HF 1795

1st Engrossment - 86th Legislature (2009 - 2010) Posted on 02/09/2010 01:55am

A bill for an act
relating to health; establishing licensure for birthing centers; limiting liability
for hospitals and physicians in certain situations; establishing fees; designating
licensed birthing centers as essential community providers; amending Minnesota
Statutes 2008, sections 62Q.19, subdivision 1; 256B.0625, by adding a
subdivision; proposing coding for new law in Minnesota Statutes, chapter 144.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1. new text begin INTENT.
new text end

new text begin Nothing in sections 2 to 6 requires a pregnant woman enrolled in medical assistance
to deliver at a birthing center.
new text end

Sec. 2.

Minnesota Statutes 2008, section 62Q.19, subdivision 1, is amended to read:

Subdivision 1.

Designation.

(a) The commissioner shall designate essential
community providers. The criteria for essential community provider designation shall be
the following:

(1) a demonstrated ability to integrate applicable supportive and stabilizing services
with medical care for uninsured persons and high-risk and special needs populations,
underserved, and other special needs populations; and

(2) a commitment to serve low-income and underserved populations by meeting the
following requirements:

(i) has nonprofit status in accordance with chapter 317A;

(ii) has tax exempt status in accordance with the Internal Revenue Service Code,
section 501(c)(3);

(iii) charges for services on a sliding fee schedule based on current poverty income
guidelines; and

(iv) does not restrict access or services because of a client's financial limitation;

(3) status as a local government unit as defined in section 62D.02, subdivision 11, a
hospital district created or reorganized under sections 447.31 to 447.37, an Indian tribal
government, an Indian health service unit, or a community health board as defined in
chapter 145A;

(4) a former state hospital that specializes in the treatment of cerebral palsy, spina
bifida, epilepsy, closed head injuries, specialized orthopedic problems, and other disabling
conditions; deleted text begin or
deleted text end

(5) a sole community hospital. For these rural hospitals, the essential community
provider designation applies to all health services provided, including both inpatient and
outpatient services. For purposes of this section, "sole community hospital" means a
rural hospital that:

(i) is eligible to be classified as a sole community hospital according to Code
of Federal Regulations, title 42, section 412.92, or is located in a community with a
population of less than 5,000 and located more than 25 miles from a like hospital currently
providing acute short-term services;

(ii) has experienced net operating income losses in two of the previous three
most recent consecutive hospital fiscal years for which audited financial information is
available; and

(iii) consists of 40 or fewer licensed beds new text begin ; or
new text end

new text begin (6) a birthing center licensed under section 144.566 new text end .

(b) Prior to designation, the commissioner shall publish the names of all applicants
in the State Register. The public shall have 30 days from the date of publication to submit
written comments to the commissioner on the application. No designation shall be made
by the commissioner until the 30-day period has expired.

(c) The commissioner may designate an eligible provider as an essential community
provider for all the services offered by that provider or for specific services designated by
the commissioner.

(d) For the purpose of this subdivision, supportive and stabilizing services include at
a minimum, transportation, child care, cultural, and linguistic services where appropriate.

Sec. 3.

new text begin [144.566] BIRTHING CENTERS.
new text end

new text begin Subdivision 1. new text end

new text begin Definition. new text end

new text begin For purposes of this section, "birthing center" means
a health care facility that is licensed for the primary purpose of performing low-risk
deliveries and that is not a hospital or in a hospital and where births are planned to occur
away from the mother's usual residence following a normal uncomplicated pregnancy.
new text end

new text begin Subd. 2. new text end

new text begin License required. new text end

new text begin (a) No person may establish, conduct, or maintain a
birthing center without first obtaining a license from the commissioner of health according
to this section. The license is effective for one year following the date of issuance.
new text end

new text begin (b) A license issued under this section is not transferable or assignable and is subject
to suspension or revocation at any time for failure to comply with this section.
new text end

new text begin (c) A birthing center licensed under this section shall not assert, represent, offer,
provide, or imply that the center is rendering or may render care or services other than the
services it is permitted to render within the scope of the license issued.
new text end

new text begin (d) The license must be conspicuously posted in an area where patients are admitted.
new text end

