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Critics of existing Area Programs feel they are not accountable enough to either the counties or the state. That assumption is only partially tree but, in any instance, can be easily remedied through building into the existing Area Program govenmnce structure (&/or contracts) accountability/performance/outcome mechanisms that woutd achieve the perceived accountability ends and avoid the divisive political battle that will inevitably ensue ff the state attempts to shift governance to counties. Counties are all over the map on this issue but, with the exception of single county Area Programs, most are adamantly opposed to county governance and their voices will be heard once and ffthe Oversight Committee comes forth with a county-based only option.. A better goal for reforming the system is to support Area Programs to continue to evolve into regional behavioral healthcare systems management entities. North Carolina Area Programs, like almost all local IVlH/DD/SA authorities across the country, started out 25 - 40 years ago as local out patient mental health programs (CMI-ICs/providers). Today they are sort of stuck between the world they were bom in and the cummt world of complex systems. The opportunity exists to use reform as a means for structuring Area Programs to manage targeted populations against defined benefits, comprehensive networks of care, and limited resources. Supporting Area Programs in becoming sophisticated regional managers of comprehensive systems of community care is a worthy and doable goal. Changing governance to a county -based system in order to control perceived deviancy, is rearranging the deck chairs and calling it reform. Thanks for the opporttmity to offer some of my perspectives. I am available at anytime ffyou'd like to talk. Again, all my best wishes. Dalliel R. Collghlin> CSW Area Director Piedmont Behavioral Healthcare 704-721-7OO0