,i  #aai? ,,congress  #a/ ,session  ,h4 
,r4 #bbbc  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,m>* #ah1 #bjbe,ms4   
,sal9as 7= h]self & ,ms4 ,bal9t7        
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce  ,a  
,,bill  ,to au?orize ! ,secret>y (      
,heal? & ,human ,s]vices to make loans1 
loan gu>antees1 & grants = pur*as+1     
plann+1 con/ruct+1 or r5ovat+ p$iatric  
or adult m5tal heal? treatm5t facilities
 & p$iatric or adult sub/ance use       
disord] treatm5t facilities1 & = o!r    
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,build+ ,capacity = ,c>e   
,act4  #b4 ,loans & loan gu>antees ,"p  
,p ( title ,,iii ( ! ,public ,heal?     
,s]vice ,act is am5d$ by ins]t+ aft]    
section #cii,v-#g ( su* ,act 7#db       
,u4,s4,c4 #bhj;g-#ag7 ! foll[+3         
#cii,v-#h4 ,loans1 loan gu>antees1 &    
grants = pur*as+1 plann+1 con/ruct+1 or 
r5ovat+ eligible facilities = p$iatric  
or adult m5tal heal? & sub/ance use     
disord] s]vices  7a7 ,9 g5]al ,!        

,secret>y may-- 7#a7 make loans1 loan   
gu>antees1 or grants to eligible        
entities = ! purpose (-- 7,a7 pur*as+1  
con/ruct+1 or r5ovat+1 includ+ plann+ ! 
pur*ase1 con/ruction1 or r5ovation (1 a 
p$iatric or adult m5tal heal? treatm5t  
facility or a p$iatric or adult sub/ance
 use disord] treatm5t facility2  7,b7   
improv+ digital infra/ructure1 teleheal?
 capabilities1 or o!r pati5t c>e        
infra/ructure at su* a facility2 or     
7,c7 add+1 or conv]t+ b$s to1 adult1    
adolesc5t1 or p$iatric psy*iatric &     
sub/ance use inpati5t b$s at su* a      
facility2 &  7#b7 subject to subsection 
7f71 make loans & loan gu>antees =      
ref9anc+ loans t 7 made = su* purpose to
 an eligible entity4  7b7 ,eligible     
entities ,an entity %all be eligible to 
receive a loan1 loan gu>antee1 or grant 
"u ?is section if-- 7#a7 su* entity is a
 public1 private =-pr(it1 & private     
n-=-pr(it-- 7,a7 hospital1 includ+ a    
g5]al acute hospital1 psy*iatric        
hospital1 critical access hospital1     

rural em]g5cy hospital1 sole community  
hospital1 *ildr5's hospital1 or o!r     
hospital z specifi$ by ! ,secret>y2     
7,b7 sub/ance use disord] treatm5t      
facility2  7,c7 m5tal heal? treatm5t    
facility2  7,d7 facility t employs      
lic5s$ m5tal heal? & sub/ance use       
disord] pr(essionals1 su* z *ild & adult
 psy*iatri/s1 *ild & adult psy*ologi/s1 
advanc$ practice nurses1 social work]s1 
lic5s$ pr(essional c\nselors1 or o!r    
lic5s$ pr(essionals t provide m5tal     
heal? or sub/ance use disord] s]vices to
 p$iatric or adult pati5ts2  7,e7       
alliance ( hospitals or facilities li/$ 
9 any ( subp>agraphs 7,a71 7,b71 7,c71  
or 7,d72 &  7,f7 heal? c>e facility1 z  
det]m9$ by ! ,secret>y2 &  7#b7 su*     
entity proposes to pur*ase1 con/ruct1 or
 r5ovate a p$iatric or adult m5tal heal?
 treatm5t facility1 or a p$iatric or    
adult sub/ance use disord] treatm5t     
facility1 t w-- 7,a7 increase ! numb] ( 
p$iatric1 adolesc5t1 or adult psy*iatric
 b$s or p$iatric1 adolesc5t1 or adult   

