This comment is related to the proposed changes starting August 1st reducing the amount of units to be billed for Mental Health Skill Building to 2 per day.  This change would have a large impact on clients currently served in the New River Valley. First, Mental Health Skill Building is a community based service aimed to assist an individual move towards independence.  The current changes will in fact promote more dependence on the service as clinicians would be seeing individuals more frequently throughout the week. Furthermore, the office that I work out of serves individuals in a rural area where they often are required to access resources that are farther away. These individuals would need 5 hour sessions in order to access these resources in order to meet their needs. Furthermore, individuals that we serve often need to access doctors that are several hours away. These appointments often produce heightened mental health symptoms and individuals are in need of support and advocacy to communicate and coordinate with medical professionals. Utilizing 5 hour sessions allows for clinicians to assist individuals with meeting their needs during the appointments.  Finally, individuals who have a serious mental illness often encounter emergency situations and require additional support. These times often require more than 3 hours in order to stabilize the individual and assist them with accessing the appropriate resources. For example, if an individual is suddenly homeless and needs to visit several housing options as well as resources for food or clothing this could take longer than 3 hours to complete.  I am recommending that this change does not take place and that Mental Health Skill Building services   continues to allow for clinicians to provide 5 or more hours to individuals who are enrolled in services. This would allow for more person centered services that account for emergencies, accessing resources and assisting with appointments that meet the client needs.