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LIABILITY For 18 years - since Piedmont was created as a Public Authority under 122C ~ the counties served have been protected and held harmless from all lawsuks, audits and Medicaid paybacks. Under the "county-based" governance model through 160A, counties will become directly liable for: 1. Tort Liability a) MH/DD/SA services are, by nature, high risk due to populations characterized by chronic disability, extreme dysfunction, criminal justice involvements, poor judgment, involvement with substance abuse, suicidal clients, etc. · Medical malpractice insurance is very expensive and malpractice judgments and settlements are high. · Please see attachmenis ~ntitled: "Key Points, H.B. 381" and the letter dated March 7, 2001from Mike Taylor to Dan Coughlin. 2. Program Liability & Medicaid Payback a) Under the law, Area Programs must serve all individuals and families needing care regardless of their ability to pay for services. In times when the economy is poor, the number of such cases can increase dramatically and the cost for services to these populations must be absorbed in the program's existing budget. b) The state can and does reduce rates and funding by fiat and according to the state's larger fiscal demands. Such has no correlation to demand for services and the requirement to serve everyone needing service does not go away. 0 The average contributions of all four counties to the Piedmont budget is 4. 74%. Piedmont develops over 95% of its revenue by money it earns down from the state, Medicaid, federal grants, 3rd party private insurance, and client fees. That's a pretty good deal for counties and one they shouM protect. d) Members of the Legislative Oversight Committee commonly assert, "There is not enough funding in local MH/DD/SA programs'. Given the state budget, where do you think they'll look to make up this ostensible under funding?