Bill
S 2606
The bill would require Medicaid to reimburse mental health rehabilitation services delivered through Clubhouse International–accredited, non-residential clubhouse programs.
Status
- Requires Medicaid reimbursement for mental health rehabilitation services delivered via accredited "clubhouse" programs.
- Passed the New Jersey Senate (40–0 on 10/28/2024); reported favorably by Senate committees with amendments. As of May–September 2025 the measure has been reported to and is pending before Assembly committees (reported to Assembly Aging & Human Services 5/8/2025; reported and referred to Assembly Health Committee 5/8/2025).
- Legislative documents include a fiscal estimate prepared by the Office of Legislative Services (OLS).
Purpose and intent
- To expand the State Medicaid program to reimburse mental health rehabilitation services when delivered through Clubhouse International–accredited, non‑residential, membership‑based psychosocial rehabilitation programs.
- Goal is to support community reintegration, social connectedness, and transition to less‑restrictive care for adults with serious mental illness.
Key provisions
- Defines “clubhouse program” as a non‑residential, community‑based psychosocial rehabilitation program accredited by Clubhouse International that is membership based and designed to alleviate emotional/behavioral problems and promote reintegration.
- Specifies that clubhouse members, with staff assistance, engage in operating program aspects and receive services such as employment training, housing assistance, educational support, food service, clerical/reception/janitorial roles, and other member services.
- Requires Medicaid reimbursement of mental health rehabilitation services provided via such clubhouse programs, subject to federal Medicaid law and federal approval of covered services.
- Explicitly states that Medicaid coverage for clubhouse services does not preclude coverage of mental health services prescribed in conjunction with clubhouse participation.
- Amends the State Medicaid statute (Section 6 of P.L.1968, c.413 / C.30:4D‑6) to include these services.
Who is affected
- Medicaid beneficiaries with serious mental illness (potentially eligible to receive reimbursable clubhouse services).
- Clubhouse programs and providers (may seek Medicaid reimbursement for eligible services).
- New Jersey Department of Human Services (administration, rulemaking, contracting, and seeking federal approvals).
- State budget: impacts on Medicaid expenditures and potential federal matching revenues.
Fiscal impact (OLS)
- Year 1: Indeterminate increase in State Medicaid expenditures (start‑up and service payments).
- Year 2 and beyond: Indeterminate potential savings to the State Medicaid program (possible reductions in inpatient hospitalizations or inpatient rehabilitation costs as clubhouse participation reduces higher‑cost utilization).
- State revenues: Indeterminate increase if federal Medicaid matching funds are obtained.
- Cost drivers: number of clubhouses authorized, scope of services approved by CMS, uptake by beneficiaries, reimbursement rates. OLS cites a Washington State reference estimating annual operating budgets of ~$600,000–$800,000 per clubhouse as contextual information.
Notes and caveats
- Federal Centers for Medicare & Medicaid Services (CMS) approval will determine which clubhouse services are eligible for federal financial participation; not all clubhouse activities may be reimbursable.
- Some source materials associated with the bill file appear to include unrelated drafts or filings (from other jurisdictions or topics); this summary focuses only on the clubhouse/Medicaid provisions in the New Jersey bill record.
Compiled from official sources — confirm details with the bill’s official record.
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