The reimbursement rate for the Clubhouse programs is too low. The result will be that Clubhouses will not be able to sustain themselves. Many of the programs in the rural communities of Virginia with limited benefactors and donor pools will not be able to market and fundraise effectively enough to maintain operation costs. The outrageous costs of the Clubhouse International trainings is yet another burden that many agencies cannot afford. For example, sending one LMHP, one Program Director and One Member for the two-week training is estimated to cost in the neighborhood of  $5,000-$7,000 and this is not a fully encompassing cost list. Additionally, the staff to be trained are expected to leave their current employment for two full weeks of training. With many programs already struggling with staffing, this would put an excessive burden on remaining staff. What happens if these trained staff no longer work for the program? Is the program then responsible for training another round of staff for thousands of dollars? Would services be considered non-billable until other staff completed training?  Another cost that providers must fund is the annual dues to Clubhouse International.