,i #aagth ,,congress #b;d ,session ,h4 ,r4 #gbcb ,,in ,,the ,,house ,,of ,,representatives ,march #bh1 #bjbb,mr4 ,crdenas 7for himself1 ,mr4 ,fitzpatrick1 ,ms4 ,matsui1 ,ms4 ,blunt ,rochester1 ,mr4 ,moulton1 ,mrs4 ,napolitano1 ,mr4 ,beyer1 and ,mr4 ,raskin7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce ,a ,,bill ,to provide for improvements in the implementation of the ,national ,suicide ,prevention ,lifeline1 and for other purposes4 #a4 ,short title 7a7 ,short title ,this ,act may be cited as the #i-h-h and ,parity ,assistance ,act of #bjbb4 7b7 ,table of contents ,the table of contents for this ,act is as follows3 ,sec4 #a4 ,short title4,title ,i--,substance ,abuse and ,mental ,health ,services ,administration,sec4 #aja4 ,behavioral ,health ,crisis ,coordinating ,office4,sec4 #ajb4 ,regional and local lifeline call center program4,sec4 #ajc4 ,mental ,health ,crisis ,response ,partnership ,pilot ,program4,sec4 #ajd4 ,national suicide prevention media campaign4,title ,,ii--,health ,resources and ,services ,administration,sec4 #bja4 ,health center capital grants4,sec4 #bjb4 ,expanding behavioral health workforce training programs4,title ,,iii--,behavioral ,health ,crisis ,services ,expansion,sec4 #cja4 ,crisis response continuum of care4,title ,,iv--,mental health and substance use disorder parity implementation,sec4 #dja4 ,grants to support mental health and substance use disorder parity implementation4 ,i ,substance ,abuse and ,mental ,health ,services ,administration #aja4 ,behavioral ,health ,crisis ,coordinating ,office ,part ,a of title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;aa et seq47 is amended by adding at the end the following3 #ejf;,b4 ,behavioral ,health ,crisis ,coordinating ,office 7a7 ,in general ,the ,secretary1 acting through the ,assistant ,secretary for ,mental ,health and ,substance ,use1 shall establish an office to coordinate work relating to behavioral health crisis care across the operating divisions of the ,department of ,health and ,human ,services1 including the ,centers for ,medicare ,medicaid ,services and the ,health ,resources and ,services ,administration and external stakeholders4 7b7 ,duty ,the office established under subsection 7a7 shall-- 7#a7 convene ,federal1 ,state1 ,tribal1 local1 and private partners2 7#b7 launch and manage ,federal workgroups charged with making recommendations regarding behavioral health crisis financing1 workforce1 equity1 data1 and technology1 program oversight1 public awareness1 and engagement2 and 7#c7 support technical assistance1 data analysis1 and evaluation functions in order to develop a crisis care system to establish nationwide standards with the objective of expanding the capacity of1 and access to1 local crisis call centers1 mobile crisis care1 crisis stabilization1 psychiatric emergency services1 and rapid post-crisis follow-up care provided by-- 7,a7 the ,national ,suicide ,prevention and ,mental ,health ,crisis ,hotline and ,response ,system2 7,b7 community mental health centers 7as defined in section #ahfa7;ff77#c77;,b7 of the ,social ,security ,act72 7,c7 certified community behavioral health clinics1 as described in section #bbc of the ,protecting ,access to ,medicare ,act of #bjad2 and 7,d7 other community mental health and substance use disorder providers4 7c7 ,authorization of appropriations ,there is authorized to be appropriated to carry out this section #aj1jjj1jjj for each of fiscal years #bjbc through #bjbg4 4 #ajb4 ,regional and local lifeline call center program ,part ,b of title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb et seq47 is amended by inserting after section #ebj;,e-#d 7#db ,u4,s4,c4 #bij;bb-#cf;d7 the following3 #ebj;,e-#e4 ,regional and local lifeline call center program 7a7 ,in general ,the ,secretary shall award grants to crisis call centers described in section #cjb7;c77#a7 of the #i-h-h ,implementation and ,parity ,assistance ,act of #bjbb to-- 7#a7 purchase or upgrade call center technology2 7#b7 provide for training of call center staff2 7#c7 improve call center operations2 and 7#d7 hiring of call center staff4 7b7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section #dda1jjj1jjj for fiscal year #bjbc1 to remain available until expended4 4 #ajc4 ,mental ,health ,crisis ,response ,partnership ,pilot ,program ,title ,v of the ,public ,health ,service ,act is amended 7#db ,u4,s4,c4 #bij;aa7 by inserting after section #ebj;,f 7#db ,u4,s4,c4 #bij;bb-#cg7 the following3 #ebj;,f-#a4 ,mental ,health ,crisis ,response ,partnership ,pilot ,program 7a7 ,in general ,the ,secretary shall establish a pilot program under which the ,secretary will award competitive grants to eligible entities to establish new1 or enhance existing1 mobile crisis response teams that divert the response for mental health and substance use crises from law enforcement to mobile crisis teams1 as described in subsection 