitating, required invasive interventions, and resulted in significant social/emotional and economic costs. Conclusions We review the course of treatment and highlight strategies to prevent and more effectively treat nutritional deficiencies in youth with autism spectrum disorder.

Integrated primary care (IPC) is an evolving model that describes the provision of behavioral health services within a primary care setting. IPC calls for professional psychologists to adopt an integrated and collaborative approach to care, while delivering a broad range of services at a faster pace, using a limited number of sessions of shorter duration, and more team interactions to address a variety of behavioral health issues. Successful implementation of IPC entails professional developmental growth through predictable stages. By tracing the development of one postdoctoral fellowship training program from colocated to fully integrated, providing case examples, and discussing lessons learned along the way, this article highlights best practices and common barriers to implementing an IPC model for others seeking to develop an IPC approach to training and/or practice.

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