S. 1673 — Mental Health Infrastructure Improvement Act of 2025

This section establishes a loan and loan guarantee program under the Public Health Service Act authorizing the Secretary of Health and Human Services to provide loans and loan guarantees to eligible entities for (1) planning, constructing, or renovating pediatric or adult mental health treatment facilities or substance use disorder (SUD) treatment facilities; (2) improving digital infrastructure, telehealth capabilities, or other patient care infrastructure at such facilities; (3) adding or converting beds to adult or pediatric psychiatric and SUD inpatient beds at such facilities; and (4) refinancing prior loans for those purposes. In awarding loans and guarantees, the Secretary must give preference to projects that increase psychiatric or SUD bed capacity in counties with insufficient supply, serve high-need rural or underresourced communities, provide services across the continuum of care, or offer integrated 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 specified terms and conditions, including credit subsidies only where necessary to expand access to care, final maturities not exceeding 20 years or 50% of an asset's useful life (whichever is less), guarantees limited to 80% of potential loss, no subordination to other debt, interest rates tied to Treasury benchmarks plus at least 1% above government borrowing costs (adjusted quarterly), and fees set to cover estimated default costs plus 1% (reviewed semiannually). (Thus, the program aims to expand inpatient psychiatric and SUD bed capacity and related infrastructure, particularly for underserved pediatric, rural, and high-need populations.)

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 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), with amounts in the fund available as provided in appropriation Acts for block grants for community 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.).