7b74 7b7 ,mobile crisis teams described ,a mobile crisis team described in this subsection is a team of individuals-- 7#a7 that is available to respond to individuals in crisis and provide immediate stabilization1 referrals to community-based mental health and substance use disorder services and supports1 and triage to a higher level of care if medically necessary2 7#b7 which may include licensed counselors1 clinical social workers1 physicians1 paramedics1 crisis workers1 peer support specialists1 or other qualified individuals2 and 7#c7 which may provide support to divert behavioral health crisis calls from the #i-a-a system to the #i-h-h system4 7c7 ,priority ,in awarding grants under this section1 the ,secretary shall prioritize applications which account for the specific needs of the communities to be served1 including children and families1 veterans1 rural and underserved populations1 and other groups at increased risk of death from suicide or overdose4 7d7 ,report 7#a7 ,initial report ,not later than one year after the date of the enactment of this section1 the ,secretary shall submit to ,congress a report on steps taken by eligible entities as of such date of enactment to strengthen the partnerships among mental health providers1 substance use disorder treatment providers1 primary care physicians1 mental health and substance use crisis teams1 and paramedics1 law enforcement officers1 and other first responders4 7#b7 ,progress reports ,not later than one year after the date on which the first grant is awarded to carry out this section1 and for each year thereafter1 the ,secretary shall submit to ,congress a report on the grants made during the year covered by the report1 which shall include-- 7,a7 data on the teams and people served by such programs1 including demographic information of individuals served1 volume and types of service utilization1 linkage to community-based resources and diversion from law enforcement settings1 data consistent with the ,state block grant requirements for continuous evaluation and quality improvement1 and other relevant data as determined by the ,secretary2 and 7,b7 the ,secretary's recommendations and best practices for-- 7i7 ,states and localities providing mobile crisis response and stabilization services for youth and adults2 and 7ii7 improvements to the program established under this section4 7e7 ,eligible entity ,in this section1 the term eligible entity means each of the following3 7#a7 ,community mental health centers 7as defined in section #ahfa7;ff77#c77;,b7 of the ,social ,security ,act74 7#b7 ,certified community behavioral health clinics described in section #bbc of the ,protecting ,access to ,medicare ,act of #bjad4 7#c7 ,an entity that operates citywide1 ,tribal-wide1 or county-wide crisis response systems1 including cities1 counties1 ,tribes1 or a department or agency of a city1 county1 or ,tribe1 including departments or agencies of social services1 disability services1 health services1 public health1 or mental health and substance disorder services4 7#d7 ,a program of the ,indian ,health ,service1 whether operated by such ,service1 an ,indian ,tribe 7as that term is defined in section #d of the ,indian ,health ,care ,improvement ,act71 or by a ,tribal organization 7as that term is defined in section #d of the ,indian ,self-,determination and ,education ,assistance ,act7 or a facility of the ,native ,hawaiian health care systems authorized under the ,native ,hawaiian ,health ,care ,improvement ,act4 7#e7 ,a public1 nonprofit1 or other organization that-- 7,a7 can demonstrate the ability of such organization to effectively provide community-based alternatives to law enforcement2 and 7,b7 has a demonstrated involvement with the identified communities to be served4 7f7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section #ajj1jjj1jjj for each of fiscal years #bjbc through #bjbg4 4 #ajd4 ,national suicide prevention media campaign ,subpart #c of part ,b of title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#ca et seq47 is amended by adding at the end the following3 #ebj,n4 ,national suicide prevention media campaign 7a7 ,national suicide prevention media campaign 7#a7 ,in general ,not later than the date that is #c years after the date of the enactment of this ,act1 the ,secretary1 in consultation with the ,assistant ,secretary for ,mental ,health and ,substance ,use and the ,director of the ,centers for ,disease ,control and ,prevention 7referred to in this section as the ,director71 shall conduct a national suicide prevention media campaign 7referred to in this section as the national media campaign71 for purposes of-- 7,a7 preventing suicide in the ,united ,states2 7,b7 educating families1 friends1 and communities on how to address suicide and suicidal thoughts1 including when to encourage individuals with suicidal risk to seek help2 and 7,c7 increasing