This proposal would let the federal health agency offer loans and loan guarantees to build, fix, or expand mental health and substance use treatment facilities for both adults and kids. Money could also upgrade telehealth and other patient tech, and add or convert beds for inpatient psychiatric and substance use care. Priority goes to projects that add beds in areas with too few, serve rural or under-resourced communities, offer a wide range of services, or handle complex cases. At least one-quarter of funds must go to facilities that mainly serve children and teens .

Loans would follow strict safeguards: terms up to 20 years (or half the life of what’s built, whichever is less), federal guarantees covering no more than 80% of potential loss, interest tied to Treasury rates with a minimum to protect taxpayers, and fees set to limit government cost. Borrowers must cover at least 25% of project costs with non-federal money, and loans can’t be subordinated to other debts. Refinancing is limited to loans made no later than 24 months before the law takes effect, and that authority ends 24 months after enactment. If a guaranteed loan defaults, the government would pay 75% of the loss and seek recovery. Funding is limited to what Congress provides, up to $200 million each year from 2026 through 2030. Any program income above costs would go into a new trust fund to support state community mental health block grants .

Key points

• Who is affected: Facilities that provide mental health or substance use treatment; communities with too few treatment beds; children and teens (with a set-aside) .
• What changes: New federal loans/guarantees to build, renovate, add beds, and improve telehealth and other patient systems; strict loan terms and borrower cost-sharing; limited refinancing window .
• When and how much: Up to $200 million per year available in 2026–2030, subject to future funding; default payouts up to 75%; creates a trust fund for extra program income to support community mental health grants .