MCBDD Performance Audit Spotlights Progress in Meeting Federal Conflict-free Management Requirements

For Immediate Release

Thursday, March 23, 2023

COLUMBUS – County boards of developmental disabilities have one year remaining to meet federal conflict-free management requirements and ensure eligible residents continue to have access to transportation, employment, and other publicly funded services.

A report released Thursday by the Ohio Auditor of State’s Office analyzed the operations of the Medina County Board of Developmental Disabilities (MCBDD), which is making progress in connecting its clients with qualified service providers.

“Our county boards of developmental disabilities are providing valuable services to vulnerable Ohioans, and that must work must continue,” Auditor Faber said. “MCBDD is well on its way toward meeting the federal conflict-free management requirements.”

Requirements instituted by the U.S. Centers for Medicare & Medicaid Services in 2014 barred county boards of developmental disabilities from providing Home and Community Based Services and case management for those services, citing the potential for conflict-of-interest issues. 

In Ohio, where county boards are required to provide case management, local boards have until March 2024 to discontinue directly providing supported employment, transportation, residential, and other services, instead linking clients to registered third-party providers.

MCBDD requested the Auditor of State’s Ohio Performance Team (OPT) conduct a performance audit on its operations and offer recommendations for improvement.

A copy of the full performance audit is available online (ohioauditor.gov/performance.html).

Overall, OPT found MCBDD to be in good fiscal health, and Thursday’s audit report includes recommendations for additional improvement.

The performance audit included a review of MCBDD’s progress in meeting the federal conflict-free case management requirements and resulting changes to its workforce. For example, between 2018 and 2021, the Board reduced its personnel expenses as it shifted from providing direct transportation services to connecting residents with third-party providers.

MCBDD will need to continue to review its workforce and determine additional staffing changes moving forward, OPT recommended: “…The Board may determine that it requires fewer positions to carry out core functions. MCBDD should continue to monitor staffing levels to ensure that it is able to continue to provide appropriate services to its clients at an efficient level.”

Thursday’s report also includes recommendations for the Ohio Department of Developmental Disabilities, including further refinement of cost projections used by county boards to forecast revenues and expenditures.


The Auditor of State’s office, one of five independently elected statewide offices in Ohio is responsible for auditing more than 5,900 state and local government agencies. Under the direction of Auditor Keith Faber, the office also provides financial services to local governments, investigates and prevents fraud in public agencies, and promotes transparency in government. 

Public Affairs
Contact: Marc Kovac