I feel that this new regulation will be detrimental to my clients and ultimately cause them to deteriorate. I am in a rural area so provider appointments often take 5 hours and yes, I could assist my clients with arranging Medicaid transportation, but there are many issues with this. First- Medicaid transportation is unreliable, at least in my area, and sometimes doesn't show up or arrives late, which causes untold complications including losing providers which causes clients to deteriorate. Second- if I am not with my client at a provider appointment, I am not able to provide optimal services such as facilitating communication, making sure they address all concerns, and de-escalating clients should something unforseen cause them to experience heightened symptoms.