New Hampshire's Bureau of Developmental Services, Department of Vocational Rehabilitation, other state and local service providers, advocates, and families are committed to increasing the employment rate and the quality of employment outcomes for people with developmental disabilities. These stakeholders met to craft an employment position statement. They framed their discussions according to factors that research has found to be common to "high-performing" states in providing integrated employment opportunities.

Oklahoma’s Developmental Disabilities Services Division (DDSD) realized the need for increased attention towards the goal of community-based employment for individuals they served. Initially, rates were based on a vendor’s costs of providing direct services such as job development and job coaching. It became increasingly apparent that claims for vocational services oftentimes reflected staff activities (e.g., job development, client assessment, and service delivery documentation), which may have been occurring without the direct involvement of the service recipient.

In North Carolina, counties have been consolidated into Local Management Entities (LMEs). These entities contract for services with community providers and provide oversight on access, utilization, best practices, and community collaborations. The Mecklenberg County LME established the Best Practices Community Committee, comprising service providers, individuals and family members, advocacy agencies, community partners, interested community volunteers, and LME staff. Sub-committees addressed several areas, including employment.

Michigan's Department of Community Health, Mental Health and Substance Abuse Administration (MDCH) has expressed a strong desire to improve the state's employment outcomes among people with intellectual and developmental disabilities (IDD). Set against this desire is a major obstacle: Michigan is among the states hardest hit by the continuing economic recession, with the highest unemployment rate in the nation.

Contracts with Industry, implemented in the 1990s as the Natural Supports Initiative, is a program option that allows the Oklahoma Department of Human Services (OKDHS) Developmental Disabilities Services Division (DDSD) to contract directly with businesses to provide job coaching supports that become a part of the natural workplace. Individuals participating in this program are employed by a business and are paid minimum wage or better.

Alabama has piloted the Gaining Access To Employment project, a collaborative effort between the state’s Department of Mental Health/Developmental Disabilities (MH/DD) and its Department of Vocational Rehabilitation (VR). Through this project, known as Project GATE, the two agencies work together to help local service providers use funds to support integrated employment opportunities. MH/DD and VR have a long history of partnering, including joint efforts on a supported employment workgroup, due to the strong relationships between colleagues at each department.

In 2006, a new Maine law mandated the creation of a waiver program that promotes the expansion of supported employment programs for people with intellectual and developmental disabilities (ID/DD). As a result, state funding for sheltered workshops was reduced for seven workshops and approximately 220 individuals throughout Maine.

Sponsored by Wisconsin's Department of Health and Family Services (DHFS) through the use of Medicaid Infrastructure Grant (MIG) funds, Wisconsin's Job Development Mentors Project (JDMP) pairs three seasoned job developers with four community-based employment support providers that cover 12 counties throughout the state.

New Hampshire implemented an innovative technical assistance model that promoted organizational change to expand individual employment opportunities. This person-to-person change began at the micro level but "trickled up" through organizations across the state.

In 2000, realizing that the state's growth in integrated employment had stalled, the Bureau of Developmental Services invested aggressively in expanding its intervention strategy by recruiting a community provider to work directly through the bureau.