The requirements around the Clubhouse model continue to be concerning, prohibitive, and may result in no resources for this service throughout Virginia.  

• limited to only one model, Clubhouse International, which presents multiple challenges.
• Implementation costs are prohibitive--Accreditation is very costly, as well as training costs around $10,000, which won't be covered by this reimbursement rate. 
• Clubhouse has to be in separate buildings, no shared space with other programs.  This is limiting in multiple ways for providers, but also for individuals. 
• Full accreditation is required within 3 years
• The model is very urban area-oriented and individual run/lead.
• it also holds additional staff requirements which are challenging in some parts of the state.