Mental Health Infrastructure Improvement Act of 2025
The Mental Health Infrastructure Improvement Act of 2025 would authorize the Department of Health and Human Services (HHS) to provide loans and loan guarantees to eligible entities for building, renovating, or planning pediatric and adult mental health facilities as well as substance use disorder treatment facilities. It also covers upgrading digital infrastructure and telehealth capabilities and adding or converting inpatient beds. In addition, the bill allows refinancing of existing eligible loans under certain time-limited conditions. Projects would receive priority in several high-need scenarios (e.g., counties with insufficient bed capacity, rural or underresourced communities, and facilities offering integrated or comprehensive services). The bill sets financial and risk-management rules for these loans and guarantees (limits on maturity, coverage of losses, and credit subsidies), imposes equity requirements for borrowers, and creates a funding mechanism that restricts total annual funding to $200 million (fiscal years 2026–2030). It also establishes the Mental Health and Substance Use Treatment Trust Fund to capture excess program revenues (beyond costs) for use in block grants to support community mental health services. The definition section clarifies what counts as eligible facilities and entities.
Key Points
- 1What is funded: Loans and loan guarantees to plan, construct, renovate, or convert pediatric and adult mental health treatment facilities and substance use disorder treatment facilities; upgrades to digital infrastructure and telehealth; and adding or converting inpatient beds.
- 2Refinancing provision: Allows refinancing of qualifying existing loans for these purposes, but only for loans entered into up to 24 months before enactment; authority terminates 24 months after enactment.
- 3Funding cap and set-aside: Up to $200 million in loans/guarantees per fiscal year (2026–2030); at least 25% of funds each year must go to facilities serving primarily pediatric and adolescent populations.
- 4Financial terms and risk controls: Maturity up to 20 years (or 50% of the asset’s useful life, whichever is less); guarantees may cover up to 80% of potential loss; loans/guarantees cannot be subordinated to other debt; interest rates must reference market benchmarks with a floor at government cost plus 1%; fees/insurance must minimize cost to the government while supporting service expansion; explicit risk assessment standards required.
- 5Borrower requirements: Borrowers must provide at least 25% of project funding from non-federal sources; fees/ premiums cannot be paid with federal loan/ guarantee funds; revenues from the loan must not be tax-exempt income for the borrower.
- 6Trust Fund: Establishes the Mental Health and Substance Use Treatment Trust Fund to hold revenues from the program that exceed costs; funds available for block grants for community mental health services under Title XIX (Public Health Service Act).