H.R. 2223 — Building Capacity for Care Act

This section establishes a new program authorizing the Secretary of Health and Human Services to make loans, loan guarantees, and grants to eligible entities—including public or private hospitals (e.g., psychiatric, children's, critical access), mental health or substance use disorder (SUD) treatment facilities, facilities employing licensed mental health/SUD professionals, alliances thereof, or other health care facilities as determined by the Secretary—for (1) purchasing, planning, constructing, or renovating pediatric or adult mental health or SUD treatment facilities; (2) improving digital infrastructure, telehealth capabilities, or other patient care infrastructure at such facilities; or (3) adding or converting beds to adult, adolescent, or pediatric psychiatric or SUD inpatient beds. Eligible projects must increase psychiatric or SUD bed capacity in underserved counties, serve high-need rural or underresourced communities, provide services across the continuum of care, or offer integrated care for complex cases. The section further authorizes loans and loan guarantees for refinancing such prior loans (subject to subsection (f)) and requires grant preferences for mental health professional shortage areas or counties with above-national-average drug overdose or suicide death rates over the prior three years. Loans and guarantees are subject to terms including a maximum maturity of 20 years (or 50% of the financed asset's useful life, whichever is less), guarantees not exceeding 80% of potential loss, no subordination to other debt, and determinations of lender responsibility and credit necessity to expand access to care.

This section establishes in the Treasury the Mental Health and Substance Use Treatment Trust Fund. The fund receives appropriations, to remain available until expended, equivalent to revenues exceeding costs from the program of loans and loan guarantees under section 399V–8 of the Public Health Service Act (as added by section 2 of this bill). Amounts in the fund are available, as provided in appropriation Acts, for Community Mental Health Services Block Grants under subpart I of part B of title XIX of the Public Health Service Act (42 U.S.C. 300x et seq.), which provide formula block grants to states to support community mental health service systems.