awareness of suicide prevention resources of the ,centers for ,disease ,control and ,prevention and the ,substance ,abuse and ,mental ,health ,services ,administration 7including the suicide prevention hotline maintained under section #ebj;,e-#c1 any suicide prevention mobile application of the ,centers for ,disease ,control and ,prevention or the ,substance ,abuse ,mental ,health ,services ,administration1 and other support resources determined appropriate by the ,secretary74 7#b7 ,additional consultation ,in addition to consulting with the ,assistant ,secretary and the ,director under this section1 the ,secretary shall consult with1 as appropriate1 ,state1 local1 ,tribal1 and territorial health departments1 primary health care providers1 hospitals with emergency departments1 mental and behavioral health services providers1 crisis response services providers1 paramedics1 law enforcement1 suicide prevention and mental health professionals1 patient advocacy groups1 survivors of suicide attempts1 and representatives of television and social media platforms in planning the national media campaign to be conducted under paragraph 7#a74 7b7 ,target audiences 7#a7 ,tailoring advertisements and other communications ,in conducting the national media campaign under subsection 7a77#a71 the ,secretary may tailor culturally competent advertisements and other communications of the campaign across all available media for a target audience 7such as a particular geographic location or demographic7 across the lifespan4 7#b7 ,targeting certain local areas ,the ,secretary shall1 to the maximum extent practicable1 use amounts made available under subsection 7f7 for media that targets certain local areas or populations at disproportionate risk for suicide4 7c7 ,use of funds 7#a7 ,required uses 7,a7 ,in general ,the ,secretary shall1 if reasonably feasible with the funds made available under subsection 7f71 carry out the following1 with respect to the national media campaign3 7i7 ,testing and evaluation of advertising4 7ii7 ,evaluation of the effectiveness of the national media campaign4 7iii7 ,operational and management expenses4 7iv7 ,the creation of an educational toolkit for television and social media platforms to use in discussing suicide and raising awareness about how to prevent suicide4 7,b7 ,specific requirements 7i7 ,testing and evaluation of advertising ,in testing and evaluating advertising under subparagraph 7,a77i71 the ,secretary shall test all advertisements after use in the national media campaign to evaluate the extent to which such advertisements have been effective in carrying out the purposes of the national media campaign4 7ii7 ,evaluation of effectiveness of national media campaign ,in evaluating the effectiveness of the national media campaign under subparagraph 7,a77ii71 the ,secretary shall-- 7,i7 take into account the number of unique calls that are made to the suicide prevention hotline maintained under section #ebj;,e-#c and assess whether there are any ,state and regional variations with respect to the capacity to answer such calls2 7,,ii7 take into account the number of unique encounters with suicide prevention and support resources of the ,centers for ,disease ,control and ,prevention and the ,substance ,abuse and ,mental ,health ,services ,administration and assess engagement with such suicide prevention and support resources2 7,,iii7 assess whether the national media campaign has contributed to increased awareness that suicidal individuals should be engaged1 rather than ignored2 and 7,,iv7 take into account such other measures of evaluation as the ,secretary determines are appropriate4 7#b7 ,optional uses ,the ,secretary may use amounts made available under subsection 7f7 for the following1 with respect to the national media campaign3 7,a7 ,partnerships with professional and civic groups1 community-based organizations1 including faith-based organizations1 and ,federal agencies or ,tribal organizations that the ,secretary determines have experience in suicide prevention1 including the ,substance ,abuse and ,mental ,health ,services ,administration and the ,centers for ,disease ,control and ,prevention4 7,b7 ,entertainment industry outreach1 interactive outreach1 media projects and activities1 the dissemination of public information1 news media outreach1 outreach through television programs1 and corporate sponsorship and participation4 7d7 ,prohibitions ,none of the amounts made available under subsection 7f7 may be obligated or expended for any of the following3 7#a7 ,to supplant ,federal suicide prevention campaigns in effect as of the date of the enactment of this section4 7#b7 ,for partisan political purposes1 or to express advocacy in support of or to defeat any clearly identified candidate1 clearly identified ballot initiative1 or clearly identified legislative or regulatory proposal4 7e7 ,report to ,congress ,not