Clients seen in this part of the state are limited to psychiatric, primary care and especially specilist providers and accessing larger communities takes excessive amounts of time often requiring 5 hours or more. For this reason many times it is difficult for clients to obtain reilable Medicaid transportation and the client who may have disabilities or other limiting factors are forced to spend entire days accessing needed provider services. In addition this lack of primary support and extended stressful time can heighten client's psychiatric symptoms and cause them to avoid recieving necessary care.