Assembly Bill A9050

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   9050
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             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:

   Section 1. The social services law is amended by adding a new  section
 368-g to read as follows:
   § 368-G. REIMBURSEMENT  FOR  MENTAL  HEALTH  CLUBHOUSES.  1.  FOR  THE
 PURPOSES OF THIS SECTION, THE TERM "MENTAL HEALTH CLUBHOUSE"  OR  "CLUB-
 HOUSE" MEANS A FACILITY THAT:
   (A)  IS  ACCREDITED, OR IS IN THE PROCESS OF BECOMING ACCREDITED, BY A
 RECOGNIZED BODY OR BODIES APPROVED BY THE OFFICE OF MENTAL HEALTH;
   (B) ADDRESSES PSYCHOSOCIAL DEFICITS AND SOCIAL DETERMINANTS OF HEALTH;
   (C) USES A THERAPEUTIC APPROACH THAT EMPHASIZES PURPOSEFUL ENGAGEMENT,
 RELATIONSHIP DEVELOPMENT, AND MUTUAL SUPPORT  FOR  PEOPLE  WITH  SERIOUS
 MENTAL ILLNESS;
   (D)  HAS  MEMBERS  AND  PROGRAM  STAFF  WORK SIDE BY SIDE TO BUILD AND
 MANAGE A NON-CLINICAL THERAPEUTIC COMMUNITY;
   (E) OFFERS MEMBERS A COMMUNITY-BASED REHABILITATIVE  ENVIRONMENT  THAT
 BOTH  ADDRESSES  PSYCHOSOCIAL NEEDS OF PEOPLE LIVING WITH SERIOUS MENTAL
 ILLNESS AND PROVIDES STRUCTURES THAT OFFER SUPPORT IN NATURAL, COMMUNITY
 ENVIRONMENTS;
   (F) OFFERS SUPPORT SERVICES FOR EMPLOYMENT,  EDUCATION,  HEALTH  CARE,
 HOUSING,  AND  OTHER  SERVICES  TO BROADLY ADDRESS HEALTH-RELATED SOCIAL
 CARE NEEDS;
   (G) IS AN ESSENTIAL PART OF THE CONTINUUM OF CARE AND WORKS IN  TANDEM
 WITH OTHER MEDICAL AND BEHAVIORAL HEALTH SERVICES;
   (H)  RELIES  ON  THE  RESTORATIVE  POWER  OF  WORK  AND  WORK-MEDIATED
 RELATIONSHIPS TO BUILD A  FIRM  FOUNDATION  FOR  GROWTH  AND  INDIVIDUAL
 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
 
   (I)  EMPHASIZES STRENGTHS-BASED TEAMWORK AND OPPORTUNITIES TO CONTRIB-
 UTE TO OPERATIONS THROUGH A WORK-ORDERED DAY; AND
   (J)  OFFERS  SOCIAL  AND COMMUNITY-BASED RECREATIONAL OPPORTUNITIES TO
 CONTRIBUTE TO A MEMBER'S PATH AND SUCCESS IN RECOVERY.
   2. THE DEPARTMENT, IN CONSULTATION WITH THE OFFICE OF  MENTAL  HEALTH,
 SHALL  AUTHORIZE  MEDICAID REIMBURSEMENT FOR SERVICES PROVIDED BY MENTAL
 HEALTH CLUBHOUSES AS DEFINED IN SUBDIVISION ONE OF THIS SECTION.
   3. IN ALIGNMENT WITH THE CLUBHOUSE MODEL'S HOLISTIC THERAPEUTIC  ENVI-
 RONMENT,  SERVICES ELIGIBLE FOR REIMBURSEMENT SHALL ADHERE TO THE STAND-
 ARDS SET FORTH BY CLUBHOUSE INTERNATIONAL AND SHALL INCLUDE,  BUT  SHALL
 NOT BE LIMITED TO:
   (A) PSYCHOSOCIAL REHABILITATION;
   (B) VOCATIONAL AND EDUCATIONAL SUPPORT;
   (C) CRISIS SUPPORT;
   (D) HOUSING ASSISTANCE;
   (E) MITIGATING LONELINESS AND SOCIAL ISOLATION;
   (F) PEER SUPPORT;
   (G) CASE MANAGEMENT; AND
   (H) HEALTH PROMOTION.
   4. THE DEPARTMENT SHALL ESTABLISH A REIMBURSEMENT MECHANISM FOR MENTAL
 HEALTH  CLUBHOUSES  THAT RECOGNIZES THE HOLISTIC NATURE OF THE CLUBHOUSE
 MODEL, SUCH AS USE OF THE H2031 BILLING CODE, AND IMPLEMENT A  STANDARD-
 IZED  PER  DIEM RATE FOR SERVICES PROVIDED UNDER THIS DESIGNATION.  SUCH
 REIMBURSEMENT SHALL BE MADE AVAILABLE  UNDER  THE  STATE  MEDICAID  PLAN
 SUBJECT  TO APPROVAL BY THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN
 SERVICES.
   5. THE OFFICE OF MENTAL HEALTH, IN CONSULTATION  WITH  THE  DEPARTMENT
 AND  ACCREDITED CLUBHOUSES, SHALL ADOPT ANY RULES AND REGULATIONS NECES-
 SARY TO IMPLEMENT THIS SECTION, INCLUDING THE  DEVELOPMENT  OF  PROVIDER
 CERTIFICATION  STANDARDS,  SERVICE  DELIVERY CRITERIA, AND REIMBURSEMENT
 METHODOLOGIES.
   § 2. This act shall take effect immediately.