I 

118TH CONGRESS 

1ST SESSION H. R. 5648 

To amend the National Housing Act to authorize mortgage insurance for 

certain treatment facilities, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

SEPTEMBER 21, 2023 

Mr. MOONEY (for himself and Ms. PETTERSEN) introduced the following bill; 

which was referred to the Committee on Financial Services 

A BILL 

To amend the National Housing Act to authorize mortgage 

insurance for certain treatment facilities, and for other 

purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Community Assistance 

5 for Recovery and Empowerment Act’’ or the ‘‘CARE Act’’. 

6 SEC. 2. MORTGAGE INSURANCE FOR CERTAIN TREATMENT 

7 FACILITIES. 

8 (a) IN GENERAL.—Section 232 of the National 

9 Housing Act (12 U.S.C. 1715w) is amended— 

10 (1) in subsection (b)— 


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1 (A) in paragraph (6)(C), by striking ‘‘and’’ 

2 at the end; 

3 (B) in paragraph (7), by striking the final 

4 period and inserting a semicolon; and 

5 (C) by adding at the end the following: 

6 ‘‘(8) the term ‘inpatient psychiatric treatment 

7 facility’ means a public facility, proprietary facility, 

8 or facility of a private nonprofit corporation or asso9 ciation that— 

10 ‘‘(A) is licensed or regulated by the State 

11 (or, if there is no State law providing for such 

12 licensing or regulation by the State, by the mu13 nicipality or other political subdivision in which 

14 the facility is located) for inpatient psychiatric 

15 treatment; or 

16 ‘‘(B) has deemed status in the State pur17 suant to accreditation by the Joint Commission, 

18 the Commission on the Accreditation of Reha19 bilitation Facilities, or the Council on Accredi20 tation; and 

21 ‘‘(9) the term ‘chemical dependence treatment 

22 facility’ means a public facility, proprietary facility, 

23 or facility of a private nonprofit corporation or asso24 ciation that— 


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1 ‘‘(A) is licensed or regulated by the State 

2 (or, if there is no State law providing for such 

3 licensing or regulation by the State, by the mu4 nicipality or other political subdivision in which 

5 the facility is located) for chemical dependency 

6 treatment; or 

7 ‘‘(B) has deemed status in the State pur8 suant to accreditation by the Joint Commission, 

9 the Commission on the Accreditation of Reha10 bilitation Facilities, or the Council on Accredi11 tation.’’; and 

12 (2) in subsection (d)— 

13 (A) by striking ‘‘, or intermediate care fa14 cility’’ and inserting ‘‘, intermediate care facil15 ity, inpatient psychiatric treatment facility, or 

16 chemical dependence treatment facility’’; 

17 (B) by striking ‘‘assisted living facility, or 

18 intermediate care facility’’ and inserting ‘‘as19 sisted living facility, intermediate care facility, 

20 inpatient psychiatric treatment facility, or 

21 chemical dependence treatment facility’’; and 

22 (C) by striking ‘‘assisted living facility, and 

23 intermediate care facility’’ and inserting ‘‘as24 sisted living facility, intermediate care facility, 


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1 inpatient psychiatric treatment facility, and 

2 chemical dependence treatment facility’’. 

3 (b) ESTABLISHMENT OF THE OFFICE OF PSY4 CHIATRIC AND ADDICTION TREATMENT FACILITIES.— 

5 Section 4 of the Department of Housing and Urban Devel6 opment Act (42 U.S.C. 3533) is amended by adding at 

7 the end the following: 

8 ‘‘(i) OFFICE OF PSYCHIATRIC AND ADDICTION

9 TREATMENT FACILITIES.— 

10 ‘‘(1) ESTABLISHMENT.—There is established 

11 within the Federal Housing Administration the Of12 fice of Psychiatric and Addiction Treatment Facili13 ties (referred to in this subsection as the ‘Office’). 

14 ‘‘(2) ASSISTANT DIRECTOR.—Not later than 1 

15 year after the date of the enactment of this sub16 section, the Secretary shall appoint an Assistant Di17 rector, who shall— 

18 ‘‘(A) carry out the functions described in 

19 paragraph (3); and 

20 ‘‘(B) report directly to the Deputy Assist21 ant Secretary for Healthcare Programs. 

22 ‘‘(3) FUNCTIONS.—The Office shall oversee 

23 mortgage insurance that is authorized under section 

24 232 of the National Housing Act (12 U.S.C. 1715w) 

25 to be provided to an inpatient psychiatric treatment 


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1 facility or a chemical dependence treatment facility 

2 (as such terms are defined in subsection (b) of such 

3 section).’’. 

