Ensure coverage for respite centers and clubhouses

Parity, Coverage, & Equitable Access
Diverse Workforce
social determinants of health
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Older Adults
People with Physical Disabilities
Coverage & Standards
Covered Benefits
Support Services
Individual ACA Plans
Federal department
Health and Human Services
house committees
House Energy and Commerce Committee
House Ways and Means Committee
senate committees
Senate Finance Committee
Senate Health, Education, Labor, and Pensions Committee


Congress should ensure that both Medicare and all state Medicaid programs cover psychosocial rehabilitation support services such as respite centers and clubhouses, which offer individuals with mental health conditions (usually a serious mental illness) a physical place where they can engage in a therapeutic community. The Department of Health and Human Services should ensure that psychosocial rehabilitation support services are covered under the Affordable Care Act’s Essential Health Benefits requirement for individual and small group health plans (i.e., Qualified Health Plans).


Clubhouses are operated by members and staff and provide a range of services and supports, including primary and psychiatric services, care management, home and community-based services, and employment and education supports. This cost-effective approach helps members reclaim their agency and dignity, while improving outcomes and reducing hospitalizations and costs.[1][2] The clubhouse model has existed for more than 65 years, and a meta-analysis of the clubhouse model found evidence that clubhouses are an important component of rehabilitative services for individuals with serious mental illness.[3] Clubhouse International, an international network of clubhouses, has quality standards and offers accreditation, which 80 percent of clubhouses have achieved.[4] Clubhouses have been shown to reduce hospitalization, incarceration, and costs.[5]


1. Fountain House. Our Services. Last Accessed July 6, 2023.

2. Kaiser Family Foundation, State Health Facts. Medicaid Behavioral Health Services: Psychosocial Rehabilitation (e.g. “Clubhouse model”). Last Accessed July 6, 2023.

3. McKay, C., Nugent, K.L. Johnsen. A Systematic Review of Evidence for the Clubhouse Model of Psychosocial Rehabilitation. Springer Link. Last Accessed August 31, 2016

4. Clubhouse International. Accreditation. Last Accessed July 9, 2023.

5. Clubhouse International. Our Impact. Last Accessed July 9, 2023.