1.1.................... moves to amend H.F. No. 3046, the first engrossment, as follows:
1.2Page 1, after line 6, insert:

1.3    "Section 1. Minnesota Statutes 2008, section 62Q.19, subdivision 1, is amended to read:
1.4    Subdivision 1. Designation. (a) The commissioner shall designate essential
1.5community providers. The criteria for essential community provider designation shall be
1.6the following:
1.7(1) a demonstrated ability to integrate applicable supportive and stabilizing services
1.8with medical care for uninsured persons and high-risk and special needs populations,
1.9underserved, and other special needs populations; and
1.10(2) a commitment to serve low-income and underserved populations by meeting the
1.11following requirements:
1.12(i) has nonprofit status in accordance with chapter 317A;
1.13(ii) has tax exempt status in accordance with the Internal Revenue Service Code,
1.14section 501(c)(3);
1.15(iii) charges for services on a sliding fee schedule based on current poverty income
1.16guidelines; and
1.17(iv) does not restrict access or services because of a client's financial limitation;
1.18(3) status as a local government unit as defined in section 62D.02, subdivision 11, a
1.19hospital district created or reorganized under sections 447.31 to 447.37, an Indian tribal
1.20government, an Indian health service unit, or a community health board as defined in
1.21chapter 145A;
1.22(4) a former state hospital that specializes in the treatment of cerebral palsy, spina
1.23bifida, epilepsy, closed head injuries, specialized orthopedic problems, and other disabling
1.24conditions; or
1.25(5) a sole community hospital. For these rural hospitals, the essential community
1.26provider designation applies to all health services provided, including both inpatient and
2.1outpatient services. For purposes of this section, "sole community hospital" means a
2.2rural hospital that:
2.3(i) is eligible to be classified as a sole community hospital according to Code
2.4of Federal Regulations, title 42, section 412.92, or is located in a community with a
2.5population of less than 5,000 and located more than 25 miles from a like hospital currently
2.6providing acute short-term services;
2.7(ii) has experienced net operating income losses in two of the previous three
2.8most recent consecutive hospital fiscal years for which audited financial information is
2.9available; and
2.10(iii) consists of 40 or fewer licensed beds; or
2.11(6) a birth center licensed under section 144.615.
2.12(b) Prior to designation, the commissioner shall publish the names of all applicants
2.13in the State Register. The public shall have 30 days from the date of publication to submit
2.14written comments to the commissioner on the application. No designation shall be made
2.15by the commissioner until the 30-day period has expired.
2.16(c) The commissioner may designate an eligible provider as an essential community
2.17provider for all the services offered by that provider or for specific services designated by
2.18the commissioner.
2.19(d) For the purpose of this subdivision, supportive and stabilizing services include at
2.20a minimum, transportation, child care, cultural, and linguistic services where appropriate."
2.21Page 3, after line 24, insert:
2.22    "Subd. 11. Report. (a) The commissioner of health, in consultation with the
2.23commissioner of human services and representatives of the licensed birth centers, shall
2.24evaluate the quality of care and outcomes for services provided in licensed birth centers,
2.25including, but not limited to, the utilization of services provided at a birth center, the
2.26outcomes of care provided to both mothers and newborns, and the numbers of transfers
2.27to other health care facilities that are required and the reasons for the transfers. The
2.28commissioner shall work with the birth centers to establish a process to gather and analyze
2.29the data within protocols that protect the confidentiality of patient identification.
2.30(b) The commissioner of health shall report the findings of the evaluation to the
2.31legislature by January 15, 2014."
2.32Page 4, line 15, before "Medical" insert "(a)"
2.33Page 4, line 16, delete "by" and insert "in" and after "144.615" insert "by a licensed
2.34health professional"
2.35Page 4, line 17, delete everything after the period
2.36Page 4, delete lines 18 to 19 and insert:
3.1"(b) The commissioner shall apply for any necessary waivers from the Centers
3.2for Medicare and Medicaid Services to allow birth centers and birth center providers to
3.3be reimbursed.

3.5In negotiating the managed care contract rates for services rendered on or after
3.6January 1, 2011, the commissioner of human services shall take into consideration and
3.7the rates shall reflect the anticipated savings in the medical assistance program due to
3.8extending medical assistance coverage to services provided in licensed birth centers,
3.9the anticipated use of these services within the medical assistance population, and the
3.10reduced medical assistance costs associated with the use of birth centers for normal,
3.11low-risk deliveries."
3.12Renumber the sections in sequence and correct the internal references