later than #ah months after implementation of the national media campaign has begun1 the ,secretary1 in coordination with the ,assistant ,secretary and the ,director1 shall1 with respect to the first year of the national media campaign1 submit to ,congress a report that describes-- 7#a7 the strategy of the national media campaign and whether specific objectives of such campaign were accomplished1 including whether such campaign impacted the number of calls made to lifeline crisis centers and the capacity of such centers to manage such calls2 7#b7 steps taken to ensure that the national media campaign operates in an effective and efficient manner consistent with the overall strategy and focus of the national media campaign2 7#c7 plans to purchase advertising time and space2 7#d7 policies and practices implemented to ensure that ,federal funds are used responsibly to purchase advertising time and space and eliminate the potential for waste1 fraud1 and abuse2 and 7#e7 all contracts entered into with a corporation1 a partnership1 or an individual working on behalf of the national media campaign4 7f7 ,authorization of appropriations ,for purposes of carrying out this section1 there is authorized to be appropriated #aj1jjj1jjj for each of fiscal years #bjbb through #bjbf4 4 ,,ii ,health ,resources and ,services ,administration #bja4 ,health center capital grants ,subpart #a of part ,d of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bed;b et seq47 is amended by adding at the end the following3 #ccj,o4 ,health center capital grants 7a7 ,in general ,the ,secretary shall award grants to eligible entities for capital projects4 7b7 ,eligible entity ,in this section1 the term eligible entity is an entity that is-- 7#a7 a health center funded under section #ccj1 or in the case of a ,tribe or ,tribal organization1 eligible1 to be awarded without regard to the time limitation in subsection 7e77#c7 and subsections 7e77#f77;,a77iii71 7e77#f77;,b77iii71 and 7r77#b77;,b7 of such section2 or 7#b7 a mental health and substance use crisis receiving and stabilization program and crisis call center described in section #cjb7;c77#a7 of the #i-h-h ,implementation and ,parity ,assistance ,act of #bjbb that have a working relationship with one or more local community mental health and substance use organizations1 community mental health centers1 and certified community behavioral health clinics1 or other local mental health and substance use care providers1 including inpatient and residential treatment settings4 7c7 ,use of funds ,amounts made available to a recipient of a grant or cooperative agreement pursuant to subsection 7a7 shall be used for crisis response program facility alteration1 renovation1 remodeling1 expansion1 construction1 and other capital improvement costs1 including the costs of amortizing the principal of1 and paying interest on1 loans for such purposes4 7d7 ,authorization of appropriations ,there are authorized to be appropriated to carry out this section #a1jjj1jjj1jjj1 to remain available until expended4 4 #bjb4 ,expanding behavioral health workforce training programs ,section #gef of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bid;e-#a7 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#a71 by inserting crisis management 7such as at a crisis call center1 as part of a mobile crisis team1 or through crisis receiving and stabilization program71 after occupational therapy12 7,b7 in paragraph 7#b71 by inserting and providing crisis management services 7such as at a crisis call center1 as part of a mobile crisis team1 or through crisis receiving and stabilization program7 after treatment services12 7,c7 in paragraph 7#c71 by inserting and providing crisis management services 7such as at a crisis call center1 as part of a mobile crisis team1 or through crisis receiving and stabilization program71 after behavioral health services2 and 7,d7 in paragraph 7#d71 by inserting including for the provision of crisis management services 7such as at a crisis call center1 as part of a mobile crisis team1 or through crisis receiving and stabilization program71 after paraprofessional field2 7#b7 in subsection 7d77#b71 by inserting or that emphasize training in crisis management and meeting the crisis needs of diverse populations specified in 7b77#b71 including effective outreach and engagement after partnerships2 and 7#c7 by adding at the end the following3 7g7 ,additional funding 7#a7 ,in general ,for each of fiscal years #bjbc through #bjbg1 in addition to funding made available under subsection 7f71 there are authorized to be appropriated #ae1jjj1jjj for workforce development for crisis management1 as specified in paragraphs 7#a7 through 7#d7 of subsection 7a74 7#b7 ,priority ,in making grants for the purpose specified in paragraph 7#a71 the ,secretary shall give priority to programs demonstrating effective recruitment and retention