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The administering county could find itself left "slowly twisting in the wind" by the State to defend such matters. It is instructive to take a look at analogous situations that arose in the past decade. In a number of lawsuits, several counties were sued over the actions of county health department soil sanitarians, e.g., EEE-ZZZ Lay Drain Co. v. N C. Dep't. of Human Resources 108 N.C. App. 24, 422 SE.2d 338 (1992), overruled, Meyer v. Wall, 347 N.C. 97, 489 S.E. 2d 880 (1997). Similarly, several counties were sued over the actions of their departments of social services. (See, the numerous cases against both county health departments and county departments of social services cited in Meyer v. Wall). The questions arose whether the State had a duty to defend these cases and whether the claims should have been brought under the Tort Claims Act. These soil sanitarians operated under state regulations over which the counties had no control, yet the State refused to defend these lawsuits. Ultimately, in Meyer v. Wall, supra, the North Carolina Supreme Court held that claims against county health department employees and county DSS employees did not fall under the Tort Claims Act, leaving the counties to contend with the considerable exposure to liability, including exposure to defense costs. Under the current area program structure, counties are insulated from this exposure to tort liability from mental health programs. Under the new draft structure counties would have no such insulation. Program Liabilit~ The new county programs, like the current area programs, wilt be required to provide mental health services, regardless of the individual client's abilky to pay: "[N]o individual may be refused services because of an inability to pay." Draft G.S. 122C-100.10. The administering county is required to provide services within the program service area. Dra~ 122C-88(g)(1). Medicaid Payback Liabilit3, The millions of dollars of Medicaid money flowing through area programs come with a big catch. A lack of documentation as to proper credentialing of staff, appropriate orders for the services being paid for, etc., can result in Medicaid paybacks. Again, the administering 'county's fund balance would be looked to for such paybacks. The administering county under the new dram scheme is exposed to all of these risks. These are some important issues that I believe need to be considered. Please let me know ifI can be of further assistance. Sincerely yours, Michael W. Taylor