H.R. 3266 — Mental Health Infrastructure Improvement Act of 2025

This section establishes a new loan and loan guarantee program under the Public Health Service Act authorizing the HHS Secretary to provide financing to eligible entities for (1) planning, constructing, or renovating pediatric or adult mental health or substance use disorder treatment facilities; (2) improving digital infrastructure, telehealth capabilities, or other patient care infrastructure at such facilities; (3) adding or converting beds to pediatric or adult psychiatric or substance use inpatient beds; and (4) refinancing prior loans for such purposes. In making awards, the Secretary must give preference to facilities that (1) increase pediatric or adult psychiatric or substance use disorder beds in counties with insufficient capacity; (2) serve high-need rural or underresourced communities; (3) provide multiple services across the continuum of care; or (4) offer integrated or specialized care for complex cases or patients with medical comorbidities; and must allocate at least 25% of funds each fiscal year to facilities serving primarily pediatric and adolescent populations. Loans and guarantees are subject to terms prescribed by the Secretary, including a maximum maturity of 20 years or 50% of the financed asset's useful life (whichever is less); loan guarantees not exceeding 80% of potential loss; no subordination to other debt; interest rates tied to Treasury benchmarks with a minimum of the government's estimated cost plus 1%; and fees set to cover estimated default costs plus 1% while minimizing government expense.

This section establishes in the Treasury the Mental Health and Substance Use Treatment Trust Fund. The section authorizes deposits into the fund, to remain available until expended, of amounts equivalent to revenues from the loan and loan guarantee program under section 399V–8 of the Public Health Service Act (added by section 2) that exceed the program's costs; amounts in the fund are available, as provided in appropriation Acts, for Community Mental Health Services Block Grants (i.e., formula grants to states for adult and child mental health services) under subpart I of part B of title XIX of the Public Health Service Act (42 U.S.C. 300x et seq.).