sub/ance use disord] b$s 9 a c\nty t has
 insuffici5t psy*iatric or sub/ance use 
disord] treatm5t b$ capacity2  7,b7     
provide m5tal heal? or sub/ance use     
disord] s]vices 9 a high-ne$ rural or   
und]res\rc$ community2  7,c7 provide    
multiple s]vices across ! cont9uum (    
m5tal heal? or sub/ance use disord] c>e2
 or  7,d7 h ! capacity to provide       
integrat$ or specializ$ m5tal heal? &   
sub/ance use disord] c>e = complex cases
 or pati5ts ) m$ical co-morbidities4    
7c7 ,application ,an eligible entity    
seek+ a loan1 loan gu>antee1 or grant "u
 ?is section %all submit to ! ,secret>y 
an application at su* "t & 9 su* mann] z
 ! ,secret>y may specify4 ,su*          
application %all conta9 ! proposal ( !  
entity to pur*ase1 con/ruct1 or r5ovate 
a p$iatric or adult m5tal heal? treatm5t
 facility1 or a p$iatric or adult       
sub/ance use disord] treatm5t facility  
7z describ$ 9 subsection 7b77#b77 & su* 
o!r in=mation z ! ,secret>y may specify4
  7d7 ,geographic pref]5ce = grants ,9  

mak+ grants "u ?is section1 ! ,secret>y 
%all give pref]5ce to eligible entities 
locat$ 9-- 7#a7 a m5tal heal?           
pr(essional %ortage area1 z designat$ "u
 section #ccb2  7#b7 a c\nty 7or a      
municipality1 if n conta9$ )9 any c\nty7
 :]e ! mean drug ov]dose dea? rate p]   
#ajj1jjj p ov] ! pa/ #c ye>s = :i*      
(ficial data is available f ! ,/ate1 is 
high] ?an ! mo/ rec5t available national
 av]age ov]dose dea? rate p] #ajj1jjj p1
 z report$ by ! ,c5t]s = ,disease       
,control & ,prev5tion2 or  7#c7 a c\nty 
7or a municipality1 if n conta9$ )9 any 
c\nty7 :]e ! mean suicide rate p]       
#ajj1jjj p ov] ! pa/ #c ye>s = :i*      
(ficial data is available f ! ,/ate1 is 
high] ?an ! mo/ rec5t available national
 av]age suicide rate p] #ajj1jjj p1 z   
report$ by ! ,c5t]s = ,disease ,control 
& ,prev5tion4  7e7 ,t]ms & conditions   
,loans & loan gu>antees "u ?is section  
%all be made on su* t]ms & conditions z 
! ,secret>y may prescribe1 subject to ! 
provisions ( ?is section includ+ !      

foll[+3 7#a7 ,! ,secret>y may all[ cr$it
 to a prospective borr[] only :]e-- 7,a7
 x is necess>y to increase ! numb] (    
psy*iatric or sub/ance use disord]      
treatm5t facilities to enhance !        
public's access to a compreh5sive       
cont9uum ( m5tal heal? & sub/ance use   
disord] s]vices2 &  7,b7 a cr$it subsidy
 is ! mo/ effici5t way to a*ieve su*    
increase 7on a borr[]-by-borr[] basis74 
7#b7 ,! f9al maturity ( loans made or   
gu>ante$ "u ?is section %all n exce$ a  
p]iod ( #bj ye>s1 or ! p]iod ( #ej p]c5t
 ( ! useful life ( any physical asset to
 be f9anc$ by ! loan1 :i*ev] is less1 z 
det]m9$ by ! ,secret>y4  7#c7 ,!        
,secret>y may n make a loan gu>antee "u 
?is section1 ) respect to any borr[]1 9 
excess ( #hj p]c5t ( any pot5tial loss  
on ! loan4  7#d7 ,! ,secret>y may n make
 any loan or loan gu>antee "u ?is       
section if ! loan w be subord9at$-- 7,a7
 to ano!r debt contract$ by ! borr[]2 or
  7,b7 to any o!r claims aga9/ ! borr[] 
9 ! case ( default4  7#e7 ,! ,secret>y  

