Oh boy. Well, it’s an opportunity I guess. James W. Steele, MSW Ohio Valley Residential Services, Inc. President & CEO 1200 Edison Drive Cincinnati, Ohio. 45216 513-200-3695 On Sep 21, 2026, at 9:22 PM, Peter Moore <PMoore@opra.org> wrote: Good evening, everyone. I hope your week is off to a great start. Today, we attended a meeting at DODD to discuss the future of Ohio’s County Boards of Developmental Disabilities. As you know, discussion and planning regarding the County Boards and their future have been evolving over the past year. Today marked the beginning of the next phase of that planning process and, ultimately, important conversations about the future of our system. In attendance were members of the DD Budget Coalition, including representatives from OPRA, OHCA, OACB, The Arc of Ohio, and County Board Superintendents. Clay Weidner provided a presentation regarding the future financial status of the County Boards, and the outlook is bleak at best. I will ask Clay to provide the same presentation to the Board in the near future so you have a clear understanding of the situation and the challenges we are facing. There were two major topics discussed: 1. Regionalization of County Boards The concept would involve regional hubs, potentially structured as Councils of Governments (COGs), assuming responsibility for Medicaid administration functions and the County Boards will retain the SSA function. 2. Full “Elevation” of the State Share of Medicaid Match This would mean that County Boards would no longer be responsible for paying the Medicaid match, with the full Medicaid financial and administrative responsibility shifting to the state. I have attached a draft of the document that was shared with us today. It provides additional details and gives us a general idea of the direction being considered. There may be additional edits and changes to the framework as the discussions continue. Please do not share this document at this time. As you know, regionalization of County Boards has been part of OPRA’s modernization plan for more than a year. This was an idea that was initially met with significant skepticism by some stakeholders, and today there is agreement among all County Boards that regionalization needs to be part of the conversation. We have been very clear that regionalization cannot simply be about changing the structure of the system. We have to improve quality. The process and interactions surrounding case management and person-centered planning must improve. We need measurable improvements in outcomes, greater efficiency, and meaningful cost savings as a result of regionalization. Regionalization also addresses several objectives identified in OPRA’s modernization plan, including: 1. Creating a consistent statewide entry and eligibility system rather than maintaining 88 different processes. 2. Ensuring conflict free case management. 3. Aligning planning and funding with quality outcomes. 4. Building a financially stable system that allows for reinvestment. 5. Reducing duplication so more resources can flow to direct support. DODD does not anticipate being ready to roll out the regionalization model until July 1, 2028, which is when they anticipate having a Performance Contract template available for the COGs. The current County Board Medicaid match obligation is estimated at approximately $600 to $700 million, and this amount will grow over time. We will not need to replace all of those funds at once. We anticipate that addressing this issue will require a strategy that spans two to three biennial state budgets. We will also have to watch the upcoming CB levy votes closely. If there are any medium to large county levies that fail, the state may need to identify the funds to fill holes sooner than anticipated. We (OPRA) anticipated many of the issues related to County Boards and our system, and now they are at our doorstep. I am sure you have heard me say, “We have to find $700 million,” more than once over the past year. We will need to work with the legislature and our system stakeholders, to address the Medicaid match issue while also ensuring that provider rates and the sustainability of the provider network do not lose ground. OPRA’s modernization plan includes ideas for where we can find efficiencies, reduce duplication, improve operations, and identify savings without compromising the quality of services. I also want to reiterate something that we strongly emphasized today. We cannot let the provider community get lost in the shadows of the County Board crisis. As we address the future of the County Boards and the structure of the system, we must also address the sustainability, advancement, and continued strength of Ohio’s provider network. DODD has been seeking our thoughts and ideas regarding the future of the system, and we will continue to offer our strategies in cooperation with the other members of the DD Budget Coalition and our broader stakeholder community. Our efforts will take time, good data, thoughtful planning, and a team effort. We look forward to partnering with you as we work through these challenges and opportunities together. There will be more information to come, and we will continue to keep the Board and the OPRA community informed as the discussions develop. I look forward to your comments and questions. Have a great week! Pete Peter Moore, President & CEO Ohio Provider Resource Association 1152 Goodale Blvd. | Columbus, OH 43212 Office: 614.224.6772 x 113 Mobile: 614.398.8353 You are receiving this important information as a member service of the Ohio Provider Resource Association. Unless messages and/or replies are specifically directed, each posting/response is sent to the entire group. This group is open only to members of the OPRA Board of Directors. The views of individual list serve users do not necessarily reflect the view of the entire OPRA Board or of the OPRA Staff. To send a message to this list serve, please use the reply button. To reply only to the original sender, please respond to the email listed after "on behalf of" in the FROM line of the message header. Thank you. <Draft-DODD-Framework-Revised[25].pdf>
