,,ii  #aai? ,,congress  #a/ ,session    
,s4 #afgc  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,may #h1 #bjbe,mr4     
,m]kley 7= himself & ,mrs4 ,hyde-,smi?7 
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to au?orize ! ,secret>y (   
,heal? & ,human ,s]vices to make loans &
 loan gu>antees = 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 ! ,m5tal 
,heal? ,infra/ructure ,improvem5t ,act (
 #bjbe4  #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-#ah7 ! foll[+3         
#cii,v-#h4 ,loans & loan gu>antees =    
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 loans & loan gu>antees to eligible 
entities = ! purpose (-- 7,a7 con/ruct+ 
or r5ovat+1 includ+ plann+ ! con/ruction
 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$s
 to1 adult or p$iatric psy*iatric &     
sub/ance use inpati5t b$s at su* a      
facility2 &  7#b7 subject to subsection 
7e71 make loans & loan gu>antees =      
ref9anc+ loans t 7 made = su* purpose to
 an eligible entity4  7b7 ,pref]5ce ,9  
mak+ loans & loan gu>antees "u ?is      
section1 ! ,secret>y %all give pref]5ce 
to eligible entities propos+ to con/ruct
 or r5ovate a p$iatric or adult m5tal   
heal? treatm5t facility1 or a p$iatric  
or adult sub/ance use disord] treatm5t  
facility1 z det]m9$ by ! ,secret>y1 t   
w-- 7#a7 increase ! numb] ( p$iatric or 

adult psy*iatric b$s or p$iatric 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$ical       
co-morbidities4  7c7 ,set-,aside ,!     
,secret>y %all allocate at lea/ #be     
p]c5t ( ! funds "u ?is section = any    
fiscal ye> = aw>ds to con/ruct or       
r5ovate facilities s]v+ prim>ily        
p$iatric & adolesc5t populations4  7d7  
,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 less 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]m9es1 at 
! ,secret>y's discretion1 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  7e7 ,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 ( ! ,m5tal 
,heal? ,infra/ructure ,improvem5t ,act (
 #bjbe2 &  7#b7 t]m9ates on ! date t is 
#bd mon?s aft] su* date ( enactm5t4  7f7
 ,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=cem5t ( ,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  7g7 ,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    
eligible entity means public1 private   
=-pr(it1 & private n-=-pr(it-- 7,a7     
hospitals includ+ g5]al acute hospitals1
 psy*iatric hospitals1 critical access  

hospitals1 rural em]g5cy hospitals1 sole
 community hospitals1 *ildr5's          
hospitals1 & o!r hospitals z specifi$ by
 ! ,secret>y2  7,b7 sub/ance use disord]
 treatm5t facilities2  7,c7 m5tal heal? 
treatm5t facilities2  7,d7 facilities t 
employ lic5s$ m5tal heal? & sub/ance use
 disord] pr(essionals1 su* z *ild1      
adolesc5t1 & adult psy*iatri/s1 *ild1   
adolesc5t1 & adult psy*ologi/s1 advanc$ 
practice regi/]$ 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$iatric1 adolesc5t1 or adult pati5ts2 
7,e7 alliances ( hospitals or facilities
 li/$ 9 any ( subp>agraphs 7,a7 ?r\gh   
7,d72 &  7,f7 o!r facilities z det]m9$  
by ! ,secret>y4  7#d7 ,! t]m m5tal heal?
 treatm5t facility-- 7,a7 includes-- 7i7
 a *ild1 adolesc5t1 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 provides 
long-t]m inpati5t c>e4  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  7#h7 ,! t]m sub/ance   
use disord] treatm5t facility-- 7,a7    
includes-- 7i7 a *ild1 adolesc5t1 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#d77;,b74  7h7 ,fund+ limitations ,!   

,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  
#bjbf ?r\gh #bjcj4  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