efforts for individuals and groups from different racial1 ethnic1 cultural1 geographic1 religious1 linguistic1 and class backgrounds1 and different genders and sexual orientations1 as specified in subsection 7b77#b74 4 ,,iii ,behavioral ,health ,crisis ,services ,expansion #cja4 ,crisis response continuum of care ,subpart #c of part ,b of title ,v of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#ca et seq471 as amended by section #ajf1 is further amended by adding at the end the following3 #ebj,o4 ,crisis response continuum of care 7a7 ,in general ,the ,secretary shall establish standards for a continuum of care for use by health care providers and communities in responding to individuals1 including children and adolescents1 experiencing mental health crises1 substance related crises1 and crises arising from co-occurring disorders 7referred to in this section as the crisis response continuum74 7b7 ,requirements 7#a7 ,scope of standards ,the standards established under subsection 7a7 shall define-- 7,a7 minimum requirements of core crisis services1 as determined by the ,secretary1 to include requirements that each entity that furnishes such services should-- 7i7 not require prior authorization from an insurance provider nor referral from a health care provider prior to the delivery of services2 7ii7 serve all individuals regardless of age or ability to pay2 7iii7 operate #bd hours a day1 #g days a week1 and provide care to all individuals2 and 7iv7 provide care and support through resources described in paragraph 7#b77;,a7 until the individual has been stabilized or transfer the individual to the next level of crisis care2 and 7,b7 psychiatric stabilization1 including the point at which a case may be closed for-- 7i7 individuals screened over the phone2 and 7ii7 individuals stabilized on the scene by mobile teams4 7#b7 ,identification of essential functions ,the ,secretary shall identify the essential functions of each service in the crisis response continuum1 which shall include at least the following3 7,a7 ,identification of resources for referral and enrollment in continuing mental health1 substance use1 or other human services relevant for the individual in crisis where necessary4 7,b7 ,delineation of access and entry points to services within the crisis response continuum4 7,c7 ,development of and adherence to protocols and agreements for the transfer and receipt of individuals to and from other segments of the crisis response continuum segments as needed1 and from outside referrals including health care providers1 law enforcement1 ,,ems1 fire1 education institutions1 and community-based organizations4 7,d7 ,description of the qualifications of crisis services staff1 including roles for physicians1 licensed clinicians1 case managers1 and peers 7in accordance with ,state licensing requirements or requirements applicable to ,tribal health professionals74 7,e7 ,requirements for the convening of collaborative meetings of crisis response service providers1 first responders1 such as paramedics and law enforcement1 and community partners 7including ,national ,suicide ,prevention ,lifeline or #i-h-h call centers1 #i-a-a public service answering points1 and local mental health and substance use disorder treatment providers7 operating in a common region for the discussion of case management1 best practices1 and general performance improvement4 7#c7 ,service capacity and quality standards ,such standards shall include definitions of-- 7,a7 adequate volume of services to meet population need2 7,b7 appropriate timely response2 and 7,c7 capacity to meet the needs of different patient populations who may experience a mental health or substance use crisis1 including children1 families1 and all age groups1 cultural and linguistic minorities1 individuals with co-occurring mental health and substance use disorders1 individuals with cognitive disabilities1 individuals with developmental delays1 and individuals with chronic medical conditions and physical disabilities4 7#d7 ,oversight and accreditation ,the ,secretary shall designate entities charged with the oversight and accreditation of entities within the crisis response continuum4 7#e7 ,implementation timeframe ,not later than #a year after the date of enactment of this title1 the ,secretary shall establish the standards under this section4 7#f7 ,data collection and evaluations 7,a7 ,in general ,the ,secretary1 directly or through grants1 contracts1 or interagency agreements1 shall collect data and conduct evaluations with respect to the provision of services and programs offered on the crisis response continuum for purposes of assessing the extent to which the provision of such services and programs meet certain objectives and outcomes measures as determined by the ,secretary4 ,such objectives shall include-- 7i7 a reduction in reliance on law enforcement response to individuals