4 (c) AUTHORIZATION OF APPROPRIATIONS.— 

5 (1) IN GENERAL.—There is authorized to be 

6 appropriated to the Federal Housing Commissioner 

7 such sums as are necessary to carry out this section, 

8 including any costs related to— 

9 (A) hiring staff and temporary consultants; 

10 (B) developing policies, procedures, and 

11 underwriting models; and 

12 (C) updating information management sys13 tems. 

14 (2) LIMITATION.—In each fiscal year, the sum 

15 of any amounts appropriated pursuant to paragraph 

16 (1) and any amounts appropriated pursuant to sec17 tion 519 of the National Housing Act (12 U.S.C. 

18 1735c) with respect to the mortgage insurance pro19 grams described in section 232 of the National 

20 Housing Act (12 U.S.C. 1715w) and section 242 of 

21 the National Housing Act (12 U.S.C. 1715z–7) shall 

22 not exceed the amount that is the total amount gen23 erated through the collection of premiums associated 

24 with such programs. 


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1 (3) RULE OF CONSTRUCTION.—If the amount 

2 that is the total amount generated through the col3 lection of premiums associated with the mortgage in4 surance programs described in section 232 of the 

5 National Housing Act (12 U.S.C. 1715w) is less 

6 than the amount equal to the net present value of 

7 claims, nothing in this section may be construed to 

8 waive or eliminate the limitation described in para9 graph (2). 

10 SEC. 3. DISASTER PREPAREDNESS AND EFFICIENCY 

11 LOANS. 

12 Section 241 of the National Housing Act (12 U.S.C. 

13 1715z–6) is amended— 

14 (1) in subsection (d)— 

15 (A) by striking ‘‘or other health facility’’ 

16 and inserting ‘‘or other health facility, including 

17 housing for employees or trainees of healthcare 

18 facilities insured under this title’’; and 

19 (B) by inserting ‘‘, including floods, hurri20 canes, earthquakes, and other natural disas21 ters’’ after ‘‘fire or other hazards’’; and 

22 (2) in subsection (e)(1), by inserting ‘‘or a 

23 group practice, medical practice facility, hospital, or 

24 other health care facility project approved by the 


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1 Secretary under section 232 or section 242,’’ after 

2 ‘‘in a multifamily housing project’’. 

3 SEC. 4. RULEMAKING. 

4 Not later than 180 days after the date of the enact5 ment of this Act, the Secretary of Housing and Urban 

6 Development shall establish a negotiated rulemaking com7 mittee as provided for under section 561 of title 5, United 

8 States Code, to establish the procedures for implementa9 tion of this Act and the amendments made by this Act. 

10 SEC. 5. REPORTING REQUIREMENT. 

11 (a) IN GENERAL.—Not later than 120 days after the 

12 end of the first fiscal year ending after the date of the 

13 enactment of this Act (and alternating fiscal years there14 after), the Secretary of Housing and Urban Development 

15 (in this section referred to as the ‘‘Secretary’’) shall sub16 mit to the House Committee on Financial Services and 

17 the Senate Committee on Banking, Housing, and Urban 

18 Affairs a report in accordance with subsection (b). 

19 (b) REPORT CONTENTS.—The report required pursu20 ant to subsection (a) shall include information on the oper21 ation of the mortgage insurance programs described in 

22 section 232 of the National Housing Act (12 U.S.C. 

23 1715w) and section 242 of the National Housing Act (12 

24 U.S.C. 1715z–7) for the 180-day period preceding the 


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1 submission of such report, including the following infor2 mation with respect to each such program: 

3 (1) The number of applications submitted to 

4 the program. 

5 (2) The volume and value of loans issued under 

6 the program. 

7 (3) The number and causes of defaults under 

8 the program. 

9 (4) The number of claims filed with respect to 

10 the program. 

11 (5) The total premiums collected each year. 

12 (6) The financial status of the program, includ13 ing the credit subsidy level of the program during 

14 the period covered by the report, as determined by 

15 the Congressional Budget Office. 

16 (c) PUBLIC INSPECTION.—Not later than 30 days 

17 after the date on which a report is submitted pursuant 

18 to subsection (a), the Secretary shall make such report 

19 publicly available on the website of the Department of 

20 Housing and Urban Development. 

Æ 


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