This amendment adds $12.5 million the first year and $25.0 million the second year from the general fund and $12.6 million the first year and $25.7 million the second year from federal Medicaid matching funds for Medicaid's Value-based Purchasing (VBP) program for nursing homes. This amendment also adds language to specify that the non-metric portion of the VBP program funding be provided as a Medicaid payment add-on to the rate instead of a lump sum payment. Under the federally-required structure of a VBP program, paying the non-metric based portion under VBP would delay payment until December for the relevant non-metric based payments. This will create a significant cash flow issue for five months beginning July 1, 2022 when rates would fully revert to having no add-on despite significant ongoing expenses. By excluding the non-metric based amount from federal approval of the VBP program and instead paying that portion as a Medicaid payment add-on to the rate (like the current $15 per day), the delay would be avoided. In addition to the cash flow issue due to the timing of the lump-sum approach delaying the non-metric based portion until December is contrary to the purpose of the funding, which was intended to help facilities get ready to meet the metrics and improve.