Theodore R. McKeldin, Governor                    787

that six new Sections, to be known as Sections 559 through 564, in-
clusive, to follow immediately after Section 558 of said Article, be
enacted in lieu thereof, to read as follows:

559. The State Board of Health is authorized to establish three
institutions for persons from the various counties and Baltimore
City who require constant medical and nursing care provided by a
hospital by reason of chronic illness or infirmity or who are suffer-
ing from a chronic disability amenable to rehabilitation.

One of the Chronic Hospitals shall be located on the Eastern
Shore, one in the central part and one in the western part of the
State. The cost of erecting, equipping and operating said hospitals
(including the cost of acquiring appropriate sites) shall be paid out
of appropriations in the budget, or in any bond issue bill making
appropriations in the budget, or in any bond issue bill making ap-
propriations for the purpose. In selecting sites and making archi-
tectural plans for each institution, provision shall be made for pos-
sible expansion and for the later addition of a unit for the treat-
ment of chronic diseases of children. The State Board of Health
shall appoint the personnel necessary for the operation of the hos-
pitals, within the limits of the budgetary appropriations.

The State Board of Health shall promulgate policies establishing
the type and scope of services rendered, and qualifications and
standards for admission and discharge.

560.    Admission to the chronic hospitals shall be made on the
basis of a statement by a physician who, after an examination, finds
that the patient is in need of chronic hospital care, and the review
and approval of the application by the chronic hospital. Final ar-
rangements for admission shall be made only after the Health Of-
ficer of the County or the Department of Welfare of Baltimore City
where the applicant resides have given their approval. No patient
shall be admitted who has tuberculosis in a form requiring treat-
ment in a tuberculosis hospital, mental disease of the type requiring
care in a mental hospital, or an orthopedic disease for which medical
treatment is available to the patient in a special orthopedic hospital.

Patients may be admitted who can pay part or all of the costs of
their care only when the special facilities required by their condi-
tions are not otherwise obtainable elsewhere in Maryland.

561.    In all cases admitted, there shall be collected from the pa-
tient or his family as much of the actual cost of care as is reason-
ably possible, but in no case shall payment be collected above the
actual per diem cost. This cost shall be determined at least once a
year by the State Board of Health and shall be calculated on the
basis of the total cost of running the hospitals.

562.    (a) For the purpose of determining the amount to be paid
for chronic hospital care, it shall be the duty of the County Welfare
Board or the Department of Welfare of Baltimore City, as the case
may be, to investigate the financial condition of such person and
also the financial condition of any relative or other person who may
be legally chargeable with his or her care, in order to determine, in
each ease, the ability of any such person, or of his or her relatives
or other persons legally chargeable with his or her care, to make
payment, in whole or in part, for the care of such person while a