in crisis who would be more appropriately served by a mobile crisis team capable of responding to mental health and substance related crises2 7ii7 a reduction in boarding or extended holding of patients in emergency room facilities who require further psychiatric care1 including care for substance use disorders2 7iii7 evidence of adequate access to crisis care centers and crisis bed services2 and 7iv7 evidence of adequate linkage to appropriate post-crisis care and longitudinal treatment for mental health or substance use disorder when relevant4 7,b7 ,rulemaking ,the ,secretary shall carry out this subsection through notice and comment rulemaking1 following a request for information from stakeholders4 7c7 ,components of crisis response continuum ,the crisis response continuum consists of at least the following components3 7#a7 ,crisis call centers ,regional clinically managed crisis call centers that provide telephonic crisis intervention capabilities4 ,such centers should meet ,national ,suicide ,prevention ,lifeline operational guidelines regarding suicide risk assessment and engagement and offer air traffic control-quality coordination of crisis care in real-time4 7#b7 ,mobile crisis response team ,teams of providers that are available to reach any individual in the service area in their home1 workplace1 school1 physician's office or outpatient treatment setting1 or any other community-based location of the individual in crisis in a timely manner4 7#c7 ,crisis receiving and stabilization facilities ,subacute inpatient facilities and other facilities specified by the ,secretary that provide short-term observation and crisis stabilization services to all referrals1 including the following services3 7,a7 #bc-;hour crisis stabilization services ,a direct care service that provides individuals in severe distress with up to #bc consecutive hours of supervised care to assist with deescalating the severity of their crisis or need for urgent care in a subacute inpatient setting4 7,b7 ,short-term crisis residential services ,a direct care service that assists with deescalating the severity of an individual's level of distress or need for urgent care associated with a substance use or mental health disorder in a residential setting4 7#d7 ,mental health and substance use urgent care facilities ,ambulatory services available #ab-bd hours per day1 #g days a week1 where individuals experiencing crisis can walk in without an appointment to receive crisis assessment1 crisis intervention1 medication1 and connection to continuity of care4 7#e7 ,additional facilities and providers ,the ,secretary shall specify additional facilities and health care providers as part of the crisis response continuum1 as the ,secretary determines appropriate4 7d7 ,relationship to state law 7#a7 ,in general ,subject to paragraph 7#b71 the standards established under this section are minimum standards and nothing in this section may be construed to preclude a ,state from establishing additional standards1 so long as such standards are not inconsistent with the requirements of this section or other applicable law4 7#b7 ,waiver or modification ,the ,secretary shall establish a process under which a ,state may request a waiver or modification of a standard established under this section4 4 ,,iv ,mental health and substance use disorder parity implementation #dja4 ,grants to support mental health and substance use disorder parity implementation 7a7 ,in general ,section #bgid7;c7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#id7;c77 7as added by section #ajjc of the ,patient ,protection and ,affordable ,care ,act 7,public ,law #aaa-adh77 is amended by adding at the end the following3 7#c7 ,parity implementation 7,a7 ,in general ,beginning #fj days after the date of enactment of this paragraph1 the ,secretary shall award grants to ,states to implement the mental health and substance use disorder parity provisions of section #bgbf1 provided that in order to receive such a grant1 a ,state is required to request and review from health insurance issuers offering group or individual health insurance coverage the comparative analyses and other information required of such health insurance issuers under subsection 7a77#h77;,a7 of such section #bgbf regarding the design and application of nonquantitative treatment limitations imposed on mental health or substance use disorder benefits4 7,b7 ,authorization of appropriations ,for purposes of awarding grants under subparagraph 7,a71 there are authorized to be appropriated #be1jjj1jjj for each of the first five fiscal years beginning after the date of the enactment of this paragraph4 4 7b7 ,technical amendment ,section #bgid of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#ie71 as added by section #ffjc of the ,patient ,protection and ,affordable ,care ,act 7,public ,law #aaa-adh7 is redesignated as section #bgie4