new text begin Subd. 3. new text end

new text begin Application. new text end

new text begin An application for a license to operate a birthing center and
the applicable fee under subdivision 6 must be submitted to the commissioner on a form
provided by the commissioner and must contain:
new text end

new text begin (1) the name of the applicant;
new text end

new text begin (2) the location of the birthing center;
new text end

new text begin (3) the name of the person in charge of the center;
new text end

new text begin (4) documentation that the standards described under subdivision 5 have been
met; and
new text end

new text begin (5) any other information the commissioner deems necessary.
new text end

new text begin Subd. 4. new text end

new text begin Suspension, revocation, and refusal to renew. new text end

new text begin The commissioner may
refuse to grant or renew, or may suspend or revoke, a license on any of the grounds
described under section 144.55, subdivision 6, and the applicant or licensee is entitled to
notice and a hearing as described under section 144.55, subdivision 7.
new text end

new text begin Subd. 5. new text end

new text begin Standards for licensure. new text end

new text begin To be eligible for licensure under this section,
a birthing center must meet the following requirements:
new text end

new text begin (1) a governing body or person must be clearly identified as being legally responsible
for setting policies and procedures and ensuring that they are implemented;
new text end

new text begin (2) care must be provided by a physician, advanced practice registered nurse, or
licensed traditional midwife during labor, birth, and puerperium; and
new text end

new text begin (3) all standards for a licensed birthing center set out by the commissioner in
Minnesota Rules.
new text end

new text begin Subd. 6. new text end

new text begin Fees. new text end

new text begin The annual license fee for a birthing center is $....... and shall be
collected and deposited according to section 144.122. The commissioner may adjust the
annual license fee for the first four years of the licensing program to include the costs
of rulemaking required under this section.
new text end

new text begin Subd. 7. new text end

new text begin Inspections. new text end

new text begin The commissioner shall annually conduct an inspection of
each licensed birthing center for the purpose of determining compliance with this section
and any rules adopted under subdivision 8.
new text end

new text begin Subd. 8. new text end

new text begin Rules. new text end

new text begin (a) The commissioner must adopt rules to establish standards for
licensing birthing centers by July 1, 2010, and may adopt any other rules necessary to
implement this section.
new text end

new text begin (b) In adopting rules for birthing centers, the commissioner must consider the
American Association of Birth Centers standards for freestanding birth centers; the
American Academy of Pediatrics/American College of Obstetricians and Gynecologists
guidelines for perinatal care; the American College of Nurse-Midwives standards; and the
American Public Health Association guidelines.
new text end

Sec. 4.

new text begin [144.567] INTEROPERABLE ELECTRONIC HEALTH RECORDS.
new text end

new text begin Birthing centers licensed under section 144.566 must have in place an interoperable
electronic health records system that is compliant with the requirements of section 62J.495.
new text end

Sec. 5.

new text begin [144.568] LIMITED LIABILITY FOR HOSPITAL TRANSFERS.
new text end

new text begin Subdivision 1. new text end

new text begin Hospital liability is limited. new text end

new text begin A hospital licensed under section
144.55 that receives a patient transferred from a birthing center, as defined in section
144.566, due to complications of labor or delivery is not liable for acts or omissions
that occurred at the birthing center prior to the transfer of the patient to the hospital. A
hospital is liable to a patient who is transferred from a birthing center for damages not to
exceed $1,000,000.
new text end

new text begin Subd. 2. new text end

new text begin Physician liability is limited. new text end

new text begin A licensed physician who receives a patient
transferred to a hospital from a birthing center, as defined in section 144.566, due to
complications of labor or delivery is not liable for acts or omissions that occurred at the
birthing center prior to the transfer of the patient to the physician's care.
new text end

new text begin Subd. 3. new text end

new text begin Birthing center liability. new text end

new text begin Nothing in this section limits the liability of a
birthing center, as defined in section 144.566.
new text end

Sec. 6.

Minnesota Statutes 2008, section 256B.0625, is amended by adding a
subdivision to read:

new text begin Subd. 53. new text end

new text begin Services provided in birthing centers. new text end

new text begin Medical assistance covers
services provided by a birthing center licensed under section 144.566. The commissioner
of human services shall apply for any necessary waiver from the Centers for Medicare and
Medicaid Services to allow birthing centers to be reimbursed.
new text end