I believe seeing clients more frequently, for shorter periods of time, creates more of a dependency on the services... but I also believe that serving clients for more than 5 hours a day would not be necessary on a frequent basis.  Clinicians providing services in rural areas may need 5 or more hours to help clients meet all of their needs.  For example, resources in rural areas are more spread out.  There are a lot of clients who set up Medicaid Transportation for scheduled appointments, but have been discharged from their providers due to Medicaid Transportation not being reliable and the client not being able to make it to their appointment.