I work in a small rural pediatric practice that is just starting to expand as its own entity of a large medical center based group. It is myself and one MD whom I have worked with for several years before this position. We are struggling with getting kids into resources due to limited availability in our rural area, however there are many services just across the state line, 10-20 minutes away. I recently became a certified PMHS and am finding that it was well worth my time as I see several patients who likely would not get a diagnosis or treatment due to our limited mental health referral base. I find I am able to manage and treat almost all of the patients that I see and have only had to refer a few out for treatment beyond my scope. I have been to several NAPNAP conferences but have not been able to attend for a few years so am looking forward to the 2024 conference in Denver.