may n make any loan gu>antee "u ?is     
section unless ! ,secret>y det]m9es t-- 
7,a7 ! l5d] is responsible2 &  7,b7     
adequate provision is made = s]vic+ !   
loan on reasonable t]ms & protect+ !    
f9ancial int]e/ ( ! ,unit$ ,/ates4  7#f7
 ,! ,secret>y may n make any loan       
gu>antee "u ?is section if ! income f ! 
loan w be exclud$ f gross income =      
purposes ( *apt] #a ( ! ,int]nal ,rev5ue
 ,code ( #aihf4  7#g7 ,! ,secret>y may n
 make any loan or loan gu>antee "u ?is  
section unless-- 7,a7 ! loan & int]e/   
supplem5ts on any loan gu>antee w be at 
an int]e/ rate t is set by ref]5ce to a 
b5*m>k int]e/ rate on m>ketable         
,treasury securities ) a simil> maturity
 to ! loan be+ made or gu>ante$2 &  7,b7
 ! m9imum int]e/ rate on ! loan-- 7i7 w 
be no less ?an ! e/imat$ co/ to !       
,gov]nm5t ( mak+ ! loan plus #a p]c5t1 )
 ! goal ( keep+ ! int]e/ rate bel[ !    
int]e/ rate ( a comp>able & competitive 
private sector b5*m>k f9ancial in/rum5t2
 &  7ii7 w be adju/$1 z det]m9$ by !    

,secret>y1 e qu>t] to take acc\nt (     
*anges 9 ! int]e/ rate ( ! b5*m>k       
f9ancial in/rum5t4  7#h7 ,! ,secret>y   
may n make any loan or loan gu>antee "u 
?is section unless-- 7,a7 fees or       
premiums on ! loan or loan gu>antee &   
correspond+ insurance cov]age w be set  
at levels t m9imize ! co/ to ! ,gov]nm5t
 7z def9$ 9 section #ejb7e7 ( ! ,f$]al  
,cr$it ,re=m ,act ( #aiij7 ( insur+ su* 
loan or loan gu>antee1 :ile support+    
a*ievem5t ( enhanc+ ! public's access to
 a compreh5sive cont9uum ( m5tal heal? &
 sub/ance use disord] s]vices1 includ+  
increas+ ! numb] ( inpati5t psy*iatric &
 sub/ance use disord] b$ c\nts 9 areas )
 insuffici5t b$ capacity2  7,b7 ! m9imum
 gu>antee fee or insurance premium      
impos$ by ! ,gov]nm5t w be no less ?an !
 level suffici5t to cov] all ( ! e/imat$
 co/s to ! ,gov]nm5t ( ! expect$ default
 claims1 plus "o p]c5t2 &  7,c7 loan    
gu>antee fees impos$ by ! ,gov]nm5t w be
 review$ e six mon?s to ensure t ! fees 
impos$ on new loan gu>antees are at a   

level suffici5t to satisfy subp>agraph  
7,b7 bas$ on ! mo/ rec5t e/imates ( su* 
co/s4  7#i7 ,! provisions ( any loan    
gu>antee "u ?is section %all /ate t !   
gu>antee is conclusive evid5ce t-- 7,a7 
! gu>antee has be5 prop]ly obta9$2  7,b7
 ! und]ly+ loan qualifi$ = ! gu>antee2 &
  7,c7 except 9 ! case ( fraud or       
mat]ial misrepres5tation by ! hold] ( ! 
loan1 ! gu>antee w be presum$ to be     
valid1 legal1 & en=ceable4  7#aj7 ,!    
,secret>y may n make any loan or loan   
gu>antee "u ?is section unless-- 7,a7 ! 
borr[] f9ances at lea/ #be p]c5t ( !    
fund$ project f o!r s\rces2 &  7,b7 !   
borr[] uses funds t 7 n d]iv$ f ,f$]al  
loans or loan gu>antees to pay ! fees or
 premiums on ! loan or loan gu>antee "u 
?is section4  7#aa7 ,! ,secret>y-- 7,a7 
%all prescribe explicit /&>ds = use 9   
p]iodically assess+ ! cr$it risk ( new &
 exi/+ direct loans & gu>ante$ loans2 & 
7,b7 %all n make a loan or loan gu>antee
 "u ?is section unless ! ,secret>y f9ds 
t !re is a reasonable assurance (       

