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I agree with Janet.  I live in the triangle area of NC.  There are good University hospitals and state hospitals. I can stay in network, and pick from several pediatric psychiatrists or go out of network and have a pick from quite a few others.  The school system is not great where I am, but they do have a public therapeutic school where difficult child attends right now. We have family advocacy groups and NAMI support.  We also have TEACCH which is great for kids with autism.  We have an appointment there for an interview on Monday. It is too hot here for me, but I have not had the problems that other discribe from the area where they live.