Marvin Mandel, Governor                             289

Amendment No. 5

On page 21 of the printed bill, under the heading "Metropolitan
Transit Authority" and under the program "General Administration",
insert the following footnote:

"That any funds derived from the operations of the Transit System
in the Baltimore Metropolitan Area, after acquisition by the Metro-
politan Transit Authority, shall be accounted for as Special Fund
revenue and may be expended only in accordance with approved
budget amendment."

Amendment No. 6

On page 35 of the printed bill, under the heading "Department of
Chesapeake Bay Affairs" and under the program "Engineering", insert
the following footnote:

"That of this appropriation, $500,000 is to be used for the purpose
of providing the State's 50% share of shore erosion projects in con-
nection with and contingent upon enactment of Senate Bill 590 such
$500,000 amount may be transferred by approved budget amendment
into the 'Shore Erosion Control Construction Loan Fund' within the
Department of Natural Resources."

Amendment No. 7

On page 47 of the printed bill, under the heading "Medical Care Serv-
ices" and under the program "Medical Assistance Program", insert the
following footnote:

"Payments hereunder are authorized not to exceed $16.00 per day,
per patient, for nursing home care in extended care facilities and
licensed nursing homes, provided those homes qualify as skilled nurs-
ing homes under the regulations promulgated by the U.S. Department
of Health, Education and Welfare under Title XIX of Public Law
89-97 (Medicaid). Such nursing homes and extended care facilities
shall be reimbursed on the following basis: (A) verified audited
"cost" as that term is determined by the Secretary of Health, Educa-
tion and Welfare in the administration of Title XVIII of the Social
Security Act Amendments of 1965; plus (B) an additional sum to
be determined by the Board of Public Works, to provide a return
greater than that customarily earned by the Public Service and Public
Utility Companies, including a profit of not less than 10% of total
costs (including those costs determined by the Board of Public
Works). In determining such additional sum the Board of Public
Works shall take into account such costs as: amortization, replace-
ment and/or modernization of plants, buildings and equipment, rea-
sonable administrative costs, reasonable rentals, reasonable interest
payments for loans by providers, and other lawful business expenses.
Homes not submitting audited costs shall be reimbursed at a rate not
to exceed $7.00 per day, per patient.

Fee schedules, items of costs and profit factors established within
this Medical Assistance Program shall be eligible for Federal match-
ing at Maryland's applicable Federal matching rate for Title XIX for
those eligible services under Title XIX. If as a result of fee schedules,
items of cost or profit factors various costs of services or portions of
costs of services are declared ineligible, by the United States' Depart-
ment of Health, Education and Welfare or any other interested Fed-
eral agency having jurisdiction over Federal reimbursement for serv-