The F.U.B.A.R. Act of 2025
Federal Uniform Behavioral Assistance and Recovery Act
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled:
Section 1. Short Title
This Act may be cited as the “F.U.B.A.R. Act of 2025”—the
Federal Uniform Behavioral Assistance and Recovery Act.
Section 2. Congressional Findings
Congress finds that:
1. The existing patchwork of state mental-health and substance-use commitment
statutes is fouled up beyond all recognition, leaving millions of citizens with
untreated psychosis or addiction to cycle between streets, jails, and emergency
rooms.
2. Severe mental disorders such as schizophrenia, schizo-affective disorder,
bipolar disorder with psychotic features, and substance use disorders
(including addiction to alcohol, opioids, or stimulants) are chronic brain
illnesses that impair judgment and self-control.
3. Anosognosia, a neurological deficit causing unawareness of illness,
frequently occurs in both psychotic and addicted individuals, rendering
voluntary treatment impossible.
4. Assisted Outpatient Treatment (AOT), when monitored and enforced, restores
stability while preserving liberty and dignity.
5. Inpatient treatment is essential for individuals whose non-adherence,
dangerousness, or severe anosognosia or addiction makes outpatient treatment
impossible or unsafe.
6. The U.S. Air Force Suicide Prevention Program (1997–2002), a mandatory
treatment model, reduced suicide by 33 percent, family violence by 54 percent,
and homicide by 51 percent, proving that structured, necessity-based treatment
saves lives.
7. Congress, under the Spending Clause and Fourteenth Amendment, may condition
federal mental-health and addiction-treatment funding on uniform, humane, and
medically necessary standards of care.
8. Property-Value and Community Stability Benefit: Uncontrolled street
homelessness and visible, untreated psychosis or addiction impose severe
negative externalities on surrounding neighborhoods. Real-estate market data
and municipal appraisals demonstrate that homes located on blocks with
persistent unsheltered individuals exhibiting psychotic or addictive behavior
experience 10 to 20 percent declines in market value, often rendering sale or
refinancing impossible. State compliance with this Act—through clinically
supervised treatment, housing stabilization, and public-safety coordination—is
expected to restore neighborhood property values, expand municipal tax bases,
and improve community well-being.
Section 3. Requirement for State Legislation
(a) Each State and territory shall, within one year of
enactment, enact laws substantially conforming to this Act.
(b) Any State failing to enact conforming legislation within the prescribed
time shall be deemed non-compliant and subject to the penalties described in
Section 10.
(c) The Secretary of Health and Human Services shall publish annually a list of
compliant and non-compliant States in the Federal Register.
Section 4. Model Commitment Standard
(a) Evaluation and Temporary Hold: A licensed mental-health
or addiction-treatment practitioner may detain an individual for up to five (5)
days upon probable cause that the person suffers from a severe mental disorder
or substance use disorder and, as a result, cannot meet essential health or
safety needs. A second independent practitioner shall confirm the diagnosis
within that period.
(b) Outpatient Commitment Preferred: The court shall first consider Assisted
Outpatient Treatment (AOT) as the default and preferred form of commitment
whenever the individual can safely receive care in the community. AOT orders
shall require medication adherence, participation in substance-use disorder
treatment where indicated, therapy attendance, case management, and periodic
medical review. Failure to comply with AOT conditions, demonstrated clinical
deterioration, relapse, or credible evidence of dangerousness shall authorize
conversion to inpatient commitment without requiring a new dangerous act.
(c) Inpatient Commitment Criteria: The court shall order inpatient commitment
when clear and convincing evidence shows that the person has a severe mental
disorder or substance use disorder and either (i) is dangerous to self or
others due to non-adherence, relapse, or loss of control, or (ii) suffers from
severe anosognosia or addiction making outpatient treatment impossible. A
finding of recent overt violence shall not be required.
(d) Duration and Renewal: Orders may extend up to one (1) year, renewable
annually for three years and every five (5) years thereafter upon medical and
judicial review.
Section 5. Definition of Anosognosia
“Anosognosia” means a medically verified neurological or
psychiatric condition that renders a person with a severe mental disorder or
substance use disorder unaware of their illness and incapable of voluntary,
informed treatment participation. A confirmed diagnosis of anosognosia,
together with serious psychiatric or addictive symptoms, constitutes mandatory
grounds for inpatient commitment under this Act.
Section 6. Treatment, Rights, and Oversight
(a) Treatment Standards: All individuals committed under
this Act shall receive evidence-based psychiatric and addiction treatment in
the least restrictive environment consistent with safety.
(b) Due Process: Patients retain the right to counsel, independent medical
evaluation, appeal, and periodic review.
(c) Progress Reporting: Facilities shall provide quarterly progress reports to
the court and patient representative.
(d) Duration of Care: No person shall be discharged until a qualified treatment
team certifies clinical stabilization and readiness for supervised community
reintegration.
Section 7. Federal Oversight and Incentives
(a) The Secretary of Health and Human Services shall certify
compliance, collect and publish data on suicide, overdose, violence,
homelessness, and relapse, and establish benchmarks modeled on the Air Force’s
33 percent suicide-reduction standard.
(b) States meeting or exceeding these benchmarks shall receive performance
grants for expanded psychiatric and addiction-treatment infrastructure.
Section 8. Severability
If any provision or application of this Act is held invalid,
the remainder remains in effect.
Section 9. Effective Date
This Act takes effect upon enactment. States must comply
within one year.
Section 10. Enforcement and Penalties
(a) Funding Reduction: Any State that fails to adopt and
maintain legislation substantially conforming to this Act shall automatically
lose fifty percent (50%) of all federal mental-health and addiction-treatment
funding, including but not limited to SAMHSA block grants and Title XIX
allocations.
(b) Restoration of Funds: Funds shall be restored prospectively upon
certification of compliance by the Secretary.
(c) Administrative Action: The Secretary may issue regulations to implement
this section and impose additional withholdings for continued non-compliance.
(d) Public Accountability: The Secretary shall report annually to Congress on
State compliance and penalties imposed.
