In the field of senior services, he led initiatives to subsidize geriatric medicine programs in state-supported medical schools and establish a statewide network of multi-purpose senior centers.
After his third term, Begala became deputy director and chief of staff at the Ohio Department of Mental Retardation and Disabilities and director of the Ohio Developmental Disabilities Planning Council.
He developed budget initiatives increasing state funding for special education, expanding home and community services, and stabilizing finance of residential facilities.
From 1986 until 1998, Begala held executive leadership positions with the Greater Cincinnati Hospital Council, University of Cincinnati Medical Center, and Greater Cleveland's MetroHealth System.
Since 2004, Begala has been a lecturer at Baldwin Wallace University, where in 2013 he was appointed Executive in Residence.