repaym5t4  7f7 ,limitation on ref9anc+  
,! au?ority ve/$ by subsection 7a77#b7--
 7#a7 au?orizes mak+ loans & loan       
gu>antees only = ref9anc+ loans t are   
ent]$ into on or be=e ! date t is #bd   
mon?s be=e ! date ( enactm5t ( ! ,m5tal1
 ,behavioral1 & ,sub/ance ,use ,disord] 
,treatm5t ,infra/ructure & ,capacity    
,act2 &  7#b7 t]m9ates on ! date t is   
#bd mon?s aft] su* date ( enactm5t4  7g7
 ,paym5t ( losses  7#a7 ,default on     
gu>ante$ loans ,if1 z a result ( a      
default by a borr[] "u a loan gu>ante$  
"u ?is section1 aft] ! hold] !re( has   
made su* fur!r collection ef=ts &       
in/itut$ su* en=cem5t proce$+s z !      
,secret>y may require1 ! ,secret>y      
det]m9es t ! hold] has suff]$ a loss--  
7,a7 ! ,secret>y %all pay to su* hold]  
#ge p]c5t ( su* loss1 z specifi$ 9 !    
gu>antee contract2  7,b7 ^u mak+ any su*
 paym5t1 ! ,secret>y %all be subrogat$  
to all ! rights ( ! recipi5t ( ! paym5t2
 &  7,c7 ! ,secret>y %all be entitl$ to 
recov] f ! borr[] ! am\nt ( any paym5ts 

made pursuant to ! gu>antee contract4   
7#b7 ,requir$ en=ce ( ,f$]al rights ,!  
,attorney ,g5]al ( ! ,unit$ ,/ates %all 
take su* action z may be appropriate to 
en=ce any "r accru+ to ! ,unit$ ,/ates z
 a result ( ! issuance ( any gu>antee "u
 ?is section4  7#c7 ,=be>ance ,no?+ 9   
?is section precludes any =be>ance = !  
b5efit ( ! borr[] ( a loan t is made or 
gu>ante$ "u ?is section :i* is agre$ ^u 
by ! p>ties to ! loan & approv$ by !    
,secret>y1 provid$ t budget au?ority =  
any result+ co/ to ! ,gov]nm5t 7z def9$ 
9 section #ejb7e7 ( ! ,f$]al ,cr$it     
,re=m ,act ( #aiij7 is available4  7h7  
,def9itions ,9 ?is section3 7#a7 ,! t]m 
*ildr5's hospital means a hospital t    
pr$om9antly s]ves pati5ts "u ! age (    
#ah4  7#b7 ,! t]m critical access       
hospital has ! mean+ giv5 to su* t]m 9  
section #ahfa7mm7 ( ! ,social ,security 
,act4  7#c7 ,! t]m m5tal heal? treatm5t 
facility-- 7,a7 includes-- 7i7 a *ild or
 adult outpati5t facility t provides--  
7,i7 int5sive outpati5t s]vices2  7,,ii7

 p>tial hospitalization s]vices2        
7,,iii7 crisis int]v5tion &             
/abilization2 or  7,,iv7 o!r m5tal1     
behavioral1 or emotional heal? s]vices  
deem$ appropriate by ! ,secret>y2  7ii7 
a hospital 7includ+ a g5]al acute       
hospital1 a psy*iatric hospital1 a      
critical access hospital1 a rural       
em]g5cy hospital1 a sole community      
hospital1 a *ildr5's hospital1 or o!r   
type ( hospital z specifi$ by !         
,secret>y7 t-- 7,i7 provides acute1     
%ort-t]m inpati5t psy*iatric treatm5t   
s]vices or outpati5t s]vices2 &  7,,ii7 
may include a milit>y s]vices program to
 meet ! ne$s ( active & retir$ milit>y  
s]vicememb]s2 &  7iii7 a facility )9 or 
ne> an em]g5cy dep>tm5t = provid+       
dis*>ge plann+ & in/ructions to em]g5cy 
dep>tm5t pati5ts 9 ne$ ( m5tal heal? or 
sub/ance use disord] treatm5t & transf] 
to an appropriate m5tal heal? or        
sub/ance use disord] treatm5t c>e sett+2
 &  7,b7 excludes a facility t provide  
long-t]m inpati5t c>e4  7#d7 ,! t]m     

