Enacts GS 153A-248.1, authorizing a county to adopt an ordinance to provide for the compensation of qualified recipients asexualized or sterilized under county authority. Requires the ordinance to include provisions to afford claimants with due process of law and prescribe the manner in which claims will be handled by the county. Establishes that any determination made by the county favorable to the claimant is final. Authorizes the county to appropriate funds for eugenics compensation if the funds are not otherwise limited as to use by law. Provides that records of all inquiries of eligibility, claims, and payments under the statute are confidential and not public record. Establishes that a payment made under the statute is not income or assets for purposes of determining eligibility for, or the amount of, any benefits or assistance under any state or local program financed in whole or in part with state funds. 

Requires, pursuant to GS 108A‑26.1, the Department of Health and Human Services to provide (1) income, resource, and asset disregard to an applicant for, or recipient of, public assistance who receives compensation under the statute equal to the total compensation paid to the individual and (2) resource protection by reducing any subsequent recovery by the state under GS 108A‑70.5 from a deceased recipient's estate for payment of Medicaid paid services by the amount of resource disregard.

Limits the county's liability related to any asexualization or sterilization performed pursuant to an order by a county to compensation authorized by this act. Clarifies that the act does not revive or extend any statute of limitations. Establishes that an agreement for the acceptance of attorneys' fees from a compensation award from the county is null and void unless counsel has sought and received an opinion from the NC State Bar that the fee arrangement is reasonable under the Rules of Professional Conduct.

Limits the application of the act to counties having a population greater than 500,000 and less than 900,000, according to the most recent federal decennial census.