FACT Pilot Program Act

This Act may be cited as the “Forensic Assertive Community Treatment Pilot Program Act” or the “FACT Pilot Program Act”.

(a) In general.—

(1) Establishment.— The Secretary of Health and Human Services, acting through the Assistant Secretary for Mental Health and Substance Use (in this section referred to as the “Secretary”), shall establish a 5-year pilot program under which the Secretary will award grants to eligible entities to enable such entities to, directly, or through a subgrant to a nonprofit organization, licensed mental health treatment agency, a local management care entity/managed care organization, or any other entity the Secretary considers appropriate, expand the forensic assertive community treatment team programs carried out in the respective jurisdiction of the eligible entity to enable such entity to serve more community members.

(2) Definitions.— In this subsection:

(A) The term eligible entity means a State or a local government that, as of the date of the enactment of this Act, is carrying out, or is partnering with, a forensic assertive community treatment team program within the respective State or locality or localities served by the local government.

(B) The term forensic assertive community treatment team program means a program—

(i) with a small client-to-team ratio under which around the clock, time-unlimited care and intensive, field-based services, including mental health care, addiction treatment, vocational training, and housing assistance, are provided to individuals with serious mental illness, who may have co-occurring substance use and physical health disorders, and who are involved with the criminal justice system;

(ii) that maintains fidelity with the Assertive Community Treatment model, while incorporating adaptions that address the criminogenic risk and needs of the individuals described in clause (i); and

(iii) in which such services are provided by a multidisciplinary team of providers that includes—

(I) representatives from the field of psychiatry (including psychiatric nursing);

(II) specialists in employment and substance use services;

(III) a criminal justice partner (such as a member of local law enforcement, a provider of pretrial services, or a probation or parole officer); and

(IV) one or more forensic peer specialists living with serious mental illness or a co-occurring disorder who have personal experience with criminal justice system involvement.

(C) The term involved with the criminal justice system means to have had contact with law enforcement, the courts, or correctional systems. Such term includes involvement at any stage, including arrest, pre-trial services, incarcerated in jail or prison, incarcerated in jail or prison and pending imminent release, recently released from incarceration or a forensic hospital setting, probation, parole, or other forms of community supervision.

(3) Authorization of appropriations.— There are authorized to be appropriated to carry out this subsection such sums as may be necessary for each of fiscal years 2027 through 2032.

(b) Study and report.—

(1) In general.— Not later than 60 days after the date of the enactment of this Act, the Secretary shall seek to enter into an agreement under which the National Academies of Sciences, Engineering, and Medicine, shall conduct a study which shall—

(A) recommend defined and measurable metrics of effectiveness that the Secretary and other Federal agencies may use in evaluating programs, including metrics measuring—

(i) the reduction in recidivism, psychiatric hospitalizations, emergency department utilization, and reoccurring hospitalization and the associated costs;

(ii) the reduction in time it takes for an at-risk individual to access stable housing;

(iii) the reduction in the time it takes for an at-risk individual to access mental health services;

(iv) the improvement in mental health outcomes;

(v) any increase in community connection and reintegration; and

(vi) improvement in overall public safety;

(B) identify key mechanisms of model fidelity that can be recognized despite the variation between local and State programs and justice systems and identify model fidelity metrics for use in future evaluations;

(C) develop policy proposals that can be made at the Federal and State level to scale up existing programs and infrastructure, with attention to implementation considerations;

(D) provide an implementation framework for States and localities interested in starting new forensic assertive community treatment team programs, with attention to the unique needs for adaptation in rural communities;

(E) provide a cost estimate for the development and implementation of such policy proposals;

(F) provide a cost-savings and benefits analysis of the program model, including the impact on health care and justice systems; and

(G) provide recommendations to the Secretary for the improvement and implementation of such model.

(2) Submission to Secretary.— The agreement entered into under paragraph (1) shall require the National Academies, not later than 18 months after the date of the enactment of this Act, to submit to the Secretary and to Congress a report containing the findings of the study conducted under such agreement.

(3) Publication.— Not later than 60 days after the submission of the report under paragraph (2), the Secretary shall—

(A) publish such report on the public website of the Department of Health and Human Services; and

(B) distribute such report to State and local governments.

(4) Authorization of appropriations.— There are authorized to be appropriated to carry out this subsection $1,500,000, to remain available until expended.