In Parma, a direct support professional helps a young man with developmental disabilities get ready for work. In Glenville, a job coach checks in with a client starting a shift at a neighborhood grocery store. In Lakewood, a mother heads to her own job knowing her adult daughter with autism has transportation and support for the day.
Behind each of these moments is a critical funding stream—a partnership between federal Medicaid funding and local investment, including voter-approved property tax dollars that support the Cuyahoga County Board of Developmental Disabilities (Cuyahoga DD).
Many Ohioans think of Medicaid primarily as health coverage. While it is administered by the Centers for Medicare & Medicaid Services and jointly funded by federal and state dollars, its impact in Cuyahoga County extends well beyond doctor visits. For residents with developmental disabilities, Medicaid funds the day-to-day supports that make community life possible — from personal care and behavioral health services to job coaching, transportation, and respite for families.
While Medicaid provides most of the service funding, it does not operate alone. In Cuyahoga County, locally approved property tax dollars supply crucial matching funds and cover services Medicaid does not. This local investment enables federal Medicaid dollars to flow into the community and helps ensure support remains stable even if state or federal policies change. In short, without Cuyahoga County property tax dollars, these Medicaid services would not exist.
Cuyahoga DD plays a key role in making those services work locally. The agency helps determine eligibility, connects individuals and families to Medicaid-funded waiver programs when needed, and coordinates services with a network of community providers. Service and Support Administrators work directly with families to develop personalized plans based on each person’s goals — whether that’s finding a job, living more independently, or building social connections. When Medicaid cannot be accessed, Cuyahoga DD uses local property tax funding to provide those services.
Much of this support is authorized under the Social Security Act, which allows states to offer home- and community-based services tailored to residents’ needs. In practical terms, that means many people with developmental disabilities in Cuyahoga County live in their own homes or with family members rather than in institutional settings.
That community-based approach reflects a broader civil rights shift. In 1999, the U.S. Supreme Court ruled in Olmstead v. L.C. that people with disabilities have the right to receive services in the most integrated setting appropriate to their needs. Today, Cuyahoga DD collaborates with providers to support individuals in neighborhoods across Greater Cleveland, consistent with that principle of community inclusion.
The impact of this shift extends beyond the individuals receiving services. Medicaid funding supports a local workforce that includes direct support professionals, nurses, therapists, transportation staff and case managers. Cuyahoga DD partners with dozens of provider agencies that employ thousands of workers throughout the county. These are real jobs in Cuyahoga County — jobs that cannot be outsourced or replaced by technology.
As federal Medicaid dollars flow into Ohio, they support community organizations and the people they employ. Local levy funding reinforces that support; without property tax dollars, it wouldn’t exist. By providing the county’s share of matching funds and supporting infrastructure — from service coordination to early intervention and crisis response — levy dollars extend the reach of every federal dollar invested. Together, these funding streams sustain a workforce rooted in Cuyahoga County. Wages paid to support staff circulate through the local economy, supporting housing, childcare, restaurants, and retail businesses. In this way, disability services serve not just as social support but also as an economic engine. In 2025, Cuyahoga DD’s $80 million Medicaid match, funded by taxpayer dollars, unlocked $475 million in Medicaid funding for County residents. Talk about getting bang for your buck.
Families also play a role in the economic landscape. Without supports funded by Medicaid and property taxes coordinated through Cuyahoga DD, many parents or guardians of individuals with disabilities would have to cut back on work hours or leave their jobs to provide full-time care. Services like adult day supports, employment programs, and respite care help caregivers stay in the workforce, boosting household stability and overall economic participation.
In some communities, disability service agencies are among the largest employers. The stability of Medicaid funding helps sustain that workforce and the wider network of services that families depend on.
For individuals, the benefits are immediate: greater independence, stronger connections, and more opportunities to contribute to their communities. For Cuyahoga County, the benefits are structural. Through its role in coordinating Medicaid-funded services, Cuyahoga DD helps ensure that public investment results in local impact — supporting residents with developmental disabilities while strengthening the county’s economic foundation.
The system works because it reflects shared responsibility. Federal and state Medicaid funding provides scale, while locally approved property tax dollars reflect the community’s direct commitment to inclusion and support for neighbors with developmental disabilities.
From morning routines in Parma to workplaces in Glenville, the partnership between Medicaid and locally supported levy funding — coordinated through Cuyahoga DD — is woven into daily life.
