Amend CSSB 23 on page 37, line 26 by amending Subsection 531.502(c)(1) as follows:

"(1)  identifying health care related state and local funds and program expenditures that; before September 1, 2011 [2007] are not being matched with federal money; and"

Amend CSSB 23 on page 37 lines 26 and 27 and page 38 lines 1 through line 9 by striking Section (1) and inserting the following new Subsection (1):

"(1)  include safeguards to ensure that the total amount of federal money provided under the disproportionate share hospitals or [and] upper payment limit supplemental payment program [programs] that is deposited as provided by Section 531.504 is, for a particular state fiscal year, at least equal to the greater of the annualized amount provided to this state under those supplemental payment programs during state fiscal year 2011 [2007], excluding amounts provided during that state fiscal year that are retroactive payments, or the state fiscal years during which the waiver is in effect; and"

Amend CSSB 23 on page 38 lines 12 and 13 by striking (A) and inserting the following new (A):

"(A)  be used to supplement hospital reimbursement under a waiver that includes terms that are consistent with, or that produce revenues consistent with, disproportionate share hospital and upper payment limit principles;"

Amend CSSB 23 on page 39 lines 3 through 8 by striking (b) and inserting the following new Subsection (b):

"(b)  The commission and comptroller may accept gifts, grants, and donations from any source, and receive intergovernmental transfers, for purposes consistent with this subchapter and the terms of the waiver. The comptroller shall deposit a gift, grant, or donation made for those purposes in the fund. Any intergovernmental transfers received, including the associated federal matching funds, shall be used only for the purposes originally intended by the transferring entity and in accordance with the terms of the waiver."