A 9050: Defines "mental health clubhouse"; provides that the department of health, in consultation with the office of mental health, shall authorize Medicaid reimbursement for services provided by mental health clubhouses.

  
  STATE OF NEW YORK ________________________________________________________________________ 9050 2025-2026 Regular Sessions  IN ASSEMBLY September 5, 2025 ___________ Introduced by M. of A. TAPIA -- read once and referred to the Committee on Health AN ACT to amend the social services law, in relation to authorizing Medicaid reimbursement for mental health clubhouses The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. The social services law is amended by adding a new section 2 368-g to read as follows: 3 § 368-g. Reimbursement for mental health clubhouses. 1. For the 4 purposes of this section, the term "mental health clubhouse" or "club- 5 house" means a facility that: 6 (a) is accredited, or is in the process of becoming accredited, by a 7 recognized body or bodies approved by the office of mental health; 8 (b) addresses psychosocial deficits and social determinants of health; 9 (c) uses a therapeutic approach that emphasizes purposeful engagement, 10 relationship development, and mutual support for people with serious 11 mental illness; 12 (d) has members and program staff work side by side to build and 13 manage a non-clinical therapeutic community; 14 (e) offers members a community-based rehabilitative environment that 15 both addresses psychosocial needs of people living with serious mental 16 illness and provides structures that offer support in natural, community 17 environments; 18 (f) offers support services for employment, education, health care, 19 housing, and other services to broadly address health-related social 20 care needs; 21 (g) is an essential part of the continuum of care and works in tandem 22 with other medical and behavioral health services; 23 (h) relies on the restorative power of work and work-mediated 24 relationships to build a firm foundation for growth and individual 25 achievement for members; EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD13616-01-5 
 A. 9050 2 1 (i) emphasizes strengths-based teamwork and opportunities to contrib- 2 ute to operations through a work-ordered day; and 3 (j) offers social and community-based recreational opportunities to 4 contribute to a member's path and success in recovery. 5 2. The department, in consultation with the office of mental health, 6 shall authorize Medicaid reimbursement for services provided by mental 7 health clubhouses as defined in subdivision one of this section. 8 3. In alignment with the clubhouse model's holistic therapeutic envi- 9 ronment, services eligible for reimbursement shall adhere to the stand- 10 ards set forth by Clubhouse International and shall include, but shall 11 not be limited to: 12 (a) psychosocial rehabilitation; 13 (b) vocational and educational support; 14 (c) crisis support; 15 (d) housing assistance; 16 (e) mitigating loneliness and social isolation; 17 (f) peer support; 18 (g) case management; and 19 (h) health promotion. 20 4. The department shall establish a reimbursement mechanism for mental 21 health clubhouses that recognizes the holistic nature of the clubhouse 22 model, such as use of the H2031 billing code, and implement a standard- 23 ized per diem rate for services provided under this designation. Such 24 reimbursement shall be made available under the state Medicaid plan 25 subject to approval by the United States department of health and human 26 services. 27 5. The office of mental health, in consultation with the department 28 and accredited clubhouses, shall adopt any rules and regulations neces- 29 sary to implement this section, including the development of provider 30 certification standards, service delivery criteria, and reimbursement 31 methodologies. 32 § 2. This act shall take effect immediately.