sub/ance use disord] treatm5t facility--
 7,a7 includes-- 7i7 a *ild or adult    
outpati5t facility t provides outpati5t 
sub/ance use disord] s]vices2 &  7ii7 a 
hospital 7includ+ a g5]al acute         
hospital1 a psy*iatric hospital1 a      
critical access hospital1 a rural       
em]g5cy hospital1 a sole community      
hospital1 a *ildr5's hospital1 or o!r   
type ( hospital z specifi$ by !         
,secret>y7 t-- 7,i7 provides acute1     
%ort-t]m inpati5t sub/ance use disord]  
treatm5t s]vices or outpati5t s]vices2 &
  7,,ii7 may include a milit>y s]vices  
program to meet ! ne$s ( active & retir$
 milit>y s]vicememb]s2 &  7,b7 excludes 
any facility describ$ 9 p>agraph        
7#a77;,b74  7#e7 ,! t]m psy*iatric      
hospital has ! mean+ giv5 to su* t]m 9  
section #ahfa7;f7 ( ! ,social ,security 
,act4  7#f7 ,! t]m rural em]g5cy        
hospital has ! mean+ giv5 to su* t]m 9  
section #ahfa7kkk7 ( ! ,social ,security
 ,act4  7#g7 ,! t]m sole community      
hospital has ! mean+ giv5 to su* t]m 9  

section #ahhf7;d77#e77;,d77iii7 ( !     
,social ,security ,act4  7i7 ,fund+     
7#a7 ,limitations = loans & loan        
gu>antees ,! ,secret>y may provide loans
 & loan gu>antees "u ?is section-- 7,a7 
only to ! ext5t or 9 ! am\nts provid$ 9 
advance 9 appropriation ,acts2 &  7,b7  
total+ n m ?an #bjj1jjj1jjj = ea* (     
fiscal ye>s #bjbe ?r\gh #bjbi4  7#b7    
,au?orization ( appropriations = grants 
,!re is au?oriz$ to be appropriat$ to ! 
,secret>y to make grants "u ?is section 
#bjj1jjj1jjj = ea* ( fiscal ye>s #bjbe  
?r\gh #bjbi4  4  #c4 ,m5tal ,heal? &    
,sub/ance ,use ,treatm5t ,tru/ ,fund    
7a7 ,e/abli%m5t ,!re is e/abli%$ 9 !    
,treasury ( ! ,unit$ ,/ates a tru/ fund 
to be kn[n z ! ,m5tal ,heal? & ,sub/ance
 ,use ,treatm5t ,tru/ ,fund 79 ?is      
section ref]r$ to z ! ,tru/ ,fund74  7b7
 ,deposits ,!re are h]eby au?oriz$ to be
 appropriat$ to ! ,tru/ ,fund1 to rema9 
available until exp5d$1 am\nts equival5t
 to any rev5ues f ! program ( loans &   
loan gu>antees "u section #cii,v-#h ( ! 

,public ,heal? ,s]vice ,act1 z add$ by  
section #b1 t exce$ ! co/s ( c>ry+ out  
su* program4  7c7 ,use ( fund ,am\nts 9 
! ,tru/ ,fund %all be available1 z      
provid$ by appropriation ,acts1 = block 
grants = community m5tal heal? s]vices  
"u subp>t ,i ( "p ,b ( title ,,xix ( !  
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #cjjx et seq474