On September 17, 2018, the MOAND Board voted to shift from a district model to a regional model. The four-region structure consists of: Northwest, Northeast, Southwest, and Southeast regions.
Northeast Region
Counties:
Scotland, Clark, Knox, Lewis, Shelby, Marion, Monroe, Ralls, Pike, Audrain, Lincoln, Montgomery, Jefferson, Franklin, Osage, Calloway, Warren, Gasconade, St Louis, St Charles
Southeast Region
Counties:
Bollinger, Butler, Cape Girardeau, Carter, Crawford, Dent, Dunklin, Howell, Iron, Madison, Maries, Mississippi, New Madrid, Oregon, Pemiscot, Perry, Phelps, Reynolds, Ripley, Saint Francois, Scott, Shannon, Ste. Genevieve, Stoddard, Texas, Washington, Wayne.
Northwest Region
Counties:
Adair, Andrew, Atchison, Bates, Benton, Boone, Buchanan, Caldwell, Carroll, Cass, Chariton, Clay, Clinton, Cole, Cooper, Daviess, DeKalb, Gentry, Grundy, Harrison, Henry, Holt, Howard, Jackson, Johnson, Lafayette, Linn, Livingston, Macon, Mercer, Miller, Moniteau, Morgan, Nodaway, Pettis, Platte, Putnam, Randolph, Ray, Saline, Schuyler, Sullivan, Worth
Southwest Region
Counties: Vernon, Saint Clair, Hickory, Camden, Pulaski, Barton, Cedar, Polk, Dallas, Laclede, Jasper, Dade, Greene, Webster, Wright, Newton, Lawrence, Christian, Douglas, McDonald, Barry, Stone, Taney, Ozark