Voters in three Northeast Ohio counties said no to new funding for their boards of developmental disabilities last week, as Ohioans continue to express frustrations with rising property taxes.
At the same time, the cost of care county boards are required by law to provide has risen dramatically since 2020, leaving several operating with a deficit.
Boards of developmental disabilities provide services like early childhood intervention, school programming and Medicaid waiver services like home health care.
Bill Whitacre, superintendent of the Mahoning County Board of Developmental Disabilities, said the largest source of rising costs is those waiver services.
"They increased the amount of the reimbursement rates for that program of which we're statutorily obligated to pay waiver match dollars on," he said. "And so that increase for us is really what's led us into the deficit spending that we are in now."
Medicaid waiver services include a wide range of services people with developmental disabilities may need day-to-day, from transportation to at home nursing care.
The state and county boards share the cost of those services, with boards covering about 40% of the cost.
Whitacre said an increase in the board's service population and inflation have also contributed to rising costs, leading the board to ask for its first new levy in over two decades. The additional levy would have provided the board with 2.4 mills of new funding, generating about $15.5 million annually.
The board has operated on a deficit since 2024 and made cuts prior to this November election through staff attrition.
Whitacre said he expects they'll have to consider additional cuts to services like their family support services program. It received funding from the state in the past, but the board now covers those costs.
"Those are for individuals that are not on waivers that we may help put a ramp on their home, do a minor home modification, may help them pay for special therapies," he said. "We'll be looking to end that program because it's not a mandated service."
The board could put a levy back on the ballot in May or November in 2027, but it will need approval from county commissioners to do so.
Board leader calls for systemic change
Amy Adam is the superintendent of the Tuscarawas County Board of Developmental Disabilities, which also saw its levy for an additional 1.2 mills fail last week.
In the short term, she said the board will have to consider difficult choices in order to maintain services over the next year. The board's newest levy is from the year 1997.
"We're still collecting at home values from those times," she said. "So we were actually living on pretty much like our salary from the 1980's and the 1990's."
She said in the long term, systemic changes need to be on the horizon and questioned whether the state could pay a greater portion of Medicaid services
"We needed that funding, but I feel like it's a bigger answer outside of just Tuscarawas County," she said. "And so that's what I'm really working hard with many, many others across the state is taking a look at that and seeing if we can do some reform as to how the system is funded."
The Ashland County Board of Developmental Disabilities also saw its levy fail last week. Assistant superintendent Ken Kelly said prior to the election that a levy failure could impact services at its Dale Roy School for children with developmental disabilities.
Kelly has not responded to requests for comment about the election results and the board's next steps.