While a service exceeding five hours in a day is not regularly required to meet the needs of a client, there are instances where this is necessary and appropriate. 

Just one Example: In rural areas where resources are very limited, clients are required to travel long distances to receive services. For example, a person living in Danville, VA may need assistance attending their first psychiatry appointment. There are currently no psychiatrists accepting Medicaid reimbursement in the Danville area and clients must travel to Roanoke, almost 2 hours away in order to receive psychiatric services. It is easy to see how limiting the number of hours that a client may receive MHSS, could seriously limit their access to care, as it will not be feasible for providers to assist clients to their needed appointments. I can provide other examples where limiting acces to care are not beneficial to the client, but I believe this is obvious. Even if limits are imposed there needs to be some some flexibility to serve clients in rural areas and/or clients who are experiencing a moment of crisis and need additional support to avoid hospitilization.