In regard to the MHSS changes that are scheduled to take place beginning in August.  Reducing the number of billable hours from 5 to 3 is an unnecessary change to a service that is working.  I work in a rural area and  often the distance clients have to travel to see physicians or psychiatrists are at least an hour to an hour and 15 minutes in travel time alone. Add in waiting and time with the provider and it’s easily another hour to an hour and 30 minutes and the clinician is already close to if not over 3 hours.  Once the clinician assists the client in obtaining new medications or refills from the pharmacy it is over 3 hours.  The other significant piece of this is that many of our clients have increased anxiety in connection to seeing a Doctor so there has to be time taken to assist them in using coping skills or work on building confidence and this slows the pace down as well, increasing the time even more.

There are also times when clients must be assisted when in crisis and clinicians often have to remain with the client to insure safety until another agency has taken over.  To decrease the time would put the clinician in a bind and reduce their flexibility to provide services in crisis circumstances.  This change will not improve service provision it will only increase the already constrained environment that the clinicians and clients presently operate within.