The document outlines the steps for organizations to develop or enhance a consumer operated service using Ohio's COS Toolkit. The steps include: 1) assessing organizational readiness for change, 2) choosing a tier-specific consumer operated service path by matching criteria to the organization's current status, 3) implementing a tier-specific project plan by editing criteria, integrating barriers, and assigning responsibilities/timelines. The overall goal is to help organizations sequentially implement consumer operated services through detailed planning.